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In Reply: We agree with Dr Boiko that grieving is important among war veterans. However, our study could not feasibly address all possible components of the deployment experience and did not investigate grieving specifically. Work tailored to the complex experience of grieving and its relationship to neuropsychological outcomes will be welcomed.

We agree with Dr Hoge that deployed soldiers' performances on neuropsychological tasks are generally encouraging, but an important strength of our study is the availability of a nondeployed comparison sample. We believe that our interpretation of the results was correct.

It is difficult to interpret as spurious the deployment-related effects revealed on 4 of the objective neurocognitive tasks (NES3 CPT omission errors, WMS3 Verbal Paired Associates learning, WMS Visual Reproduction retention, and Automated Neuropsychological Assessment Metric [ANAM] simple reaction time). The objective tasks showing deployment effects, both advantageous and disadvantageous, present a coherent, nonrandom pattern suggestive of a biologically . . . [Full Text of this Article]

Jennifer J. Vasterling, PhD
jvaster@tulane.edu
VA South Central Mental Illness Research, Education, and Clinical Center
New Orleans, La

Susan P. Proctor, DSc
US Army Research Institute of Environmental Medicine
Natick, Mass

Paul Amoroso, MD, MPH
Madigan Army Medical Center
Fort Lewis, Wash

Robert Kane, PhD
VA Maryland Healthcare System
Baltimore

Timothy Heeren, PhD; Roberta F. White, PhD
Boston University School of Public Health
Boston, Mass

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Deployment to the Iraq War and Neuropsychological Sequelae
Patricia Boiko
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Deployment to the Iraq War and Neuropsychological Sequelae
Charles W. Hoge
JAMA. 2006;296(22):2678-2679.
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