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To the Editor The underlying assumption that personal weakness rather than war is responsible for the high rates of mental health disorders among military personnel ignores historical data and raises questions about the study and its conclusions by Kessler et al1 published in JAMA Psychiatry. Retrospective analyses of premilitary, military, and postmilitary risk factors conducted since World War I almost uniformly conclude that the single best predictor for stress casualties is cumulative exposure to war stress followed by perception of low social support.2
Russell MC, Butkus SN. Mental Health and the Army. JAMA Psychiatry. 2014;71(8):966-967. doi:10.1001/jamapsychiatry.2014.695