Brian I. O’Toole

Brian I. O’Toole

University of Sydney Brain & Mind Research Institute, Australia

Title: Secondary Effects of War Service: The Families of Australian Vietnam Veterans


Brian holds a BSc in Mathematics, PhD in Psychology, and MPH in Epidemiology. He has been researching psychological effects of trauma for 25 years with domestic violence victims, child sexual assault victims, and combat veterans. He conducted the first ever epidemiological study of any returned Australian veterans, and has extended this to a three-decade follow-up, with the veterans and their families. He has been a board member of the Vietnam Veterans Counselling Service over 18 years, and has taught epidemiology and statistical analysis at Sydney, Queensland and NSW Universities, and has published more than 150 papers and government reports.


When combat soldiers return home, they carry the legacy of combat and posttraumatic stress disorder into their post-war lives. An epidemiological cohort study of 1,000 Australian veterans of the Vietnam War has examined the associations of combat trauma exposure on the physical and mental health of the veterans and their wives and partners three decades after the war, using standardised combat assessments and WHO/CIDI psychiatric interviews. Veteran combat is strongly associated with alcohol use disorders, domestic violence, posttraumatic stress disorder, depression and other psychiatric disorders in the veterans, and with anxiety and depression, suicidality and marital dysfunction in their wives. The cohort has now included 315 veterans’ adult children to examine any “ripple effects” in combatants’ children. This paper will present the first findings for the association of veteran combat and PTSD on the mental health of their adult offspring, using the same standardised psychiatric interviews. Results include that veterans’ depression, PTSD and combat are associated with offspring PTSD [OR (95%CI) for PTSD diagnosis = 2.25 (1.10, 4.75)]; veteran alcohol dependence is associated with offspring reports of father’s interpersonal violence [OR (95%CI) = 8.30 (2.52, 27.35) and offspring PTSD [OR (95%CI) = 2.49 (1.07, 5.80), and veteran PTSD is associated with offspring substance dependence [OR (95%CI) = 2.98 (1.21, 7.34)]. The fighting currently occurring around the world may carry with it higher post-conflict public health risks of psychiatric disorders not only in the fighters but also in their families.