Chalsa M. Loo, Ph.D.
Race and ethnicity are important indicator variables that help further our understanding of posttraumatic stress disorder (PTSD). Studies of ethnic minority veterans have helped us understand how race and ethnicity relate to PTSD. Ethnic minority Vietnam veterans, through their participation in surveys, research studies, and clinical case studies, have made a major contribution toward our understanding of PTSD in these special populations.
Are there differences in rates of PTSD among ethnic minorities and whites?
Researchers have conducted various studies of PTSD in one or more of the ethnic minority Vietnam veteran populations. The results of the studies are not entirely consistent, but the overall finding seems to be that most ethnic minority veteran groups have a higher rate of PTSD than White veterans. Some or much of this may be due to psychological conflicts related to identification with the Vietnamese and/or due to higher exposure to war zone stressors. The various studies may have revealed different PTSD rates because of differences in the samples, use of different measures, or differences in whether the interviewer and participant were racially paired. Ethnic minority veterans may be more likely to disclose problems or engage in treatment when paired with a clinician of the same race. 1 Despite study differences, the trend suggests that being an ethnic minority may cause one to be more “at risk” for PTSD.
The National Vietnam Veterans Readjustment Study found differences among Hispanic, African American, and White Vietnam theater veterans in terms of readjustment after military service. 2 Both Hispanic and African American male Vietnam theater veterans had higher rates of PTSD than Whites. Rates of current PTSD in the 1990 study were 28% among Hispanics, 21% among African Americans, and 14% among Whites. 2 African Americans had greater exposure to war stresses and had more predisposing factors than Whites, which appeared to account for their higher rate of PTSD. After controlling for these other factors, the differences in PTSD rates between Whites and African Americans largely disappeared.
Among Vietnam veterans, Hispanics had higher rates of PTSD than Whites, which remained the case even after controlling for the fact that Hispanics had greater exposure to war stresses. 2 Rates of PTSD among American Indian Vietnam veterans ranged from 22% to 25% (depending on the tribe) 3 . American Indians were exposed to greater war zone stresses (e.g., atrocities, violence, and combat) than Whites, including psychological conflict resulting from identification with the enemy. Differences in PTSD rates between American Indians and Whites disappeared after controlling for the greater war zone stresses experienced by American Indians. Clinical case studies of African American and American Indian veterans described psychological tension and ambivalence because the African American and American Indian participants associated the condition of the Vietnamese with that of their own people. 4, 5 The rate of PTSD among Native Hawaiian Vietnam veterans was 12%, and the rate of PTSD among Japanese Americans was 2% 6 compared to 14% for Whites. 2
Lifetime prevalence rates for PTSD in Vietnam veterans were higher among all ethnic minority veteran samples (except for Japanese Americans) than among Whites. Between 45% and 57% of the American Indian Vietnam veterans had PTSD for lifetime events, 43% of the African Americans suffered from PTSD associated with lifetime events, and 39% of the Hispanic Vietnam veterans suffered from lifetime PTSD, compared to 24% of the Whites and 9% of the Japanese Americans. 2, 3, 6
The experience of the Japanese Americans does not appear to be the experience of other Asian American Pacific Islander Vietnam veterans. Clinical case studies of Vietnam veterans of Asian American Pacific Islander ancestry describe ethnic-related stresses associated with racially looking like the enemy. These veterans also experienced psychological conflicts that arose because they personally identified with the Vietnamese as persons of the same race. 7, 8 In a survey of Asian American Pacific Islander Vietnam veterans, a majority felt they were similar or very similar to the Vietnamese in terms of physical characteristics, felt they were mistaken for Vietnamese, felt their ethnicity affected how others perceived them as soldiers, and felt their ethnicity affected how the Vietnamese people treated them. 9 Native Hawaiians had a higher PTSD prevalence rate than Chinese Americans, who had a higher rate than Japanese Americans.
A study of Chinese, Filipino, Korean, Japanese, Hawaiian, Chamorro, and Asian-mixed race Vietnam veterans found that 37% suffered from PTSD, using the Mississippi Scale as the measure of PTSD. 10 This percentage was within the range of what had been found for African Americans, Hispanics, Native Americans, and Native Hawaiians in other studies using this same measure.
Related Fact Sheets
Epidemiology
Information about rates of PTSD in the United States among different populations
Native Hawaiian and Japanese-American veterans
Describes the effects of trauma on Native Hawaiian and Japanese American veterans
References
1. Rosenheck, R. A., Fontana, A, & Cottol, C. (1995). Effect of clinician-veteran racial pairing in the treatment of posttraumatic stress disorder. American Journal of Psychiatry, 152 (4), 555–563.
2. Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., et al. (1990). Trauma and the Vietnam war generation , 503–520.
3. Beals, J., Manson, S.M., Shore, J.H., Friedman, M., Ashcraft, M., Fairbank, J.A., et al. (2002). The prevalence of posttraumatic stress disorder among American Indian Vietnam veterans: Disparities and context. Journal of Traumatic Stress, 15, 89–97.
4. Holm, T. (1992).  Statistics and data: The National Survey of Indian Vietnam Veterans. In Report of the Working Group on American Indian Vietnam Era Veterans (pp. 25–34). Washington, DC: Readjustment Counseling Service, Department of Veterans Affairs.
5. Parson, E.R. (1984). The gook-identification and post-traumatic stress disorder.  Black Psychiatrist of American Quarterly, 25, 65– 85.
6. National Center for American Indian and Alaska Native Mental Health Research and National Center for Post-Traumatic Stress Disorder. (1997). Matsunaga Vietnam Veterans Project: Final report. White River Junction, VT: National Center for PTSD.
7. Kiang, P. (1991).  About face: Recognizing Asian and Pacific American Vietnam veterans in Asian American Studies . Amerasia Journal, 17 , 22–40.
8. Loo, C.M. (1994).  Race-related trauma and PTSD: The Asian American Vietnam veteran. Journal of Traumatic Stress, 7, 1–20.
9. Matsuoka, J., Hamada, R., Kilauano, W. & Coalson, R. (1992). Asian-Pacific American Vietnam veterans: An exploratory study of wartime experiences and post-war adjustment. Journal of Multicultural Social Work. 2, 103–111.
10. Loo, C. M., Fairbank, J.A., Scurfield, R.M., Ruch, L.O., King, D.W., Adams, L., et al. (2001).  Measuring exposure to racism: Development and validation of a race-related stressor scale (RRSS) for Asian American Vietnam veterans . Psychological Assessment, 13, 503–520.
These vital statistics and facts have been taken from the National Center for PTSD website where you can follow the links for more in debt information www.ncptsd.gov.