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IQ Helps Buffer Post Traumatic Stress

New research finds intellect an aid, but combat still key in Vietnam vets' PTSD

WEDNESDAY, Jan. 30, 2002 (HealthDayNews) -- Intellect appears to be some sort of buffer against the severity of post traumatic stress, says novel new research involving Vietnam war veterans.

The research also confirms that Vietnam vets with post traumatic stress disorder (PTSD) often have problems with attention and learning.

But the findings in no way minimize the well-documented role of combat stress in PTSD, says lead researcher Jennifer Vasterling. She and her colleagues at the Veterans Affairs Medical Center in New Orleans found that the most important gauge for determining the severity of PTSD was the extent of combat experience.

"We don't want anyone to go away thinking, 'If only I were smarter, I wouldn't have gotten PTSD,'" Vasterling says.

"Like a number of other studies, we found that the biggest predictor of whether people got PTSD was how extensive their combat exposure was. And contributing a little bit on top of that was estimated pre-military IQ," she adds. "What it suggests is that IQ might buffer the stress-symptom relationship a little bit."

PTSD is a debilitating disorder that can affect people who have been exposed to severe psychological trauma, such as combat or torture. The National Vietnam Veterans Readjustment Study estimates that almost 31 percent of male Vietnam veterans and almost 27 percent of female Vietnam veterans suffer from the disorder at some point in their lives.

People with PTSD often have flashbacks to the trauma, are irritable, have difficulty concentrating and sleeping, and find their ability to cope with day-to-day life compromised.

The new study, which appears in the current issue of the journal Neuropsychology, essentially had two components.

One looked at attention, learning abilities and memory in 26 combat veterans with PTSD and 21 combat veterans without PTSD. Those with PTSD showed some problems with sustained attention, working memory and new learning. These results held true even after the researchers factored in the level of combat exposure.

Much of the focus in the past has been on the headline-grabbing side of PTSD -- the flashbacks and nightmares. This study draws attention to more mundane but equally debilitating symptoms of the disorder.

"What they're saying is that these things may be making PTSD such a chronic and devastating illness," says Dr. William Apfeldorf, associate professor of clinical psychiatry at Weill-Cornell Medical School in New York City.

"These symptoms interfere with the ability to cope, to get on with life, to recover," he adds. "If you are going to rely on memory, attention and learning to guide therapy [for people with PTSD], then these people are starting out with a strike against them."

The second part of the study measured the "pre-war estimated IQ" in the same group of volunteers. The researchers found that the veterans with higher pre-combat IQ's had less severe PTSD symptoms, even after adjusting for combat exposure.

The lesson here, says psychologist Alan Hilfer, the director of internship training at Maimonides Medical Center in Brooklyn, N.Y., is that the veterans with the higher IQ's may be "able to look at what's going on and access other resources both within [themselves] and interpersonally to be able to ameliorate a situation."

Being "smart," however, doesn't necessarily mean having an IQ of 150. It might mean having access to opportunities and education to help you understand the world. That's a particularly troublesome issue in the case of the men and women who served in Vietnam, many of whom did not have college degrees.

There may be some obvious ways that IQ can translate into better life skills and coping strategies, Vasterling says.

"The literature suggests that if you can verbalize the experience and make it a narrative in some way, this may help you make sense of the experience," she says. Greater internal resources may also help you seek out social support, she adds.

This study has a number of practical implications, Vasterling adds. For instance, military personnel who are likely to serve in a war zone might benefit from learning coping strategies before they leave.

And trauma survivors, not just combat veterans, who feel their concentration and memory are suffering don't necessarily need to worry about these problems on top of everything else. These can be normal reactions to trauma. "A lot of people worry they have Alzheimer's, but it's something that's related to the stress they're going through and hopefully it will go away," Vasterling says.

"The most important advice for people who have gone through a traumatic experience is to talk about it," says Hilfer. "Expressing it is going to be helpful. People who have less comfort with verbalizing tend to keep stuff inside, and those are the people we worry about."

What to Do: The National Center for PTSD is an excellent site to learn more about post traumatic stress disorder. It also includes information on the National Vietnam Veterans Readjustment Study. And the National Institute of Mental Health also has lots of information about PTSD.

SOURCES: Interviews with Jennifer J. Vasterling. Ph.D., associate director for research, Veterans Affairs South Central Mental Illness Research and Education Center, New Orleans; William Apfeldorf, M.D., Ph.D., associate professor, clinical psychiatry, Weill-Cornell Medical School, New York City; Alan Hilfer, Ph.D., director of internship training, Maimonides Medical Center, Brooklyn, N.Y.; January 2002 Neuropsychology
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