War Stress Research Articles

The Confluence of Mystic and Animalistic Constituents Problematizes Human Consciousness: A Study of Ted Hughes’s Selected Poems

The study expounded upon “The Confluence of Mystic and Animalistic Constituents Problematizes Human Consciousness: A Study of Ted Hughes’s Selected Poems”. The impacts of the chaotic forces of the universe, lack of equilibrium between man’s material and mystic self, post-traumatic stress of World war I & II, dispersion of emotions, the dilemma of fear, doubt and uncertainty on the construct of individual’s socio psychic existence are the pivotal focus of this research. It explored those hurdles that obstacle the elevation of man’s actual self regardless of his multiple performative identities. This paper probed into the perpetuity of the contention between positive and negative energies of the World, necessary for the pacification of the wild instinctive self of man, and the quest for a singular identity were the core features that fabricate human consciousness. It was qualitative research undertaking psychoanalytical reading of Hughes’s poetry. Freudian theory of psychoanalysis, Jungian theory of individuation, Lacan’s concept of Lack, Gaze, Desire, and Mirror stage were the key concepts to explore the modern man’s socio psychic maladaptive attitude. The study may have further implications on the researchers studying advanced psychological and sociological theories related to the ruptured consciousness of the human mind in this dynamic World.

Neuroticism as Mediator and Moderator Between War Atrocities and Psychopathology in Syrian Refugee Children and Adolescents.

BackgroundDespite the extensive research on war atrocities and risk factors for psychopathology, there is a paucity of research on the potential mediating and moderating effect of neuroticism in refugee children and adolescents.ObjectiveThis study aimed to analyze whether neuroticism mediated and/or moderated the relationship between war atrocities and different types of psychopathology in Syrian refugee children and adolescents who resettled in Lebanon and Jordan.Participants and SettingParticipants were 1,000 Syrian refugee children and adolescents of both sexes.MethodsQuestionnaires were administered in an interview format with children at school by two trained psychologists. Descriptive statistics and inter-correlations among variables were used Then the mediator and moderator effect of neuroticism in the relationship between war atrocities and posttraumatic stress, emotion regulation and behavioral and emotional disorders were examined.ResultsA partial mediating effect of neuroticism on posttraumatic stress disorder (PTSD), emotion dysregulation, and emotional and behavioral disorders was revealed. Findings also indicated full moderating effects of neuroticism on PTSD as well as partial moderating effects on emotion dysregulation, and emotional and behavioral.ConclusionsFindings contribute to the neuroticism literature by showing that high-N children develop more problems that are psychopathological and have more severe affective reactions to war atrocities in post- resettlement contexts. Early interventions aimed to reduce neuroticism might contribute to a better prognosis in refugee children at high-risk for psychological disorders.

Post-traumatic stress disorder among victims of great march of return in the Gaza Strip, Palestine: A need for policy intervention

This study aimed to assess the level of Post-Traumatic Stress Disorder (PSTD) and to examine the relationship between exposure to war stress and posttraumatic symptoms among people who were injured during the Great March of Return (GMR) in the Gaza Strip, Palestine. A sample of 264 adults who were injured during participation in the events of GMR completed the Impact Event Scale-Revised (IES-R). IES-R has three sub-scales; intrusion, avoidance, and hyper-arousal. Only 27.3% of the participants had two or more injuries and 38.4% of participants reported having disability due to their injuries. The results showed that 95.4% of the participants had severe posttraumatic symptoms. Total score of IES-R ranged between 29 and 88 (mean = 61.28). The most frequent symptoms of trauma subscales was “Intrusion” (mean = 2.90), followed by “Avoidance” (mean = 2.73), and then “Hyper-arousal” (mean = 2.70). Level of PTSD was affected by working status, need for hospitalization, need for a referral for treatment outside the Gaza Strip, disability and severity of injury. Such high level of PSTD will have negative consequences on participants' physical and mental status. Therefore, a need for special counseling programs is required to help them to survive with least consequences of PTSD on their wellbeing.

