PTSD in SOF Personnel

by
Jud Kauffman
ExBellum.com
As a special operations soldier, I always held the belief that my fellow operators and
I were relatively immune to post-traumatic stress disorder (PTSD) when compared
with other soldiers. Of course no one is really immune to such a disorder, but it was
so rarely a problem with anyone I worked with, and we talked about it often. After a
violent engagement or a traumatic event, wed briefly discuss the events openly and
critically and then move on. We were sensitive to the dangers of mental and
emotional problems associated with combat because we had had hours of classes
and training on the subject, but it never became a major problem within our units.
Speaking from personal experience, when I was on my very first real combat
operation, we became surrounded by enemy forces and took effective and sustained
fire. I distinctly remember having a discussion during the engagement with a fellow
rookie about how calm we were. I had always expected to have tunnel vision and be
so amped that my decisions would be less than clear. That was not at all the case. I
was calm and collected and after we returned to base I fell right asleep.
From then on I knew that our training actually worked and worked well. As a
result of these experiences I came up with a hypothesis regarding PTSD in Special
Operations Forces. Consider the following: a typical conventional soldier joins when
he is eighteen years old and fresh out of high school. He is given fifteen weeks or so
of basic training before being shipped to combat upon which time he is immediately
exposed to shocking experiences. Clearly, he will likely not react well to such
traumatic experiences. Conversely, SOF recruits are generally older and more
mature, and are trained for 18 to 24 months in highly specialized courses of
instruction before ever setting foot on a battlefield. These men will have a
significantly lower likelihood of experiencing trauma when they see combat because
they are exceptionally prepared for it, theyre mature, and have had ample time to
psychologically prepare for what is to come. Therefore it is natural to expect to see
a lower incidence of PTSD in SOF personnel than in conventional infantry soldiers.
I developed this hypothesis based purely on anecdotal evidence. However, in light
of recent media knee-jerk reaction to one or two crazy veterans who became violent
and subsequent PTSD finger-pointing, I decided to research the subject. I found a
number of studies which support my hypothesis and counter the medias broad
brush strokes.
A study conducted by the US National Center for PTSD in 2003[i] found that SOF
combat personnel were much less likely to suffer symptoms of PTSD than
conventional infantry. The study, which was conducted at Fort Bragg, tested
whether SOF soldiers have neurological differences that make them more resilient
to post-traumatic stress disorder than the average soldier. SOF soldiers were tested

for levels of a molecule called neuropeptide Y (associated with preventing stress)

in their blood. The researchers found that nearly all SOF personnel had elevated
levels of neuropeptide Y in their blood. According to the researchers, studies have
shown a correlation between high levels of norepinephrine and chronic feelings of
stress; neuropeptide Y molecule blocks norepinephrine, and this could be the
functional basis for its effectiveness in lower stress levels.
Matt Friedman, the director of the National Center for PTSD, explained at the 2003
conference of the American Association for the Advancement of Science that the SOF
soldiers in the Fort Bragg study demonstrated a higher capacity to mobilize the
neuropeptide Y molecule and sustain it for longer periods of time. Furthermore, the
level of neuropeptide Y their bloodstream returned to normal levels within twentyfour hours, whereas conventional soldiers still showed decreased levels.
According to Friedman, the capacity to mobilize neuropeptide Y is correlated to a
lower likelihood of developing PTSD. He believes that neuropeptide Y may offer the
key to primary prevention of PTSD, if a means of artificially elevating it could be
discovered. Although the work has been going on for several years, researchers are
still uncertain whether the SOF members enhanced capacity to endure trauma was
genetic or had been acquired through Special Forces training.
A broader and more focused study conducted in 2012 by researchers in the
Department of Psychological Medicine in Sri Lanka[ii] compared the mental health
problems of SOF personnel with conventional forces who had been engaged in
combat for at least one year. Exposure to traumatic events and problems with
family life were identified as risk factors. The outcome measures were common
mental disorder, fatigue, multiple physical symptoms and hazardous alcohol use.
The researchers found that while overall exposure to potentially traumatic events
was high in both groups, the SOF personnel experienced significantly more
traumatic events during their tours than conventional forces. In spite of this, Special
Forces personnel exhibited significantly fewer common mental disorders, fatigue or
poor general health than regular forces. Prevalence of PTSD was only 1.9% in the
Special Forces and 2.9% among the conventional forces. So, even with more
exposure to trauma, the SOF members still had lower rates of PTSD. The
researchers suggested that better training, comradeship, and unit cohesion
protected Special Forces personnel from negative mental health outcomes of
combat.
I also looked at studies of PTSD in civilian populations. PTSD rates in studies of
civilian populations vary, and depend on the background and experiences of the
cohorts these studies. However, civilian populations tend to have only slightly lower
rates of PTSD than do military personnel who have served one or more combat
tours. Incidents such as car accidents, losing a loved one, assaults, or simply
prolonged periods of elevated stress are all common causes of PTSD amongst the
non-military populations.

