Skip to main content

Advertisement

SpringerLink
Log in

Do the Military’s Frontline Psychiatry/Combat Operational Stress Control Programs Benefit Veterans? Part Two: Systematic Review of the Evidence

  • Published:
Psychological Injury and Law Aims and scope Submit manuscript

Abstract

The second of a three-part review provides the first-ever systematic investigation into the military’s claim that its century-old policy of preventing evacuation of psychiatric casualties from war zones is beneficial to the health and well-being of individual service members and their families. We conducted an extensive literature search for studies on the military’s frontline psychiatry doctrine, particularly research comparing the differential effects of deployed personnel returned-to-duty (RTD) via frontline psychiatry or combat and operational stress control (COSC) and behavioral health interventions, as opposed to those evacuated out of war zones as psychiatric casualties. In addition, we examined partial and indirect evidence in support of the military’s argument that RTD and preventing psychiatric evacuations enhances posttraumatic growth and reduces adverse impact from mental health stigma, shame, and guilt, as well as lowering the risk of developing PTSD or other war stress injury causing premature military discharge. Results indicate support that frontline psychiatry benefits the war-fighting mission and goal of military medicine to prevent psychiatric attrition, with RTD rates of 60 to 100% and severely limiting psychiatric evacuations. However, there is paucity of research on differential outcomes, with only three, small uncontrolled retrospective Israeli studies from the 1982 Lebanon War reporting modest long-term benefit, from frontline versus undefined rear hospital treatment, such as lower PTSD rates. Overall, the review showed insufficient and often contradictory evidence of individual health benefits from frontline psychiatry, which calls for further research on military’s chief mental health policy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ahronson, A., & Cameron, J. E. (2007). The nature and consequences of group cohesion in the military sample. Military Psychology, 19, 9–25.

    Article  Google Scholar 

  • Allerton, W. S. (1969). Army psychiatry in Viet Nam. In P. G. Bourne (Ed.), The psychology and physiology of stress: With reference to special studies of the Viet Nam War (pp. 1–17). New York: Academic Press.

    Chapter  Google Scholar 

  • Armistead-Jehle, P., Johnston, S. L., Wade, N. G., & Ecklund, C. J. (2011). Posttraumatic stress in U.S. marines: The role of unit cohesion and combat exposure. Journal of Counseling & Development, 89, 81–88.

    Article  Google Scholar 

  • Bartemeier, L. H., Kubie, L. S., Menninger, K. A., Romano, J., & Whitehorn, J. C. (1946). Combat exhaustion. Journal of Nervous and Mental Disease, 104, 358–389.

    Article  PubMed  Google Scholar 

  • Belenky, G. L., Tyner, C. F., & Sodetz, F. J. (1983). Israeli battle shock casualties: 1973 and 1982. Washington, DC: Walter Reed Army Institute of Research.

    Google Scholar 

  • Benyamini, Y., & Solomon, Z. (2005). Combat stress reactions, posttraumatic stress disorder, cumulative life stress, and physical health among Israeli veterans twenty years after exposure to combat. Social Science & Medicine, 61, 1267–1277.

    Article  Google Scholar 

  • Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748–766.

    Article  PubMed  Google Scholar 

  • Brill, N. Q., & Beebe, G. W. (1952). Psychoneurosis: Military applications of a follow-up study. U.S Armed Services Medical Journal, 3, 15–33.

    Google Scholar 

  • Brooke, E. M. (1946). Battle exhaustion review of 500 cases from Western Europe. British Medical Journal, 2, 491–493.

    Article  PubMed Central  Google Scholar 

  • Brown, W. (1919). War neurosis: A comparison of cases seen in the field with those seen at a base. Lancet, 1, 833–836.

    Article  Google Scholar 

  • Buckman, J. E. J., Forbes, H. J., Clayton, T., Jones, M., Jones, N., Greenberg, N., … Fear, N. T. (2012). Early service leavers: A study of the factors associated with premature separation from the U.K. armed forces and the mental health of those that leave early. European Journal of Public Health, 23, 410–415.

  • Camp, N. M. (1994). Ethical challenges for the psychiatrist during the Vietnam conflict. In F. D. Jones, L. R. Sparacino, V. L. Wilcox, & J. M. Rothberg (Eds.), Textbook of military medicine, military psychiatry: Preparing in peace for war (pp. 133–150). Washington, DC: Office of the Surgeon General, U. S. Army, Borden Institute.

    Google Scholar 

  • Camp, N. M. (2014). U.S. army psychiatry in the Vietnam War: New challenges in extended counterinsurgency warfare. Fort Sam Huston: Borden Institute, U.S. Army Medical Department Center and School.

