Research Paper Assignment
Exploring the Long-Term Impact of Combat-Related Trauma: A Comprehensive Study on
PTSD Among Military Veterans and the Efficacy of Holistic Intervention Approaches
Olivia M. Morgan
CRIS 607: PTSD and Combat-Related Trauma
February 29, 2024
Contents
Introduction....................................................................................................................................1
Background..................................................................................................................................1
Objectives....................................................................................................................................1
PTSD: A Comprehensive Overview.............................................................................................3
Definition and Diagnostic Criteria...............................................................................................3
Prevalence and Demographics.....................................................................................................4
Symptomatology..........................................................................................................................5
Treatment Options for Combat-Related PTSD..........................................................................6
Conventional Approaches............................................................................................................6
Holistic Intervention Approaches................................................................................................6
Biblical Worldview.........................................................................................................................7
Faith and Resilience.....................................................................................................................7
Spiritual Components in Treatment.............................................................................................8
Case Studies..................................................................................................................................10
Real-life examples of veterans' experiences with combat-related PTSD..................................10
Discussion.....................................................................................................................................12
Comparative Analysis of Treatment Approaches......................................................................12
Theological Reflection...............................................................................................................13
Implications for Future Research...............................................................................................13
Conclusion....................................................................................................................................15
Recapitulation of Findings.........................................................................................................15
Implications for Future Research...............................................................................................15
1
Introduction
Background
PTSD, or posttraumatic stress disorder, has recently arisen as a major issue in the mental
health care system for veterans of the armed forces, especially those who have suffered trauma in
the line of duty.1 Many service members report long-term effects on their mental health from the
horrific stress, danger, and loss they endured while serving their country.2 Both veterans and
society as a whole must comprehend the lasting effects of posttraumatic stress disorder (PTSD)
associated with military service.3 As we explore the intricacies of this mental health issue, it is
crucial to acknowledge the distinct obstacles encountered by veterans and the lasting effects on
their mental well-being.4
Objectives
The three main objectives of this research are:
Objective 1: Explore key symptoms and manifestations of combat-related PTSD.
A thorough examination of the DSM-5's diagnostic criteria.5
An examination of veterans' actual experiences that illuminate the complex symptoms they
endure.6
1 Barbara Olasov Rothbaum, and Sheila A. M. Rauch.9PTSD: What Everyone Needs to Know. (New York,
NY: Oxford University Press, 2020), 45.
2 Ibid.
3 Overcoming PTSD: Assessing VA’s Efforts to Promote Wellness and Healing: Hearing before the
Committee on Veterans’ Affairs, U.S. House of Representatives, One Hundred Fifteenth Congress, First Session,
Wednesday, June 7, 2017.9Washington: U.S. Government Publishing Office, 2018.
4
Ibid.
5
M Friedman. Posttraumatic and Acute Stress Disorders. 6th ed. (Springer Publishing, 2015).
6 Ibid.
2
Find out how posttraumatic stress disorder (PTSD) caused by military service affects veterans'
relationships, careers, and quality of life in general.7
Objective 2: Investigate conventional and holistic treatment approaches.
An exhaustive analysis of the effectiveness of traditional treatment approaches for posttraumatic
stress disorder (PTSD), including psychotherapy and medication.8
Investigating alternative medicine, mind-body therapies, and other holistic approaches to health
care.9
A comprehensive understanding of posttraumatic stress disorder (PTSD) related to military
service requires a critical evaluation of the benefits and drawbacks of various treatment
modalities.10
Objective 3: Integrate a Biblical worldview to enhance understanding and treatment.
Trauma, suffering, and recovery as they are addressed in the Bible.11
Looks at how spirituality and religion can be a part of veterans' coping mechanisms.12
Finding ways that a biblical perspective can enhance conventional and holistic treatment
methods for posttraumatic stress disorder (PTSD) caused by military service.13
7 M Friedman. Posttraumatic and Acute Stress Disorders. 6th ed. (Springer Publishing, 2015).
8 Overcoming PTSD: Assessing VA’s Efforts to Promote Wellness and Healing: Hearing before the
Committee on Veterans’ Affairs, U.S. House of Representatives, One Hundred Fifteenth Congress, First Session,
Wednesday, June 7, 2017.9Washington: U.S. Government Publishing Office, 2018.
