The mental health of sons and daughters of Australian Vietnam veterans

O’Toole, B., Dadds, M., Outram, S., & Catts, S. (2018). The mental health of sons and daughters of Australian Vietnam veterans. International Journal of Epidemiology, 0, 1-9.


Background: War service increases the risk of post-traumatic stress disorder (PTSD) to combatants, and has been shown to increase the risk of PTSD in their offspring. The extent to which there is an excess compared with the general population is not yet established, nor whether PTSD increases the risk of other psychiatric problems.

Methods: A national sample of 133 sons and 182 daughters of a cohort of 179 Australian Vietnam veterans’ families were assessed in person, using structured psychiatric interviews. The prevalence of trauma exposures, DSM-IV (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition) diagnoses and suicidality were compared with the Australian Bureau of Statistics’ 2007 National Survey of Mental Health and Wellbeing data matched for age and sex. The risk of mental health problems potentially attributable to PTSD was also assessed.

Results: Sons and daughters were more likely than population expectations to report exposures to natural disasters, fire or explosions and transport accidents, and sons more likely to report exposure to toxic chemicals whereas daughters were more likely to report sexual assault. Sons and daughters had higher prevalences of alcohol and other substance dependence, depression and anxiety, and PTSD, and children’s PTSD was associated with substance dependence, depression and suicidal ideation. There were strong associations between children’s PTSD and comorbid conditions of substance use disorders, depression and anxiety.

Conclusions: Higher rates of mental health problems in veterans’ families, together with comorbidity with PTSD and the link between veterans’ and children’s PTSD, suggest that the effects of trauma may continue into subsequent generations.

DOI/Australian-New Zealand Clinical Trials Registry