    Google Scholar 

  • Castro, A. C. (2014). The US framework for understanding, preventing, and caring for the mental health needs of service members who served in combat in Afghanistan and Iraq: A brief review of the issues and the research. European Journal of Psychotraumatology, 5, 1–12.

    Article  Google Scholar 

  • Cigrang, J. A., Peterson, A. L., & Schobitz, R. P. (2005). Three American troops in Iraq: Evaluation of a brief exposure therapy treatment for the secondary prevention of combat-related PTSD. Pragmatic Case Studies in Psychotherapy, 1, 1–25.

    Article  Google Scholar 

  • Cohen, S. P., Brown, C., Kurihara, C., Plunkett, A., Nguyen, C., & Strassels, S. A. (2010). Diagnoses and factors associated with medical evacuation and return to duty for service members participating in Operation Iraqi Freedom or Operation Enduring Freedom: A prospective cohort study. Lancet, 375, 301–309.

    Article  PubMed  Google Scholar 

  • Cooper, E. L., & Sinclair, A. J. M. (1942). War neuroses in Tobruk: A report on 207 patients from the Australian Imperial force units in Tobruk. The Medical Journal of Australia, 2, 73–81.

    Google Scholar 

  • Dean, E. T. (1997). Shook over hell: Post-traumatic stress Vietnam and the Civil war. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Dekel, R., Solomon, Z., Ginzburg, K., & Neria, Y. (2003). Combat exposure, wartime performance, and long-term adjustment among combatants. Military Psychology, 15(2), 117–131.

    Article  Google Scholar 

  • Department of Navy, & U.S. Marine Corps. (2010). Combat and operational stress control. Washington, DC: U.S. Navy, NTTP 1-15M; U.S. Marine Corps, MCRP 6-11C. December 2010.

    Google Scholar 

  • Department of the Army. (2006). Combat and operational stress control: Field manual 4-02.51 (FM 8-51). Washington, DC: Headquarters, Department of the Army.

    Google Scholar 

  • Department of Veterans Affairs, & Department of Defense. (2010). VA/DoD clinical practice guideline for the management of post-traumatic stress. Washington, DC: Veterans Health Administration, Department of Veterans Affairs and Health Affairs, Department of Defense, Office of Quality and Performance publication 10Q-CPG/PTSD-10.

    Google Scholar 

  • Dillon, F. (1939). Neuroses among combatant troops in the Great War. British Medical Journal, 2, 66.

    Google Scholar 

  • Du Preez, J., Sundin, J., Wessely, S., & Fear, N. T. (2012). Unit cohesion and mental health in the UK armed forces. Occupational Medicine, 62, 47–53.

    Article  PubMed  Google Scholar 

  • Elbogen, E. B., Johnson, S. C., Wagner, H. R., Newton, V. M., Timko, C., Vasterling, J. J., & Beckham, J. C. (2012). Protective factors and risk modification of violence in Iraq and Afghanistan. Journal of Clinical Psychiatry, 73, 767–773.

    Article  Google Scholar 

  • Fear, N. T., Jones, M., Murphy, D., Hull, L., Iversen, A. C., Coker, B., … Wessely, S. (2010). What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. Lancet, 375, 1783–1797.

  • Frappell-Cooke, W., Gulina, M., Green, K., Hacker Hughes, J., & Greenberg, N. (2010). Does trauma risk management reduce psychological distress in deployed troops? Occupational Medicine, 60, 645–650.

    Article  PubMed  Google Scholar 

  • Ginzburg, K., & Solomon, Z. (2011). Trajectories of stress reactions and somatization symptoms among war veterans: A 20-year longitudinal study. Psychological Medicine, 41, 353–362.

    Article  PubMed  Google Scholar 

  • Glass, A. J. (1947). Effectiveness of forward neuropsychiatric treatment. Bulletin of the U.S Army Medical Department, 7, 1034–1041.

    PubMed  Google Scholar 

  • Glass, A. J. (1966). Army psychiatry before World War II. In A. J. Glass & R. J. Bernucci (Eds.), Medical Department United States Army. Neuropsychiatry in World War II, Vol. I: Zone of interior (pp. 3–23). Washington, DC: Office of the Surgeon General, Department of the Army.

    Google Scholar 

  • Gordon, E. L. (1967). Division psychiatry: Documents of a tour. US Army Vietnam Medical Bulletin, November/December, 62–69.

