Flashbacks and post-traumatic stress disorder: The genesis of a 20th-century diagnosis

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Abstract

Background: It has been argued that post-traumatic stress disorder (PTSD) is a timeless condition, which existed before it was codified in modern diagnostic classifications but was described by different names such as 'railway spine' and 'shellshock'. Others have suggested that PTSD is a novel presentation that has resulted from a modern interaction between trauma and culture. Aims: To test whether one core symptom of PTSD, the flashback, has altered in prevalence over time in soldiers subjected to the intense stress of combat. Method: Random selections were made of UK servicemen who had fought in wars from 1854 onwards and who had been awarded war pensions for post-combat disorders. These were studied to evaluate the incidence of flashbacks in defined, at-risk populations. Results: The incidence of flashbacks was significantly greater in the most recent cohort, veterans of the 1991 Persian Gulf War; flashbacks were conspicuous by their absence in ex-servicemen from the Boer War and the First and Second World Wars. Conclusions: Although this study raises questions about changing interpretations of post-traumatic illness, it supports the hypothesis that some of the characteristics of PTSD are culture-bound. Earlier conflicts showed a greater emphasis on somatic symptoms.

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APA

Jones, E., Hodgins Vermaas, R., McCartney, H., Beech, C., Palmer, I., Hyams, K., & Wessely, S. (2003). Flashbacks and post-traumatic stress disorder: The genesis of a 20th-century diagnosis. British Journal of Psychiatry, 182(FEB.), 158–163. https://doi.org/10.1192/bjp.182.2.158

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