The Psychological Sequelae of Involvement in Combat: A Preliminary Investigation (original) (raw)
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Psychological dysfunction in battle: combat stress reactions and posttraumatic stress disorder
Clinical Psychology Review, 1990
AZt~ugh +ychologic~ dysfunction arising from stress on the batt&iild has been k~wn to exist since tk Amerkcan civil War, it is not until recite that sys~~t~ research has investigated possible etiology, treatment, and prevention strategks Jbr this disor&r. Our paper, threfore, examines critically the literature on the nature of psycholog2'cal dysfunction in battle. Classifiation of Combat Stress hieaction (CSR) and combat-relaled PostTrauma& Stress Disorder (PTSD) is examined. Literature about the epid;Pmiology, etiology, assessment, and treatment of PTSD is emp~ised in this review. A cognitive beeves perspective is presented as a~ui~u~ direction~r future research.
Battle events, acute combat stress reaction and long-term psychological sequelae of war
Journal of Anxiety Disorders, 1988
This study assesses the relationship between battle events and combat stress reaction manifestations, on the one hand, and long-term disorders, on the other. One hundred and four combat stress reaction casualties of the 1982 Lebanon War completed self-report questionnaires assessing their psychosocial status one year after combat. Results indicated a significant positive relationship between particular combat stress reaction manifestations and similar long-term disorders. Battle events were found to have a direct negative relationship with long-term disorders, but a positive indirect relationship via combat stress reaction. The discussion focused on the implications of combat experiences in the development and content of long-term disorders.
The impact of posttraumatic stress disorder in military situations
The Journal of clinical psychiatry, 2001
The constant threat to life and gruesome sights and sounds of war take their toll on the soldier psychologically as well as physically. A significant number of war veterans suffer from a wide range of debilitating psychological symptoms that vary in duration. For some the symptoms are transient, while for others profound and prolonged psychological and somatic sequelae manifest in the form of posttraumatic stress disorder (PTSD) and other comorbid conditions. This article reviews current understanding regarding combat stress reaction--often the first indicator of psychological breakdown--and posttraumatic sequelae. The longer-term detrimental consequences of PTSD and the impact of secondary traumatization. reactivation, and delayed-onset PTSD are also addressed.
2014
Aim. To evaluate how the type of trauma is related to specific symptom patterns in patients with post-traumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) cri-teria. Methods. A total of 136 PTSD patients exposed to war-related traumatic experiences were divided in four groups: 79 veterans, 18 former prisoners (who witnessed or were subject to torture or frequent assaults), 15 victims of rape, and 24 refugees from Bosnia and Herzegovina. Each group was homogenous in regard to traumatic experiences. Results. Significant inter-group differences were found in symptoms listed in the DSM-IV criteria, and under criteria C (avoidance) and D (arousal). No such differences were observed in symptoms listed under criterion B (intrusive symp-toms). The results indicate that stressor characteristics may play a role not only in the variety of symptoms exhibited, but particularly in the number of avoidance and arousal symp...
The Israel Journal of Psychiatry and Related Sciences, 2013
Objective: War captivity is a recognized pathogenic agent for both posttraumatic stress disorder (PTSD) symptoms and disorder of extreme stress not otherwise specified (DESNOS) symptoms, also known as Complex PTSD. However, the relationship between the two disorders remains unclear. While some scholars assume that the two diagnoses are overlapping and share the same predictors, others believe that the two diagnoses are relatively independent and differ in phenomenology and functional impairment. This study aims to assess both PTSD and DESNOS symptoms and their interrelations among ex-prisoners of war (ex-POWs) and matched controls, 35 years after the end of the war. Method: The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-POWs (n = 176) and comparable veterans who had not been held captive (n = 118). PTSD and DESNOS symptoms, battlefield and captivity stressors, and ways of coping in captivity were assessed using self-report questionnaires in 2008. Results: Ex-POWs reported a higher number of PTSD symptoms and higher rates of PTSD symptoms that fill criteria for the diagnosis of PTSD than controls. Furthermore, ex-POWs reported a higher number of DESNOS symptom clusters and higher rates of DESNOS symptoms that fill criteria for the diagnosis of DESNOS. Moreover, we found positive relationships between PTSD symptom clusters and DESNOS symptom clusters. Finally, weight loss and mental suffering in captivity, loss of emotional control and total number of DESNOS symptoms predicted total number of PTSD symptoms. However, only the total number of PTSD symptoms predicted the total number of DESNOS symptoms. Conclusions: This study demonstrated the heavy and extensive toll of war captivity, three decades after the ex-POWs' release from captivity. Importantly, approaching the publication of DSM-5, this study depicts both the high number of DESNOS symptom clusters alongside PTSD symptoms and highlights the complex relationship between the two diagnostic entities. Thus, DESNOS characteristics might be viewed as associated features of PTSD but also that the symptoms of PTSD are the core foundations of DESNOS.