A self-help app for Syrian refugees with posttraumatic stress (Sanadak): results of a randomized controlled trial

Abstract Background Syrian refugees often develop posttraumatic stress as a result of the Syrian civil war and migration stressors. However, there is a lack of adequate treatments. The smartphone app Sanadak was developed and evaluated to provide cognitive behavioral therapy-based self-help in the Arabic language for Syrian refugees with posttraumatic stress. Methods In a randomized controlled trial, eligible individuals were allocated to the intervention group (IG; app) or control group (CG; psychoeducational reading material). Data were collected during structured face-to-face interviews at 3 assessments (preintervention/baseline, postintervention/after 4 weeks, follow-up/after 4 months). Using adjusted mixed-effects models, changes in posttraumatic stress and secondary outcomes were investigated as intention-to-treat (ITT) and per-protocol (PP) analysis. Results Of 170 screened individuals (aged 18-65 years), 133 were eligible and randomized to the IG (n = 65) or CG (n = 68). Although there was a pre-post reduction in posttraumatic stress, ITT showed no significant differences between IG and CG after 4 weeks (Posttraumatic Diagnostic Scale for DSM-5, Diff -0.90, 95%CI -0.24 to 0.47; P=.52) and after 4 months (Diff -0.39, 95%CI -3.24 to 2.46; P=.79). The same was true for PP. Regarding secondary outcomes, ITT indicated a treatment effect for self-stigma after 4 weeks (Self-Stigma of Mental Illness Scale/SSMIS-stereotype agreement: d = 0.86, 95%CI 0.46 to 1.25; stereotype application: d = 0.60, 95%CI 0.22 to 0.99) and after 4 months (d = 0.52, 95%CI 0.12 to 0.92; d = 0.50, 95%CI 0.10 to 0.90). Conclusions Sanadak reduced mild to moderate posttraumatic stress in Syrian refugees, but not superior to the control condition. Therefore, Sanadak may not be suitable as a standalone treatment. However, as the app usability was very good, no harms detected, and stigma significantly reduced, Sanadak has potential as a bridging aid within a stepped and collaborative care approach.

Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review.

ABSTRACTBackgroundAlthough combat stress and psychiatric casualties of war have consistently contributed to the need for deployed patient transport to higher echelons of care, little is known regarding specific evidence-based strategies for providing psychological support and optimal transport interventions for warriors.Study ObjectiveThe purpose of this scoping review is to map existing literature related to considerations for deployed mental health patient transport. The review’s primary aims are to identify the existing scientific research evidence, determine research and training gaps, and recommend critical areas for future military research.MethodsWe used Arksey and O’Malley’s six-stage scoping review methodological framework (identify the research question, identify relevant studies, select studies, chart data, report results, and consultation). Using a systematic search strategy, we evaluated peer-reviewed literature from five databases (PubMed, CINAHL, PsycINFO, Web of Science, and Embase) and gray literature from the Defense Technical Information Center. All publications were independently screened for eligibility by two researchers during three review rounds (title, abstract, and full text).ResultsWe identified 1,384 publications, 61 of which met our inclusion criteria. Most publications and technical reports were level IV evidence and below, primarily retrospective cohort studies and epidemiologic surveillance reports. Few rigorously designed studies were identified. Eight research themes and a variety of research and critical training gaps were derived from the reviewed literature. Themes included (1) characterizing mental health patients aeromedically evacuated from theater; (2) in-flight sedation medications; (3) need for aeromedical evacuation (AE) in-theater education, training, and guidelines for staff; (4) epidemiological surveillance of AE from theater; (5) mental health management in deployed settings; (6) suicide-related event management; (7) transport issues for mental health patients; and (8) psychological stressors of AE. Research is needed to establish clinical practice guidelines for mental health condition management in theater and throughout the continuum of en route care.

