Combat addiction: Overview of implications in symptom maintenance and treatment planning

“Combat addiction” is discussed as a concept central to understanding the chronicity and treatment-resistant quality of post-traumatic stress disorder in Vietnam combat survivors. Possible neurophysiologic, neurochemical, neuroelectrical, and behavioral parameters are addressed with regard to these mutually reinforcing excitatory states beginning with multiple combat experiences. Interviews with 100 such veterans revealed the remarkably frequent (94%) description of intrusive realistic reexperiencing of combat, particularly nightmares, as feeling powerful, exciting — a “high” or “rush” — with intervening states being experienced as unpleasant. Other findings are also presented which tend to support this concept. Implications for treatment planning are outlined.