The Cost of War

Author(s):  
Stephen Garton

War has shaped Australian society profoundly. When we commemorate the sacrifices of the Anzacs, we rightly celebrate their bravery, but we do not always acknowledge the complex aftermath of combat. In The Cost of War, Stephen Garton traces the experiences of Australia’s veterans, and asks what we can learn from their stories. He considers the long-term effects of war on returned servicemen and women, on their families and communities, and on Australian public life. He describes attempts to respond to the physical and psychological wounds of combat, from the first victims of shellshock during WWI to more recent understandings of post-traumatic stress disorder. And he examines the political and social repercussions of war, including debates over how we should commemorate conflict and how society should respond to the needs of veterans. When the first edition of The Cost of War appeared in 1996, it offered a ground-breaking new perspective on the Anzac experience. In this new edition, Garton again makes a compelling case for a more nuanced understanding of the individual and collective costs of war.

2007 ◽  
Vol 13 (5) ◽  
pp. 358-368 ◽  
Author(s):  
Gwen Adshead ◽  
Scott Ferris

Not all traumatic events cause post-traumatic stress disorder (PTSD), and people develop PTSD symptoms after events that do not seem to be overwhelmingly traumatic. In order to direct services appropriately, there is a need to distinguish time-limited post-traumatic symptoms and acute stress reactions (that may improve spontaneously without treatment or respond to discrete interventions) from PTSD, with its potentially more chronic pathway and possible long-term effects on the personality. In this article, we describe acute and chronic stress disorders and evidence about the most effective treatments.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yajing Sun ◽  
Yuanyuan Qu ◽  
Jianwei Zhu

Background: Stress disorders, such as post-traumatic stress disorder (PTSD), are attracting much attention. However, the relationship between traumatic stress and inflammation is rarely discussed.Subjects and Methods: As studies have linked PTSD to altered susceptibility to various diseases, such a psychiatric condition may lead to long-term systematic changes in physiological functions. We searched PubMed with the keywords “traumatic stress,” “stress disorders,” “post-traumatic stress disorder,” and “inflammation.”Results: Based on 65 previously published studies, we reviewed the long-term effects of PTSD, as well as traumatic events, on inflammatory function from both epidemiological and biological perspectives. Post-traumatic stress disorder is related to the immune response, including an increase in inflammatory factors and a reduction in anti-inflammatory factors. Additionally, it has been demonstrated that traumatic stress disorder and immune disease share a common genetic basis at the gene expression level.Conclusions: Understanding this relationship is of great significance for optimizing treatment plans for patients with PTSD.


2021 ◽  
Vol 9 (2) ◽  
pp. 250-262
Author(s):  
Andrea Roxana Bellot

Abstract Outside Paducah: The Wars at Home (2016), a play written and performed solo by James Allen Moad II, a former Air Force pilot, explores the enduring effects of war on American veterans and their families after soldiers return home from the battleground. The play moves beyond the individual representation of a traumatized veteran by addressing two intertwined issues: the collective and transgenerational burden of war, both in the form of physical wounds and/or moral injuries. Outside Paducah contributes to promoting the stage as a dynamic place to think about the war legacy and to question and challenge war itself by stressing the importance of understanding the cost of war on both personal and societal levels. The play shows that the scenes of war fought in foreign lands are brought back to the home territories and families, who become equally demoralised by the perpetuation of war in their homelands. The soldiers return as ghosts of their previous selves and haunt their families and friends from one generation to the next. Therefore, war remains an open wound at the core of the American nation. At the same time, the play sheds some light on the harsh realities of the underprivileged and how joining the military often seems to provide a way out of the world of poverty and lack of resources.


2019 ◽  
Vol 48 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Martina Hinsberger ◽  
Leon Holtzhausen ◽  
Jessica Sommer ◽  
Debra Kaminer ◽  
Thomas Elbert ◽  
...  

AbstractBackground:Post-traumatic stress but also aggressive attitudes and behaviour can be found in adolescents living in a context of ongoing community and gang violence in the low-income urban areas of Cape Town, South Africa.Aims:We investigated the long-term effects (15–20 months after therapy) of (a) Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET) and (b) the cognitive behavioural intervention ‘Thinking for a Change’ (CBT) on post-traumatic stress disorder (PTSD) and aggression compared with a waiting list.Method:Fifty-four young males participated in the treatment trial, of which 17 completed the FORNET intervention, 11 the CBT intervention, and 26 were on a waiting list. The primary outcome was the change score for the Appetitive Aggression Scale; secondary outcomes were the PTSD Symptom Scale-Interview change scores, and the number of perpetrated violent event types.Results:The reduction in scores for PTSD that had been observed in FORNET completers at the first follow-up were still significant at the second long-term follow-up (Cohen’s d = 0.86). In this treatment arm (FORNET), the scores for appetitive aggression were also significantly reduced (Cohen’s d = 1.00). There were no significant changes observed for CBT or for the waiting list.Conclusions:The study indicates that FORNET can successfully reduce post-traumatic stress as well as the attraction to violence even for individuals living under conditions of continuous traumatic stress.


BMJ ◽  
2021 ◽  
pp. n1648
Author(s):  
Harry Crook ◽  
Sanara Raza ◽  
Joseph Nowell ◽  
Megan Young ◽  
Paul Edison

Abstract Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes. Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache. This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.