An Anecdotal Case Study in Psychological Anthropology of Two Retired Middle School Teachers’ Perceptions of Classroom Life in the United States

In this qualitative study, interviews of two former middle school teachers were conducted and analyzed for how they fostered a supportive classroom environment in the United States despite the national stress of the Vietnam War during the late 1960s and early 1970s. Half a century later in 2020-2021, similar trends seem to remain just as important in society though the context has shifted. Implications for social-emotional learning from then and now are discussed. Each of the two participants in this study established centralized control through slightly different means and both used written guidelines and rules while emphasizing prosocial behaviors. Three themes emerged: 1) a syllabus was important in management style, 2) sports, and 3) the national social context—such as the Vietnam War—manifested itself in the discourse of the social environment to affect classroom life. Implications for the socio-spatial context of school architectural layout are explored.

The Impact of War-Related Stress on Coronary Artery Disease Severity in War Survivors: A SYNTAX Study.

Background: Due to the strong relationship between stress and heart disease, particularly acute myocardial infarction (MI), this study investigated the complexity of coronary artery disease (CAD) among Syrian refugee patients referred to Jordan University Hospital and its relation to war-related stressors. Methods: This is a retrospective study that utilized the SYNTAX I score in order to evaluate all Syrian refugees that underwent coronary artery catheterization at Jordan University Hospital during the period between May of 2014 and December of 2017. Results: There was a significant association between war-related stressors and high SYNTAX score (SX score), thus indicating a higher complexity of CAD in Syrian war survivors with higher stress scores. The strongest war-related correlation was observed with crossing green-lines, in which Syrian refugee patients who had crossed such lines had significantly higher SYNTAX scores. Regression analysis demonstrated that war stressors were positive predictors of increased SYNTAX scores even when adjusted for conventional CAD risk factors. Surprisingly, none of the CAD risk factors were significantly associated with SYNTAX score. Conclusion: Our findings suggest that exposure to multiple war-related stressors may increase the complexity and severity of CAD in Syrian war survivors. Thus, special attention, efforts, and resources should be allocated to screen for such vulnerable patients in order to provide them with the appropriate healthcare.

Strategic Reassessments: Aid and Bureaucracy in Australia‐India Relations 1951–1970*

Australia‐India relations during the Cold War years were tense. The dominant argument in the current literature that explains this tension is the Nehru‐Menzies dissonance, which resulted in fundamentally opposite readings of the Cold War. However, the role of Australian aid to India has been understudied in the bilateral relations literature. India was the largest receiver of Australian aid between 1951–1969, but in 1969, there was a marked decrease in this aid as Indonesia replaced India as the main aid recipient. By drawing on archival material, this article suggests an additional explanation for the dramatic change to the Australia‐India relationship. By examining the role of Australian ministers and senior bureaucrats, this paper argues that between 1951–1969, Australia’s aid to India was driven by its strategic interests in India. However, by 1966 Australia’s strategic interests in India became tenuous due to the souring of United States‐India relations, primarily because of the stresses of the Vietnam War. Thus, a sizeable cut in Australian aid to India was made in 1969 and the subsequent decision to make Indonesia the foremost beneficiary of its aid was a result of strategic reassessments in Australian foreign policy, to adhere more closely to United States (US) interests in Asia.

Despair and Suicide-Related Behaviours in Palorinya Refugee Settlement, Moyo, Uganda

