Matt Friedman, the director of the National Center for PTSD, explained at the 2003 conference of the American Association for the Advancement of Science that the SOF soldiers in the Fort Bragg study demonstrated a higher capacity to mobilize the neuropeptide Y molecule and sustain it for longer periods of time. Furthermore, the level of neuropeptide Y their bloodstream returned to normal levels within twenty-four hours, whereas conventional soldiers still showed decreased levels.

According to Friedman, the capacity to mobilize neuropeptide Y is correlated to a lower likelihood of developing PTSD. He believes that neuropeptide Y may offer the key to primary prevention of PTSD, if a means of artificially elevating it could be discovered.  Although the work has been going on for several years, researchers are still uncertain whether the SOF members’ enhanced capacity to endure trauma was genetic or had been acquired through Special Forces training.

A broader and more focused study conducted in 2012 by researchers in the Department of Psychological Medicine in Sri Lanka[ii] compared the mental health problems of SOF personnel with conventional forces who had been engaged in combat for at least one year.  Exposure to traumatic events and problems with family life were identified as risk factors. The outcome measures were common mental disorder, fatigue, multiple physical symptoms and hazardous alcohol use.The researchers found that while overall exposure to potentially traumatic events was high in both groups, the SOF personnel experienced significantly more traumatic events during their tours than conventional forces.

In spite of this, Special Forces personnel exhibited significantly fewer common mental disorders, fatigue or poor general health than regular forces.  Prevalence of PTSD was only 1.9% in the Special Forces and 2.9% among the conventional forces.  So, even with more exposure to trauma, the SOF members still had lower rates of PTSD.  The researchers suggested that better training, comradeship, and unit cohesion protected Special Forces personnel from negative mental health outcomes of combat.

I also looked at studies of PTSD in civilian populations. PTSD rates in studies of civilian populations vary, and depend on the background and experiences of the cohorts these studies. However, civilian populations tend to have only slightly lower rates of PTSD than do military personnel who have served one or more combat tours.  Incidents such as car accidents, losing a loved one, assaults, or simply prolonged periods of elevated stress are all common causes of PTSD amongst the non-military populations.

A study conducted in 1991[iii] examined PTSD rates among non-military urban youth in Detroit, a sample with an above-average exposure to traumatic events.  Within the sample, 39% had been exposed to traumatic events, and among those exposed, 23.6% reported symptoms of PTSD.  A 1993 study of PTSD[iv] rates among civilian American women found that lifetime prevalence of PTSD was 9.4% among women who were not victims of crime, and 25.8% among women who had been victims of crime. These studies are congruent with reporting from the National Center for PTSD, which says that about 8% of the overall population will experience PTSD at some point in their lives.[v]

Generally speaking, available literature on the subject tends to support the hypothesis that Special Operations Forces have a higher resilience to combat stress.  It is interesting that biochemical markers associated with stress control and reduction have been found to be higher and sustained for longer periods of time in SOF personnel than in conventional soldiers; this discovery demands more attention.  It is possible that this could be a result of the extended and more rigorous training SOF personnel are given.  A number of studies[vi] have shown that prolonged exercise cause the body to exhibit elevated levels of pain-killing neurochemicals, so it is safe to assume that a similar mechanism may be at work in SOF training.  Perhaps extended exposure to rigorous, but controlled, environments, allows trainees to develop elevated levels of stress-reducing neurochemicals.

My own experience, along with the available research on the subject, indeed leads me to believe and assert that SOF personnel do have higher resilience to combat stress and are less likely to exhibit PTSD symptoms than conventional soldiers.  Furthermore, my research suggests that PTSD levels in the military overall are very near the averages of civilian rates of PTSD.  At any rate, it is clear that more research needs to be done and less assumptions need to be made anytime a person who served in the military does something violent. If the reasons for this phenomenon are discovered, we may be able to use that knowledge to reduce PTSD in combat personnel throughout the Armed Forces as a whole.