Post-Traumatic Stress Disorder and the Earnings of Military Reservists

By David S. Loughran; Paul Heaton | Go to book overview

CHAPTER ONE
Introduction

Between 2001 and 2007, roughly 1.2 million members of the active component of the U.S. military and 455,000 members of the National Guard and Reserve were deployed to Iraq and Afghanistan and exposed to the physical and mental stress of daily life in a combat zone in support of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) (CRS, 2008). Several recent studies indicate that a substantial fraction of service members returning from Iraq and Afghanistan suffer lasting psychological injury (Hoge, Auchterlonie, and Milliken, 2006; Hoge et al., 2004). Although psychological injury can take many forms, concern among policymakers and the public has largely focused on the particular condition known as post-traumatic stress disorder (PTSD), an anxiety disorder that occurs as the result of experiencing “a traumatic event in which a threat of serious injury or death was experienced or witnessed and an individual’s response involved intense fear, helplessness, or horror” (Tanielian and Jaycox, 2008). Recent evidence suggests a high prevalence of PTSD among returning active- and reserve-component service members, which has prompted a review of military policies related to the screening and treatment of PTSD.1

Given that thousands of service members are likely to experience symptoms associated with PTSD—intense physical reaction and feelings of distress when reminded of the event, feelings of detachment and emotional numbness, anxiety, and hyperarousal—for the foreseeable future, understanding the extent to which such symptoms affect the ability of returning service members to readjust to civilian life remains an important area of research. In this report, we focus on the effect of being symptomatic of PTSD on the employment and earnings of members of the National Guard and Reserve (hereafter referred to as reservists) in the years following deployment.2 Military reservists constitute a compelling study group given their extraordinary use during OEF/OIF and the fact that, unlike most members of the active component, they typically reenter the civilian labor market upon completing their deployment.

A small but growing empirical literature in economics and elsewhere has demonstrated a negative correlation between the occurrence of a mental disorder and earnings, employment, and absenteeism (Chatterji et al., 2007; Chatterji, Alegria, and Takeuchi, 2008; Ettner, Frank, and Kessler, 1997; Alexandre and French, 2001; Berndt et al., 1998; Kessler et al., 1999; Cseh, 2008). However, these studies typically do not examine PTSD or do not distinguish between the effect of PTSD and that of other mental conditions.3 A number of small-sample stud-

1 Recent studies suggest that 15 to 25 percent of OEF/OIF reservists report symptoms associated with PTSD. See, for example, Milliken, Auchterlonie, and Hoge (2007) and Tanielian and Jaycox (2008).

2 See Tanielian and Jaycox (2008) for a comprehensive review of research on the effects of PTSD on other life domains.

3 For example, in the Chatterji, Alegria, and Takeuchi (2008) study, PTSD is one of 14 diagnoses that would cause a respondent to be coded as having a psychiatric disorder.

-1-

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