This descriptive study illustrates the multitude of intertwining factors contributing to suicidal ideation and attempts, and deaths by suicide among South Sudanese refugees in Moyo/Obongi Palorinya settlements in northern Uganda. It was conducted from 2019 to 2020 due to escalating rates of suicide attempts and deaths by suicide noted in a rapid assessment by Lutheran World Federation mental health and psychosocial support (MHPSS) workers. This study aimed to better understand factors contributing to suicidal ideation and attempts among refugees, to tailor MHPSS interventions and prevent potential escalation of suicidality across the region, including nearby refugee hosting districts in Adjumani/Lamwo. Data collection techniques included key informant interviews, focus group discussions, case studies and review of the lead author’s therapy recovery notes. The findings highlighted the following factors contributing to escalating suicidality among the refugees: war stressors (experiencing and witnessing violent acts), daily stressors, social fragmentation, normalised violence, social isolation, lack of economic opportunities, loss of assets and loss of confidence and hope, among others. The assessment found that the spiking trend of increased suicidal behaviour is apparently unique to Moyo/Obongi, compared to neighbouring settlements, but emphasises the need for monitoring and preventive interventions in neighbouring districts. The psychosocial as well as economic impact of a reduction in funding for MHPSS programming is underlined, emphasising the need for long-term funding to consolidate programme effects and respond to realities on the ground. Community-based psychosocial support interventions provided by Lutheran World Federation are described that have subsequently helped to mitigate and respond to the escalating trend in suicidality and reflections given to strengthen the ongoing response with lessons learned for other contexts.

Is war hard on the heart? Gender, wartime stress and late life cardiovascular conditions in a population of Vietnamese older adults.

Populations in the global south are disproportionately exposed to the stressors of development, disaster and armed conflict, all of which heighten cardiovascular disease (CVD) risk. We consider how war-related stressors exert a lasting influence upon population health, in particular the cardiovascular health of war survivors now entering older adulthood. Data come from the 2018 Vietnam Health and Aging Study conducted among 2447 northern Vietnamese adults age 60 and older. We conduct survey-adjusted logistic regression analyses to examine the associations among respondents' wartime exposure to combat and physical threat, malevolent environment conditions, and four CVD conditions (hypertension, dyslipidemia, heart disease, and stroke). We examine posttraumatic stress disorder (PTSD) as it mediates the association between wartime stress exposures and late life CVD, and gender as it moderates the relationship between wartime stressors and CVD. We find that exposure to wartime combat and violence, as well as malevolent living conditions, exhibit significant, positive associations with cardiovascular conditions. These associations are mediated by the severity of recent PTSD symptoms. For certain CVD conditions, particularly hypertension, the associations between wartime stressors and late life cardiovascular conditions diverge across gender with women experiencing a greater penalty for their exposure to war-related stressors than their male counterparts. We conclude that the stressors of war and resultant PTSD, widespread in this cohort of Vietnamese older adults who endured myriad forms of war exposure during their young adulthood, exhibit modest, yet significant associations with late-life cardiovascular conditions. Women, especially those exposed to wartime violence and combat, bear this CVD burden alongside men.

Mental Distress and Psychological Disorders Related to COVID-19 Mandatory Quarantine

Abstract: Background: Restrictions that were enforced from COVID-19 have affected many people’s lifestyles and ability to earn. They caused a distress that even added to the war stress that the Syrian population has encountered for the last 10 years. This study aims to assess this distress and the major concerns of the people related to COVID-19. Methods: Online questionnaires were distributed using SPTSS, K10, and MSPSS were used with other demographic, war- and COVID-19-related questions that were taken from The (CRISIS) V0.1 Adult Self-Report Baseline Form. Outcomes: Our sample included 5588 with the mean age of 26.84 ± 7.815 years. Of those, only one was a confirmed COVID-19 case. Over 42.7% had two or more positive PTSD symptoms, 42.6% had moderate or severe mental disorder, but only 14.9% had low social support. Higher PTSD and K10 scores overall were seen in females and with most of war variables (P<0.05). Relationship with partner were negatively affected in most and distress from the declined ability to work and provide food were the most prominent. Interpretation: The indirect effect of COVID-19 is far more than that of the pathogen itself. Reduced ability to earn and to provide food was the main concerns. Relationships deteriorated mainly in participants with high K10 and PTSD scores who also felt more symptoms and used more hypnotics in the last 4 weeks. Smoking changes were not related to K10 and PTSD. Social support played a role in reducing stress, but with the relationships being affected, lower support was seen. Funding Statement: None. Declaration of Interests: The authors have no conflict of interest to declare. Ethics Approval Statement: The study protocol and ethical aspects were reviewed and approved by Damascus University deanship, Damascus, Syria. Online informed consent was taken before proceeding with the survey for participating in the research, and for using and publishing the data.

