Trauma deepens trauma: the consequences of recurrent combat stress reaction.Isr J Psychiatry Relat Sci. 1990; 27(4):233-41.IJ
This study examines whether a second episode of combat stress reaction (CSR) leads to more or less severe consequences than an initial episode. Two groups of Israeli veterans, all of whom took part in both the 1973 Yom Kippur war and the 1982 Lebanon war, participated in the study. Veterans in the second time CSR group (N = 24) were diagnosed with suffering combat stress reaction (CSR) during both wars; the first time CSR group (N = 39) suffered from CSR only in the second war. The second time CSR group was found to have more severe pathology and a lower level of social functioning than the first time group. Clinicians' interview ratings of the second time CSR subjects showed that their adjustment and symptomatology were significantly worse following the second war than after the first. The two groups also revealed different attitudes towards PTSD and different self-expectations regarding future wars.