A study conducted in 1991[iii] examined PTSD rates among non-military urban

youth in Detroit, a sample with an above-average exposure to traumatic
events. Within the sample, 39% had been exposed to traumatic events, and among
those exposed, 23.6% reported symptoms of PTSD. A 1993 study of PTSD[iv] rates
among civilian American women found that lifetime prevalence of PTSD was 9.4%
among women who were not victims of crime, and 25.8% among women who had
been victims of crime. These studies are congruent with reporting from the National
Center for PTSD, which says that about 8% of the overall population will experience
PTSD at some point in their lives.[v]
Generally speaking, available literature on the subject tends to support the
hypothesis that Special Operations Forces have a higher resilience to combat
stress. It is interesting that biochemical markers associated with stress control and
reduction have been found to be higher and sustained for longer periods of time in
SOF personnel than in conventional soldiers; this discovery demands more
attention. It is possible that this could be a result of the extended and more rigorous
training SOF personnel are given. A number of studies[vi] have shown that
prolonged exercise cause the body to exhibit elevated levels of pain-killing
neurochemicals, so it is safe to assume that a similar mechanism may be at work in
SOF training. Perhaps extended exposure to rigorous, but controlled, environments,
allows trainees to develop elevated levels of stress-reducing neurochemicals.
My own experience, along with the available research on the subject, indeed leads
me to believe and assert that SOF personnel do have higher resilience to combat
stress and are less likely to exhibit PTSD symptoms than conventional
soldiers. Furthermore, my research suggests that PTSD levels in the military overall
are very near the averages of civilian rates of PTSD. At any rate, it is clear that more
research needs to be done and less assumptions need to be made anytime a person
who served in the military does something violent. If the reasons for this
phenomenon are discovered, we may be able to use that knowledge to reduce PTSD
in combat personnel throughout the Armed Forces as a whole.
Jud Kauffman, ExBellum.com
ExBellum.com is an exclusive online network of special operations personnel, both active and separated,
designed to connect the community with employers and with each other.

________________________________
[i] Battacharya, Shaoni. 2003. Molecular secret of Special Forces toughness. New
Scientist.
[ii] Hanwella R, de Silva V.2012. Mental health of Special Forces deployed in battle.
Social Psychiatry and Psychiatric Epidemiology 47(8): 1343-51.
[iii] Breslau N et al. 1991. Traumatic events and posttraumatic stress disorder in an

urban population of young adults. JAMA Psychiatry (Archives of General Psychiatry)

48(3):216-222.
[iv] Resnick H et al. 1993. Prevalence of civilian trauma and posttraumatic stress
disorder in a representative national sample of women. Journal of Consulting and
Clinical Psychology 61(6):984-991.
[v] Vorenberg, Sue. 2012. Civilians also suffer from PTSD. The Columbian
(Vancouver, WA).
[vi] Kotlyn K.F. 2000. Analgesia following exercise: a review. Sports Medicine 29(2):
85-89.