Post-Traumatic Stress Disorder (PTSD)

1980

“The catastrophic stress of combat leaves its marks on the psyche that require both time and confrontation to erase.” These words, written in reference to returning Vietnam War veterans, apply equally well to soldiers of earlier and later wars. In World War I, thousands of soldiers on both sides experienced severe psychological distress that was labeled Shell Shock. Subsequently, during World War II, hundreds of thousands of young American soldiers experienced what was then called war neurosis or combat fatigue. But the problems of Vietnam veterans seemed more severe and endured for years after they returned home. Higher rates of drug abuse, spousal violence, divorce, and suicide were reported than in the aftermath of earlier wars.

Unfortunately, at the time when the Vietnam War ended, many mental health professionals refused to recognize that the problems of war veterans often persisted after the war. In the then-current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), there was no term specific to the symptoms of those who had undergone traumatic experiences, whether of war or natural disasters. Yet it was clear that thousands of Vietnam veterans were suffering and causing real damage to their families and to the social fabric of the country—for example, a sergeant who returned home from Vietnam experienced a flashback that led him to believe that the shopping mall he was in was under attack by the North Vietnamese. In an attempt to repel the “attackers,” he shot and wounded several police before being shot himself.

By the late 1970s, veterans joined with survivors of the Nazi Holocaust and other disasters and atrocities to convince the mental health professions that a new diagnostic category was needed—one that could lead to research and effective interventions. Post-traumatic stress disorder appeared for the first time in the DSM-III in 1980.

SEE ALSO Hysteria (1886), Shell Shock (1915), Stress (1950)

This powerful photograph from June 1968 shows D. R. Howe (Glencoe, MN) treating the wounds of Private First Class D. A. Crum (New Brighton, PA), “H” Company, 2nd Battalion, Fifth Marine Regiment, during Operation Hue City. PTSD came into usage as a term to describe the psychological effect of combat in Vietnam on many US soldiers.