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Example research essay topic: Traumatic Stress Disorder World War Ii - 2,009 words

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It was not until World War I that specific clinical syndromes came to be associated with combat duty. In prior wars, it was assumed that such casualties were merely manifestations of poor discipline and cowardice. However, with the protracted artillery barrages commonplace during "The Great War, " the concept evolved that the high air pressure of the exploding shells caused actual physiological damage, precipitating the numerous symptoms that were subsequently labeled "shell shock. " By the end of the war, further evolution accounted for the syndrome being labeled a "war neurosis" (Glass, 1969). During the early years of World War II, psychiatric casualties had increased some 300 percent when compared with World War I, even though the pre induction psychiatric rejection rate was three to four times higher than World War I (Figley, 1978 a). At one point in the war, the number of men being discharged from the service for psychiatric reasons exceeded the total number of men being newly drafted (Tiffany and Allerton, 1967). During the Korean War, the approach to combat stress became even more pragmatic.

Due to the work of Albert Glass (1945), individual breakdowns in combat effectiveness were dealt with in a very situational manner. Clinicians provided immediate onsite treatment to affected individuals, always with the expectation that the combatant would return to duty as soon as possible. The results were gratifying. During World War II, 23 percent of the evacuations were for psychiatric reasons. But in Korea, psychiatric evacuations dropped to only six percent (Bourne, 1970). It finally became clear that the situational stresses of the combatant were the primary factors leading to psychological casualty.

Surprisingly, with American involvement in the Vietnam War, psychological battlefield casualties evolved in a new direction. What was expected from past war experiences -- and what was prepared for -- did not materialize. Battlefield psychological breakdown was at an all-time low, 12 per one thousand (Bourne, 1970). It was decided that use of preventative measured learned in Korea and some added situational manipulation which will be discussed later had solved the age-old problem of psychological breakdown in combat.

As the war continued for a number of years, some interesting additional trends were noted. Although the behavior of some combatants in Vietnam undermined fighting efficiency, the symptoms presented rare but very well documented phenomenon of World War II began to be reserved. After the end of World War II, some men suffering from acute combat reaction, as well as some of their peers with no such symptoms at war's end, began to complain of common symptoms. These included intense anxiety, battle dreams, depression, explosive aggressive behavior and problems with interpersonal relationships, to name a few. These were found in a five-year follow-up (Futterman and Pumpian- Mindlin, 1951) and in a 20 -year follow-up (Archibald and Tuddenham, 1965). A similar trend was once more observed in Vietnam veterans as the war wore on.

Both those who experienced acute combat reaction and many who did not began to complain of the above symptoms long after their combatant role had ceased. What was so unusual was the large numbers of veterans being affected after Vietnam. The pattern of neuropsychiatric disorder for combatants of World War II and Korea was quite different than for Vietnam. For both World War II and the Korean War, the incidence of neuropsychiatric disorder among combatants increased as the intensity of the wars increased. As these wars wore down, there was a corresponding decrease in these disorders until the incidence closely resembled the particular prewar periods.

The prolonged or delayed symptoms noticed during the postwar periods were noted to be somewhat obscure and few in numbers; therefore, no great significance was attached to them. However, the Vietnam experience proved different. As the war in Vietnam progressed in intensity, there was no corresponding increase in neuropsychiatric casualties among combatants. It was not until the early 1970 s, when the war was winding down, that neuropsychiatric disorders began to increase. With the end of direct American troop involvement in Vietnam in 1973, th During the same period in the 1970 s, many other people were experiencing varying traumatic episodes other than combat. There were large numbers of plane crashes, natural disasters, fires, acts of terrorism on civilian populations and other catastrophic events.

The picture presented to many mental health professionals working with victims of these events, helping them adjust after traumatic experiences, was quite similar to the phenomenon of the troubled Vietnam veteran. The symptoms were almost identical. Finally, after much research (Figley, 1978 a) by various veterans' task forces and recommendations by those involved in treatment of civilian post-trauma clients, the DSM III (1980) was published with a new category: post-traumatic stress disorder, acute, chronic and / or delayed. e number of veterans presenting neuropsychiatric disorders began to increase tremendously (President's Commission on Mental Healt More than 8. 5 million individuals served in the U. S. Armed Forces during the Vietnam era, 1964 - 1973.

Approximately 2. 8 million served in Southeast Asia. Of the latter number, almost one million saw active combat or were exposed to hostile, life- threatening situations (President's Commission on Mental Health, 1978). It is this writer's opinion that the vast majority of Vietnam era veterans have had a much more problematic readjustment to civilian life than did their World War II and Korean War counterparts. This was due to the issues already discussed in this chapter, as well as to the state of the economy and the inadequacy of the GI Bill in the early 1970 s.

In addition, the combat veterans of Vietnam, many of whom immediately tried to become assimilated back into the peacetime culture, discovered that their outlook and feelings about their relationships and future life experiences had changed immensely. According to the fantasy, all was to be well again when they returned from Vietnam. The reality for many was quite different. A number of studies point out that those veterans subjected to more extensive combat show more problematic symptoms during the period of readjustment (Wilson, 1978; Strayer & Ellenhorn, 1975; Kormos, 1978; Shatan, 1978; Figley, 1978 b). The usual pattern has been that of a combat veteran in Vietnam who held on until his DEROS date. He was largely asymptomatic at the point of his rotation back to the U.

