Post Traumatic Stress
Disorder: Historical
Perspective
John S Price, Ph.D.
Psychological Services
San Antonio Police Department
Combat Related Stress Injuries
Old problem but a new name
 Greek and Roman References
 17th Century through US Civil War
 Nostalgia
 Soldier’ Heart

Combat Related Stress Injuries
World War I: Shell Shock
 World War II: Combat Exhaustion or Battle
Fatigue
 1973 Israelis: Battle Shock
 Combat Stress Reaction

Combat Related Stress Injuries
DSM I: Hysteria
 DSM II: Hysteria
 DSM III: Acute Stress Disorder
Post Traumatic Stress Disorder
 DSM IV: Acute Stress Disorder
Post Traumatic Stress Disorder

PTSD

***A psychiatric disorder that can occur
following the experience/witnessing of
life threatening events such as:
Military Combat
 Natural Disasters
 Terrorist Incidents
 Serious Accidents
 Violent Personal Assaults: Such as Rape

PTSD

Can Include
Nightmares
 Flashbacks
 Difficulty Sleeping
 Feeling Detached or Estranged
 Can Impair Daily Life

PTSD

Occurs in Conjunction with Other
Disorders

Such As:
 Depression
 Substance
Abuse
 Problems with Cognition
 Physical or Mental Health Issues
 Can Impair Ability to Function in Social or Family
Life
PTSD
Estimated 7.8 % will experience PTSD at
some point in their lives
 Women (10.4%) twice as likely as men
(5%)
 About 3.6% of US Adults aged 18-54 (5.2
million) have PTSD during the course of a
given year
 60.7% of men and 51.2% of women
reported at least one traumatic event

PTSD

Events Most Associated with PTSD

Women
Rape
 Sexual Molestation
 Physical Attack
 Threatened with a Weapon
 Childhood Physical Abuse


Men
Rape
 Combat Exposure
 Childhood Neglect
 Childhood Physical Abuse

PTSD
In a 2005 VA study of 168,528 veterans,
20% were diagnosed with psychological
disorders, including 1,641 with PTSD
 The Marines and Army were nearly 4x
more likely to report PTSD than Navy or
Air Force because of their greater
exposure to combat situations
 Enlisted men were twice as likely as
officers to report PTSD

Combat Related Stress Injuries
World War I
 Shell Shock
 Nerveshock
 Nerveshock Crisis
 September 21, 1916 The German
Association for Psychiatry convened a
special “War Congress”

Combat Related Stress Injuries

After briefly discussing the evidence the
“War Congress”, settled the debate by
voting that persistent distress or functional
impairment following exposure to a
traumatic event could only in an individual
with Hysteria
Combat Related Stress injuries
1980 DSM III PTSD replaces Hysteria
 Normalization model: PTSD is seen as a
normal reaction to an abnormal situation

Combat Related Stress injuries
Stress Injuries as physical damage to the
brain
 Implications of returning to a Medical
Model of stress injuries

Lori and I have been looking forward to attending the Pick-up Party; unfortunately we are having problems with car. We have a friend who also joined The Flock
John S Price
Combat Related Stress Injuries

Questions