Post-Traumatic Stress Disorder During and After World War I

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Introduction

Post-traumatic stress disorder (PTSD) is a medical definition of the condition closely associated with depression and the consequences of trauma. As a diagnosis, it was discovered and labeled in 1980 after the American Psychological Association incorporated it in its disease testing and Statistical Manual for mental health professionals (Crocq & Crocq, 2000). The story of PTSD is a combination of the role of society and politics in the steps of the invention. It has links with the American war in Vietnam, where military personnel who served there were being blamed for their roles in the fight against defenseless masses. This negative reception was a factor for soldiers, and it affected them in a way that some had difficulties, including antisocial behavior (Rivers, 1918). A number of them who sought to consult psychiatrists were diagnosed with anxiety state, depression, substance misuse, personality disorder, or schizophrenia; these diagnoses were later supplanted by PTSD. This paper will examine the prerequisites and manifestations of PTSD during and after World War I, despite the absence of this term at that time, and how diagnosis and treatment are made.

Methodology

The information for this research paper was collected through secondary methods. This type of data is already available from studies that have either been published online or printed as books, articles, and journals. It is data gathered from primary sources and used to provide further insights into the research question or topic. Additionally, these are the pieces of evidence that are derived from existing knowledge. The technique involved searching for themes relevant to the study topic from online articles, journals, websites, and reports.

Context analysis was used to identify patterns and themes in the data from various sources, including primary resources, articles, journals, and websites. It helped the researcher derive the purpose and meanings that related to and answered the research topic. The method of revealing the semantic relationship of relevant concepts with the subject in question is a potentially successful approach. This technique is suitable for unobtrusive data gathering, where information is analyzed without the direct involvement of the participants, and therefore, the presence of the researcher does not influence the results. Such a method can provide reliable findings because it follows a systematic procedure.

Results

Early Recognition of Post-Traumatic Stress Disorder

Although the term PTSD itself first appeared after World War I, the first evidence that this diagnosis could be studied at that time may be obtained from primary sources. In the letters of the participants in that war, soldiers talk about the battles, telling their friends and relatives about the tragedies and horrors of military operations (Trenches, n.d.). One of the soldiers describes the medical condition of a colleague known to the letters recipient as being in a shocking state (Trenches, n.d.). Although PTSD was not labeled as a phenomenon associated with negative experiences and trauma from what they saw, the symptoms were similar to the conditions that are today assessed as those of PTSD.

Another primary source from that period provides more accurate clinical data on patients who survived the fighting during World War I. Among the symptoms mentioned in his academic work, Mott (1916) lists amnesia, headache, gait, tremors, sensory, cardiac, and vasomotor disturbances, loss of hearing, speech, sight, and terrifying dreams. Being a military doctor, the author also details how some of his patients recovered from the condition (Mott, 1916). Although the term neurosis is used, the symptoms and prerequisites for the development of the aforementioned problems are consistent with those found in patients with PTSD.

During World War I, the study of mental problems in patients who had experienced negative experiences in combat operations was not common. However, in his research of the period, Myers (1915) assesses the conditions of several patients and gives the appropriate symptomatology by observing the manifestations of the psychological trauma experienced. While revealing the corresponding manifestations of the problem and its causes, the author most often uses the concept of shell shock (Myers, 1915). However, this definition cannot be considered synonymous with that of PTSD because, along with physical problems resulting from mental trauma due to intense experiences, psychological disorders are characteristic of PTSD.

Given the lack of evidence base, researchers had to rely on existing medical terms and concepts to interpret the relevant clinical manifestations. In his work, Rivers (1918) describes anxiety states in World War I soldiers based on other researchers earlier findings. One of the authors main findings is that any attempt to reassure soldiers that their participation in hostilities will not happen again does not work because anxiety symptoms persist (Rivers, 1918). As a result, of not being able to influence patients mental states, doctors of that period could only ascertain neurotic states in soldiers who had experienced a traumatic experience and correlate their assessments with existing cases.

PTSD After World War I

World War I can be considered an event that significantly catalyzed the dynamics of research on analysis and symptomatology related to PTSD. Crocq and Crocq (2000) describe the experience of research after the war and note that by the time it ended, different researchers had already had extensive data to interpret and determine the impacts on the human psyche. Particular attention was paid to the clinical picture of the problems that combatants reported. For the medicine of the post-war period, much data appeared, which made it possible to interpret different pieces of evidence and place the corresponding symptomatic manifestations in a separate group. As a result, based on the information already available, researchers and doctors were able to identify how the condition under consideration differed from those documented in earlier times. This contributed to drawing conclusions about the ambiguous nature of a potentially new disorder. It was believed to affect the mental state in a distinctive way than normal neurosis and to be stimulated by traumatic experiences, as a rule, due to patients military background.

