Changes in Scholarly Conversation over Time
In Module 1, Characteristics of Information, you learned about how information changes and develops over time as part of the information lifecycle. Mass media information begins publication closest to the time of the event, followed by publication of increasing in-depth information. Scholarly journal articles are the end product of on-going scholarly conversations that develop over years. The timeline in this module illustrates a conversation over the course of 100+ years. This conversation is not over, it continues today. (1)
The timeline illustrates how the scholarly conversation about post-traumatic stress disorder (PTSD) has evolved over time. Notice how theterminology changed, as well as how the scholarly conversation impacted care for and attitudes toward combat-related PTSD.
Notice the strategies that Dr. Rivers, Debbie, and David use to find current research.
World War Ⅰ: Shell Shock & War Neuroses
General attitude towards soldiers traumatized by the war is overwhelmingly negative: shell-shock sufferers were ‘lead-swingers’ and malingerers who should be treated in an appropriately punitive fashion and not sent on holiday in the Scottish countryside” (Webb, 2006).
Dr. Rivers: British Psychiatrist & Anthropologist
W. H. R. Rivers comes back from doing research in Melanesia and visits his friend, the psychology lecturer T. H. Pear. Rivers feels out of the loop and wants to catch up on the latest in psychology research. He asks Pear to recommend articles and books about Freud , specifically on Freud’s theory of the unconscious.
Rivers and World War Ⅰ
Rivers works at Craiglockheart War Hospital, which was used specifically to treat victims of shell shock . He keeps up to date on recent research by subscribing to peer-reviewed journals and attending meetings of the Royal Society of Medicine .
Rivers and Freud
Rivers uses Freud’s new theory of forgetting to devise treatment for his war neuroses patients. Instead of telling soldiers to suppress their war experiences, he advises them to process their memories and emotions but not to “dwell persistently upon painful memories…[or] brood upon feelings of regret and shame” (Jureidini, 2006).
Conversations with Colleagues
Rivers writes a paper about his observations, “The Repression of War Experience,” and presents it to his colleagues in the field of psychiatry at one of the meetings of the Royal Society of Medicine. The study references Freud’s theories about repression. His paper, along with comments from his peers and his response to those comments, is published in the group’s journal, Proceedings of the Royal Society of Medicine in 1918.
A Change in Sentiment Begins
River’s work helps shape future treatment and public opinion towards war neuroses in Europe. However, public opinion in the United States will not begin to change for many more decades (Herman, 1997).
World War Ⅱ: Combat Exhaustion & Battle Fatigue
The set of symptoms previously known as shell shock is now referred to as combat exhaustion or battle fatigue . Attitudes towardcombat exhaustion are still mostly negative and place blame on the soldiers or the soldiers’ mothers for not weaning them properly and sending them too many letters (Pfau, 2008).
Diagnostic and Statistical Manual Ⅰ (DSM-Ⅰ)
This manual includes a diagnosis for gross stress reaction : “Under conditions of great or unusual stress, a normal personality may utilize established patterns of reaction to deal with overwhelming fear…This diagnosis is justified only in situations in which the individual has been exposed to severe physical demands or extreme emotional stress, such as in combat or in civilian catastrophe” (DSM-Ⅰ, p. 40).
The scholarly conversation’s transition from placing blame on the soldiers to examining the effects of trauma on soldiers (and treating them) resulted in more robust preventative mental health care for soldiers in the Vietnam War. For example, every battalion had medical personnel trained in psychiatric care (Scott, 1990).
DSM: Ⅱ Published
Gross stress reaction is not included in the DSM-Ⅱ (Andreasen, 2004). Some scholars blame military influence; others attribute its absence to the writers of the DSM-Ⅱ not having experience with veterans and that psychiatrists serving in the Vietnam War were using other diagnostic terms like “ adjustment reaction to adult life ” (Scott, 1990).
Chaim Shatan: Psychiatrist and Advocate for Vietnam Veterans
Shatan writes an Op-Ed piece for The New York Times about post-Vietnam syndrome . This article garners a great deal of support for adding a diagnosis for combat-related trauma back to the DSM (Scott, 1990).
Debbie: A College Student
Debbie reads Chaim Shatan’s New York Times article about post-Vietnam syndrome and is inspired to do further research.
Debbie’s Search for Information
Debbie needs to write a paper for class. She asks a librarian for help finding recent research because she can’t find any articles or books on post-Vietnam syndrome . The librarian recommends two journals : Comprehensive Psychiatry and Archives of General Psychiatry , which have both published recent articles about psychiatric problems in Vietnam War veterans.
Debbie: Writer and Advocate
Debbie writes a paper for her class about Vietnam veterans coming back from the war and argues for including post-Vietnam syndromein the next DSM.
The DSM-Ⅲ includes the diagnosis posttraumatic stress disorder (PTSD) . Notice that the term is not hyphenated. The current DSM-Ⅴ also does not hyphenate the term posttraumatic stress disorder . However, many scholarly and medical publications do (i.e., post-traumatic stress disorder ). There is no consensus among dictionaries on the proper spelling. Searching with the hyphen and without the hyphen produces different results.
David: Soldier, Student, and Scholar
David does a year of service with the Army. While in Afghanistan, he experiences a traumatic event, and he now suffers from PTSD .
Exploring His Story and Others
David enrolls in college as a psychology major and does research about the long history of PTSD to help put his experiences into perspective. He also blogs about his experiences and research. David decides to broaden his search, goes to a library database, and sets up an alert to identify the most recent research as it is published.
Let’s explore some of the other strategies David can use to find new research. (26)