In a word, yes. There are very few (but there are a few, and usually in cohesive, small, highly trained and very hard groups) who do not need affirmation from those who send them.
That a society would send them and then betray them openly and loudly, (MSM et al, the success of this tactic starting in the 60’s and now well practiced) lends itself towards fewer and fewer altruistic volunteers, and increasing cynicism.

It seems to give short shrift to the ROE restrictions that understandably cause frustration and impotence in dangerous situations as a significant factor in post-traumatic stress. The memories of helplessness, of not being able to control the environment through action, and having to weigh the need to respond to aggressive behavior against the penalties for departing from ROE should have been more deeply explored as risk factors.

In civilian life, these feelings of impotence, in an abuse victim for example, prove to be the critical, driving factor in the long-term mental turmoil that can follow. It’s not so much the stress event itself as it is a feeling of being able to confidently do something about it; i.e., being allowed to handle it effectively without fear of punishment. That frustrating trap is probably a greater operative factor in PTSD than the report accounts for.

The other is the effect of society’s view of the war, and the degree of support they feel behind them. Early in the war, we heard of very few PTSD cases, despite heavy combat. As public support for the war eroded, more and more PTSD cases seemed to come to light. If soldiers return home after experiencing the horrors of combat and are received by hostility, disrespect and shunning, could that even be a major catalyst for PTSD? If someone with the same experiences comes home feeling approved of, honored and admired for fighting in the war, could that be a way for society to “inoculate” against PTSD?

Although I have no evidence for this, I would imagine that society writ large plays a pivotal role in the occurance of PTSD, as does relentlessly negative media coverage of your mission, your work and your efforts in a difficult task. A soldier faced with a constant barrage of information about the futility and downright uselessness of his efforts surely has a harder time shaking off PTSD.

The past couple of years have seen an explosion of the negative personal effects the Iraq War has had on individual soldiers. Victim-oriented stories and exposes on the emotional horrors of PTSD outstrip positive stories about the heroics and successes of well-adjusted, confident soldiers.

In general, the report zeroes in on the individual soldier as the element that is broken, and needs to “get fixed” while ignoring the effects of larger social factors we’re all responsible for.

In the same vein, the approval and mission support they feel or don’t feel from close family and friends also should be looked at. We’ve all heard stories about soldiers whose Mom or Dad discouraged enlistment and didn’t approve of, or respect the military or the war. I wonder especially if parental opposition to the war also plays a part in the occurance of PTSD. Just a layperson’s thoughts — Thanks for your work.