  • Government Accountability Office. (2016). Human capital: Additional actions needed to enhance DoD’s efforts to address mental health care stigma: GAO-16-404. Washington, DC: Government Accountability Office.

    Google Scholar 

  • Granado, N. S., Zimmermann, L., Smith, B., Jones, K. A., Wells, T. S., Ryan, M. A., … Smith, T.C. (2012). Individual augmentee deployment and newly reported mental health morbidity. Journal of Occupational Environmental Medicine, 54, 615–620.

  • Grinker, R. R., & Spiegel, J. P. (1943). War neuroses in North Africa: The Tunisian campaign (January-May 1943). Restricted report prepared for The Air Surgeon, Army Air Forces. New York: Josiah Macy, Jr. Foundation.

    Google Scholar 

  • Han, S. C., Castro, F., Lee, L. O., Charney, M. E., Marx, B. P., Brailey, … Vasterling, J. J. (2014). Military unit support, post deployment social support, and PTSD symptoms among active duty and National Guard soldiers deployed to Iraq. Journal of Anxiety Disorders, 28, 446–453.

  • Hanson, F. R., & Ranson, S. W. (1949). Statistical studies. In F. R. Hanson (Ed.), Combat psychiatry: Experiences in the North African and Mediterranean theaters of operation American ground forces, World War II. Honolulu: U.S. Army Medical Department, University Press of Pacific.

    Google Scholar 

  • Harman, D. R., Hooper, T. I., & Gackstetter, G. D. (2005). Aeromedical evacuations from Operation Iraqi freedom: A descriptive study. Military Medicine, 170, 521–527.

    Article  PubMed  Google Scholar 

  • Hauret, K. G., Taylor, B. J., Clemmons, N. S., Block, S. R., & Jones, B. H. (2010). Frequency and causes of non-battle injuries air evacuated from operations Iraqi freedom and enduring freedom, U.S. army, 2001–2006. American Journal of Preventive Medicine, 38, 94–107.

    Article  Google Scholar 

  • Hing, M., Cabrera, J., Barstow, C., & Forsten, R. (2012). Special operations forces and incidence of post-traumatic stress disorder symptoms. Journal of Special Operations Medicine, 12, 23–35.

    PubMed  Google Scholar 

  • Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services and attrition from military service after returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295, 1023–1032.

    Article  PubMed  Google Scholar 

  • Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351, 13–22.

    Article  PubMed  Google Scholar 

  • Hoge, C. W., Castro, C. A., & Eaton, K. M. (2006). Impact of combat duty in Iraq and Afghanistan on family functioning: Findings from the Walter Reed Army Institute of research land combat study. In: Human dimensions in military operations—military leaders’ strategies for addressing stress and psychological support (pp. 5-1–5-6). Meeting Proceedings RTO-MP-HFM-134, Paper 5. Neuilly-sur-Seine, France: RTO. Available from: http://www.rto.nato.int/abstracts.asp

  • Hoge, C. W., Lesikar, S. E., Guevara, R., Lange, J., Brundage, J. F., Engel, C. C., … & Orman, D. T. (2002). Mental disorders among US military personnel in the 1990’s: Association with high levels of health care utilization and early military attrition. American Journal of Psychiatry, 159, 1576–1583.

  • Hoge, C. W., Toboni, H. E., Messer, S. C., Bell, N., Amoroso, P., & Orman, D. T. (2005). The occupational burden of mental disorders in the US military: Psychiatric hospitalizations, involuntary separations, and disability. American Journal of Psychiatry, 162, 585–591.

    Article  PubMed  Google Scholar 

  • Holden, W. (1998). Shell shock: The psychological impact of war. London: Macmillan.

    Google Scholar 

  • Holsenbeck, L. S. (1996). Psych force 90. In J. A. Martin, L. R. Sparacino, & G. Belenky (Eds.), The gulf war and mental health (pp. 39–58). Westport: Praeger.

    Google Scholar 

  • Horesh, D., Solomon, Z., Zerach, G., & Ein-Dor, T. (2011). Delayed-onset PTSD among war veterans: The role of life events throughout the life cycle. Social Psychiatry and Psychiatric Epidemiology, 46, 863–870.

    Article  PubMed  Google Scholar 

  • Hoyt, T., Garnica, G., Marsh, D., Clark, K., Desadier, J., & Brodniak, S. (2015). Behavioral health trends throughout a 9-month brigade combat team deployment to Afghanistan. Psychological Services, 12, 59–65.

    Article  PubMed  Google Scholar 

  • Hung, B. (2008). Behavioral health activity and workload in the Iraq theater of operations. US Army Medical Department Journal, 39, 42.

