UCI Study on Vets Grief Highlights Overlooked PTSD Connection

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A new study from the University of California, Irvine is the first to focus on veterans' grief. 

“Our goal was to better understand how combat veterans experience the deaths of their military comrades in battle or by suicide and what factors predict the nature and level of their grief,” said the study’s senior author, Roxane Cohen Silver, UCI professor of psychological science, public health and medicine.

In a 2017 Iraq and Afghanistan Veterans of America survey, 58 percent of participants indicated that they knew a veteran who had died by suicide, and 65 percent knew a veteran who had attempted to take his or her own life. These losses may have serious consequences for the health and well-being of surviving veterans.

“While there has been abundant research quantifying war’s psychological impact, much of it has focused on PTSD, depression, and substance or alcohol abuse associated with combat exposure,” said lead author Pauline Lubens, who earned a doctorate in public health at UCI last year and is now a policy analyst at the Institute for Veteran Policy at Swords to Plowshares in San Francisco. “There has been limited focus on grief among veterans.”

The study results revealed seven themes: 
  1. Suicide death is unexpected and can make acceptance of the loss more difficult.
  2. Combat death is expected and can ease acceptance of the loss.
  3. Combat death is heroic and can make acceptance of the loss easier.
  4. The brotherhood forged in combat intensifies emotional responses.
  5. Guilt over the inability to prevent a comrade’s death, whether in battle or by suicide, makes acceptance harder.
  6. Attribution of blame for a death creates anger.
  7. Detachment from the civilian world may make it more difficult to cope with a comrade’s death.

“The more we can delineate the distinct toll of suicide and combat loss among the current generation of veterans, the better we can minimize the public health impact of the most recent U.S. wars,” Lubens said. “Veterans’ postwar health outcomes undoubtedly cascade to their immediate and extended families as well as their broader communities. Insight into the toll of these losses may inform interventions that enable families to recognize the consequences of grief and to acknowledge it as a postwar malady distinct from PTSD.”