Shell Shock

[James A. Landau]

In earlier postings on this thread I was citing from memory from a pamphlet I
had once read.  I now have that pamphlet in front of me:

Tom Williams, Psy.D. "Post-Traumatic Stress Dirorder Among Military Veterans"
Disabled Americans Veterans, National Service Program, 807 Maine Avenue, SW,
Washington DC 20024, dated 3/96.

<begin quote>
       In the 1860's this emotional response was called "railroad spine."  It
was related to railroad workers who had been exposed to life threatening
accidents and were reluctant to return to work.  They often reported back
pain, but there were no physical injuries.  They also were nervous, had
nightmares, depression, and sleeplessness.
       During the Civli War, Dr. Decosta, a U.S. Army surgeon, reported high
levels of tension, fast heart rate, inability to sleep, and fear about
returning to combat.  This response to combat was called "solders heart."
       During World War I, this same phenomena was called by a more familiar
term, "shell shock."  The thinking of the medical profession at that time was
that tremendous shelling caused small blood vessels in the brain to burst.
The symptoms included running amok, jumpiness, irritability, trouble
sleeping, and physical tremors.
       World War II brought us "battle fatigue," a term which started with
the U.S. forces in Tunisia, North Africa.  <snip>
       In the Korean War, the term "gross stress reaction" was used to
describe the emotional turmoil that was a result of combat and being a
prisoner of war.
       During the Vietnam War, there were very few battlefield emotional
casualties.  The emotional distress began to show later, after the veterans
returned home from their one-year combat tours.  This delay in the appearance
of symptoms was called "delayed stress reaction" and "post-Vietnam syndrome."
       In the 1970s, other terms started being used to describe the same
emotional response, but cause by other traumatic events, such as "rape
traume,", "battered woman syndrome," "police officers shooting trauma," and
"abused child syndrome."
       <snip> Since 1980, the American Psychiatric Association has included
"Post-traumatic stress disorder" in its official diagnostic manuals.  The
current diagnostic manual is used worldwide as the bible of mental
difficulties.  The diagnosis of PTSD is given to people who have been
confronted with events which seem to be potentially harmful to themselves or
others.  The people responded to the event or series of events with intense
fear, hopelessness or horror."
<end quote>

       The "diagnostic manual" mentioned above is entitled the "Diagnostic
and Statistical Manual of Mental Disorders" ("DSM" for short) and is
currently in its fourth version, known as the "DSM-IV".  I don't know whether
it was the DSM-IV or the DSM-III that was current when this pamphlet was
published.

       Etymological data:  this pamphlet does not tell which version of the
DSM was the one published in 1980.  However, it should not be too difficult
to track down a copy of the 1980 edition and check that
"Post-Traumatic-Stress Disorder" is listed.  This by itself will not tell
when the "PTSD" was coined, merely when it was adopted as a diagnosis by the
American Psychiatric Association.

Another pamphlet: "The American Legion Guide to Post Traumatic Stress
Disorder, Fourth Edition" The American Legion, National Veterans Affairs &
Rehabilitation Division, 1608 K St. NW, Washington DC 20006, no date given.

<begin quote>
Post-Traumatic Stress Disorder (PTSD) has been around for a very long time.
Military medicine had recognized this condition with a variety of labels.
During the Civil War the condition was called "Solder's Heart."  BY WWI, it
was re-named "Shell Shock," and duirng WWII, "Battle Fatigue."  Korean War
veterans were diagnosed with "War Neurosis," and "Vietnam Syndrome" was the
label for that generation of veterans.  VA was service connecting former
combatants with a "Nervous Condition" or some other type of disorder prior to
the advent of PTSD.
       <snip> PTSD first appeared in [the DSM], puslibhed by the APA, in 1980
after significant research studies with Vietnam combat veterans.
<end quote>

            James A. Landau