    Google Scholar 

  • Hunter, D. (1946). The work of a corps psychiatrist in the Italian campaign. Journal of the Royal Army Medical Corps, 86, 127–130.

    PubMed  Google Scholar 

  • Institute of Medicine. (2014a). Preventing psychological disorders in service members and their families: An assessment of programs. Washington, DC: The National Academies Press.

    Google Scholar 

  • Institute of Medicine. (2014b). Treatment for posttraumatic stress disorder in military and veteran populations: Final assessment. Washington, DC: The National Academies Press.

    Google Scholar 

  • Jarrett, T. A. (2013). Warrior resilience and thriving (WRT): Rational emotive behavior therapy (REBT) as a resiliency and thriving foundation to prepare warriors and their families for combat deployment and posttraumatic growth in operation Iraqi freedom, 2005–2009. Journal of Rational-Emotive & Cognitive-Behavioral Therapy, 31, 93–107.

    Article  Google Scholar 

  • Johnson, W., & Rows, R. G. (1923). Neurasthenia and war neuroses. In W. G. Macpherson, W. P. Herringham, T. R. Elliott, & A. Balfour (Eds.), History of the Great War based on official documents, medical services, diseases of the war (Vol. 2, pp. 2–61). London: HMSO.

    Google Scholar 

  • Joint Mental Health Advisory Team-8. (2013) Operation enduring freedom 2013 Afghanistan (12 August 2013). Office of the Surgeon General United States Army Medical Command and Office of the Command Surgeon HQ, USCENTCOM and Office of the Command Surgeon U.S. Forces Afghanistan (USFOR-A). Retrieved from http://armymedicine.mil/Documents/J_MHAT_8_OEF_Report.pdf

  • Jones, F. D. (1995a). Psychiatric lessons of war. In R. Zatchuk & R. F. Bellamy (Eds.), Textbook of military medicine: War psychiatry (pp. 1–34). Washington, DC: Office of the Surgeon General, U. S. Army, Borden Institute.

    Google Scholar 

  • Jones, F. D. (1995b). Traditional warfare combat stress casualties. In R. Zatchuk & R. F. Bellamy (Eds.), Textbook of military medicine: War psychiatry (pp. 35–61). Washington, DC: Office of the Surgeon General, U. S. Army, Borden Institute.

    Google Scholar 

  • Jones, N., Fear, N. T., Jones, M., Wessely, S., & Greenberg, N. (2010). Long-term military work outcomes in soldiers who become mental health casualties when deployed on operations. Psychiatry: Interpersonal and Biological Processes, 73, 352–364.

    Article  Google Scholar 

  • Jones, E., & Palmer, I. P. (2000). Army psychiatry in the Korean War: The experience of 1 Commonwealth Division. Military Medicine, 165, 256–260.

    PubMed  Google Scholar 

  • Jones, N., Seddon, R., Fear, N. T., McAllister, P., Wessely, S., & Greenberg, N. (2012). Leadership, cohesion, morale, and the mental health of UK Armed Forces in Afghanistan. Psychiatry, 75(1), 49–59.

    Article  PubMed  Google Scholar 

  • Jones, E., Thomas, A., & Ironside, S. (2007). Shell shock: an outcome study of a first world war ‘PIE’ unit. Psychology Medicine, 37, 215–223.

  • Jones, E., & Wessely, S. (2003). Forward psychiatry in the military: Its origin and effectiveness. Journal of Traumatic Stress, 16, 411–419.

    Article  PubMed  Google Scholar 

  • Jones, E., & Wessely, S. (2007). A paradigm shift in the conceptualization of psychological trauma in the 20th century. Journal of Anxiety Disorders, 21, 164–175.

    Article  PubMed  Google Scholar 

  • Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1990). Trauma and the Vietnam War generation: Report of findings from the National Vietnam Veterans readjustment study. New York: Brunner/Mazel.

    Google Scholar 

  • L’eri, A. (1919). Shell shock, commotional and emotional aspects. London: University of London Press.

    Google Scholar 

  • Lande, R. G., Williams, L. B., Francis, J. L., Gragnani, C., & Morin, M. L. (2010). Efficacy of biofeedback for post-traumatic stress disorder. Complimentary Therapies in Medicine, 18, 256–259.

    Article  Google Scholar 

  • Lerner, P. (2003). Hysterical men: War, psychiatry, and the politics of trauma in Germany, 1890–1930. London: Cornell University Press.

    Google Scholar 

  • Levav, I., Greenfeld, H., & Baruch, E. (1979). Psychiatric combat reactions during the Yom Kippur War. American Journal of Psychiatry, 136, 637–641.