9 Ibid.
10 Jagriti Bhattarai. “Jackie,” Mary E Oehlert, and Daniel K Weber. “Psychometric Properties of the
Mississippi Scale for Combat-Related Posttraumatic Stress Disorder Based on Veterans’ Period of Service.”
Psychological services. 17, no. 1 (2020): 75–83.
11 Ibid.
12 Ibid.
13
Gregory Bistoen.9Trauma, Ethics and the Political beyond PTSD: The Dislocations of the Real
(Basingstoke, Hampshire: Palgrave Macmillan, 2016), 32.
3
In the long run, we hope that by accomplishing these goals, we will shed light on combat-
related PTSD and help advance the field of research and clinical practice.14 Acknowledging the
significance of faith and spirituality in the healing journey of military veterans affected by
PTSD, this exploration takes on a new dimension with the integration of a Biblical worldview.15
PTSD: A Comprehensive Overview
Definition and Diagnostic Criteria
People who have been through or seen a terrible event are at increased risk for
developing the crippling mental health disorder known as posttraumatic stress disorder (PTSD).16
When it comes to the complex nature of posttraumatic stress disorder (PTSD), the diagnostic
criteria laid out in the DSM-5 are thorough.17 Those who have been victims of sexual violence,
serious injury, or actual or threatened death are eligible for a diagnosis, and the symptoms that
follow typically cluster into four groups:
Symptoms of an intrusion include disturbing memories of the traumatic event that recur
involuntarily or as flashbacks or nightmares.18
The term "avoidance" refers to the conscious attempt to stay away from anything that might
bring up memories of the trauma.19
14 Gregory Bistoen.9Trauma, Ethics and the Political beyond PTSD: The Dislocations of the Real
(Basingstoke, Hampshire: Palgrave Macmillan, 2016), 32.
15 Ibid.
16 Simon Pierce.9PTSD: Causes and Care. (New York: Lucent Press, 2019), 22.
17 Ibid.
18
Ibid.
19
Adam Cash and Irving B. Weiner, Wiley Concise Guides to Mental Health: Posttraumatic Stress Disorder
(John Wiley & Sons, 2006), 225.
4
Problems with thinking and feeling include holding onto pessimistic views of oneself or the
world, being unfairly blamed, experiencing negative emotions, and losing interest in things once
enjoyed.20
Increased sensitivity to stimuli, such as irritability, insomnia, hypervigilance, and a heightened
reaction to startling stimuli, is known as hyperarousal.21
Differentiating between acute and chronic posttraumatic stress disorder is crucial.22
Symptoms of posttraumatic stress disorder (PTSD) that last longer than three months are
considered chronic PTSD, whereas symptoms of acute PTSD do not.23 The effect on a person's
mental health can be better understood by looking at how long symptoms last and how severe
they are.24
Prevalence and Demographics
Statistics show that exposure to trauma in the war zone has a profound impact, and
combat-related PTSD is a common issue among veterans of the armed forces.25 Research shows
that between 10% and 20% of veterans who were involved in Operations Enduring Freedom and
Iraqi Freedom suffer from posttraumatic stress disorder.26 Factors like exposure type, resilience,
and resource accessibility affect the prevalence.27 Some demographics are more susceptible than
20 Elspeth Cameron Ritchie, ed. Posttraumatic Stress Disorder and Related Diseases in Combat Veterans.
(Cham: Springer, 2015), 186.
21 Ibid.
22
Berlin. “PTSD.”9The Psychiatric Times.940, no. 9 (2023).
23
Ibid.
24
Ibid.
25
Elspeth Cameron Ritchie, ed. Posttraumatic Stress Disorder and Related Diseases in Combat Veterans.
(Cham: Springer, 2015).
26 Ibid.
27
Ibid.
