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Gulf War and Health, Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress
Graves registration, the handling and retrieving of dead bodies or body parts, can also be stressful for military personnel. McCarroll and colleagues found that regardless of age, sex, previous experience with handling remains, or volunteer status, veterans who handled remains or even saw body transfers had more PTSD symptoms than veterans with other military occupations (McCarroll et al. 2001) and a higher rate of diagnosis of PTSD (Sutker et al. 1994). Mere anticipation of working in the mortuary with exposure to mass deaths was stressful to many of the military personnel, although those who had more mortuary experience and those who had volunteered for the duty found it less stressful than those who did not (McCarroll et al. 1993, 1995). Stressors associated with mortuary work included handling bodies, working with x-rays, handling personal effects, and observing bodies being moved from transfer cases.
Uncertainty about the duration of deployment was a continuing concern for U.S. troops during the Gulf War, particularly during the early phases of the buildup (Wright et al. 1996). A large epidemiologic study of Gulf War veterans (Fiedler et al. 2006) found that veterans who had had other deployments, such as in Vietnam or Bosnia, in addition to their deployment to the gulf did not have an increased risk of major depression or generalized anxiety disorder or any anxiety disorder, including PTSD. However, additional deployments were associated with a two-fold increase in substance dependence. A study of nearly 60,000 military and civilian peacekeepers deployed on a NATO mission to Bosnia (Huffman et al. 1999) found that prior deployment was associated with lower rates of depression symptoms (measured with the Self-Rating Depression Scale) and PTSD (determined with the PTSD Checklist). Neither study queried veterans regarding the length of their deployment.
DoD Mental Health Advisory Team surveys of both active-duty troops and reserve and National Guard soldiers deployed to Iraq during OIF in 2005 and 2006 found that the most important noncombat stressors were deployment length and family separation; deployment length was of even higher concern to soldiers who had been deployed more than once (MHAT 2006a,b). Furthermore, the number of soldiers who were anxious about uncertain redeployment dates rose from 35% in 2005 to 40% in 2006. DoD noted that the 5% increase may have been due to the survey’s inclusion of soldiers from a brigade combat team that had had its tour extended beyond 12 months and had learned of the extension only from their spouses, who, in turn, had learned of the extension from the garrison leadership. Morale was particularly low among enlisted men who had had multiple deployments to Iraq. The committee notes that in April 2007 the length of deployment of active-duty Army personnel in Iraq was extended from 12 to 15 months and that 13,000 National Guard troops were expecting to be called up for second tours to Iraq. Marines have shorter deployments than Army soldiers, generally 9 months compared with 12 months.
About one-third of the soldiers in the 2006 DoD survey reported finding their work boring and repetitive. Of particular concern to many soldiers and Marines was a perceived inequity in access to base amenities, such as recreational equipment and communication equipment, for personnel who had missions outside the base camp (MHAT 2006b). Those concerns contributed to the low morale of the troops.