As the symptoms in question were studied, scholars and doctors came to the conclusion that patients mental disorders did not arise only as a result of physical injuries. Myers (2012) describes the findings related to the evaluation of the mental state of patients with hysteria, dissociation, and mental repression. When assessing these conditions, the author argues that the initial beliefs of doctors of that time that only explosions experienced on the battlefield caused mental disorders were incorrect (Myers, 2012). It was crucial to consider not individual events but the experience of participating in hostilities in general as a driver for the development of anxiety states that manifested themselves through the aforementioned symptoms. According to the study by Chamberlin (2012, 362), during World War II, the concept of shell shock gave way to the term combat fatigue. The author also cites the example of the Vietnam War, during which much attention was paid to both the medical and social manifestations of PTSD (Chamberlin, 2012). As a result, a more extensive and reliable research base had been collected by the time the existence of such a diagnosis as PTSD was officially announced.

Benchmarking associated with the emergence of the new medical condition was increasingly reported in clinical documentation after World War I. According to Jones et al. (2003), who describe cases of diagnosing a disorder resembling PTSD based on earlier reports, flashbacks, and hallucinations were documented as common symptoms of ex-combatants. It is noteworthy that doctors paid particular attention to the interpretation of the experienced events by patients themselves. Jones et al. (2003) compare the clinical presentations of two men, one of whom could control his memories of the war while the other could not. The state of the latter, in this case, strongly resembles the type of disorder that corresponds to post-traumatic stress, when negative emotions and memories cannot be contained. Thus, after World War I, more data allowed researchers and doctors to gather an expanded clinical base to draw conclusions about the new form of mental disorder.

Diagnosis and Treatment of PTSD

Given the lack of theoretical background, diagnosing PTSD during and even after World War I was difficult, let alone treated. As Chamberlin (2012) states, there was no apparent pathology, and any conclusions could be drawn based on empirical data only without valid scientific reasoning. As a result, patients with PTSD symptoms were unwittingly stigmatized, and it was only after World War II that real breakthroughs in treatment were achieved. Psychiatric screening by medical professionals helped identify the telltale signs of the disease and create an environment in which patients could receive the support and care they needed (Chamberlin, 2012). Doctors used treatment approaches similar to those utilized to treat depression and psychological trauma, which was partly rational and allowed for improving the morale of the target patients.

Particularly noteworthy are the ideas of some experts regarding the nature of PTSD, namely the role of cultural drivers and not only experienced traumas. Jones et al. (2003) describe this situation by explaining it as a lack of knowledge about the problem and, consequently, alternative treatment options associated with social rather than medical interventions. However, although from a social perspective, PTSD patients need the support of loved ones, help from qualified professionals is a necessary factor in mitigating symptoms.

Conclusion

Post-traumatic stress disorder (PTSD) was discovered and labeled as a diagnosable condition in 1980 after the American Psychological Association incorporated it in its disease testing and Statistical Manual for mental health professionals. During World War I, researchers and doctors lacked the appropriate rationale and often interpreted conditions comparable to those of PTSD as neuroses and anxiety disorders. During the subsequent wars, more evidence emerged, which made it possible to highlight both the medical and social aspects of the disorder. The comparative analysis became a valuable factor in favor of studying PTSD and documenting cases where patients could not contain their negative memories. Stigmatization was one of the consequences of little knowledge about treatment, but the use of approaches similar to those utilized for the treatment of depression reduced the anxiety of the target audience. World War I was the period that gave the actual start to research on the outcomes of experienced stress and trauma.

References

Chamberlin, Sheena M. Eagan. 2012. Emasculated by Trauma: A Social History of Post-Traumatic Stress Disorder, Stigma, and Masculinity. The Journal of American Culture 35 (4): 358-365.

Crocq, Marc-Antoine, and Louis Crocq. 2000. From Shell Shock and War Neurosis to Posttraumatic Stress Disorder: A History of Psychotraumatology. Dialogues in Clinical Neuroscience 2 (1): 47-55.

Jones, Edgar, Robert Hodgins Vermaas, Helen McCartney, Charlotte Beech, Ian Palmer, Kenneth Hyams, and Simon Wessely. 2003. Flashbacks and Post-Traumatic Stress Disorder: The Genesis of a 20th-Century Diagnosis. The British Journal of Psychiatry 182 (2): 158-163.

Mott, Frederick W. 1916. The Lettsomian Lectures on the Effects of High Explosives upon the Central Nervous System. The Lancet 190 (4828): 441-553.

Myers, Charles S. 1915. A Contribution to the Study of Shell Shock: Being an Account of Three Cases of Loss of Memory, Vision, Smell, and Taste, Admitted into the Duchess of Westminsters War Hospital, Le Touquet. The Lancet 185 (4772): 316-320.

Myers, Charles S. 2012. Shell shock in France, 1914-1918: Based on a war diary. Cambridge: Cambridge University Press.

Rivers, William H. R. 1918. The Repression of War Experience. Proceedings of the Royal Society of Medicine 11 (Sect_Psych): 1-20.

Trenches. n.d. Letters from the First World War, 1915. The National Archives. Web.

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