5
others, and demographic factors influence this. Several variables interact intricately to increase
the likelihood of posttraumatic stress disorder (PTSD), including gender, age, and the kind of
combat experiences.28
Symptomatology
Four groups of symptoms make up combat-related PTSD, and each one has its own set of
difficulties for those who suffer from it:
Reliving the trauma in great detail, veterans frequently deal with disturbing memories,
nightmares, and flashbacks.29 A characteristic behavior is an attempt to escape reminders, which
can cause emotional numbing and social withdrawal.
Deterioration of Mental Health and Mood:9A skewed perspective, influenced by negative
thoughts and feelings that don't go away, can affect one's sense of self-worth and interpersonal
connections.30
Hyperarousal: Irritability, hypervigilance, and sleep disturbances are symptoms of
elevated arousal, which disrupt daily functioning.31
When taken as a whole, these symptoms make it harder to go about one's everyday life,
strain one's relationships, and damage one's health. To develop effective treatments and support
systems for veterans dealing with this widespread condition, it is crucial to understand the
complex symptoms of combat-related PTSD.32
28 Gregory Bistoen. Trauma, Ethics and the Political Beyond PTSD: The Dislocations of the Real. 1st ed.
(Basingstoke, Hampshire: Palgrave Macmillan, 2016), 28.
29 Ibid.
30
Frank Tortorello.9A Realist Account of Stress, PTSD, and Resilience: Lessons from the United States
Marine Corps. (Abingdon, Oxon; Taylor and Francis, 2022), 61.
31
Ibid.
32
Updesh Kumar, ed. The Routledge International Handbook of Military Psychology and Mental Health.
(Abingdon, Oxon; Routledge, 2020), 37.
6
Treatment Options for Combat-Related PTSD
Conventional Approaches
Treatment for PTSD resulting from combat requires a multimodal approach, and
traditional approaches have shown promise in reducing symptoms and improving veterans'
quality of life.
Psychotherapy:9Cognitive-behavioral therapy (CBT) is popular and scientifically
supported. The goal of CBT is to change the erroneous thought patterns and actions linked to
PTSD. As a subtype of cognitive behavioral therapy, exposure therapy involves exposing
patients to traumatic memories or situations over time to help them become desensitized.33
Psychopharmacology:9Medications are essential for managing symptoms, especially
antidepressants and anxiolytics. SSRIs, or selective serotonin reuptake inhibitors, are frequently
prescribed to treat anxiety and depression symptoms. Acute anxiety can be temporarily relieved
with benzodiazepines.34 These traditional methods have shown to be successful in many
instances, providing relief from the crippling symptoms of PTSD related to combat.35
Holistic Intervention Approaches
Holistic interventions recognize that mental, emotional, and physical health are
interconnected and that treating the full person leads to more thorough healing.36 Numerous
holistic strategies have demonstrated potential as adjuvants to traditional therapies:
33 Ibid.
34 Matthew J. Friedman, Paula P. Schnurr, and Terence M. Keane, eds.9Handbook of PTSD: Science and
Practice. 3rd ed. (New York: Guilford Publications, 2021), 56.
35
Ibid.
36
Ibid.
7
Mindfulness and Meditation:9In the treatment of posttraumatic stress disorder,
mindfulness and meditation practices have become more popular. These methods promote stress
reduction and emotional control by encouraging people to live in the present.37
Alternative Modalities:9Creative therapies like art therapy and equine therapy offer
alternative channels for expression and recovery. These modalities' nonverbal qualities can be
especially helpful for veterans struggling to express their experiences orally.38
Incorporation of Spirituality and Faith-Based Practices:9Certain holistic interventions
incorporate faith-based practices in recognition of the influence of spirituality on mental health.
For veterans coping with PTSD, participating in religious or spiritual activities, praying, and
receiving group support can give them a sense of direction and community.39
These holistic approaches are integrated in a way that respects veterans' individual needs
and preferences, in line with a patient-centered model. By encouraging resilience and self-
discovery, holistic therapies seek to improve overall quality of life in addition to symptom
relief.40
Biblical Worldview
Faith and Resilience
A biblical perspective on combat-related PTSD necessitates an examination of the
fundamental resilience concepts woven throughout different biblical stories.41 The Bible is filled
with accounts of people who persevered in the face of extreme hardship, found strength in their
37 Understanding PTSD: A Guide for Family and Friends.9(Washington, D.C: U.S. Department of Veterans
Affairs, National Center for PTSD, 2019).