The Comparison of Social Support Against the Life Quality of The Spinal Cord Injury Under Stress

Introduction: The stress of war has caused severe problems for the individual and family. Spouses of veterans are gradually involved in family erosion. Lack of social protection and social dysfunction decreased life satisfaction and reduce intimacy between partners. Purpose: this study has been done in the purpose of comparing social support against the veteran’s life who are under stress. Method: This cross-sectional study was done on 79 posttraumatic stress disorder veteran wives and it was also done on 79 ordinary wives through convenience sampling. The instrument to collect the required information was the quality of life questionnaire which contained 36 SF questions and Medical Outcomes Study Social Support Survey (MOS-SS).and the needed information was collected by self-reported method. Results: Veteran wives social support with the mean and the standard deviation was 19.3±5.1 while it was 31.1±3.7 versus the ordinary wives and this difference was significant (Pless than 0.01).It showed the veteran wives quality of life with the mean and standard deviation of 46.3±.088 while it showed 66.9±8.5the mean and standard deviation for the ordinary wives and it showed the significant difference (Pless than 0.01). Conclusions: the obtained result showed that the quality of life related to the health and social support in veteran wives is lower in compare with the ordinary wives with the same situation, therefore educational, treatment and supporting and promoting plans for this group is necessary

Supplemental Material for Do Different Types of War Stressors Have Independent Relations With Mental Health? Findings From the Korean Vietnam Veterans Study

Supplemental Material for Do Different Types of War Stressors Have Independent Relations With Mental Health? Findings From the Korean Vietnam Veterans Study

The Route to Nuclear War

Between nuclear powers, no-first-use declarations are built on sand. Even if a declaration is signed in good faith during peacetime, no aggressor can count on it being maintained in the stress of war.

The social context of technological systems: dreadnoughts, computers, and flags

Using the performance of the Royal Navy as an illustration, this paper shows that systems of systems break apart at the perilous edge where human behavior meets engineered systems. The development of accurate long-range naval gunnery enabled rapid, fundamental, and interrelated changes capital ship design, known today as the “dreadnought revolution.” The engineered technical systems for rangefinding, aiming, armament, centralized direction, and speed were integrated into new complex ships—the dreadnought battleship and the battlecruiser. These complex machines were in turn integrated into massive fleets. These fleets posed a challenge for the social order of the Royal Navy, which met the challenge through the development of rigid and formalized techniques for command and control (C2). The rules of command and control represent the practitioners’ efforts at systems thinking, and are heavily influenced by the social context of the institution. When subject to the stresses of war, the Royal Navy’s system broke down, resulting in poor performance and tragic losses. Ultimately, systems theorists need to have an understanding of the social context in which technological systems operate that goes beyond rational choice models of human behavior if they want to better understand the performance of systems of systems.

Bugsplat: The Politics of Collateral Damage in Western Armed Conflicts by Bruce Cronin

