Peacekeeping Missions

According to the United Nations, peacekeeping is “the deployment of a United Nations presence in the field, hitherto with the consent of all the parties concerned, normally involving the United Nations military and/or police personnel and frequently civilians as well” (United Nations, 1992, n.p.). Because of the changing nature of peacekeeping operations in the 1990s and asymmetric operations beginning in the 21st century, documentation of a phenomenon known as peacekeeping stress has been identified among the troops of participating nations. Peacekeepers are a well-studied population with respect to stress. In international samples of peacekeepers, posttraumatic stress disorder is often associated with considerable comorbidity, most frequently depression, anxiety, and alcohol and substance use. Recent studies of peacekeepers found that 32.9% had major depressive disorder, 32.0% had dysthymia, 61.6% abused alcohol, and 10.5% abused drugs. These findings pertaining to alcohol abuse replicate other peacekeeping stress studies of outpatient peacekeepers, in which 44% to 80% of international samples of more than 5,300 peacekeepers met criteria for alcohol abuse. And, in a study of inpatient peacekeepers, 91% met the lifetime criteria for substance abuse disorder.

For peacekeepers, just as with combat-related posttraumatic stress disorder (PTSD), the nature of service in dangerous military operations seems to have comparable effects in escalating alcohol and depression problems following such missions. European peacekeeping studies reported that nearly one half of more than 1,600 peacekeepers sampled reported that their alcohol consumption increased. In peacekeeping studies from New Zealand, increased psychological distress was reported only months after the deployment. More specifically, studies found that Canadian peacekeepers demonstrated greater amounts of depression and poorer health after deployment. In a Norwegian study of nearly 16,000 UN peacekeepers serving from 1978 to 1991, mortality caused by suicide increased by 43%. One interpretation of these results is that stress factors and socially disintegrative processes, such as alcohol abuse, might produce depressive problems associated with suicide. This theory is also supported in a study of peacekeepers with PTSD in which 57% of 117 PTSD cases engaged in suicidal behavior. In another study, peacekeepers with 100% lifetime PTSD and 87% current PTSD had extensive comorbidity with major depressive disorder. In summary, therefore, the likelihood of comorbidity with stress-induced disorders, such as depression and alcohol problems, is significantly increased with lifetime PTSD.

Therefore, peacekeeping appears to be a fertile breeding ground for traumatic stress. Current data suggests that approximately 10% to 20% of armed forces personnel deployed for peacemaking, peace enforcement, peacekeeping, or humanitarian disaster relief present with PTSD following their tours of duty. During the post–Cold War period of 1990 to 1999, when U.S. operations other than war were at their height, there were 1,380 hospitalizations and 18,597 ambulatory visits for treatment of active duty soldiers for PTSD. Currently, one in five Canadian peacekeepers in the Afghan theater is reported as having traumatic stress reactions. Similar studies using samples of peacekeepers observed a prevalence of full PTSD in more than 20% 6 months after [Page 419]redeployment. These findings are consistent with those from studies from the Vietnam War. Estimates for various peacekeeping exposure groups from different countries and different conflicts fall within a 95% confidence interval of the National Vietnam Veterans Readjustment Study (NVVRS).

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