    Article  PubMed  Google Scholar 

  • Linden, S. C., Jones, E., & Lees, A. J. (2013). Shell shock at Queen Square: Lewis Yealland 100 years on. Brain, 136, 1976–1988.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ludwig, A., & Ranson, S. (1947). A statistical follow-up of effectiveness of treatment of combat-induced psychiatric casualties: Returns to full combat duty. Military Surgeon, 100, 51–62.

    PubMed  Google Scholar 

  • Martin, J. A., & Cline, W. R. (1996). Mental health lessons from the Persian Gulf War. In J. A. Martin, L. R. Sparacino, & G. Belenky (Eds.), The Gulf War and mental health: A comprehensive guide (pp. 161–178). Westport: Praeger.

    Google Scholar 

  • Mattila, A. M., Crandall, B. D., & Goldman, S. B. (2011). U.S. Army combat operational stress control throughout the deployment cycle: A case study. Cancer Biomarkers, 38, 13–18.

    Google Scholar 

  • McGeorge, T., Hughes, J. H., & Wessely, S. (2006). The MoD PTSD decision: A psychiatric perspective. Occupational Health Review, 122, 21–28.

    Google Scholar 

  • McLay, R. N., McBrien, C., Wiederhold, M. D., & Wiederhold, B. K. (2010). Exposure therapy with and without virtual reality to treat PTSD while in the combat theater: A parallel case series. Cyberpsychology, Behavior and Social Networking, 13, 37–43.

    Article  PubMed  Google Scholar 

  • Mental Health Advisory Team-I. (2003). MHAT Operation Iraqi freedom 16 December 2003. U.S. Army Surgeon General. Retrieved from http://www-tc.pbs.org/wgbh/pages/frontline/shows/heart/readings/mhat.pdf

  • Mental Health Advisory Team-II. (2005). Operation Iraqi freedom-II, Mental Health Advisory Team (MHAT-II), 20 January 2005. U.S. Army Surgeon General. Retrieved from http://armymedicine.mil/Documents/MHAT-Team-II-OIF-II-REPORT.pdf.

  • Mikulincer, M., Solomon, Z., & Benbenishty, R. (1988). Battle events, acute combat stress reaction and long term psychological sequelae of war. Journal of Anxiety Disorders, 2, 121–133.

    Article  Google Scholar 

  • Momen, N., Strychacz, C. P., & Virre, E. (2012). Perceived stigma and barriers to mental health care in Marines attending the combat operational stress control program. Military Medicine, 177, 1143–1148.

    Article  PubMed  Google Scholar 

  • Moore, B. A., & Krakow, B. (2007). Imagery rehearsal therapy for acute posttraumatic nightmares among combat soldiers in Iraq. The American Journal of Psychiatry, 164, 683.

    Article  PubMed  Google Scholar 

  • Noy, S., Levy, R., & Solomon, Z. (1984). Mental health care in the Lebanon War 1982. Israel Journal of Medical Sciences, 20, 360–363.

    PubMed  Google Scholar 

  • Ogle, A. D., Bradley, D., Santiago, P., & Reynolds, D. (2012). Description of combat and operational stress control in regional command east, Afghanistan. Military Medicine, 177, 1279–1286.

    Article  PubMed  Google Scholar 

  • Oliver, L. W., Harman, J., Hoover, E., Hayes, S. M., & Pandhi, N. A. (1999). A quantitative integration of the military cohesion literature. Military Psychology, 11, 57–83.

    Article  Google Scholar 

  • Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychology Bulletin, 129, 52–73.

    Article  Google Scholar 

  • Parrish, B. D. (2008). Dialectical behavior therapy deployed: An aggressive alternative to traditional mental health on the noncontiguous battlefield. U.S. Army Medical Department Journal, 24–31.

  • Peterson, A. L., Baker, M. T., & McCarthy, K. R. (2008). Combat stress casualties in Iraq. Part 2: Psychiatric screening prior to aeromedical evacuation. Perspectives in Psychiatric Care, 44, 159–168.

    Article  PubMed  Google Scholar 

  • Phillips, C. J., LeardMann, C. A., Gumbs, G. R., & Smith, B. (2010). Risk factors for posttraumatic stress disorder among deployed US male marines. BMC Psychiatry, 10, 52.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pietrzak, R. H., Johnson, D. C., Goldstein, M. B., Malley, J. C., Rivers, A. J., Morgan, C. A., & Southwick, S. M. (2009). Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of operations enduring freedom and Iraqi freedom: The role of resilience, unit support, and post-deployment social support. Journal of Special Operations Medicine, 9, 74–78.