Reviewed by: Bugsplat: The Politics of Collateral Damage in Western Armed Conflicts by Bruce Cronin Thomas W. Smith (bio) Bruce Cronin, Bugsplat: The Politics of Collateral Damage in Western Armed Conflicts (Oxford University Press, 2018), ISBN 978-0-19-084911-5, 180 pages. First, a word about the title of the book: "Bugsplat" was the unfortunate moniker of a 2003 Pentagon software package designed to model and mitigate collateral damage caused by US airstrikes. If one wanted to telegraph the banality of killing civilians in war, one could not choose a better image than that of an insect plastered on a windshield (that is what a bomb's "probable damage field" resembled). It is hard to say which is more surprising: how acronym-free and bluntly un-Pentagonese the name was; or, in light of the attention showered on civilian protections in recent years, that defense officials would choose such a flippantly dehumanizing title in the first place. True to form, the Pentagon later changed the name of the software to "Fast Assessment Strike Tool—Collateral Damage," or "FAST-CD." "Bugsplat" is, however, the perfect title for Bruce Cronin's primer on collateral damage in modern Western warfare. In several brisk case studies—the Persian Gulf War, NATO/Serbia, Israel/Hezbollah, and the US/Al-Qaeda—Cronin identifies an almost scripted strategy for the conduct of high-tech, low-risk warfare: transfer risk from soldiers to civilians, employ overwhelming force, and seek decisive victory. The means of choice are airpower, drone-launched missiles, and other stand-off weapons that protect the safety of Western soldiers and ensure the detachment of democratic societies back home. Cronin shows that most of these civilian casualties are not accidents or oversights amid the heat of battle, but flow from carefully considered strategies and tactics. This is not the fog of war at all; it is deliberate, normalized violence against civilian populations. These tactics constitute what Cronin calls "reckless endangerment warfare." It is illegal for belligerents to directly target civilians or to show wanton or depraved indifference to their fate, in the case of a mass aerial bombing, for example. Even if attacks on civilians are not technically intended, Cronin argues, they nonetheless occur in predictable [End Page 1020] and preventable ways. Nor are these civilian losses outweighed by military necessity; most attacks fail to secure the "definite military advantage" that customary humanitarian law requires. Even state-of-the-art targeting comes up short. The operational appeal of Bugsplat was its speed in estimating the civilian spillover of airstrikes (five to ten minutes as opposed to a cumbersome process of pre-vetting targets). The ethical appeal of the program was that it would reduce the numbers of civilians killed or maimed. Cronin contends that high-tech targeting systems have failed to live up to the humanitarian hype, instead allowing attackers to expand the target set and penetrate more deeply into civilian areas. His main takeaway is that precision-guided munitions, computerized modelling, and other advanced technologies do "not appear to have had any effect on reducing collateral damage in armed conflicts."1 While Western belligerents point to improvements in targeting and compare themselves favorably to their adversaries, especially in asymmetric wars, detachment from the actual impact of violence on the ground is also a prime mover of reckless warfare. Cold War rhetoric about "strategic rings" and "centers of gravity" has been replaced by the language of "dual-use" infrastructure and "effects-based" strikes against military objects, but also economic, diplomatic, and information targets. The dream is a war with zero same-side casualties. As Cronin notes, drone warfare comes close to smashing all semblance of reciprocity. Strikes on named targets as well as signature strikes based on observed patterns of behavior cause more civilian fatalities than the Pentagon concedes. Though even risk-free tactics exact costs on both sides. Drone operators stationed at consoles, continents away from the violence, are not immune to Post-Traumatic Stress Disorder (PTSD) and other stressors of war, perhaps because they virtually hover over bomb sites and see the human costs of war up close. Cronin's affirmative argument for "feasible precaution" is less well developed. He wants belligerents to...

La psiquiatría militar alemana en la Segunda Guerra Mundial. Artículo histórico

Introduction: Combat stress reaction (CSR), now called «acute stress reaction» (ICD-10), refers to a transient anxiety reaction in the soldier, which has historically led to an inability to face the struggle of war. Most military, historical and medical analyzes of the activity carried out by the Wehrmacht in World War II reported no serious problems due to stress. The reasons are based on the exceptional quality of the small military units and the leadership of the German Army. However, over the years, it was no longer possible to avoid reporting the high number of casualties secondary to combat stress reactions, which has cast doubt on the myth of the German soldiers’ immunity to the stress of war. Conclusions: At the end of WWII, the CSR was a common topic in offi cial reports, meetings and guides. The psychiatrists who had the opportunity to report it were those who continuously underestimated the role of this stress disorder in the Wehrmacht. Thus, the widespread perception that the Wehrmacht did not suffer serious problems of emotional breakdown in soldiers, typical of combat stress, can be modifi ed to some extent.