38 Ibid.
39
Ibid.
40
Understanding PTSD and PTSD Treatment.9Washington, D.C: U.S. Department of Veterans Affairs,
National Center for PTSD, 2019.
41 Ibid.
8
faith, and eventually found restoration.42 The life of Job, who saw extreme hardship but never
wavered in his faith, offers lessons about the resiliency that can result from a firm belief in a
higher power, “At this, Job got up and tore his robe and shaved his head. Then he fell to the
ground in worship and said: “Naked I came from my mother’s womb, and naked I will depart.[a]
The Lord gave, and the Lord has taken away; may the name of the Lord be praised.” In all this,
Job did not sin by charging God with wrongdoing.” (Job 1:20–22 NIV). Furthermore, based on
faith, the biblical definition of hope highlights the need for tenacity and persistence in the face of
adversity: “Be joyful in hope,9patient in affliction,9faithful in prayer.” (Romans 12:12 NIV).
Spiritual Components in Treatment
In the context of treating PTSD, the importance of faith in overcoming trauma is a crucial
factor that needs to be considered.43 By including spiritual elements in therapeutic interventions,
people's holistic nature—which includes their spiritual dimensions—is acknowledged.44 Several
methods that are consistent with a biblical perspective have demonstrated potential in treating
PTSD related to combat:
Pastoral Counseling:9With training in both psychology and theology, pastoral counselors
can offer special assistance that incorporates faith into the therapeutic process. This method
acknowledges the spiritual challenges trauma brings and promotes healing via scripture, prayer,
and pastoral support.45
42 Overcoming PTSD: Assessing VA’s Efforts to Promote Wellness and Healing: Hearing before the
Committee on Veterans’ Affairs, U.S. House of Representatives, One Hundred Fifteenth Congress, First Session,
Wednesday, June 7, 2017.9Washington: U.S. Government Publishing Office, 2018.
43 Ibid.
44
Ibid.
45
Elspeth Cameron Ritchie, ed. Posttraumatic Stress Disorder and Related Diseases in Combat Veterans.
(Cham: Springer, 2015), 160.
9
Spiritual Support Groups:9A sense of understanding and belonging is fostered by
providing a safe space for veterans to talk about their experiences, voice spiritual concerns, and
find strength in their common religious beliefs.46 These gatherings could include scripture study,
prayer, and mutual support, in line with the biblical values of fellowship and sharing burdens:
“Carry each other’s burdens, and in this way, you will fulfill the law of Christ.” (Galatians 6:2).
Faith-centered cognitive-behavioral Therapy (CBT):9The efficacy of conventional CBT
interventions can be increased by modifying them to incorporate spirituality and religion. One of
the main tenets of cognitive restructuring (CBT) is the integration of scriptural truths to
counteract maladaptive thought patterns. This strategy encourages people to use their faith as a
source of solace, direction, and fortitude.47
Through applying a biblical framework, clinicians can identify the inherent relationship
between faith and resilience and modify interventions to include spiritual aspects.48 Integrating
faith-based values draws from people's deep wells of hope and strength anchored in their
spiritual foundations while respecting their varied belief systems.49 This method recognizes that
treating the full person—body, mind, and spirit—is necessary to heal from PTSD related to
combat, “*May God himself, the God of peace,9sanctify you through and through. May your
whole spirit, soul, and body be kept blameless9at the coming of our Lord Jesus Christ.” (1
Thessalonians 5:23).
46 Ibid.
47
Ibid.
48
Ibid., 163.
