Loyola University Chicago Loyola eCommons Dissertations Theses and Dissertations 1991 A Comparative Investigation of Survivor Guilt Among Vietnam Veteran Medical Personnel Maurice E. Kaufman Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_diss Part of the Education Commons Recommended Citation Kaufman, Maurice E., "A Comparative Investigation of Survivor Guilt Among Vietnam Veteran Medical Personnel" (1991). Dissertations. 3177. https://ecommons.luc.edu/luc_diss/3177 This Dissertation is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Dissertations by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 1991 Maurice E. Kaufman I\ L-U.M.Pl\RAliVE lNVESTlGATIUN OF SURVlVUH GUILT AM.UNG VIETNAM VEfEHAN MEDICAL PERSONNEL by .Maur·lce E. Kautrw:ln A Vls1:;er· tn ti on 0u bmi t ted to the faculty of the Gt adua te ;ic hcml nf Edu cat; ton o.t Loyola lJni ver-s l Ly of Lhi cago J.n Par·tlal Fulf:lil1oe11t ot the RequirP.ruents •• tor toe IJPp;n:>e oJ IJoctrw o1 Educa.ticm May l 9'J l ACKNOWLEDGMENTS I would like to thank Dr. Manuel Silverman tor giving me the opportunity and independence to pursue various ideas, and for valuable discussions throughout my graduate studies. I am obliged to recognize Dr. Ronald Morgan and Dr. Terry Williams for their useful discussions along with their contributions to this project, without which it would not have been completed. I would also like to acknowledge Mr. Matthew Galloucis for his assistance and support with the technical aspects of this project. I am indebted to Mr. Julian V. Poole, Jr. for his numerous discussions and support,.to Princess Coleman for her assistance and suggestions relative to the survey, and to all of the staff of the Oak Park Veterans Center for their generosity and assistance during my graduate career. And I especially thank my family - Ollie, my wife, and my children, Maurice, Jr. 1 Theresa and Martin Kaufman, for their love and endless support. 11 VITA The author, Maurice Edward Kaufman, is the son of George C. Kaufman and Gwendolyn V. <Fisher) Kaufman. He was born June 25, 1948 in Chicago, Illinois. His elementary education was completed at St. Thomas the Apostle School in Chicago, Illinois. His secondary education was obtained at Hyde Park High School in Chicago, Illinois. In August, 1971, Mr. Kaufman entered Olive-Harvey College where he matriculated until receiving the degree of Associate of Arts in Liberal Arts in January, 1973. In January, 1973, Mr. Kaufman entered Chicago State University which he attended until receiving the degree of Bachelor of Arts in Psychology in December, 1974. In July, 1976, Mr. Kaufman entered the Master of Science in Education program, which he completed earning a degree in Counseling and Guidance in April, 1978. As a graduate student in the Department of Counseling and Educational Psychology, Loyola University of Chicago, Mr. Kaufman was granted an assistantship in the Counseling Center in partial fulfillment of the requirements for the degree of Doctor of Education. He was inducted as a member of Alpha Sigma Nu, the National Jesuit Honor Society, May 2, 1988. 111 TABLE OF CONTENTS Page ACKNOWLEDGEMENTS 11 VITA 111 LIST OF TABLES vi LIST OF FIGURES Viii Chapter I. INTRODUCTION. 1 Purpose of the Study 2 Assumptions .... 3 Statement of the Problem 4 Definition of Terms 6 Limitations 8 I I. REVIEW OF LITERATURE AND RELATED RESEARCH 9 Post Traumatic Stress Disorder. 12 Medical Personnel and P.T.S.D .. 17 Survivor Guilt 21 III. RESEARCH METHOD 27 Subjects . 28 Procedure 29 Instrumentation 30 Hypotheses . 33 IV. ANALYSES AND DISCUSSION 36 Demographic Variables 36 Missing Data. 36 Characteristics of the Sample 41 Characteristics of the Sample by Group 58 Treatment of Data 62 iv TABLE OF CONTENTS Continued Chapter Page v. SUXMARY AHD CONCLUSIONS 81 Overview . .. 81 Restatement of the Problem. 81 Results and Conclusions . , .. 84 Recommendations for Further Research 95 REFERENCES. 97 APPENDIX A 107 Correspondence from Dr. Parson 108 Letter of Introduction. Stating the Nature and Purpose of the Study 109 Follow Up Letter to Non-Respondents 110 APPENDIX B. 111 History of Combat Exhaustion <Battle Fatigue> ... 112 APPENDIX C. 113 Combat Exposure Scale . 114 Beck Depression Inventory. , . 115 Selected Laufer-Parson Guilt Inventory Questions . 118 Laufer-Parson Guilt Inventory. 119 APPENDIX D 122 Written Responses to Section Von Questionnaire. ... 123 APPENDIX E . 14'/ Survey Instrument,. 147 V LIST OF TABLES Table Page 1. Total Number and Percentages of Each Group Group in Sample Population in the State of Illinois. 28 2. Summary of Characteristics of Sample Population 37 3. Summary of Demographic Data by Group 42 4. Chi Square Statistics of Selected Variables 63 5. Means of the Laufer-Parson Guilt Inventory Totals Score by Group 65 6. Means of the Beck Depression Inventory Total Scores by Group 65 7. Means of the Vietnam Combat Exposure by Group 67 8. Means of Laufer-Parson Guilt Inventory Survivor Guilt Questions. 