Explore chapters and articles related to this topic
Neuropsychiatry in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Hurst also championed the use of physiotherapy in the context of re-education.4 He offered a more complete description in an article in the British Medical Journal in 1917.5 He described the emotions produced by a horrible incident in the trenches that would cause “stupor and amnesia, psychasthenia, and hysterical symptoms.” Concussion or toxins were obviously considered as main causes but rapidly dismissed. Hurst also provided a great neurologic insight into the phenomenon of overlay and how a structural lesion could change into a functional manifestation:When one side of the brain has been chiefly affected by the concussion, an initially organic hemiplegia merges into hysterical hemiplegia. I have watched several cases, in which all the physical signs of organic paraplegia or hemiplegia were at first present but have gradually disappeared in the course of a few days or weeks, although the paralysis has remained, until by suggestion or persuasion it has been cured in a few minutes. Sometimes, however, some organic signs remain, and suggestion then can only produce an, incomplete cure, a slightly spastic gait or some slowness and lack of accuracy in the first movements of a limb being left as the permanent result of the shell shock.6
The Psychological Body
Published in Roger Cooter, John Pickstone, Medicine in the Twentieth Century, 2020
It is important to recognize the limitations to the influence of psychology within each of these institutional sites before the Second World War. The new profession struggled when it infringed on the territory of better established, more powerful groups. The resistance to mental tests from the military in the US Army during the First World War has already been noted. There was a similar tension in other combattant armies over whether shell-shocked troops were suffering from a psychological condition or were simply malingerers, with the military most concerned to protect manpower resources and trained to regard the problem as one of morale rather than psychology. Studies of the education system in interwar Britain also point to the relatively limited advance of psychological as opposed to more traditional scholastic examinations. This was partly the result of lack of resources and the scarcity of psychologists, and it was partly a reflection of the caution towards the new expertise from those who administered the system. The special school system in fact expanded little beyond the scale it had already reached in 1913 before the widespread availability of psychologists and their tests.
Psychiatry in contexts
Published in Gerrit Glas, Person-Centered Care in Psychiatry, 2019
Ad [a]. Large historical, socioeconomic, and/or physical events are a mixed bag, with war, migration (refugees), natural disasters, famine, and nuclear explosions as major contributors to mental health problems. Textbox 7.1 discusses an intriguing historical example: the fate of effort syndrome, which offers a clear picture of how wars not only determine the incidence of mental disorder, but also the way symptoms are labeled and sanctioned. Without medical sanctioning, these soldiers could expect to be accused of malingering and, therefore, of desertion. The history of “shell shock” is an even more telling case, with around 300 death penalties for malingering and even some medically unexamined soldiers who were sentenced to death (Shephard 2000, p. 67ff).
Matthew J. Friedman, M.D., Ph.D. and His Legacy of Leadership in the Field of Post-traumatic Stress Disorder
Published in Psychiatry, 2022
John H. Krystal, Steven M. Southwick, Matthew J. Girgenti
In order to appreciate the impact of the two initiatives led by Matt on our understanding of the neurobiology of PTSD, one must first appreciate how limited our understanding of PTSD was prior to the creation of NCPTSD. Although physiologic studies of “shell shock,” “combat fatigue,” and related conditions took place in the context of both World Wars, modern neuroscience approaches to PTSD began following the establishment of this diagnosis in DSM III in 1980 (Krystal et al., 1989). The emergence of neuroscience as an important domain of PTSD research revolved around five key perspectives: 1) aspects of PTSD resembled Pavlovian fear conditioning (Blanchard et al., 1982), 2) antidepressant medications were helpful in reducing PTSD symptoms (Frank et al., 1988; Friedman, 1988), 3) studies of urine hormone levels implicated sympathetic arousal and cortisol dysregulation (Kosten et al., 1987; Mason et al., 1986), 4) sleep EEG studies reported altered sleep architecture (Lavie et al., 1979), and 5) basic neuroscience could provide a framework that would inform our understanding of the neurobiology and treatment of PTSD (Van der Kolk et al., 1985).
Disaster mental health: remembering the past, shaping the future
Published in International Review of Psychiatry, 2021
Disasters require innovation; great disasters require great innovation. Interestingly, and as alluded to previously, much of the foundation of the field of disaster mental health can be traced to the two great world wars of the 20th Century. Field observations from World War I gave rise to the construct of ‘shell shock.’ Shell shock consisted of what was then termed a neurosis-like syndrome characterized by anxiety, withdrawal, hyper-arousal, and revivifications. Based on clinical observations of veterans of World War I and World War II, Abram Kardiner (1941) referred to the syndrome as a ‘physioneurosis.’ Kardiner chose the term in contradistinction to Freud’s psychoneurosis (Aktualneurose). The work of Kardiner can be seen as a precursor to the development of the diagnostic construction of posttraumatic stress disorder (PTSD).
Traumatic brain injury among refugees and asylum seekers
Published in Disability and Rehabilitation, 2019
PTSD has been a part of the brain injury conversation for over 100 years, dating back at least to World War I with the use of the term “Shell Shocked” to describe abnormal behaviors of returning soldiers [14]. Even in a non-refugee population PTSD is relatively common after a head injury. A British hospital reporting on 1534 civilians involved in traffic accidents showed development of PTSD in 48% of individuals who experienced a loss of consciousness for <15 min and in 23% of the group with no loss of consciousness [15]. The prevalence of PTSD among refugees and asylum seekers has been shown to be quite high even without a history of brain injury. In a review of 10 studies, Hollifield et al. [16] found a range in prevalence of PTSD in refugee populations from 4 to 86%. PTSD is also widespread among refugee children who may be subjected to physical violence against them or have been forced to observe violence inflicted upon relatives and peers. In a review of 42 articles, PTSD was reported to be present in 40–63% of refugee children [17]. The symptoms experienced by individuals with TBI can share many similarities to PTSD and separating symptoms between the two conditions can be challenging, if not impossible.