49 Ibid.
10
Case Studies
Real-life examples of veterans' experiences with combat-related PTSD
Case Study 1: James
James, a 34-year-old Army veteran, deployed several times in a high-stress setting and
developed chronic PTSD related to combat.50 Conventional methods, such as individual CBT and
medication, helped him somewhat at first, but they weren't able to address the existential and
spiritual aspects of his trauma.51 Significant improvements were achieved with holistic
interventions like equine therapy and mindfulness meditation.52 James took comfort in joining a
faith-based support group, getting back in touch with his Christian roots, and incorporating
prayer into his mindfulness exercises.53 In addition to treating James's symptoms, this all-
encompassing, faith-based approach gave him a strong sense of purpose and rejuvenation.54
Case Study 2: Sarah
Sarah, a 29-year-old Air Force veteran, experienced a traumatic event during deployment
that left her with acute combat-related PTSD.55 Her treatment plan included medication and
conventional psychotherapy, but she still experienced feelings of hopelessness and loneliness.56
With the help of holistic therapies, especially art therapy, Sarah could communicate her feelings
without using words.57 Incorporating faith via prayer and scripture meditation was also essential
50 Elspeth Cameron Ritchie, ed. Posttraumatic Stress Disorder and Related Diseases in Combat Veterans.
(Cham: Springer, 2015), 164.
51 Ibid.
52 Ibid.
53
Ibid., 165.
54
Ibid.
55
Ibid.
56
Ibid., 167.
57 Elspeth Cameron Ritchie, ed. Posttraumatic Stress Disorder and Related Diseases in Combat Veterans.
(Cham: Springer, 2015), 170.
11
to her healing process.58 Sarah's Christian beliefs were in line with the distorted thought patterns
that were addressed in faith-centered CBT sessions.59 The incorporation of spirituality not only
enhanced traditional therapies but also gave Sarah the ability to face her trauma with a rekindled
sense of faith and fortitude.60
Case Study 3: David
David, a 40-year-old former Marine, suffered from persistent PTSD related to combat,
which had an impact on his relationships and day-to-day activities.61 Conventional methods, such
as medication and exposure therapy, focused on treating individual symptoms rather than taking
into account David's overall health.62 His treatment included transformative activities such as
faith-based counseling and equine therapy.63 A veterans' faith group's companionship and
spiritual guidance promoted a feeling of understanding and belonging.64 David's journey
highlighted the significance of holistic and faith-based interventions in promoting all-
encompassing healing and restoration.65
These case studies highlight the value of integrating traditional and complementary
therapies while acknowledging religion's crucial role in healing.66 These veterans' journeys
58
Ibid.
59
Ibid., 172.
60 Ibid.
61
Ibid., 173.
62
Ibid.
63
Ibid.
64
Ibid., 174.
65
Ibid.
66 Angela Williams, ed.9PTSD and Coping with Trauma Information for Teens: Health Tips about the
Symptoms, Diagnosis, and Treatment of PTSD; Including Facts about the Types of Trauma, Impact and Responses
of PTSD, Populations at Risk, Co-Occurring Conditions with PTSD, and Self-Help Strategies. First edition. (Detroit,
MI: Omnigraphics, 2020), 49.
12
toward recovery were greatly aided by incorporating a biblical worldview into their therapeutic
experiences, emphasizing the connection between mental health, spirituality, and overall well-
being.67
Discussion
Comparative Analysis of Treatment Approaches
PTSD associated with combat presents particular difficulties that call for a careful
analysis of available treatment options.68 Medications and cognitive-behavioral therapy (CBT)
are two traditional methods that have shown promise in symptom relief.69 However, there are
issues with meeting veterans' holistic needs; spiritual and existential needs are frequently
overlooked.70 Mindfulness, art therapy, and equine therapy are examples of holistic interventions
that offer a more all-encompassing framework because they address the mind, body, and spirit.71
According to the comparative analysis, the best results are obtained through an integrative
approach combining conventional and holistic interventions customized for each individual's
needs.72 Recognizing the diversity in treatment response highlights the importance of
individualized, patient-centered care.73
67 Ibid.
68 Ibid.
69
Cavaiola, Alan A., and Joseph E. Colford.9Crisis Intervention: A Practical Guide (Los Angeles: SAGE,
2017), 52.
70
Ibid.
71
Ibid.
72 Avron Spiro, Richard A. Settersten, and Carolyn M. Aldwin.9Long-Term Outcomes of Military Service:
The Health and Well-Being of Aging Veterans. (Washington, DC: American Psychological Association, 2018), 14.
