Lecture
The theory of post-traumatic stress disorder (PTSD) developed over several decades and drew on numerous studies, clinical observations, and changes in diagnosis and treatment. Here is a brief history of the development of this theory:
War and neuroses: The origins of PTSD theory go back to the beginning of the 20th century, when military psychiatrists began studying the neuroses that appeared in soldiers after combat. During the First World War, such states were called "combat stress" or "war neurosis."
The Second World War and "combat fatigue": Similar neurotic reactions in soldiers were also observed during the Second World War and were described as "combat fatigue." This was the first recognition that military conflicts could produce serious psychological consequences.
The development of the concept of PTSD: In 1980, the American Psychiatric Association introduced the term "post-traumatic stress disorder" into its classification manual - the DSM-III (Diagnostic and Statistical Manual of Mental Disorders). This was an important milestone in the history of PTSD theory, since it broadened the diagnostic criteria and made it easier to identify and treat the disorder.
Research on the effects of stress on the psyche: In the 1950s and 1960s, researchers began studying the effects of stress on the psyche more systematically. An important contribution was Hans Selye's book "Stress Without Distress" (1950), which introduced the concept of "stress" and its effects on the organism. This research became the foundation for further investigations in the psychology of stress.
Post-traumatic stress disorder after wars: Studies of military conflicts such as the Vietnam War helped document numerous cases of PTSD among veterans. These studies also contributed to increased attention to PTSD-related problems in civilian society.
The spread of the PTSD concept: Over time, the concept of PTSD extended beyond military conflicts and came to be applied to describe traumatic events in everyday life, such as accidents, violence, and natural disasters.
Contemporary research and approaches: Today PTSD remains an actively studied research field. Thanks to modern brain-research methods and psychological techniques, more effective methods of treatment and support have been developed for people suffering from PTSD.
The modern understanding of post-traumatic stress
disorder (PTSD) took its final shape by the 1980s, although
information about the effects of traumatic experiences had been recorded
over the centuries.
The first systematic description of the mental disorders
caused by severe psychological trauma was made in 1867
by the English surgeon J.E. Erichson in his work “Railway Spine and
Other Injuries of the Nervous System,” in which he described a number of symptoms
of mental disorder that he observed in people injured in
a railway accident. For many weeks after
the accident these patients experienced a constant feeling of “mental
discomfort,” suffered from disturbed sleep with distressing dreams
related to the accident. Objectively they showed
impairment of memory and diminished concentration. Erichson
tried to explain these disorders as the result of “molecular
damage to the spinal cord.” However, this conclusion subsequently did not find
support among scholars and practitioners.
In 1889 the German neurologist H. Oppenheim introduced the term
“traumatic neurosis” for diagnosing mental disorders in
combatants, the causes of which he attributed to
organic damage to the brain, caused by both physical
and psychological factors.
The consequences of the First World War provided additional material
for the development of ideas about the psychological consequences of military
trauma.
Thus, Myers, in his work “Shell Shock in France 1914—
1919,” introduced the concept of “shell shock” - a mental state caused by
severe stress. Reactions to participation in combat were called
differently by different authors: “war weariness,” “combat exhaustion,” “war
neurosis,” “post-traumatic neurosis.”
Kardiner, in 1941, carried out one of the first systematic
studies of the phenomenon, which he called “chronic war neurosis.” He
was the first to give a comprehensive description of its symptomatology:
Kraepelin E. used the term “fright neurosis” to
designate a distinct clinical condition encompassing numerous
nervous and physical phenomena arising as a result of various
emotional shocks or sudden fright, which develop into
anxiety. He was also the first to draw attention to the fact that in his
psychopathological picture, hysterical
reactions and compensation-seeking attitudes of patients play a significant role. The scientist considered it essential,
in their rehabilitation, to limit pensions and benefits and to bring about the earliest
possible return to their usual work.
Thanks to the work of S. Freud, in the 1920s—1930s a psychoanalytic
understanding of traumatic neuroses emerged in Europe. Freud wrote:
“The terrible war which has just ended has given rise to a great
number of “traumatic neuroses,” and it has at least put an end
to the temptation to attribute these cases to organic damage of the
nervous system caused by mechanical force.” Freud believed that the main
cause of the disorder was surprise and fear.
Beginning in the 1940s, the center of research on this problem shifted to
the United States. Thus, E. Lindemann proposed using the concept of
“pathological grief” to define disorders caused by severe psychological
trauma. According to the author, this syndrome could develop immediately
after the misfortune or after some time had passed, and could be either
exaggeratedly pronounced or, conversely, barely noticeable. Lindemann gave
the first classification of disorders observed in people affected by
an accident. This included somatic disorders, a feeling of longing,
irritability, loss of habitual patterns of behavior, anger, self-destructive
behavior, and changes in relationships with relatives or friends.
Subsequently, research by scholars such as R.S. Leopold, N.
Dillon, W.G. Niederland, and R.J. Lifton uncovered the following
psychological disorders: intrusive and distressing memories,
anxiety attacks, which were defined as “survivor syndrome.”
Researchers introduced the concept of “rape trauma syndrome,” defining it as
a specific psychosomatic syndrome that develops within a
certain period of time in about a third of those who have been
raped.
The Vietnam War and its veterans forced researchers to reconsider
some of the existing views on the problem of traumatic stress.
Thus, about 25% of soldiers who fought in Vietnam developed
adverse personality changes under the influence of psychological trauma.
About 100,000 Vietnam veterans committed suicide (as of the early
1990s). About 40,000 lead an isolated way of life and have almost no
contact with the outside world. A high level of acts of violence,
family dysfunction, and impaired social contacts has also been noted.
The etiology and symptomatology of the mental disorders were established,
and methods of diagnosis and psychotherapy were developed.
Thus, by the end of the 1970s a substantial
body of material had accumulated showing that, regardless of the
varied nature of the events that caused the psychological trauma, affected individuals
displayed a whole series of common and recurring symptoms of mental
disorder. Since these disorders did not correspond as a whole to any
single nosological category, M. Horowitz proposed distinguishing them
as an independent syndrome under the name “post-traumatic stress
disorder.” Since 1980, post-traumatic stress disorder has been included
by the American Psychiatric Association in its diagnostic nomenclature.
The history of PTSD theory shows how this problem came to be gradually recognized and studied, leading to the development of more effective ways of helping those who suffer from this disorder.
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