Geisinger Health System senior investigator and U.S. Army veteran Joseph Boscarino, Ph.D., is proud of his military service, yet he doesn't like to talk much about his combat experiences.

Before becoming a renowned researcher of psychological trauma, Dr. Boscarino served a tour of duty with an artillery unit in Vietnam from 1965-66, during which he witnessed heavy combat and its aftermath. To this day, he tries hard not to reflect on those battlefield memories.

New research by Dr. Boscarino and Tulane University investigator Charles Figley, Ph.D., shows that for some people exposed to traumatic events, repressing these memories may be less harmful in the long run.

"Going back to the days of Sigmund Freud, psychiatrists and mental health experts have suggested that repression of traumatic memories could lead to health problems," Dr. Boscarino said. "Yet we have found little evidence that repression had an adverse health impact on combat veterans exposed to psychological trauma many years later."

In a study that appears in the June issue of the research publication Journal of Nervous & Mental Diseases, Drs. Boscarino and Figley examined the long-term mortality rates of Vietnam veterans who were evaluated in 1985 with follow up in 2000.

By studying the death certificates and records of a random sample of more than 4,000 veterans 30 years after military service, the researchers found that having PTSD along with a repressive personality trait does not necessarily lead to premature death.

The researchers say this is an important finding because exposure therapy is a prevailing practice in psychiatry, a technique that encourages patients to relive painful or traumatic events. Yet, for some patients, this therapy may inadvertently cause a resurfacing of PTSD symptoms and psychological distress, putting that patient at risk for health problems.

Previous research by Boscarino has shown that PTSD may cause premature death from heart disease, leads to elevated white blood cell counts and higher erythrocyte sedimentation rate levels (both of which indicates inflammation), and may cause other disease such as rheumatoid arthritis.

"While the dominant therapy model for PTSD should not be abandoned at this point, emerging research suggests that it might need to be seriously re-evaluated, at least for some PTSD patients," Dr. Boscarino said. "More research is clearly needed."

Dr. Figley, another renowned trauma scholar who co-authored the 2007 book Combat Stress Injuries, said he was not surprised by the findings since it they are consistent with a new theory of combat-related stress.

"Repression is a self-regulator and a method of memory management," Dr. Figley said. "In other words, 'keeping your stressful memories in side or it will kill you' is a myth."

Dr. Figley, who served in Vietnam as a Marine at the same time as Dr. Boscarino, believes this study is a wake- up call to all those who care about combat veterans.

"These men and women deserve our respect in recognizing that they often know better than we do in how to manage their stressful memories, in most cases," Dr. Figley said.

About Geisinger Health System

Founded in 1915, Geisinger Health System is one of the nations largest integrated health services organizations. Serving more than 2.6 million residents throughout central and northeastern Pennsylvania, the physician-led organization is a nationally recognized leader in the use of electronic health records, patient access and engagement in their healthcare, and in medical education for the next generation. Geisinger is comprised of three medical center campuses, a 740-member group practice, a not-for-profit health insurance company and research that extends across our large system- all dedicated to creating new models for scientific discovery, quality patient care, and successful clinical outcomes. Geisinger's Weis Center, Center for Health Research and Center for Clinical Studies include basic science, population-based and clinical trials research, complemented by collaborative relationships with top academic centers. Geisinger Ventures, the system's for profit entrepreneurial arm, seeks and promotes opportunities to speed the delivery of medical innovation to benefit patients.