    PubMed  Google Scholar 

  • Potter, A. R., Baker, M. T., Sanders, C. S., & Peterson, A. L. (2009). Combat stress reactions during military deployments: Evaluation of the effectiveness of combat stress control treatment. Journal of Mental Health Counseling, 31, 137–148.

    Article  Google Scholar 

  • Rabasca, L. (2000). More psychologists in the trenches: Under a new military directive, mental health professionals’ work gains prominence. APA monitor, 31, 50.

    Google Scholar 

  • Ramchand, R., Rudavsky, R., Grant, S., Tanielian, T., & Jayconx, L. (2015). Prevalence of, risk factors for, and consequences of posttraumatic stress disorder and other mental health problems in military populations deployed to Iraq and Afghanistan. Current Psychiatry Reports, 17, 1–11.

    Article  Google Scholar 

  • Ritchie, E. C. (2002). Psychiatry in the Korean War: Perils, PIES, and prisoners of war. Military Medicine, 167, 898–903.

    PubMed  Google Scholar 

  • Ritchie, E. C. (2007). Update on combat psychiatry: From the battle front to the home front and back again. Military Medicine, 172, 11–14.

    Article  PubMed  Google Scholar 

  • Ruck, D. C. (1996). 18th airborne corps OM team. In J. A. Martin, L. R. Sparacino, & G. Belenky (Eds.), The gulf war and mental health: A comprehensive guide (pp. 59–72). Westport: Praeger.

    Google Scholar 

  • Rundell, J. R. (2006). Demographics of and diagnoses in operation enduring freedom and operation Iraqi freedom personnel who were psychiatrically evacuated from the theater of operations. General Hospital Psychiatry, 28, 352–356.

    Article  PubMed  Google Scholar 

  • Russel, C. (1919). The management of psychoneuroses in the Canadian army. Journal of Abnormal Psychology, 14, 29–30.

    Article  Google Scholar 

  • Russell, M. (2006). Treating combat-related stress disorders: A multiple case study utilizing eye movement desensitization and reprocessing (EMDR) with battlefield casualties from the Iraqi War. Military Psychology, 18(1), 1–18.

    Article  Google Scholar 

  • Russell, M. C., & Figley, C. R. (2016). Does the military’s frontline psychiatry/combat and operational stress control doctrine harm veterans?—Part one: Framing the issue. Manuscript submitted for publication.

  • Russell, M. C., Zinn, B., & Figley, C. R. (2016). Exploring options including class action to transform military mental healthcare and ends the generational cycle of preventable wartime behavioral health crises. Psychological Injury and Law, 9, 166–197.

    Article  Google Scholar 

  • Salmon, T. W. (1917). The care and treatment of mental diseases and war neuroses (‘shell shock’) in the British Army. Mental Hygiene, 1, 509–547.

    Google Scholar 

  • Salmon, T. W., & Fenton, N. (1929). In the American expeditionary forces (section 2). Neuropsychiatry. Vol. 10. In the Medical Department of the United States Army in the World War. Washington, DC: Office of the Surgeon General, U.S. Army.

    Google Scholar 

  • Schmitz, K. J., Schmied, E. A., Webb-Murphy, J. A., Hammer, P. S., Larson, G. E., Conway, T. L., Galameau, M. R., Boucher, W. C., Edwards, N. K., & Johnson, D. C. (2012). Psychiatric diagnoses and treatment of U.S. military personnel while deployed to Iraq. Military Medicine, 177, 380–389.

  • Scott, J. N. (2005). Diagnosis and outcome of psychiatric referrals to the field mental health team, 202 field hospital, Op Telic I. Journal of the Royal Army Medical Corps, 151, 95–100.

    Article  PubMed  Google Scholar 

  • Shepard, B. (2001). A war of nerves: Soldiers and psychiatrists in the twentieth century. Cambridge: Harvard University Press.

    Google Scholar 

  • Smith, T. C., LeardMann, C. A., Smith, B., Jacobson, I. G., & Ryan, M. A. K. (2009). Postdeployment hospitalizations among service members deployed in support of the operations in Iraq and Afghanistan. Annals of Epidemiology, 19, 603–612.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Benbenishti, R., & Mikulincer, M. (1988). A follow-up of Israeli casualties of combat stress reaction (‘battle shock’) in the 1982 Lebanon War. British Journal of Clinical Psychology, 27, 125–135.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Benbenishti, R., & Mikulincer, M. (1991). The contribution of wartime, pre-war, and post-war factors to self-efficacy: A longitudinal study of combat stress reactions. Journal of Traumatic Stress, 4, 345–362.