Author(s):  
Roman Popeliushko ◽  

The article emphasizes that Ukrainian society is suffering from the effects of the war in the east of the country. These consequences are manifested both in the direct participants in the hostilities and in their family members, who have been in a state of stress for a long time, waiting for the disappointing news from the east about their relatives and friends. It is noted that while participating in hostilities, many combatants receive combat mental injuries. These injuries further lead to post-traumatic stress disorder and other psychosomatic disorders that cause his psychoso-cial self-isolation, disruption of relationships with family and self-destructive behav-ior that leads to premature death. An urgent and urgent problem of today's Ukrainian state is the organization of effective social and psychological rehabilitation of combatants and their families. But at the moment, Ukraine has not created a single comprehensive program of social and psychological rehabilitation of combatants and their families. Therefore, the aim of the article is to analyze the initial diagnostic indicators of psychological trauma of combatants who took part in our proposed program of psy-chological support of combatants and their families, at the initial, first stage of this program. The methodological bases of the work were such general scientific and special methods as: method of analysis and generalization of psychodiagnostic indicators, formal-logical method, psychological and clinical methods and tests. This paper briefly considers the purpose, main tasks and structural components of the proposed program of psychological support of combatants and their families. The main focus of the work is focused on the first (diagnostic) phase of the program. The purpose of this stage was to carry out a psychological diagnosis of the long-term effects of stressors in combatants. The implementation of the diagnostic stage was carried out during 2018, on the basis of military units, recreational facilities, social, volunteer and rehabilitation centers, etc. The total number of combatants covered by the study was 356 people. It is emphasized that for the experimental study of long-term effects of stress-ors in combatants, a proven set of clinical-psychopathological and psychodiagnostic techniques was proposed to study 5 factors that have become key in building a sys-tem of psychological rehabilitation of combatants. These factors included: the pres-ence of signs of post-traumatic stress disorder; the presence of signs of stress; the presence of signs of anxiety; the presence of signs of depression; and combat experi-ence of the combatant. Analysis of the results of the first stage of the program of psychological sup-port combatants noted the presence of a large number of subjects, such phenomena as post-traumatic stress disorder (more than 60% of combatants), stress (more than 45% of combatants), anxiety (more than 35% of combatants), depression (more than 30% of combatants). Also drawn attention to the fact that the findings confirm the results of previ-ous studies of domestic and foreign researchers and practitioners that some of the combatants who participated in the fighting eventually begin to suffer from long-term effects of stress effects. Therefore, further implementation of the program of psychological support of combatants, with long-term effects of stress, and their families, on the basis of genetic-psychological-axiological approach, namely the second stage, which provides psychological and social assistance or support to combatants and their families, is a promising and effective means of their psychological rehabilitation.


2019 ◽  
Vol 37 (8_suppl) ◽  
pp. 97-97
Author(s):  
Anne Rogiers ◽  
Gil Awada ◽  
Julia Schwarze ◽  
Jennifer De Cremer ◽  
Laila Ben Salama ◽  
...  

97 Background: Immunotherapy with the CTLA-4 blocking mAb ipilimumab (IPI) has improved the long-term (>3 y) survival of a subpopulation (15-20%) of patients (pts) with metastatic melanoma. Little is known about the psychosocial outcome and the long-term effects of immune-related adverse events in these survivors. Methods: Pts with advanced melanoma (AJCC stages IIIC or IV) who were in complete remission for at least 2 y after treatment initiation, were eligible for this ongoing study. Data on health related quality of life (HRQOL), psychosocial outcome and neurocognitive function (NCF) were collected using 5 validated questionnaires, a semi-structured psychiatric examination (SSPE), and computer-based NCF testing. Results: Test results from 17 pts (5 F/12 M), median age 57 y (range 33-86) were analyzed. Median time since start of IPI was 5.5 y (range 2-7). Seven pts (41%) had elevated scores on the Cognitive Failure Questionnaire (CFQ). Nine pts (53%) had elevated scores on the Hospitalization Depression Scale (HADS) indicating moderate anxiety (4 pts), severe anxiety (2 pts), and moderate depression (3 pts). The SSPE revealed that all 10 pts who were professionally active at the time of diagnosis, had to change or stop work due to their illness. Nine pts (53%) reported persisting emotional distress: anxiety, existential problems, survivor guilt, post-traumatic stress symptoms or daily worrying about the disease. Three pts were referred for suicidal ideation in relation with their disease. Four pts (24%) developed hypophysitis and suffered from comorbid depression (1 pt), adjustment disorder (2 pt), or post-traumatic stress disorder related to the symptoms of hypopituitarism (1 pt). Five years after the incidence of hypophysitis, all pts had elevated scores on the Fatigue Severity Scale, the HADS; and 3 pts on the CFQ. All cases of skin toxicity (8 pts), hepatitis (2 pts), colitis (2 pts), sarcoidosis (2 pts), and Guillain-Barre syndrome (1 pt) resolved without long-term impact on HRQOL. Conclusions: A majority of melanoma survivors treated with IPI continues to suffer from emotional distress and cognitive problems impacting their HRQOL. Timely detection and providing adaptive care is imperative.


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