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Military psychology is a specialist discipline within applied psychology. It entails the application of psychological science to military operations, systems and personnel. The specialty was formally founded during World War I in the UK and the USA, and it was integral to many early concepts and interventions for psychological and neuropsychological trauma. It also established a fundamental basis for the psychological assessment and selection of military personnel. During and after World War II, military psychology continued to make significant contributions to aviation psychology, cognitive testing, rehabilitation psychology and many models of psychotherapy. Military psychology now consists of several subspecialties, including clinical, research and occupational psychology, with the latter often referred to in the USA as industrial/organisational psychology. This article will provide an overview of the origins, history and current composition of military psychology in the UK, with select international illustrations also being offered., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Traumatic stressors have always been a part of the human experience. What is now referred to as posttraumatic stress disorder (PTSD) was first studied in the context of military trauma during the Civil War and World War I but most extensively in World War II. Much of what we know about the medical and psychological management of PTSD has its origins in military psychiatric approaches, and a review of these practices reveals important tenets that should be applied in current treatment for both military and nonmilitary PTSD. These practices include intervention as soon as possible after the traumatic exposure, provision for a safe and supportive therapeutic milieu designed for an individual's relatively rapid return to his or her responsibilities and normal activities, and using a combination of pharmacotherapy and psychotherapy (especially exposure to the traumatic memory). A review of current guidelines for treatment of PTSD reveals that few treatments are endorsed with great certainty, owing in large part to a paucity of clinical trials, particularly of pharmacotherapy. This shortcoming must be addressed to enable translation of promising discoveries in the neuroscience of fear into the therapeutic advances patients need and deserve. [AJP at 175: Remembering Our Past As We Envision Our Future March 1947: Psychiatric Experience in the War, 1941-1946 Brig. General William C. Menninger "Another observation which can be made as a result of our experience, is that if intensive treatment was provided early, in an environment in which the expectation of recovery prevailed, remarkable results were obtained." (Am J Psychiatry 1947; 103:577-586 )].

The 100th anniversary of the outbreak of World War 1 could be viewed as a tempting opportunity to acknowledge the origins of military psychiatry and the start of a journey from psychological ignorance to enlightenment. However, the psychiatric legacy of the war is ambiguous. During World War 1, a new disorder (shellshock) and a new treatment (forward psychiatry) were introduced, but the former should not be thought of as the first recognition of what is now called post-traumatic stress disorder and the latter did not offer the solution to the management of psychiatric casualties, as was subsequently claimed. For this Series paper, we researched contemporary publications, classified military reports, and casualty returns to reassess the conventional narrative about the effect of shellshock on psychiatric practice. We conclude that the expression of distress by soldiers was culturally mediated and that patients with postcombat syndromes presented with symptom clusters and causal interpretations that engaged the attention of doctors but also resonated with popular health concerns. Likewise, claims for the efficacy of forward psychiatry were inflated. The vigorous debates that arose in response to controversy about the nature of psychiatric disorders and the discussions about how these disorders should be managed remain relevant to the trauma experienced by military personnel who have served in Iraq and Afghanistan. The psychiatric history of World War 1 should be thought of as an opportunity for commemoration and in terms of its contemporary relevance-not as an opportunity for self-congratulation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

During the First World War combatants of all armies were prey to nervous disorders or psychological breakdown. These war neuroses were a response to the highly-industrialised nature of the warfare as well as to the fatigue engendered over four years of intense conflict. Yet while fear and mental breakdown were universal, national responses varied. A comparison of British and Belgian shell shock indicates that men suffered in very similar ways but that symptoms met with rather different responses: in Britain treatment and diagnostic regimes stressed the importance of class difference and shell shock was often linked to cowardice. These issues were not of overriding importance in the Belgian army. In the longer term shell shock became, and remained, a topic of political and social concern in Britain whereas in Belgium men suffering from kloppe (extreme fear) tended to be forgotten and the topic has not excited much popular interest or scholarly attention. Yet despite these differences one overarching theme remains clear, namely that despite the extensive experience of war neuroses during and after the First World War, there still remains a fierce stigma about the mental wounds of war.

We have little understanding of the increased active duty military suicide rates found in the United States, and little understanding of what is historically normative for combatants. Therefore, we examined historical records on suicides among the British Army during the Crimean War for the years 1854-1856. There were 18 documented suicides in the British Army during this period. Calculating an accurate annual suicide rate per 100,000 is impossible because it is unclear how many of the 111,313 military personnel were in country for each of the 2 years of the war. However, the range is conservatively estimated between 8 and 16 per 100,000, with the likely answer somewhere near the middle. This suggests the possibility that increasing suicide rates among active duty military may be a modern U.S. phenomenon., (Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.)

