Psychological Factors in Combat Fatigue

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Abstract
This paper is based upon experience with subacute cases of combat and operational fatigue, seen at a Naval convalescent hospital. The combination of symptoms for this group is anxiety, irritability, startle reaction to sudden noises, insomnia, and nightmares. These symptoms are very constant. Their common nucleus is the emergency physiologic mobilization for fight or flight with its psychological concomitants. When this physiological mobilization becomes intense enough to upset the individual''s psychological equilibrium of emotional forces it produces persisting symptoms rather than merely aiding the reaction to fight or flight. The intensity of the reaction depends upon both the external precipitating circumstances and the internal make-up of the man. The control of the reaction depends also upon both external and internal factors. The essence of the combat fatigue syndrome is that the man''s experiences stimulate and mobilize emotions which have always been important in the personality, and which overwhelm and strain his forces of control. He is unable to digest the experiences or to regain control of the emotions that have been aroused. Chief among these emotions is hostility with its accompanying reaction to violence.

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