There is little empirical research looking at service members who are exposed to acts of terrorism as opposed to other service connected stressors. When discussing terrorism induced stress among service members, one can conceive of potentially unique stressors as well as opportunities to mitigate negative outcomes. There has been much debate over the years in the field of psychotraumatology regarding soldiers and veterans. Despite PTSD’s origins to, in part, explain the plight of service members returning from conflicts such as the Vietnam War, there has been debate as to the how the language of traumatology captures the veteran experience. Like civilians, service members are potential targets of various terrorist groups pursuing a political aim. However, immediately following a terroristic act, unlike most civilians, service members don the role of first responders, and in most cases, defenders against the act of terrorism. The service member’s trauma may not be “being shot at”, but rather the witnessing of a severely wounded civilian. Some may have a classic PTSD picture with fear, anxiety and avoidance that may respond to the traditional desensitization and habituation that exposure therapy provides. Yet others may have overwhelming depression, guilt, and shame based on their inability to act or perceived failure. These complexities may necessitate a different approach and exposure may temporarily aggravate symptoms, but clinical awareness of these set of potentially unique issues is critical to ensuring the highest quality care.

Disclaimer: The views expressed are those of the authors and do not represent the views of the US Government, Department of Defense, the Uniformed Services University of the Health Sciences or any other agency either public or private.