Combat exposure and the etiology of postdischarge substance abuse problems among Vietnam veterans

Abstract This study finds a highly significant (p < 0.0002) relationship between combat exposure and problems with drugs or drinking too much following discharge from the Armed Forces among a large (N = 1,176) national random probability sample of Vietnam veterans. Exposure to heavy combat more than doubled a typical Vietnam veteran's risk of reporting a postdischarge substance abuse problem, as compared to what would have been expected had he served, but seen no combat, in Vietnam. Employing an ordinary least‐squares multiple regression model, this study also found a highly significant relationship (p < 0.0001) between the self‐report of a postdischarge substance abuse problem and age at assignment to Vietnam. These findings support the residual stress theory proposed by Figley (1978), as opposed to the stress evaporation hypothesis advanced by Borus (1973). Providing empirical support for the psychoanalytic construct of normal developmental lines advanced by Anna Freud (1965) and Erikson (1968), this study posits that younger Vietnam combat veterans, having achieved less developmental stability and personality integration than relatively older veterans, were therefore at greater risk for the subsequent emergence of substance abuse problems as a result of their exposure to combat.