U.S. peacekeepers are military personnel, typically trained as
combatants, who serve in missions in which they are charged with
maintaining cease-fires, implementing peace settlements, or
assisting in humanitarian operations (e.g., in Bosnia, Somalia,
Lebanon). The psychological affects of peacekeeping vary and depend
on the demands of each mission. The impact of the mission is
influenced by the requirements of the mission, the degree of
training and amount of specific preparation the individual
undergoes, the unique characteristics of the person, and the
recovery environment.
Do peacekeeping missions often involve traumatic and highly
stressful situations?
Stressors common to both peacekeeping and traditional war zone
missions include sudden changes in lifestyle, separation from
family, exhaustion, unfavorable climatic conditions, uncertainty
about length of the mission, and demoralization about the efficacy
of a mission.
1,
2 Unique stressors
associated with peacekeeping missions include (1) feelings of
helplessness about reducing peopleâs suffering and improving
their safety, (2) boredom, (3) conflict about roles and duties, (4)
taunting and harassment by civilians, and (5) uncertainty about
rules of engagement and conditions under which offensive action is
defined as acceptable.
3,
4 Additional stressors that
are unique to peacekeeping include close proximity to potentially
hostile individuals so that humanitarian assistance, protection,
and deterrence can be provided. There is also the possibility of
additional stress arising from the belief held by many peacekeepers
that the stress they experience goes unrecognized by their
families, friends, and governments.
5 Research has demonstrated that these low-level stressors
have a lasting negative psychological impact and can contribute to
the development of PTSD.
1
While deployed, peacekeepers are often confronted with traumatic
events that are typical of war zones. For example, they may witness
death and dying, be charged with the clearing of civilian corpses,
or be involved in serious accidents. . Peacekeepers are sometimes
confronted with unexploded land mines or fired upon as a result of
misunderstandings. They may find themselves accidentally in the
crossfire of two armed feuding parties or fired upon during
ãfiring close,ä which is gunfire meant to intimidate the
peacekeepers in order to keep them away from certain areas.
Peacekeepers also sometimes witness the malicious destruction of
property or atrocities committed against fellow peacekeepers and
civilians. Bramsen et al.
3 reported that 85% of the peacekeepers in their study had
witnessed shootings, and 47% had seen dead or wounded people. The
nature and frequency of potentially traumatic events will vary
tremendously with different peacekeeping missions. Peacekeeping
missions range from benign observer operations (e.g., Sinai) to
highly dangerous peace-enforcement missions (e.g., Somalia and
Bosnia).
What is the prevalence of PTSD following peacekeeping
operations?
In an investigation of Norwegian peacekeepers who served in the
United Nations Interim Force in Lebanon, Weisaeth, Mehlum, &
Mortensen
6 documented that 15% of those who completed their service
developed PTSD. Twenty-five percent of those who had their service
interrupted due to disciplinary, social, or medical problems also
developed PTSD. Litz, Orsillo, Friedman, Ehlich, and Batres
7, in a large-scale investigation of 3,461 U.S. servicemen and
women, found that approximately 8% of American peacekeepers in
Somalia met criteria for PTSD five months after their return to the
United States. In contrast, Bramsen et al.
3 reported that although more than one fifth of their sample
reported at least some significant PTSD symptoms, only 3% of Dutch
peacekeepers in the former Yugoslavia developed PTSD. Studies have
demonstrated that, in addition to those who develop full PTSD, many
more peacekeepers will suffer from significant, if sub-threshold,
levels of PTSD symptoms.
Prevalence rates of PTSD following peacekeeping operations may
also vary as a function of the time elapsed between the end of a
mission and the psychological evaluation. For instance, during a
two-year longitudinal study of New Zealand peacekeepers, MacDonald,
Chamberlain, Long, Pereira-Laird, and Mirfin
8 found that psychological distress was quite high at
predeployment and at follow-up, but it was significantly lower
during the mission itself. These findings are consistent with
O'Brien's5 observation that the presentation rate of psychiatric
difficulties during war is quite low and that many soldiers develop
difficulties after their service periods are over. Because of this,
if researchers make estimates of the incidence of PTSD immediately
or very soon after missions end, they may be underestimating the
full extent of distress incurred by peacekeepers.