The aim of this article is to offer an overview of the research into diagnosis and treatment of war neuroses at the Clinic for Nervous and Mental Diseases at the Jagiellonian University in Krakow before the outbreak of World War II. It also includes a profile of the work of Prof. Jan Piltz, the then director of the Clinic, and his major scientific achievements. The publications cited in the article date in the main from the period of World War I, and comprise clinical analyses of the consequences of stress suffered at the front as well as a description of the ways in which they were treated. These are presented alongside other major findings related to war neuroses being made in Europe at the time. The article draws attention to the very modern thinking on treatment of war neuroses, far ahead of the average standards of the day, evinced by Prof. Piltz and his team. The most important innovative elements of their treatment of these conditions were the fact that they perceived the cause of the neurosis to lie in previous personality disorders in the patients, their recommendation of psychotherapy as the main method of treatment, and their emphasis on the need for further rehabilitation following the completion of the course of hospital treatment. They also paid significant attention to the importance of drawing up individual therapy plans for each patient.

World War I witnessed the admission of large numbers of German soldiers with neurological symptoms for which there was no obvious organic cause. This posed a considerable challenge for the military and medical authorities and resulted in an active discussion on the etiology and treatment of these disorders. Current historiography is reliant on published physician accounts, and this represents the first study of treatment approaches based on original case notes. We analyzed patient records from two leading departments of academic psychiatry in Germany, those at Berlin and Jena, in conjunction with the contemporaneous medical literature. Treatment, which can be broadly classified into reward and punishment, suggestion, affective shock, cognitive learning, and physiological methods, was developed in the context of the emerging fields of animal learning and neurophysiology. A further innovative feature was the use of quantitative methods to assess outcomes. These measures showed good response rates, though most cured patients were not sent back to battle because of their presumed psychopathic constitution. While some treatments appear unnecessarily harsh from today's perspective and were also criticized by leading psychiatrists of the time, the concentration of effort and involvement of so many senior doctors led to the development of psychotherapeutic methods that were to influence the field of psychiatric therapy for decades to come.

Friedrich Mauz is one of the medical perpetrators of the second tier whose biography is difficult to comprehend. Autobiographies from three different political systems exist - Weimar Republic, the Third Reich, and postwar Germany in which he constantly reinvented himself. While after 1933 he suddenly emphasized his participation in the civil war turmoil during the early period of the Weimar Republic and his patriotism, he then depicted himself after 1945 as an apolitical person characterized by Württemberg pietism who inwardly rejected the Nazi State but had found himself prepared to accept "all sorts of humiliating concessions." He claimed that he had always remained true to his scientific code of conduct and had distanced himself from psychiatric genetics. In point of fact, Mauz was among those exonerated in the denazification trial in 1946 and was able to pursue his career in the Federal Republic of Germany. However, if the sources are read against the grain, a different picture emerges. Mauz's career stalled in the 1930s, not because he had been politically offensive, but because his scientific work was flimsy and considered lacking originality, particularly since he had chosen constitution research and psychotherapy as his main fields of interest, which were overshadowed by research in genetic psychiatry in the 1930s. Mauz tendered his services to the Nazi policy of genetic health, served as a medical assessor in proceedings based on the "Law for the Prevention of Genetically Diseased Offspring," permitted himself to be recruited for the T4 program as a medical expert, even participated in the deliberations on a future "Law on Euthanasia," and as a consulting psychiatrist for the German Armed Forces contributed to military medicine.

Herbert Spiegel, MD, was a pioneer in American psychiatry and the field of hypnosis, which he first started using as an army psychiatrist posted at Fort Meade, Maryland. He served as a battalion surgeon during the invasion of North Africa and later in the Tunisian campaign. On the battlefield, Spiegel used hypnosis for quick symptom resolution and pain control. He was wounded in action on May 7, 1943, and was awarded a Purple Heart for his courage and bravery. When Spiegel was evacuated back to America, he began writing about short-term treatment strategies based on cognitive restructuring, hypnosis, and other clinical techniques. This article details his early life and career.

During the Great Patriotic War in Kirov Red Army soldiers provided specialized psychiatric care. 24 June 1942 on the basis of evacohospital N 1322 was organized by the psychiatric ward. This department carries out all necessary psychiatric care until November 1945.

