The socioeconomic consequences of traumatic stress exposure have been understudied. Research on the long-term effects of traumatic stress has focused largely on mental health outcomes, with little attention to broader social and economic consequences. The few existing studies suggest that there may be some link between a history of trauma, psychological adjustment, and socioeconomic, specifically, labor market outcomes. However, each of these studies has problems in measurement and sampling that confound the interpretation of findings. Using data from the National Vietnam Veterans Readjustment Study (NVVRS), the investigators will study the relationship between exposure to a particular type of trauma-- war zone stress, subsequent psychiatric disorder, and labor market outcomes. An extensive literature review did not uncover other epidemiologic studies that were purposively designed to assess each of these constructs multidimensionally and in a psychometrically sound manner. The NVVRS focused its resources on obtaining representative samples of men and women and rigorous measurement of traumatic stress exposure, posttraumatic stress disorder (PTSD) and other psychiatric conditions, and labor market outcomes. Thus, the proposed study presents a unique opportunity to examine the socioeconomic sequelae of trauma. This study has three specific aims. The first is to assess the effects of both military experience and exposure to war zone stress on Vietnam veterans' employment status, wages, and occupational stability (the study's three primary labor market outcome variables).
This aim will be addressed using the three main cohorts in the NVVRS: Vietnam theater veterans, Vietnam era veterans, and civilian counterparts. Next, we will evaluate the extent to which any impact of war stress on labor market participation appears to be mediated by PTSD. This and subsequent aims will be addressed in analyses using the cohort of Vietnam theater veterans. Finally, we will examine the impact of the psychiatric disorders most frequently comorbid with PTSD for men and for women on the labor market indicators. The analyses involve the development and verification of models of the various labor market outcomes to address the study's three major aims. Modeling will proceed separately for men and women. For men, the influence of race/ethnicity on each of the labor market outcomes variables and any interactions with psychiatric disorder will be carefully examined throughout model development. A split-sample approach will be taken in which one portion of the data will be used for model development, the other for model testing. Although exploratory, these models should provide much needed information about the extent to which trauma has economic as well as psychological effects. Evidence of such a relationship has important implications for public policy planning. On a practical level, it implies that it might be economically prudent to provide more assistance to individuals who have histories of traumatic stress exposure.