    Article  Google Scholar 

  • Solomon, Z., & Benbenishty, R. (1986). The role of proximity, immediacy, and expectancy in frontline treatment of combat stress reaction among Israelis in the Lebanon War. American Journal of Psychiatry, 143, 613–617.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Debby-Aharonl, S., Zerach, G., & Horesh, D. (2011). Marital adjustment, parental functioning, and emotional sharing in war veterans. Journal of Family Issues, 32, 127.

    Article  Google Scholar 

  • Solomon, Z., & Flum, H. (1988). Life events, combat stress reaction and post-traumatic stress disorder. Social Science & Medicine, 26, 319–325.

    Article  Google Scholar 

  • Solomon, Z., & Mikulincer, M. (1988). Psychological sequelae of war: A 2-year follow-up study of Israeli combat stress reaction casualties. The Journal of Nervous and Mental Disease, 176, 264–269.

    Article  PubMed  Google Scholar 

  • Solomon, Z., & Mikulincer, M. (1992). Aftermaths of combat stress reactions: A three-year study. British Journal of Clinical Psychology, 31, 21–32.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Mikulincer, M., & Bleich, A. (1988). Characteristic expressions of combat-related posttraumatic stress disorder among Israeli soldiers in the 1982 Lebanon War. Behavioral Medicine, 14, 171–178.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Mikulincer, M., & Hobfoll, S. E. (1986). Effects of social support and battle intensity on loneliness and breakdown during combat. Journal of Personality and Social Psychology, 51, 1269–1276.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Mikulincer, M., & Jakob, B. R. (1987). Exposure to recurrent combat stress: Combat stress reactions in Israeli soldiers in the Lebanon war. Psychological Medicine, 17, 423–433.

    Article  Google Scholar 

  • Solomon, Z., Mikulincer, M., & Kotler, M. (1987). A two year follow-up of somatic complaints among Israeli combat stress reaction casualties. Journal of Psychosomatic Research, 31, 463–469.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Mikulincer, M., & Waysman, M. (1991). Delayed and immediate onset posttraumatic stress disorder: II. The role of battle experiences and personal resources. Social Psychiatry and Psychiatric Epidemiology, 26, 8–13.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Oppenheimer, B., Elizur, Y., & Waysman, M. (1990). Trauma deepens trauma: Consequences of recurrent combat stress reaction. Israeli Journal of Psychiatry Relationship Science, 27, 233–241.

    Google Scholar 

  • Solomon, Z., Oppenheimer, B., & Noy, S. (1986). Subsequent military adjustment of combat stress reaction casualties—A nine year follow-up study. Military Medicine, 151, 8–11.

    PubMed  Google Scholar 

  • Solomon, Z., Shklar, R., & Mikulincer, M. (2005). Frontline treatment of combat stress reaction: A 20-year longitudinal study. The American Journal of Psychiatry, 162, 2309–2314.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Waysman, M., Fried, B., Mikulincer, M., Benbenishty, R., Florian, V., & Blieich, A. (1992). From frontline to home front: A study of secondary traumatization. Family Process, 31, 289–302.

    Article  PubMed  Google Scholar 

  • Solomon, Z., Waysman, M., Levy, G., Fried, B., Mikulincer, M., Benbenishty, R., … & Bleich, A. (1992). From front line to home front: A study of secondary traumatization. Family Process, 31, 289–302.

  • Solomon, Z., Weisenberg, M., Schwarzwald, J., & Mikulincer, M. (1987). Posttraumatic stress disorder among frontline soldiers with combat stress reaction: The 1982 Israeli experience. The American Journal of Psychiatry, 144, 448–454.

    Article  PubMed  Google Scholar 

  • Steiner, M., & Neuman, M. (1978). Traumatic neurosis and social support in the Yom Kippur war returnees. Paper presented at the Second International Conference on Psychological Stress and Adjustment in Time of War and Peace, Jerusalem, Israel, 19–23 June 1978.

  • Stetz, M. C., McDonald, J. J., Lukey, B. J., & Gifford, R. K. (2005). Psychiatric diagnoses as a cause of medical evacuation. Aviation Space, and Environmental Medicine, 76, 15–20.

    Google Scholar 

  • Stoller, C. C., Greul, J. H., Cimini, L. S., Fowler, M. S., & Koomar, J. A. (2012). Effects of sensory-enhanced yoga on symptoms of combat stress in deployed military personnel. American Journal of Occupational Therapy, 66(1), 59–68.

