PTSD: Modern name, ancient affliction
Some First World War soldiers were executed for cowardice, as ‘ shell shock’ was thought to be widely faked
For a disorder that didn’t officially exist until 1980, posttraumatic stress has a long history.
Descriptions of the psychological wounds of war can be traced back as far as the fifth century, when Herodotus, a Greek historian, wrote about the battles between the Greeks and Persians.
First World War
In the First World War, the term “shell shock” was used to describe soldiers with symptoms of fatigue, impaired vision, nightmares, confusion and seizure- like tendencies. A soldier was diagnosed as having shell shock when no obvious physical injury could be found and he was believed to be mentally unsound.
At the time, no medical personnel really understood the cause ( some tried to attribute it to the physical impact and sound of artillery shells), and as a result, the behaviour was often perceived as cowardice. Based on the idea that soldiers were faking their psychological problems to escape the front lines, many were put on trial, even executed. By the end of the war in 1918, more than 100,000 soldiers from the British, Canadian and American armies showed signs and symptoms related to shell shock.
Second World War
During the Second World War, psychologists and experts began making a bigger effort to understand these psychological wounds, and the term “shell shock” was replaced by “combat fatigue” or “combat exhaustion.” Soldiers who showed signs of combat fatigue were taken off the front line and placed in makeshift mental wards; some were given barbiturate drugs to help ease stress. Psychiatrists were starting to understand the close link between psychological damage and warfare, but it would still be several decades until PTSD was established as a mental disorder.
DSM- I guide
In 1952, the first edition of a standard guide for the classification of mental disorders ( called the Diagnostic and Statistical Manual of Mental Disorders or DSM- I) included a section on gross stress reaction, but nothing specific on PTSD.
Then came the Vietnam War, with its legions of troubled American soldiers returning home with what was described as “Post Vietnam Syndrome.”
That war and the psychological problems it caused for participants are commonly credited with the term posttraumatic stress disorder finally becoming official. The term was included in the diagnostic manual’s third version, known as DSM- III, published in 1980. That edition defined PTSD as a traumatic event that created a “catastrophic stressor” in an individual, different from a typical human experience. Such stressors included events such as war, torture, natural disasters and humanmade disasters.
“When PTSD became recognized as a legitimate condition to have, it happened because of the political movement of veterans coming back from the Vietnam War,” said Kalina Christoff, an associate professor of psychology at the University of B. C. “The veterans, those soldiers coming back, formed a political movement demanding the recognition of veterans’ conditions.”
The veterans suffered from flashbacks, anxiety, anger, depression and alcohol and drug abuse. Public antagonism against the war combined with the psychological damage done to veterans put public pressure on experts and psychiatrists to address their psychological issues, which were much different than the typical mood and anxiety disorders of the time.
Revisions to disorder
The definition of PTSD was revised in 1987 to include witnessing or learning of a family member’s exposure to a lifethreatening event or death.
In 1994, it was revised again to include experiencing, witnessing or confronting “an event or events that involved actual or threatened death or severe injury, or a threat to the physical integrity of self or others.”
The latest definition of PTSD, outlined in the diagnostic manual’s fifth version in 2013, officially included sexual assault as a traumatic event.