I wish the UK would wake up to this for our own military.

Vincent J. Felitti, MD posted:

War trauma may be the trigger and not the primary cause.  Some years ago I was on a government committee to look into why there was so much PTSD in Gulf War 1 when there were only 170 hours of ground combat, GW1 being all aerial bombardment.  I remembered from my days as an Army doctor how the Army was a wonderful metaphor for a supportive family, especially if you didn't have one.  GW1 was also the first time an all-volunteer Army was put in the field, the Draft having been discontinued.  

There was little Committee interest in pursuing this, but some years later I ran across an article General Shinseki wrote expressing concern about the high rate of suicide amongst military recruits, who had not yet been exposed to battlefield trauma.  Remembering the huge and proportionate relationship of ACE Score to subsequent suicide attempts, I wrote to him suggesting a possible relationship to explore.  He passed my letter on to the Psychiatric Consultant to the US Army, who was stationed at Ft Hood, Texas, a major infantry training center.  This Colonel decided to pursue the point and, meeting with Dr. Anda and me, told us he was going to use the ACE Questionnaire with all incoming recruits.  We of course were thrilled at the opportunity for further understanding that this would present.

The process started, but after 2.5 months temporarily had  to be shut down because the Drill Instructors (sic!) could not handle the effect on them of the huge number of recruits breaking down crying while filling out the Questionnaire.  The Colonel's intent was to figure out how to put the DIs together again and then re-institute the program.  Unfortunately, his wife became mortally ill at that point and the program was never re-instituted, but a highly suggestive insight was derived:  might an all-volunteer Army be a magnet for those with special vulnerability due to seriously damaging experiences during their developmental years, this making them later highly vulnerable to suicide or PTSD?

 

I completely agree with this important point and think it's unfortunate that you didn't have the opportunity to finish the study at that time. 

War trauma may be the trigger and not the primary cause.  Some years ago I was on a government committee to look into why there was so much PTSD in Gulf War 1 when there were only 170 hours of ground combat, GW1 being all aerial bombardment.  I remembered from my days as an Army doctor how the Army was a wonderful metaphor for a supportive family, especially if you didn't have one.  GW1 was also the first time an all-volunteer Army was put in the field, the Draft having been discontinued.  

There was little Committee interest in pursuing this, but some years later I ran across an article General Shinseki wrote expressing concern about the high rate of suicide amongst military recruits, who had not yet been exposed to battlefield trauma.  Remembering the huge and proportionate relationship of ACE Score to subsequent suicide attempts, I wrote to him suggesting a possible relationship to explore.  He passed my letter on to the Psychiatric Consultant to the US Army, who was stationed at Ft Hood, Texas, a major infantry training center.  This Colonel decided to pursue the point and, meeting with Dr. Anda and me, told us he was going to use the ACE Questionnaire with all incoming recruits.  We of course were thrilled at the opportunity for further understanding that this would present.

The process started, but after 2.5 months temporarily had  to be shut down because the Drill Instructors (sic!) could not handle the effect on them of the huge number of recruits breaking down crying while filling out the Questionnaire.  The Colonel's intent was to figure out how to put the DIs together again and then re-institute the program.  Unfortunately, his wife became mortally ill at that point and the program was never re-instituted, but a highly suggestive insight was derived:  might an all-volunteer Army be a magnet for those with special vulnerability due to seriously damaging experiences during their developmental years, this making them later highly vulnerable to suicide or PTSD?