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Empirical research has shown that exposure to race-related stressors in the military by Asian American Pacific Islander Vietnam veterans, now reliably measurable, contributes uniquely and significantly to post-traumatic stress disorder (PTSD) symptoms and generalized psychiatric distress; moreover, studies reveal that adverse race-related events can meet Diagnostic and Statistical Manual of Mental Disorders-IV criteria for a PTSD diagnosis. Competence in treating PTSD or general psychiatric distress requires understanding the types of, and effects of, adverse race-related events experienced by ethnic minority veterans. Case studies highlight two types of race-related stressors-"bicultural identification and conflict" and "racial stigmatization"-which placed the veteran at greater risk of death and reduced cohesion with fellow service members. The studies demonstrate the presence of race-related stressors in one or more of the four major types of war zone stressors: traditional combat, atrocities-abusive violence, perceived threat, and malevolent environment. These case studies supplement the empirical findings on race-related stressors and PTSD, enlarging the clinician's understanding of this unique type of mental health risk factor.

Treatment for symptoms arising from exposure to adverse race-related events is critical to culturally competent healthcare delivery to ethnic minorities, particularly in light of recent findings demonstrating significant relationships between adverse race-related events and post-traumatic stress disorder (PTSD) and general psychiatric distress. This article offers a developmental model consisting of stages by which psychological symptoms develop in response to race-related stressors in the military. This article also describes a model of group treatment for ethnic minority veterans related to psychological symptoms arising from exposure to race-related stressors. Both models were used in a race-related support group for Pacific Islander Vietnam veterans diagnosed with PTSD. A combined approach of group intervention, psychosocial education, identity reframing, cognitive differentiation, and cognitive restructuring, which included 'depersonalizing discrimination' and rejection of faulty beliefs, appear to offer an effective approach to treating psychological sequelae arising from adverse race-related events. This article offers an intervention model that is linked to a developmental model of race-related stressors for Asian American Pacific Islander minority personnel in the military.

This article presents a conceptual framework by which to understand race-related post-traumatic stress disorder (PTSD) for the Asian American Vietnam veteran. The framework draws from cognitive schema theory, social behaviorism, the notion of cumulative racism as trauma, and the assumption that bifurcation and negation of one's bicultural identity is injurious. Classifications of race-related stress or trauma that may be experienced by Asian American Vietnam veterans, with exemplifying clinical case material, are presented. These types of stressors include being mistaken for Vietnamese, verbal and physical assaults that are race-related, death and near-death experiences that are race-related, racial stigmatization, dissociation from one's Asian identity, and marginalization. As studies of combat trauma and sexual assault forced the psychological stresses attendant to war and sexist oppression into public consciousness, so this article addresses psychological stress and trauma attendant to racism.