The C's Flashcards
What is combat fatigue?
diagnostic term adopted by the US army to replace ‘combat exhaustion’ and was in use throughout the Vietnam War (1961–75). It was intended to convey the message that a more or less normal person with previously satisfactory military service had been overwhelmed by the intolerable stress of severe or prolonged combat in circumstances of marked physical fatigue, sleep deprivation and inadequate food intake (Glass, 1973, p. 993). Because it had been shown during World War Two that even the best soldiers will break down if subjected to prolonged and intense combat, it was no longer considered appropriate to imply that personal weakness played a routine role in such responses.
What is combat exhaustion?
In October 1945, the US army replaced the term ‘exhaustion’ by ‘combat exhaustion’, although its first application was during the Korean War. By emphasising combat as the causative factor, it was designed to eliminate the diagnoses ‘psychoneurosis’ or ‘personality disorder’ from psychiatric battle casualties. This modification was probably introduced by Colonel Albert Glass who organised psychiatric services in Korea (1973, p. 992).
Where was combat stress reaction (CSR) included, the DSM or the ICD?
not included in either DSM-IV (1994) or ICD-10 (1992), although the latter does refer to ‘combat fatigue’ within acute stress reaction.
Did Colonel Albert Glass coin the term combat stress reaction (CSR)?
Despite suggestions that Colonel Albert Glass was responsible for the term ‘combat stress reaction’, a detailed survey of his writings revealed that he never used the term.
Did Dr Harry Kormos coin the term combat stress reaction (CSR)?
Many studies of CSR cite a chapter by Dr Harry Kormos entitled ‘The nature of combat stress’ as their definitional text (1978, pp. 3–22). In fact, Kormos did not employ the term CSR
How Dr Harry Kormos refer and define the term combat stress reaction (CSR)?
he referred to it as an ‘acute combat reaction’, which he defined as:
Behaviour by a soldier under conditions of combat, invariably interpreted by those around him as signalling that the soldier, although expected to be a combatant, has ceased to function as such. For completeness, it should be added that the behaviour in question is polymorphous and cannot be primarily accounted for by somatic factors (Kormos, 1978, p. 8).
Why Kormos proposed the term ‘acute combat reaction’?
to correct the established belief (expressed by the terms ‘combat exhaustion’ and ‘combat fatigue’) that breakdown in battle was always a reversible, normal reaction, and that genuine psychiatric casualties only included individuals with a healthy psychological constitution.
When the term ‘combat stress reaction’ became accepted usage?
Diagnostic labels in military psychiatry are often tied to particular conflicts and it appears that the Lebanon War of 1982 provided the context for CSR. It probably emerged among Israeli and American psychiatrists and psychologists in the same way that the diagnostic term shell shock entered medical literature during 1915.
No particular author has claimed credit for its invention.
Because American military psychiatrists remained focused on PTSD in Vietnam veterans, rather than the immediate effects of combat, it is possible that CSR originated in Israel.
When combat stress reaction or CSR was first seen in a medical publication?
It appears that CSR was first used in a medical publication during 1985, the first identified example being Mareth and Brooker (1985).
What is the consensus on how CSR should be defined?
no clear consensus definition has emerged. Mareth and Brooker defined it ‘as an individual’s temporary psychological response when torn by a sense of duty to comrades and as a soldier’ (1985, p. 186). In 1993, Solomon wrote that CSR is ‘characterised by a wide range of emotional, physical and behavioural symptoms of which the most common denominator is a sharp decline in the soldier’s level of functioning’ (Solomon, 1993).
Subsequently, Professor Solomon offered a different definition: A CSR occurs when a soldier is stripped of his psychological defences and feels so overwhelmed by the threat that he or she becomes powerless to counteract or distance himself or herself from it and is inundated by feelings of utter helplessness and anxiety. In this state, the soldier is a danger to self and unit and is no longer able to perform military duties (Solomon, 2001, p. 11).
How did the Israel Defence Force characterise CSR?
as ‘a normal and transitional crisis stemming from exposure to the stress of combat in unfavourable external circumstances, such as the lack of social support from fellow soldiers or officers, physical deprivation such as lack of food or sleep’ (Shalom, Benbenishty and Solomon, 1995, p. 260).
This causal definition focused on the situation in which the serviceman found himself rather than on any predispositional psychology.
Is CSR same as Shell Shock?
Some authors have suggested that CSR is the same as shell shock. Given that shell shock is a culture-bound syndrome (invested with the beliefs and state of medical knowledge existing in the early twentieth century), this cannot be the case even though some clinical presentations may have elements in common. The relationship between CSR (an acute response to combat) and PTSD (a delayed and/or chronic response to trauma) is still the subject of research.