What are the risk and resiliency factors associated with
peacekeeping missions?
A few studies have examined risk and resiliency factors in
peacekeepers. Less psychological distress postdeployment has been
linked to a number of factors: self-disclosure, the availability of
social support, positive homecoming receptions, and fewer
additional life stressors. Peacekeepers who felt more positive
about military cohesion and morale during their deployment
9 and those who noted less frustration with aspects of the
mission have reported fewer symptoms of PTSD. Furthermore, Bramsen
and colleagues
3 have identified two predeployment personality traits that
are significant predictors of PTSD. Individuals who scored higher
on scales of negative, hostile, or a generally dissatisfied outlook
on life and individuals who scored higher on scales assessing
highly suspicious or paranoid thoughts were more likely to develop
PTSD following peacekeeping missions.
Conclusions
The majority of soldiers deployed as peacekeepers cope very well
with the demands of peacekeeping and do not develop significant
psychological distress. However, PTSD and other forms of
psychological distress, such as depression and alcoholism, do occur
following deployment in a notable percentage of peacekeepers.
Although peacekeeping operations have historically been viewed as
relatively benign compared to traditional combat missions, these
operations frequently involve changeable goals, ambiguous rules of
engagement, civilian combatants, and exposure to the aftermath of
violence or ongoing atrocities. Researchers have begun to outline
factors associated with risk and resilience so that negative
psychological consequences may be reduced and the peacekeepers most
adversely affected can be identified.
References
1.
King, D.W.,
King, L.A., Foy, D.W., Keane, T.M., & Fairbank, J.A. (1999).
Posttraumatic stress disorder in a national sample of female and
male Vietnam veterans: Risk factors, war-zone stressors, and
resilience-recovery variables.
Journal of Abnormal Psychology, 108, 164-170.
2.
Rosebush, P.A. (1998). Psychological
intervention with military personnel in Rwanda.
Military Medicine, 163, 559-563.
3.
Bramsen,
I., Dirkzwager, A.J.E., & Van der Ploeg, H.M. (2000).
Predeployment personality traits and exposure to trauma as
predictors of posttraumatic stress symptoms: A prospective study of
former peacekeepers.
American Journal of Psychiatry, 157(7), 1115-1119.
4.
Litz, B.T.,
King, L.A., King, D.W., Orsillo, S.M., & Friedman, M.J. (1997).
Warriors as peacekeepers: Features of the Somalia experience and
PTSD.
Journal of Consulting and Clinical Psychology, 65(6),
1001-1010.
5.
OâBrien, L. S.
(1994). What will be the psychiatric consequences of the war in
Bosnia? A bad war from the psychiatric point of view, leading to
hidden pathology.
British Journal of Psychiatry, 164, 443-447.
6.
Weisaeth, L., Mehlum, L., &
Mortensen, M. (1996). Peacekeeper stress: New and different?
National Center for PTSD Clinical Quarterly, 6,
12-15.
7.
Litz, B.T.,
Orsillo, S.M., Friedman, M., Ehlich, P., & Batres, A. (1997).
Post-traumatic stress disorder associated with peacekeeping duty in
Somalia for U.S. military personnel.
American Journal of Psychiatry, 154, 178-184.
8.
MacDonald, C., Chamberlain, K.,
Long, N., Pereira-Laird, J., & Mirfin, K. (1998). Mental
health, physical health, and stressors reported by New Zealand
defense force peacekeepers: A longitudinal study.
Military Medicine, 163, 477-481.
9.
Litz, B.T.
(1996). The psychological demands of peacekeeping for militar