A systematic review of the psychosocial impact of emotional numbing in US combat veterans.

CONTEXT: Previous studies have linked posttraumatic emotional numbing symptoms in US combat veterans with an adverse impact in multiple important life domains. OBJECTIVES: We updated and evaluated the evidence examining the psychosocial impact of combat-related emotional numbing, including ethnoracial and gender differences. METHOD: We reviewed 1,209 articles published betwen January 2012 and 2018 and selected 24 studies for inclusion. We assessed the overall study quality as fair using a national quality assessment tool. RESULTS: Studies found emotional numbing to wield adverse effects in the areas of symptom nonimprovement, mental health difficulties, increased service utilization, poor relationship functioning, reduced quality of life, substance use disorders, suicidality, and aggression/violence. We also found evidence of ethnoracial and gender differences in veterans' posttraumatic stress disorder-related emotional numbing symptoms. CONCLUSION: Clinicians should incorporate findings on emotional numbing into assessment, treatment planning, and monitoring, to improve treatment retention and psychosocial outcomes. Implications for ethnoracial and gender differences require further exploration.