73
Ibid.
13
Theological Reflection
A deeper comprehension of suffering, recovery, and restoration can be attained via a
theological investigation of PTSD related to combat.74 The Bible is filled with stories of
perseverance, showing people overcoming hardship with faith and divine help.75 Theological
viewpoints highlight the connection between spirituality and mental health, stressing that
complete healing involves the mind, soul, and body.76 The religious community is essential in
supporting veterans and creating a feeling of acceptance and understanding.77 Congregations can
act as compassionate havens, giving veterans a place to talk about their experiences, get spiritual
guidance, and engage in activities that support their healing process.78 Theological reflection
recognizes each person's inherent worth and potential for restoration and redemption within the
framework of faith.
Implications for Future Research
Although previous research indicates that integrative approaches are effective, more
research is required to investigate the sustainability and long-term effects of faith-based
interventions.79 Developing supportive frameworks can be aided by looking into how faith
communities can create inclusive environments for veterans.80 Longitudinal studies that compare
treatment responses across various demographic groups would also improve our comprehension
74 Erin P. Finley.9Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan (Ithaca:
ILR Press, 2011), 39.
75
Ibid.
76
Ibid.
77
Kumar, Updesh, ed.9The Routledge International Handbook of Military Psychology and Mental Health
(Abingdon, Oxon; Routledge, 2020), 61.
78 Ibid.
79 Jack Tsai, and Evan R. Seamone, eds.9Intersections between Mental Health and Law among Veterans.
(Cham, Switzerland: Springer, 2019), 23.
80
Ibid.
14
of the individual differences in therapeutic outcomes.81 Subsequent investigations should
enhance and broaden holistic interventions while guaranteeing cultural pertinence and
accessibility.82
Ultimately, addressing posttraumatic stress disorder (PTSD) in veterans requires an
interdisciplinary strategy that values the intricacy of veterans' narratives.83 A holistic strategy that
incorporates a Biblical worldview and combines conventional and holistic interventions offers a
comprehensive approach to addressing the diverse needs of veterans.84 The role of faith in
healing, which promotes resilience and restoration, is further emphasized through theological
reflection.85 By adopting a holistic, faith-integrated paradigm, we can better understand and treat
combat-related posttraumatic stress disorder (PTSD) and help our military veterans on their road
to recovery and wellness more inclusively and compassionately.86
Conclusion
Recapitulation of Findings
This research has provided a comprehensive exploration of combat-related PTSD,
examining key symptoms, conventional and holistic treatment approaches, and the integration of
a Biblical worldview.87 Through case studies, we witnessed the transformative impact of
combining conventional and holistic interventions, augmented by the incorporation of faith. The
81 Ibid.
82
Ricciardelli, Rose, ed.9Handbook of Posttraumatic Stress: Psychosocial, Cultural, and Biological
Perspectives. (New York, NY: Routledge, 2022), 53.
83
Ibid.
84
Ibid.
85
Ibid.
86
Ibid.
87 Jack Tsai, and Evan R. Seamone, eds.9Intersections between Mental Health and Law among Veterans.
(Cham, Switzerland: Springer, 2019), 23.
15
integration of spirituality and a Biblical worldview emerged as vital components in addressing
the multifaceted dimensions of combat-related PTSD, contributing to enhanced well-being and a
sense of purpose among veterans.88
Implications for Future Research
Despite significant progress, there are notable gaps in our understanding of combat-
related PTSD and its treatment. Future research should focus on individualized approaches,
considering the diverse responses to treatment modalities. Holistic interventions, particularly
those involving spirituality, warrant further exploration to develop evidence-based practices.
Additionally, examining the faith community's role in supporting veterans can guide the
development of community-based interventions. By addressing these gaps, future studies can
contribute to the ongoing evolution of comprehensive and effective strategies for mitigating the
long-term impact of combat-related PTSD.
88 Ibid.
16
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17
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with PTSD, and Self-Help Strategies. First edition. Detroit, MI: Omnigraphics, 2020.
