Complex PTSD, especially for small children facing abuse and neglect, changes the brain. I don’t think that has changed to suddenly become a “modern” thing. It’s just that we now recognize it, children suffering from it aren’t just some “bad apples”.

People in general want to think of “bad things happening” as something to be put behind you, something that doesn’t affect you at all anymore. They don’t want to hear that something is still haunting you, especially if it happened decades ago. It’s one thing if it is something physical, but mental… you are supposed to just “get over it”. So I’m not at all surprised if there aren’t that much of medical reports about PTSD historically… you want romanticised stories about war heroes, not write about somebody still waking up to the war decades after it ended.

http://www.youtube.com/watch?v=jeGKuTZtkpg 

“I don’t like words that hide the truth. I don’t like words that conceal reality. I don’t like euphemisms, or euphemistic language. And American English is loaded with euphemisms.

Cause Americans have a lot of trouble dealing with reality. Americans have trouble facing the truth, so they invent the kind of a soft language to protect themselves from it, and it gets worse with every generation. For some reason, it just keeps getting worse. I’ll give you an example of that.

There’s a condition in combat. Most people know about it. It’s when a fighting person’s nervous system has been stressed to it’s absolute peak and maximum. Can’t take anymore input. The nervous system has either (click) snapped or is about to snap.

In the first world war, that condition was called shell shock. Simple, honest, direct language. Two syllables, shell shock. Almost sounds like the guns themselves.

That was seventy years ago. Then a whole generation went by and the second world war came along and very same combat condition was called battle fatigue. Four syllables now. Takes a little longer to say. Doesn’t seem to hurt as much. Fatigue is a nicer word than shock. Shell shock! Battle fatigue.

Then we had the war in Korea, 1950. Madison avenue was riding high by that time, and the very same combat condition was called operational exhaustion. Hey, we’re up to eight syllables now! And the humanity has been squeezed completely out of the phrase. It’s totally sterile now. Operational exhaustion. Sounds like something that might happen to your car.

Then of course, came the war in Viet Nam, which has only been over for about sixteen or seventeen years, and thanks to the lies and deceits surrounding that war, I guess it’s no surprise that the very same condition was called post-traumatic stress . Still eight syllables, but we’ve added a hyphen! And the pain is completely buried under jargon. Post-traumatic stress disorder.

I’ll bet you if we’d of still been calling it shell shock, some of those Viet Nam veterans might have gotten the attention they needed at the time. I’ll betcha. I’ll betcha.”

http://dryhootch.org/profiles/blogs/george-carlin-amp-ptsd

It appears to me most of the discussion here is people talking past each other, but that’s nothing new in any setting or context.

 The Frueh and Smith article on Civil War diagnoses is behind a paywall at $36 a peek, as is the McNally response, as is the Ben-Ezra article on trauma in antiquity.

While I find the subject interesting, and believe I see serious flaws in the arguments as summarized here, I’m reluctant to shell out $30-$100 of my entertainment money towards advancing an argument on the Internet.

If you’ve read the journal articles, would you be willing to digest them and write a more complete post summarizing them in your view?

Finding similar symptoms documented from earlier wars would be complicated by the differing military expecatations and reactions of the time; which would have impacted on the surviving ‘sample’. I assume that the WWI approach, however inequitable, was more progressive than previous approaches; so it’s possible that only the mildest cases of PTSD survived earlier conflicts, with the most severe cases being left on the battlefield.

None of your counter-examples work because for people who are raped, survive robberies, or see a friend being killed (or accidentally kill someone themselves, or… list goes on) there is not a comparable legitimate reason for any of those things happening. It’s pretty much the same thing – there was no reason for those things to happen. No justification will ever make up for it.

As another example, note that people who justify murdering someone to themselves with a reason that, to their deranged mind, is legitimate probably don’t get PTSD. Or to make it political again, a freedom fighter is probably not going to get PTSD after they assassinate (aka murder) a terrible dictator in cold blood. Not that they can’t, of course, it’s just much less likely than people who are sent into war zones and all their friends get blown to bits right in front of them for no particularly legitimate reason.

Also, it does say that soldiers were disproportionately likely to suffer from substance abuse. While that is clinically not diagnosable as PTSD, it is definitely a symptom of trauma. These researchers are looking to far into the DSM and not far enough into the humans who experienced trauma.

For another thing, warfare has changed a lot more than bashings, rape, torture, etc. have changed. In the American Civil War, most battles lasted less than a day, and the longest were only about three days. In the First World War, most battles lasted months, and soldiers could spend weeks in the trenches before being rotated out. It would probably make more sense to compare survivors of slave plantations with survivors of Nazi death camps, than to compare survivors of different wars. I’m sure each of these can mess up people’s stress responses, but not the same way.

http://drvitelli.typepad.com/providentia/2007/10/shell-shocked-p.html

http://drvitelli.typepad.com/providentia/2007/11/shell-shocked-p.html

In other words, there would have been many more having terrifying experiences but despite the higher rates of trauma and mentions of other mental problems, there is virtually no mention of anything like the intrusive thoughts or flashbacks of PTSD.

In a world where there are no movies or television and even photographs are rare, how many triggers would there be?

I just read Brin’s Dogma of Otherness, and now I realize a lot of that goes on in BB threads. 

I think the answer is that they’re looking in the wrong damn place.  I doubt people in the mid-1800s typically thought of weird behavior or intrusive thoughts as in any way a medical  issue; why would they have put them in medical case notes?  “His leg amputation healed, so he’s fine now.  Discharged.”  Those would have been a matter for prayer, personal journals, or in very very rare cases, consulting an “alienist”.

If you were to look back at journals and accounts from people’s families, I think you’d find something completely different.  Read James Thurber’s comedic telling of his family’s story “The Night the Bed Fell”, for instance, and under the comedy you find a Civil War veteran who in the 1920s, 60 years later, is still hyper-sensitive to imagined threats, keeps an old pistol around at all times, flies into rages, and wakes up in the middle of the night thinking he’s under attack.  That sounds rather like the (stereotypic) modern aftermath of combat PTSD to me.

It’s possible that having the shakes for weeks, or years, or decades after combat might have been taken for granted. 

[Edited: added missing space in "any way"]

Lara Croft: I want you to list every “he’s not been right since the war” ever mentioned in Greek history.
Butler: There’s liable to be thousands!
Lara Croft: Then we’ll read thousands.

I’m also quite certain that societal pressures exacerbate these.  I don’t want to give the impression that I’m defending anything, but I can’t help thinking that molestation was probably a more traumatic experience for a boy in 1950s America than it was in say, ancient Greece or Rome.