Combat/Operational Stress Adaptations and Injuries

Men and women who participate in combat or who deploy to military operations in support of combat have always been affected by these experiences. Persistent reactions to combat and operational stress are clearly identifiable in the literature of antiquity (Shay, 1994, 2002), and military surgeons have described characteristic stress reactions since at least the 18th century (Jones, 1995b). The specific reactions experienced by warriors have changed, somewhat, from generation to generation and war to war (Jones, 1995a), but a lot has not changed over time. Terror is still terror. Grief is still grief. Courage, honor, and self-sacrifice-the most venerable of reactions to stress-still play the role they always have in military operations. And the core features of the major adverse operational stress reactions are much the same now as they were in the American Civil War (Dean, 1997) and the many wars of the 20th century (Shephard, 2001; Solomon, 1993).