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PubMed2006

Psychiatry and race during World War II.

Although the American literature on "war neuroses" expanded during World War II, psychiatrists remained more interested in dramatic instances of "combat fatigue" than in the problems of soldiers who broke down far from the field of battle. This bias in the medical literature shaped both diagnosis and treatment. It had an especially powerful effect on African American soldiers who, in the "Jim Crow" army of World War II, were assigned in disproportionate numbers to service units. When military neuropsychiatrists did write about troubled young African Americans, many revealed a racial conservatism that was surprising given the liberal environmentalist paradigm of the day. (Here, a particularly useful source is the two-volume history of Neuropsychiatry in World War II, produced by the Medical Department of the U.S. Army.) The major challenge to such views came from the National Medical Association (NMA). Despite its many criticisms of military medicine, the NMA argued that African American soldiers and veterans needed more, not fewer, psychiatric services. NMA members also joined their white counterparts in the campaign to diminish the stigma of mental illness, especially among the families of soldiers returning home. We need more investigation of the subsequent history of race and psychiatry, especially within the Veterans Administration.

Black or African American↗
PubMed1990

Memories of Vietnam: post-traumatic stress disorders in Australian veterans.

We compared a random sample of Australian Vietnam veteran inpatients suffering from Post Traumatic Stress Disorder (PTSD) (N = 13) with veteran inpatients with other neurotic diagnoses. Those with PTSD had experienced substantially higher levels of combat stress, were more likely to have manifested conduct disorder in childhood, and had poorer work adjustment. Only three had been diagnosed as having traumatic or war neuroses by their original treating psychiatrist in the Veterans Affairs Department. Post traumatic stress disorder (or war neurosis) has possibly been under-diagnosed by treating psychiatrists in the Veterans Affairs Department, especially in the pre-DSM-III era.

Adaptation, Psychological↗
PubMed2005

[The "war neurosis"-- an early model of a pluridimensional outlined trauma-theory in psychiatry].

The war neurosis, mainly observed during the first World War, caused a lively debate on its origin and etiology. In psychiatric history this debate is often portrayed in a somewhat simplifying manner. Namely Oppenheim was considered as the leading exponent of the organic etiology of traumatic neurosis, while others, with growing interest in psychodynamic theories, were thought to favor exclusively psychogenesis of this condition. However, only discussing matters in this way would be too simple. Rather, the controversy was much more differentiated and led to important insights: First, it turned out to be impossible to explain any psychopathological syndrome exclusively in terms of neuropathological, i. e. structural alterations, in particular, a syndrome presenting with a sudden onset of dissociative and conversion symptoms. Secondly, the psychiatric theory of hysteria of Charcot and Freud was developed and extended further. And, last, the etiology of war neurosis was recognized to be multifactorial. Thus, the discourse on this issue was not one-dimensional and favoring a single explanation for a complex disorder, but revealed "pluridimensional" features. Subsequently psychotherapy, for the first time, was widely introduced into clinical practice with a clear indication and well-defined methodological approach. In summary, war neuroses can be addressed as an early model of traumatic stress disorder, such as acute stress disorder or post-traumatic stress disorder.

Combat Disorders↗
PubMedDate not supplied

[Ernst Simmel and psychosomatic medicine today].

The contribution made by Ernst Simmel to the development of psychoanalytic psychosomatics has been suitably appreciated only during the last few years. At the end of World War I, Simmel attracted the first time public attention with his book on war neuroses and psychic trauma. In 1921 he founded the first psychoanalytic outpatient service, together with Max Eitingon and in 1927 he opened the first psychoanalytic clinic, both in Berlin. He treated patients who were inappropriate for out-patient settings, like psychotic and addicted persons. His own treatment system already embodied essentials of modern clinical psychotherapy, for example the inclusion of nurses in psychotherapy. His clinic served as a model for the Menninger Clinic in Topeka. After the failure of his project following the breakdown of world economy in 1931 and his emigration, his model appeared to have faded out without establishing a tradition. However, further research may assess his possible indirect influence on the German development after the 2nd World War, by reimportation of his ideas from the U.S.A.

Germany↗
PubMed1987

The Macy reports: Combat fatigue in World War II fliers.

Having supported psychiatric investigation into the psychosomatic aspects of "war neurosis" since 1931, the Josiah Macy, Jr., Foundation published five volumes on combat fatigue and its prophylaxis, recognition, treatment, and administrative aspects during World War II. The five volumes were as follows: "War Neuroses in North Africa," by R. R. Grinker and J. P. Spiegel (1943); "Psychiatric Experiences of the Eighth Air Force," by D. W. Hasting, D. G. Wright, and B. G. Glueck (1944); "How Can the Flight Surgeon Better Treat Anxiety?" by D. D. Bond, and "Notes on Men and Groups Under Stress of Combat," by D. G. Wright (a single volume, 1945); "Personality Disturbances in Combat Fliers," by N. A. Levy (1945); and "Observations on Combat Flying Personnel," by D. G. Wright (1945). The author corresponded with Drs. Spiegel, Grinker, Glueck, and Levy about the circumstances leading to these monographs, and has combined their reminiscences and observations with a brief historical view of psychiatric practice in the U.S. Army Air Force during the war. This review contrasts two therapeutic philosophies concerning combat fatigue, and comments on the lack of more modern psychiatric data about combat flying.

