COMMENTARY War and Anxiety Disorders

Psychologic reactions are common after trauma. Much attention has been devoted toposttraumatic stress disorder after harrowing events, including natural disasters such as earthquakes and floods, assault of individuals, episodes of mass violence such as riots and terrorist attacks, and combat.1–5 The prevalence of stress disorders varies among these studies, in part as a result of differences in sampling schemes, type and timing of measurements, and types of exposures (eg, natural or manmade, extent of damage).6 In this issue of EPIDEMIOLOGY, Donald Black and his colleagues7 report on anxiety among Gulf War veterans. Their article provides insights into the psychologic impact of trauma—both in general and as it relates to combat in particular. Importantly, this report assesses not only veterans who experienced combat, but also those who were deployed and not in combat, as well as personnel who were not deployed. It is notable that an increase in psychologic symptoms was seen in both deployed groups, whether or not they directly experienced combat. Previous studies have focused mostly on direct victims of violence, and, in the case of mass disasters, the victims ’ families, first-responders, and their families. There are fewer data on responses among the general population or among persons considere