Combat Posttraumatic Stress Disorder as Complex and Considerations for Future Treatment of Combat Complex PTSD

Abstract

Research on Post-Traumatic Stress Disorder (PTSD) indicates that veterans of Operation Iraqi Freedom and Operation Enduring Freedom experience significantly higher rates of PTSD than the general population. Despite the availability of evidence-based treatments such as Prolonged Exposure Therapy (PE) and Cognitive Processing Therapy (CPT), many veterans discontinue treatment prematurely. Factors contributing to these high dropout rates include a desire to manage symptoms independently, professional and unit-related barriers, time constraints, mental health stigma, and discomfort with processing traumatic experiences. Furthermore, current trauma-focused therapies often fail to capture the full complexity of combat trauma, leading to inadequately addressed mental health complications. Given these challenges, combat-related PTSD may be more accurately conceptualized as complex PTSD (C-PTSD), which necessitates a more comprehensive, phased treatment approach. This dissertation advocates shifting away from a one-size-fits-all model toward a flexible, individualized approach that acknowledges the multifaceted realities of combat trauma. Future treatment strategies should incorporate strengths-based principles from positive psychology as well as integrate a Catholic-Christian perspective on healing, virtue, and the redemptive potential of suffering. By blending theological and philosophical insights with clinical practice, the proposed approach seeks to honor relationality, vocationality, and virtue while emphasizing personal resilience, humility, and fortitude. Without addressing the physiological, psychological, and moral dimensions inherent in combat PTSD, current treatment paradigms will continue to fall short.