Aerospace Medicine↗
PubMedDate not supplied

Posttraumatic stress disorder revisited.

In this review we trace the history of and professional discussion on psychological traumatization due to "railroad spine syndrome," "shell-shock syndrome," and "war neuroses," as well as the more or less endemic "posttraumatic stress disorder" of today. Psychological trauma engenders longlasting consequences in the biological, intrapsychic, and social organization of individuals. Medical experts have reported a shift in attention from exogenous to endogenous and back to exogenous causes, as indicated by new diagnostic systems (DSM-IV and ICD-10). As far as the relevant literature is concerned, the medical profession demonstrates the same partial amnesia as their patient counterparts. The purpose of this review is to overcome this fragmented memory and thus reach a more integrated view of what constitutes psychological trauma by reviewing trauma-related articles published in Psychosomatic Medicine. Moreover, we point out the direction in which research is desperately needed and ought to develop.

Arousal↗
PubMed1999

[Medical history of trauma].

'Trauma' tends to exceed human understanding. It disrespects boundaries, interrupts all kinds of units and makes them blend, it disturbs bodily and psychic organisms and upsets social and historical organization. Some characteristics of the history of trauma have their origin in this situation. One of them is the gradual extension for instance of the notion of 'trauma' which makes the surgical 'wound' (greek: trauma) evolve into a bio-psycho-social phenomenon. Other characteristics of the history of trauma are its association with questions of endogenous versus exogenous causes of suffering and with the issue of guilt and its recurrent falling into oblivion. The paper traces the history of traumatogenic illness from the simple wound to forensically important damages like the 'railway-injuries' entitling to claims for damages, to 'traumatic-' and 'war-neuroses' and finally to the more or less endemic 'posttraumatic stress syndrome' of present time.

Combat Disorders↗
PubMed2000

[Psychopathology and treatment of traumatic mental disorders--on the vicissitude and controversy around theory and practice].

Recently, among advanced nations, including the United States, there have been growing interest in trauma related psychopathology. Regarding Japan, since Hanshin Awaji Great Earthquake and Sarin gas terrorism by Aum Shinrikyo, interest for psychological trauma has grown high. It is only about twenty years since active research and discussion around these issues started. Therefore, there are still hot dispute around psychopathology of these disorders. Also, therapeutic method is ever progressing. Regarding psychotherapy, there remain a lot of dispute and no general agreement has been made. In this paper, I would like to summarize the literature on psychological trauma and trauma-related psychopathology historically and provide current overview about the theory and practice of this pathology. The summary of the overview is as follows: 1. Psychological trauma is defined as a state caused by traumatic event described in DSM-IV, not as a traumatic event itself. Traumatic mental disorder should be understood as a spectrum of disorders, ranging from phobias and panic reactions related to distinct traumatic events to personality disorders, where intense and chronic traumatic experience is integrated into the personality organization. 2. Historically speaking, traumatic disorders were studied from two directions; war neuroses and etiology of hysteria. Each is corresponds to physioneurosis model and memory processing disturbance model, respectively, which is thought to be two major etiological models of this disorder. 3. Regarding treatment, although corresponding therapeutic idea for each model is provided, currently, most promising treatments are pharmacotherapy using SSRI and novel cognitive-behavioral techniques such as PE (prolonged exposure treatment), SIT (stress inoculation training) and EMDR (eye movement desensitization and reprocessing). As for psychotherapy, hot arguments has been done as to how authentic recovered traumatic memories are and how to deal with them. Regardless of these disputes, it is essential to establish empathic therapeutic bond with the patients.

Antidepressive Agents, Tricyclic↗
PubMed1981

War, revolution, and psychoanalysis: Freudian thought begins to grapple with social reality.

Psychoanalytic theory and practice have been affected by external events as well as by internal development. Specifically, the period of the Great War and its aftermath was a turning point in the history of psychoanalysis. These experiences emphasized the inadequacy of the libido theory alone, accelerated Freud's impetus toward metapsychology, and encouraged the articulation of theories of innate destructive urges, of ego instincts, of the superego, and of social interaction. Discussions of war neuroses, of aggression and the death instinct, of the reality principle, and of the mechanisms of social psychology undermined Freud's original biologism in favor of a social-scientific approach. Psychoanalytic theory began to take more account of social experience and was profoundly changed in the process.

Austria↗
PubMed1951

Children and war.

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Combat Disorders↗
PubMed1953

[Emotion and war].

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Combat Disorders↗