Combat Stress Control

History

Observations of combat stress were noted very early in the history of American war. Physicians who observed the reactions of those during the Civil War described a functional syndrome called “irritable heart.” Observations during World War I resulted in descriptions of “shell shock,” “war neurosis,” or “neurasthenia.” Later, the term “battle fatigue” was adopted. Generally, these various terms shared descriptions of a range of physical, cognitive, emotional, and behavioral reactions to combat stress, though they may have overlapped with symptoms of medical conditions as well.

Management strategies also date back almost a century. For example, a study of shell shock during World War I resulted in the development of a three-echelon system. This system included embedded psychiatrists located close to the front lines in the divisions, a second echelon of care involving 1 to 3 weeks of treatment off the front line, and finally a third echelon involving hospitals further removed from the fighting where weeks or months of treatment was rendered. Combat stress control efforts were also utilized during conflicts in Korea, Vietnam, and the Persian Gulf War.

Activities

Current CSC programs can include a wide range of activities, given their broad purposes. CSC programs aim to prevent the development of maladaptive CSRs, identify problematic reactions when they occur, and manage these reactions in a manner that supports the health of the service member and preserves the fighting strength of the military organization.