ABSTRAKUsing twin methodology, we assessed late-life psychological outcomes of World War II flight combat exposure among identical-twin pilots raised, educated, and trained together but discordant for combat exposure and war imprisonment. We hypothesized that the prisoner of war (POW) survivor would exhibit psychopathology attributable, in part, to nonshared environmental events, specifically war trauma. Differences were evident in reported psychological symptoms, Minnesota Multiphasic Personality Inventory profile patterns, psychiatric diagnoses, and intellectual performances. Assigned a lifetime diagnosis of posttraumatic stress disorder, the former POW showed deficits in visuospatial analysis and organization, planning, impulse control, concept formation, and nonverbal memory. Results may be used to enhance understanding of measurements of stress related symptoms among robust and well-trained servicemen.