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found. More non-veterans tended to have higher incomes, compared to combat veterans and non-combat veterans. Non-combat veterans tended to enter professional or managerial occupations more often than combat veterans or non-veterans, the researchers found.

Dr. Gerald Fletcher is a professor of medicine at the Mayo Clinic College of Medicine in Jacksonville, Fla., and a spokesman for the American Heart Association. Commenting on the results, he said, "Tremendous mental and emotional stress may have been a factor in the long term."

At least one earlier study found a short-term adverse effect of combat on the cardiovascular system, Fletcher said. Autopsies of men killed in the Korean War found accelerated atherosclerosis, which is blockage of the arteries that can lead to heart attack or stroke, he said.

Combat service should be taken into account when a doctor assesses cardiovascular health, Fletcher said.

"We don't have enough data yet to call stress a modifiable risk factor, but that is because it has not been studied enough," he said.

Federal agencies are aware of the problems facing troops returning from Iraq and are taking steps to manage them, said Dr. Harold S. Kudler, an associate clinical professor of psychiatry at Duke University, and coordinator for mental health services at the Department of Veterans Affairs Medical Center in Durham, N.C.

"The Department of Veterans Affairs is working alongside the Defense Department to do assessments when people go to war and when they return",

Kudler said. "The idea is that we are trying to get complete computerized records so we can have follow-up, entire records that would be readable by any person.

"With this generation we're getting the best baseline that anyone has had. We're also working on early intervention, trying to build the record early rather than trying to catch up later."

More information

A guide to post-traumatic stress disorder and other possible psychological problems for troops serving in Iraq is given by the Department of Veterans Affairs.

Page 6 (Printed version)

Page 7 (Printed version)

GLOBAL ASSESSMENT SCORES

What they mean:

By Larry Stimling

GAF scores are one part of what the VA uses in determining your percentage of disability due to PTSD. The list below can give you some idea of what it means as for as how PTSD is affecting you.

100-91 Superior functioning in a wide range of activities; life's problems never seem to get out of hand, is sought out by others because of his or her many positive qualities. No symptoms.

90-81 Absent or minimum symptoms (e.g. mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns ("e.g.. an occasional argument with family members)

80-71 If symptoms are present, they are transient and expectable reactions to psychosocial stressors (e.g., difficulty concentrating after family argument); no more than slight impairment in social, occupational, or school functioning (e.g temporarily falling behind in schoolwork).

70-61 Some mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships.

60-51 Moderate symptoms (e.g.. flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers).

50-41 Serious symptoms (e.g., suicidal ideation, severe obsessive rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).

40-31 Some impairment in reality testing or communication (e.g... speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g depressed man avoids friends, neglects family, and is unable to work: child frequently beats up younger children. Is defiant at home, and is failing at school).

30-21 Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communications or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas. (e.g. stays in bed all day; no job, home, or friends).

20-11 Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death, frequency violent; manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g smears feces) OR gross impairment in communication (e.g. largely incoherent or mute.)

10-0 Persistent danger of severely hurting self or others. (e.g. recurrent violence) OR recurrent inability

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3/3 RVN Newsletter  Vol 1, Issue 6