But she wanted to learn more about their coping strategies and personality traits. She persuaded the Department of Defense to fund the research, saying that it could lead to "new ways to increase soldiers' resilience and recovery from combat-related distress, and thus increase military retention."
Nearly two years ago, she and three other VA psychologists went to Camp Shelby, Miss., where 2,500 Minnesota Guard troops were preparing to deploy to Iraq. Of those, 531 agreed to fill out 22-page questionnaires covering everything from their childhood and family life to how they handle setbacks.
Col. Michael Rath, a National Guard physician who collaborated on the research, said that the study could help the military develop an early-warning system of sorts. Rath, a family physician in Mankato, said there's no good way to predict who will fare well in combat, psychologically speaking. The project may develop some indicators, and also offer better ways to prepare troops, he said.
At the start, Polusny expected the soldiers to be in good mental health. The most important insights will come later, as the researchers follow them for two more years.
A little worried
Gazelka admits that he was a little worried when his National Guard unit left for Iraq. He had heard so much about PTSD, he said, that he wondered, "Will I be able to deal with it?"
In Iraq, he saw plenty of horror as he cleared roadside bombs. His own vehicle was hit by one. Miraculously, he said, "We came out unscathed." He also shared his combat experiences in a blog, which he called a stress-release valve.
In July, Gazelka returned home to his wife, April, and son Landon, 2. "I've had a lot of close calls. And I'm very thankful to God and everyone else that I made it out," he said.
He and his guard buddies are watching for signs of stress. But he doesn't worry if they jump at loud noises or feel restless. "That's not necessarily a symptom -- we just came from a war zone," he said. "As far as I've seen, everyone is adapting pretty well. So far, so good."
PTSD has gone by many names over the years -- shell shock, combat stress, the walking wounded. But most of what scientists know about it has emerged since the Vietnam War, Polusny said. By some accounts, it affected as many as 30 percent of Vietnam veterans.
Since then, the military has launched programs to train troops to recognize symptoms and to find help if they need it.
Don Elverd, a psychologist and a Vietnam veteran, said the military is doing a much better job with this generation than with his own. "The pendulum has really swung," said Elverd, who counsels veterans with PTSD at Hazelden, near Center City.
Not everyone has it
But he also worries that there may be too much talk about post-traumatic stress. Some veterans walk in with PTSD checklists, believing they have the disorder, even if their problems are less severe.
"They've got memories, they feel sad, they have some stuff that bothers them. But they do not meet full criteria for PTSD," said Elverd, who suffered from PTSD.
He says that he doesn't minimize the problem, but that "you have to be careful [that it does] not become a self-fulfilling prophecy."
Polusny sees no danger of that. The more that people know about PTSD, she said, the sooner they recognize symptoms and seek help.