Current progress and future perspective in combat stress reactions

• Main Authors: FENG Zhengzhi, WANG Jia
• Format: Article
• Language: zho
• Published: Editorial Office of Journal of Third Military Medical University 2019-02-01
• Series: Di-san junyi daxue xuebao
• Subjects: military psychology; combat stress reactions; influencing factors; psychological intervention
• Online Access: http://aammt.tmmu.edu.cn/Upload/rhtml/201809150.htm

Soldiers in the combat field may demonstrate such non-adaptive reactions as panic disorder, narrow visual field and hearing disturbance, which potentially cause non-combat attrition and compromise the high-level cognitive functions (reasoning, judgment and decision-making). These non-adaptive reactions, known collectively as combat stress reactions (CSR), can be categorized into different subtypes based on the severity and types of the symptoms. The protective factors against CSR include social support, positive copping style, self-efficacy, strong team leadership and group cohesion, which all help to reduce the impact of stress events. The threat of death, harsh environment and poor health condition are the risk factors that contribute to the occurrence of CSR. Studies of CSR in a neurological perspective revealed that in the event of CSR, catecholamine release might promote the levels of alertness and excitability of an individual to enhance the combat efficacy; excessive alertness in this scenario, however, may cause overestimation of the risk information. Meanwhile, the interaction between the activated amygdala and the prefrontal cortex interferes with the execution control functions, leading to possible irrational behaviors. Long-term stress may even change the brain structure and potentially cause post-trauma stress disorder (PTSD). Based on these observations, military psychologists proposed several intervention principles for CSR, including PIE, IMPRESS and BICEPS. These principles point to the importance of simple and quick handling of CSR with necessary physical, emotional and social support to help the soldiers regain combat abilities soon. The specific measures of CSR control include battle mind debriefing, trauma risk management, eye movement desensitization and reprocessing, and ego-state therapy. Future studies of CSR will focus on developing quick evaluation tools and standards and accurate prediction of CSR occurrence; reinforcement of combat-oriented simulation training and establishment of systemic strategies of countermeasures against CSR; reinforcement of CSR management in combat field and establishment of CSR control unit in the field hospitals; and exploration of the mechanisms of CSR occurrence and the pathways that mediate its effects.