68 9. Means of the Laufer-Parson Guilt Inventory Total Scores by Age at Time of Service 69 10. Means of the Beck Depression Inventory Total Scores by Age at Time of Service 70 11. Means of the Laufer-Parson Guilt Inventory by Level of Vietnam Combat Exposure 72 12. Means of the Beck Depression Inventory Scores by Level of Vietnam Combat Exposure . 73 Vi LIST OF TABLES Continued Table Page 13. Means of Laufer-Parson Guilt Inventory Total Scores by Tours and by Group. 75 14. Means of the Beck Depression Inventory Total Scores by Tours and by Group. 76 15. Mean Total Scores for Medical and Combat Groups on Selected Laufer-Parson Guilt Inventory Questions 77 16. Themes and Examples of Written Responses on Questionnaire .. 78 vii LIST OF FIGURES Figure Page 1. Bar Graph and Frequency Table of Group Assigned. 59 2. Bar Graph and Frequency Table of Branch of Service 60 3. Crosstabulation of Group Assigned by Ethnicity. 61 4. Crosstabulation of Exposure by Group Assigned. 62 5. Graph of Mean Laufer-Parson Guilt Inventory Total Scores by Level of Exposure by Group 74 viii CHAPTER I INTRODUCTION Studies documenting psychological distress among Vietnam veterans have increased dramatically over the past ten years, beginning as early as 1981. A major epidemiological study conducted by the Center for Policy Research <Egendorf, Kadushim, Laufer. Rothbart & Sloan, 1981) found that Vietnam veterans exhibited a wide variety of stress related problems when compared with non-Vietnam veteran cohorts. Recently, there has been a more careful analysis of immediate and long-term psychological effects of the war. For example, it has been documented that combat exposure is the most powerful predictor of Post Traumatic Stress Disorder <P.T.S.D.) in Vietnam veterans. Political, moral, and ethical confusion reportedly produced the special characteristics of the Vietnam combat veteran. Shatan (1978) listed several of those characteristics: <1) delayed stress reactions, <2> guilt feelings and self-punishment, (3) feelings of being scapegoated, (4) rage and other violent impulses against indiscriminate targets, (5) psychic 1 2 numbing, (6) alienation, and (7) doubt about continued ability to love and trust others. Those special charac­ teristics are considered to have considerable importance with respect to selection of a treatment plan <Walker & Hash, 1981). In addition, bitter Post Vietnam experiences may have reinforced many Vietnam veterans' beliefs that they have been betrayed and exploited by the country they served <Brown, 1984). Purpose ct the Study The study to be reported here was designed to explore levels of survivor guilt among Vietnam veteran medical personnel. A comparative examination was made of the Vietnam veteran's experience with respect to levels of combat exposure, current levels of depression and levels of current guilt. The possible value of such a study is that it would: 1. add to our overall body of knowledge by identifying major themes related to survivor guilt; 2. add to knowledge in the field of Post~Traumatic Stress Disorder by examining it at a personal level; 3 3. provide insight into this population's concerns which will allow practitioners to better understand the experiences of the client; and 4. stimulate further research into the area of survivor guilt with respect to the effects on Vietnam veteran medical personnel. Hopefully, the added information will contribute to our planning and treatment efforts with respect to providing services for those who suffer from Post-Traumatic Stress Disorder <Survivor Guilt). Assumptions 1. Few of the medical persons who went to Vietnam were prepared for the number and severity of casualties nor were they prepared in terms of the threat to their own safety. 2. Combat Exhaustion <P.T.S.D.) is a normal adaptive failure to function in combat environments, and has probably been seen in all the wars America fought. 3. There are special characteristics of post-trau­ matic stress syndrome, including sleep disturbances, .survival guilt, intrusive thoughts, and depression, as it exists in the Vietnam combat veteran. 4 4. The Vietnam War was unique in that: a. Political confusion created doubt for everyone. b. On returning home, the combat-weary veteran was spat on and cursed. 5. Experiencing profound feelings of guilt by people who survive massive trauma is a frequent occurrence. Statement of the Problem Exposure to combat may result in an array of disturb­ ances, the most common of which is combat stress reaction, also known as combat exhaustion or battle shock. It has been estimated <Roberts, 1988) that, for as many as half a million Vietnam veterans, war related anxiety and problems associated with the war are a way of life.