    Article  PubMed  Google Scholar 

  • Stouffer, S. A., Lumsdaine, A. A., Lumsdaine, M. H., Williams, R. M., Smith, M. B., Janis, I. L., … Cottrell, L. S. (1949). The American soldier: Combat and its aftermath. Volume 2. New Jersey: Princeton University Press.

  • Strange, R. E. (1969). Effects of combat stress on hospital ship psychiatric evacuees. In P. G. Bourne (Ed.), The psychology and physiology of stress: With reference to special studies of the Viet Nam War (pp. 75–93). New York: Academic Press.

    Chapter  Google Scholar 

  • Strecker, E. A. (1919). Experiences in the immediate treatment of war neuroses. The American Journal of Psychiatry, 76, 45–69.

    Article  Google Scholar 

  • Sundin, J., Mulligan, K., Henry, S., Hull, L., Jones, N., Greenberg, N., … Fear, N. T. (2012). Impact on mental health of deploying as an individual augmentee in the U.K. Armed Forces. Military Medicine, 177, 511–516.

  • Tedeschi, R. G. (2011). Posttraumatic growth in combat veterans. Journal of Clinical Psychology in Medical Settings, 18, 137–144.

    Article  PubMed  Google Scholar 

  • Turner, M. A., Kiernan, M. D., McKechanie, A. G., Finch, P. J. C., McManus, F. B., & Neal, L. A. (2005). Acute military psychiatric casualties from the war in Iraq. British Journal of Psychiatry, 186, 476–479.

    Article  PubMed  Google Scholar 

  • Vaughan, C. A., Farmer, C. M., Breslau, J., & Burnette, C. (2015). Evaluation of the operational stress control and readiness (OSCAR) program. Santa Monica: RAND Corporation.

    Google Scholar 

  • Weinick, R. M., Beckjord, E. B., Farmer, C. M., Martin, L. T., Gillen, E. M., Acosta, J. D., … Scharf, D. M. (2011). Programs addressing psychological health and traumatic brain injury among U.S. military service members and their families. Prepared for the Office of the Secretary of Defense Center for Military Health Policy Research. Santa Monica: RAND.

  • Whitesell, A. A., & Owens, G. P. (2012). The impact of patriotism, morale, and unit cohesion on mental health in veterans of Iraq and Afghanistan. Traumatology, 18, 1–7.

    Article  Google Scholar 

  • Wilde, J. F. (1942). Narco-analysis in the treatment of war neuroses. British Medical Journal, 2(4252), 4–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wiltshire, H. (1916). A contribution to the etiology of shell shock. Lancet, 1, 1207–1212.

    Article  Google Scholar 

  • Wojcik, B. E., Akhtar, F. Z., & Hassell, L. H. (2009). Hospital admissions related to mental disorders in U.S. Army soldiers in Iraq and Afghanistan. Military Medicine, 174, 1010–1018.

    Article  PubMed  Google Scholar 

  • Xue, C., Ge, Y., Tang, B., Liu, Y., Yang, P., Wang, M., & Zhang, L. (2015). A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. PLoS One, 10, 1–11.

    Google Scholar 

  • Yealland, L. R. (1918). Hysterical disorders of warfare. London: MacMillan.

    Google Scholar 

  • Zerach, G., Solomon, Z., Horesh, D., & Ein-Dor, T. (2013). Family cohesion and posttraumatic intrusion and avoidance among war veterans: A 20-year longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 48, 205–214.

    Article  PubMed  Google Scholar 

  • Zohar, J., Fostick, L., Cohen, A., Bleich, A., Dolfin, D., Weissman, Z., … Shalev, A. Y. (2009). Risk factors for the development of posttraumatic stress disorder following combat trauma: A semiprospective study. Journal of Clinical Psychiatry, 70, 1629–1634.

Download references

Acknowledgements

We thank David Gellman for his assistance with the literature review. This study was unfunded.

Author information

Authors and Affiliations

  1. Antioch University Seattle, Seattle, WA, 98121, USA

    Mark C. Russell

  2. Tulane University, New Orleans, LA, USA

    Charles R. Figley

Authors
  1. Mark C. Russell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charles R. Figley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles R. Figley.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Russell, M.C., Figley, C.R. Do the Military’s Frontline Psychiatry/Combat Operational Stress Control Programs Benefit Veterans? Part Two: Systematic Review of the Evidence. Psychol. Inj. and Law 10, 24–71 (2017). https://doi.org/10.1007/s12207-016-9279-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12207-016-9279-x

Keywords

Search

Navigation