Risk factors for post-traumatic stress disorder symptoms following critical …
Crit Care, 2007
Background. There is considerable interest in understanding further the factors that increase the risk of post-traumatic stress disorder (PTSD) for military personnel. This study aimed to investigate the relative contribution of demographic variables ; childhood adversity ; the nature of exposure to traumatic events during deployment ; appraisal of these experiences ; and home-coming experiences in relation to the prevalence of PTSD ' caseness' as measured by a score of o50 on the PTSD Checklist (PCL) in UK Armed Forces personnel who have been deployed in Iraq since 2003. Method. Data were drawn from the first stage of a retrospective cohort study comparing UK military personnel who were deployed to the 2003 Iraq War with personnel serving in the UK Armed Forces on 31 March 2003 but who were not deployed to the initial phase of war fighting. Participants were randomly selected and invited to participate. The response rate was 61 %. We have limited these analyses to 4762 regular service individuals who responded to the survey and who have been deployed in Iraq since 2003. Results. Post-traumatic stress symptoms were associated with lower rank, being unmarried, having low educational attainment and a history of childhood adversity. Exposure to potentially traumatizing events, in particular being deployed to a ' forward' area in close contact with the enemy, was associated with post-traumatic stress symptoms. Appraisals of the experience as involving threat to one's own life and a perception that work in theatre was above an individual's trade and experience were strongly associated with post-traumatic stress symptoms. Low morale and poor social support within the unit and non-receipt of a home-coming brief (psycho-education) were associated with greater risk of post-traumatic stress symptoms. Conclusions. Personal appraisal of threat to life during the trauma emerged as the most important predictor of posttraumatic stress symptoms. These results also raise the possibility that there are important modifiable occupational factors such as unit morale, leadership, preparing combatants for their role in theatre which may influence an individual's risk of post-traumatic stress symptoms. Therefore interventions focused on systematic preparation of personnel for the extreme stress of combat may help to lessen the psychological impact of deployment.
Stressor characteristics and post-traumatic stress disorder symptom dimensions in war victims
Croatian medical journal, 2001
To evaluate how the type of trauma is related to specific symptom patterns in patients with post-traumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria. A total of 136 PTSD patients exposed to war-related traumatic experiences were divided in four groups: 79 veterans, 18 former prisoners (who witnessed or were subject to torture or frequent assaults), 15 victims of rape, and 24 refugees from Bosnia and Herzegovina. Each group was homogenous in regard to traumatic experiences. Significant inter-group differences were found in symptoms listed in the DSM-IV criteria, and under criteria C (avoidance) and D (arousal). No such differences were observed in symptoms listed under criterion B (intrusive symptoms). The results indicate that stressor characteristics may play a role not only in the variety of symptoms exhibited, but particularly in the number of avoidance and arousal symptoms. Victims of rape tende...
The Effect of Different Traumatic Experiences on the Development of Post-Traumatic Stress Disorder
Military Medicine, 1995
This investigation was conducted during the war in Croatia from 1991 to 1993. General characteristics, traumas, and frequency of post-traumatic stress disorder (PTSD) were compared in three groups of soldiers: (1) soldiers who sustained non-disabling injuries; (2) soldiers who sustained permanently disabling injuries; (3) active soldiers (controls). Significant differences were found in general characteristics and in PTSD in the groups observed, Both groups of wounded soldiers were significantly younger (mean of B years), fewer of them were married, and they had fewer children than active soldiers (controls). The differences in marital status and the number of children were obviously due to the age difference. Soldiers who sustained non-disabling injuries developed PTSD significantly more often than soldiers who sustained permanently disabling injuries and active soldiers (controls). Possible reasons for the differences of PTSD in compared groups of soldiers are discussed.