S. for the reasons previously discussed; on his return home, the joy of surviving continued to suppress any problematic symptoms. However, after a year or more, the veteran would begin to notice some changes in his outlook (Shatan, 1978). But, because there was a time limit of one year after which the Veterans Administration would not recognize neuropsychiatric problems as service-connected, the veteran was unable to get service-connected disability compensation. Treatment from the VA was very difficult to obtain. The veteran began to feel depressed, mistrustful, cynical and restless.

He experienced problems with sleep and with his temper. Strangely, he became somewhat obsessed with his combat experiences in Vietnam. He would also begin to question why he survived when others did not. For approximately 500, 000 veterans (Wilson, 1978) of the combat in Southeast Asia, this problematic outlook has become a chronic lifestyle affecting not only the veterans but countless millions of persons who are in contact with these veterans. The symptoms described below are experienced by all Vietnam combat veterans to varying degrees.

However, for some with the most extensive combat histories and other variables which have yet to be enumerated, Vietnam-related problems have persisted in disrupting all areas of life experience. According to Wilson (1978), the number of veterans experiencing these symptoms will climb until 1985, based on his belief of Erickson's psychosocial developmental stages and how far along in these stages most combat veterans will be by 1985. Furthermore, without any intervention, what was once a reaction to a traumatic episode may for many become an almost unchangeable personality characteristic. The vast majority of the Vietnam combat veterans I have interviewed are depressed. Many have been continually depressed since their experiences in Vietnam. They have the classic symptoms (DSM III, 1980) of sleep disturbance, psychomotor retardation, feelings of worthlessness, difficulty in concentrating, etc.

Many of these veterans have weapons in their possession, and they are no strangers to death. In treatment, it is especially important to find out if the veteran keeps a weapon in close proximity, because the possibility of suicide is always present. When recalling various combat episodes during an interview, the veteran with a post-traumatic stress disorder almost invariably cries. He usually has had one or more episodes in which one of his buddies was killed.

When asked how he handled these death when in Vietnam, he will often answer, "in the shortest amount of time possible" (Howard, 1975). Due to circumstances of war, extended grieving on the battlefield is very unproductive and could become a liability. Hence, grief was handled as quickly as possible, allowing little or no time for the grieving process. Many men reported feeling numb when this happened.

When asked how they are now dealing with the deaths of their buddies in Vietnam, they invariable answer that they are not. They feel depressed; "How can I tell my wife, she'd never understand?" they ask. "How can anyone who hasn't been there understand?" (Howard, 1975). Accompanying the depression is a very well developed sense of helplessness about one's condition. Vietnam-style combat held no final resolution of conflict for anyone. Regardless of how one might respond, t he overall outcome seemed to be just an endless production of casualties with no perceivable goals attained.

Regardless of how well one worked, sweated, bled and even died, the outcome was the same. Our GIs gained no ground; they were constantly rocketed or mortared. They found little support from their "friends and neighbors" back home, the people in whose name so many were drafted into military service. They felt helpless. They returned to the United States, trying to put together some positive resolution of this episode in their lives, but the atmosphere at home was hopeless. They were still helpless.

Why even bother anymore? Many veterans report becoming extremely isolated when they are especially depressed. Substance abuse is often exaggerated during depressive periods. Self medication was an easily learned coping response in Vietnam; alcohol appears to be the drug of choice. Combat veterans have few friends. Many veterans who witnessed traumatic experiences complain of feeling like old men in young men's bodies.

They feel isolated and distant from their peers. The veterans feel that most of their non-veteran peers would rather not hear what the combat experience was like; therefore, they feel rejected. Much of what many of these veterans had done during the war would seem like horrible crimes to their civilian peers. But, in the reality faced by Vietnam combatants, such actions were frequently the only means of survival. Many veterans find it difficult to forget the lack of positive support they received from the American public during the war. This was especially brought home to them on the return from the combat zone to the United States.

Many were met by screaming crowds and the media calling them "depraved fiends" and "psychopathic killers" (DeFazio, 1978). Many personally confronted hostility from friends and family, as well as strangers. After their return home, some veterans found that the only defense was to search for a safe place. These veterans found themselves crisscrossing the continent, always searching for that place where they might feel accepted. Many veterans cling to the hope that they can move away from their problems. It is not unusual to interview a veteran who, either alone or with his family, has effectively isolated himself from others by repeatedly moving from one geographical location to another.

The stress on his family is immense. The fantasy of living the life of a hermit plays a central role in many veterans' daydreams. Many admit to extended periods of isolation in the mountains, on the road, or just behind a closed door in the city. Some veterans have actually taken a weapon and attempted to...


Free research essays on topics related to: traumatic stress disorder, post traumatic stress, traumatic experiences, vast majority, world war ii

Research essay sample on Traumatic Stress Disorder World War Ii

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