Razine anksioznosti kod prognanika i povratnika

This study aimed to examine the impact of war stress on some aspects of anxiety in refugees and returnees.The subjects were refugees from Eastern Slavonia (N=80) and returnees from the Dalmatian hinterland (N=80), whereas the citizens of the city of Split (N=81), who have been indirectly exposed to the war events, served as the control group.The subjects were given Endler's Multidimensional Anxiety Scales (EMAS-S and EMAS-T) that are designed to measure the state anxiety and the trait anxiety in usual, everyday situations and in situations of social evaluation. In addition, two scales were administered that were constructed for assessment of the perception of threatening aspects of war and of the exposure to war related stress (Gregov et al., 1995).The results showed that the anxiety level was higher in the returnees than the refugees, while the control group had the lowest degree of both state and the trait anxiety. This finding is in accordance with the hypothesis that the stress experienced during the refugee period and in the new situation of the return would have cumulative effects which could be manifested in short-term consequences (increased level of state anxiety and perceived threat of some war aspects) and in longterm consequences (increased level of trait anxiety).

The peculiarities of brain bioelectrical activity in infants who suffered from stress due to military conflict depending on type of feeding

The aim of the research is to study the peculiarities of brain electrical activity in infants who suffered from stress due to military conflict and who were on different types of feeding.&#x0D; An electroencephalographic study was conducted in 68 infants who were in the military conflict zone and formed the main group. These infants were divided into 2 subgroups. Subgroup Ia included 36 infants who were breastfeeding. Subgroup Ib included 32 infants who were on artificial feeding. EEG was also made to 88 children who made up a control group and were outside the zone of military conflict. Of these, 47 children were breastfed, who entered the subgroup IIa and 41 children were on artificial feeding, included in subgroup IIb.&#x0D; The study was carried out with the help of a hardware-software complex for recording and processing electroencephalograms and evoked potentials DX-NT 32.&#x0D; The most pronounced physiological changes in brain bioelectrical activity were detected in the group of children undergoing stress of war and being on artificial feeding, which were manifested by lower parameters of the amplitude, frequency and time index of alpha and beta rhythms, increased amplitude, frequency and time index of delta and theta rhythms.

The Darker Side of Military Mental Healthcare Part One: Understanding the Military’s Mental Health Dilemma

The military’s primary mission is to prevent, fight, and win wars. A critical key to its success is the military’s dual mission of force health protection that translates to preventing and treating the physical and psychological wounds of war in order to preserve the fighting force. To accomplish both missions, the military relies extensively on documenting its lessons learned to build upon its successes and prevent avoidable disasters caused by repeating its failures. The military’s commitment to learning battlefield lessons are directly responsible for unparalleled technological and medical, life-saving advances that greatly benefit both military and private sectors. However, the evolution of modern industrialized warfare’s capacity to kill, maim, and terrorize has exceeded the limits of human endurance whereby psychiatric casualties have outnumbered the total of combatants, both wounded- and killed-in-action, since the Second World War. Psychiatric attrition and skyrocketing costs associated with psychiatric treatment and disability compensation threaten the military’s capacity to accomplish its primary mission as well as risk straining the finances of society, thereby presenting a significant mental health dilemma. Central to the military’s mental health dilemma are two competing alternatives: (1) to fulfill its moral, ethical, and legal obligation of preventing and treating war stress injuries by learning from its documented lessons learned, or (2) develop strategies to avoid learning its war trauma lessons in order to avoid psychiatric attrition, treatment, and pensions. The first option conjures deep-seated fears of mass evacuation syndromes should the military treat mental wounds similar to physical injuries. Consequently, the military has embraced the second option that inevitably has been harmful to veterans, their families, and society, in what we refer to as the darker side of military mental healthcare. In this, the first of a three-part review, we examine the contextual factors framing the military’s dilemma and 10 strategies utilized to avoid learning its war trauma lessons, which will be explored in-depth in parts two and three. While disturbing, these signs of failures are readily ignored and dismissed by a war wary republic. To our knowledge, such an analysis has never been undertaken before or publicly disclosed. When considered as parts of the whole, the findings point to a critical need for improvement in treating military psychological injuries in the war theater.