War zone stress without direct combat: the Australian naval experience of the Gulf War.J Trauma Stress. 2005 Jun; 18(3):193-204.JT
This study examines psychological stressors reported by Australian Navy Gulf War veterans in relation to the 1991 Gulf War and other military service. Using a 44-item questionnaire, veterans reported few direct-combat encounters during the Gulf War; however, they reported many other stressful experiences, including fear of death and perceived threat of attack, more frequently in relation to the Gulf War than other military service. Reporting of stressful experiences was associated with younger age, lower rank, and deployment at the height of the conflict. These experiences may partly explain increased rates of psychological disorders previously demonstrated in this Navy veteran population. Findings highlight the importance of documenting war experiences in close proximity to deployment, and developing war exposure instruments which include naval activities and which reflect stressors other than those related to direct combat.