That doesn’t mean they haven’t tried. “During World War II, there were psychiatrists stationed at all the draft boards, and they screened everybody,” says Blank. “Those they thought might have some psychological susceptibility to war neurosis were given a 4F classification. By 1944, a million people had been screened out of the draft for psychiatric reasons, and another million had been discharged from military duty for psychological problems.”
When Army Gen. Dwight D. Eisenhower became president of Columbia University in New York in 1948, he commissioned economics professor Eli Ginzberg to investigate why so many men had been rejected. “Ginzberg formed a commission comprising many of the psychiatrists from the draft boards [that] did a study and published the Ginzberg report, which basically noted there’s no way of telling who’s going to break down in combat,” says Blank. “So a lot of people have worked quite hard on the question, but we haven’t accomplished much so far.”
There are, however, factors that increase the likelihood of developing PTSD. “The more close calls a person has — like a bullet hitting the person next to you — the greater the chances you’ll get PTSD. The more close buddies who are killed, the higher the chances,” Blank says. A third factor is exposure to gruesomeness.
[CONTINUES ON PAGE 88]
Traumatic Brain Injuries
Traumatic brain injury (TBI) has become one of the most common types of trauma suffered by servicemembers in Afghanistan, because of IED and mortar attacks. It’s also one of the most difficult to diagnose; like PTSD, there often are no outward signs of injury. But even if a service-member isn’t struck by shrapnel, shock waves from nearby explosions can cause sudden movement of the brain within the skull, damaging brain tissue and often causing intracranial bleeding.
“The problem is that TBIs aren’t visible,” notes Gregory Ford, Ph.D., an assistant professor of biology at Morehouse College in Atlanta. “But if there’s damage such as a slow bleed in the brain, you have a situation where the person’s brain is dying. And sometimes it isn’t detected until days later. So the person may gradually begin to lose certain brain functions: They may develop tingling in the fingertips or begin to forget things. In some cases, symptoms associated with PTSD may actually be the consequence of an undiagnosed TBI.”
Though there is no effective treatment for TBI unless a penetration is involved, improving awareness and empowering servicemembers to seek help are key. A recent partnership between the Army and the National Football League (NFL) aims to do just that. Leaders from both organizations and a panel of soldiers and retired NFL players who suffered concussions met in August 2012 to discuss research, prevention, and treatment of TBI. Army Chief of Staff Gen. Ray Odierno and NFL Commissioner Roger Goodell both agreed the challenge is getting soldiers and football players to ask for help after receiving concussions.
APRIL 2013 MILITARY OFFICER 57
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