Dr Ruwan M Jayatunge

Currently the definition of delayed-onset PTSD encompasses symptoms that surface only up to 6 months following an event. Sometimes PTSD can emerge many years after the original trauma. According to Robertson and colleagues (Ruzich, Looi, & Robertson, 2005), large numbers of older veterans are present with nightmares and intrusive memories of the war. Some are experiencing these features for the first time in their lives. For some World War II veterans, memories of the war can still be upsetting more than 50 years later.

Late onset trauma plagues war veterans in a devastating manner. Those who are in their old age are now troubled by disturbing war memories. The delayed reaction, could be triggered by a subsequent stressful event

In a study of 147 Dutch veterans who had fought in the Resistance against the Nazis in WW2, it was found that forty years after the end of the war over half of these people are still suffering from PTSD and only 4% showed no symptoms at all (Hovens et al., 1992).

A new study (Boscarino & Adams, 2009) that assessed New Yorkers exposed to the events of September 11, 2001 provides additional evidence that posttraumatic stress disorder (PTSD) can surface up to 2 years after the event in individuals with preexisting emotional or social problems.

Some of the Sri Lankan veterans too have shown delayed-onset PTSD reactions. They have manifested posttraumatic features many years after original trauma. Combat trauma experienced by them may result in long-term sequelae.

Sergeant TH7 was an experienced combatant who participated in numerous combat operations in the North. During 1988 / 89 insurgency period, his platoon was deployed in the Southern part of Sri Lanka to fight the left wing Sinhala rebels who launched attacks against the Government. In the height of the conflict, the rebels attacked the Army killing several soldiers. This incident escalated to fathomless atrocities.

In 1989, Sergeant TX7 and his group arrested some of the suspects and eliminated them. Sergeant TX7 tortured one of the suspects who was believed to have masterminded the attack on soldiers. He shot the suspect, poured petrol while the victim was alive. Then set fire. When the victim was on fire, he made an unsuccessful attempt to grab Sergeant TX7. Sergeant TX7 narrowly escaped the fire and he became shocked and utterly frightened. Then he aimed his firearm towards the blazing man and fired several shots. Then the suspect died instantly. After a few weeks, he completely forgot the incident.

In 2002, thirteen years after this incident one night Sergeant TX7 s wife tried to light the Kerosene lamp while they were having dinner. Then she accidentally dropped it and the lamp exploded. His wife s clothes caught the fire. She was on flames. Immediately Sergeant TX7 poured water onto his wife and extinguished the fire. She went unharmed. But Sergeant TX7 was utterly devastated.

When his wife was on fire, the 1989 incident came into his mind immediately. Instead of his wife, he saw the JVP suspect who tried to grab him a moment before death. From that night, he had nightmares of the original incident and continuous intrusive memories. Sergeant TX7 startled easily and he was gradually turned in to different person. He became depressed and started abusing alcohol. He lost his life interests. Once he planned to commit suicide. He went to the railway station and walked along the railway tract. When the train was a few meters away, he changed his mind and jumped off.

Sergeant TX7 was diagnosed with PTSD in late 2002 and treated with medication and psychotherapy. (EMDR and CBT). By 2003, he was free of most of the PTSD symptoms.