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The journey from moral inferiority to post-traumatic stress disorder

What has been learned over the past century about the psychological injuries of war?

One of the striking differences between recent conflicts and the conflagrations of the past century is that the number of physical casualties has been drastically reduced, a change that has placed greater focus on the psychological costs of war. To place the enormity of earlier losses into context: around 14% of those who served in World War I died (over 60 000 Australians), and a further 40% (more than 156 000 men and women) were wounded, gassed or taken prisoner — at a time when the nation’s population was only 4.9 million.1

Those who survived the Great War were regarded as fortunate, even if they returned home with crippling injuries. There was often little empathy for the psychological wounds of the veterans, construed by many as reflecting moral inferiority, compensation-seeking or “poor seed”. In particular, there was considerable debate within the medical profession as to whether the traumatic neurosis of war — shell shock — was organic or psychogenic in origin.2

Recognition of post-traumatic stress disorder

Veterans of the Vietnam War confronted the medical establishment in the United States and Australia about the lack of understanding for their mental suffering shown by veterans’ affairs officials. They…