Soldier's heart was a medico-psychiatric condition that was first documented during the American Civil War. This condition affected British and American soldiers during the late-nineteenth and early-twentieth centuries; doctors recorded patients experiencing palpitations, breathlessness, headaches, and praecordial pain among other symptoms. While the number of cases of this disorder reached its peak in the First World War, it disappeared shortly afterwards. Based on an analysis of experimental results published in generalist and specialized medical journals as well as the correspondence between physicians and researchers that these journals maintained, this study challenges the view that soldier's heart disappeared because doctors realized that the disorder was, in fact, psychosomatic. Instead, this article shows that this notion was an unintentional by-product of the research conducted into the condition, the results of which opposed the somaticist philosophy that many of the researchers had tried to uphold.

During the Second World War, through innovations in officer selection and group therapy, the army psychiatrists John Rickman and Wilfred Bion changed our understanding of leadership. They showed how soldiers under stress could develop real authority through their attentiveness to each other. From contrasting experiences 25 years earlier each had seen how people in groups are moved by elemental forces that undermine judgement and thought. This article arose from my experiences as a trainee at the Tavistock Clinic, where the method of reflective work discussion, giving individuals seated in a circle the choice to speak or to remain silent, seemed similar to a Quaker meeting. Many decades later, I found that this association had a basis in fact. Among other influences on Bion -- a childhood in India, distinguished service in the First World War, and a surgical apprenticeship with Wilfred Trotter -- there is a little-acknowledged Quaker source, in John Rickman, for Bion's radical work in the army that led to new methods of training and organizational consultancy in the postwar Tavistock.

Privation and disease have mainly killed soldiers until very recently. Now that enemy action predominates, faster and better control of bleeding and infection before and during evacuation spares ever more lives today. This essay focuses on psychological war wounds, placing them in the context of military casualties. The surgeon's concepts of 'primary' wounds in war, and of would 'complications' and 'contamination', serve as models for psychological and moral injury in war. 'Psychological injury' is explained and preferred to 'Post-Traumatic Stress Disorder', being less stigmatizing and more faithful to the phenomenon. Primary psychological injury equates to the direct damage done by a bullet; the complications - for example, alcohol abuse - equate to hemorrhage and infection. Two current senses of 'moral injury' equate to wound contamination. As with physical wounds, it is the complications and contamination of mental wounds that most often kill service members or veterans, or blight their lives.

Objective: The aim of this paper was to review the literature written by doctor-prisoners of the Japanese working on the Burma-Thai Railway with particular emphasis on the psychological and psychiatric conditions they encountered., Conclusions: The enormous respect and gratitude expressed by survivors for their medical attendants is an indication that in addition to performing extraordinary surgical and medical care in appalling conditions and with very limited available resources, these doctors also very adequately attended the clinical problems of demoralization, depression and acute delirium.

The shell-shock epidemic of 1915 challenged the capacity and expertise of the British Army's medical services. What appeared to be a novel and complex disorder raised questions of causation and treatment. To address these pressing issues, Moss Side Military Hospital at Maghull became a focus for experiment in the developing field of psychological medicine as clinicians from diverse backgrounds and disciplines were recruited and trained at this specialist treatment unit. By contrast, the Maudsley wing of 4th London General Hospital expanded from the neurology department of King's College Medical School and drew upon the neuropathology research of Frederick Mott at Claybury Asylum. By focusing on the psychodynamics of environmental factors, doctors at Maghull offered an alternative to the physicalist hypotheses (heredity and neuropathy acquired as a result of disease or aberrant behavior) explored at the Maudsley. To understand the cause and pathology of shell shock, both institutions admitted a diverse range of patients and experimented with treatments. The individual attention offered to service patients who were not psychotic allowed psychiatry to develop in a way that had not been possible in the county asylum system. The design and operation of Maghull and the Maudsley provided models for departments of psychological medicine in the post-war period.

The article presents an observe of questions of organization of psychiatric aid during the Great Patriotic War, main disadvantages of the first period of war, their dependence from circumstances of prewar period, ignoring of experience of last war. There was marked the role of famous native psychiatrists in organization of psychiatric aid to military servicemen in theatre of combat actions.

War is an inherently traumatizing experience, and during the First World War more than 15,000 Canadian soldiers were diagnosed with some form of war-related psychological wounds. Many more went unrecognized. Yet the very act of seeking an escape from the battlefield or applying for a postwar pension for psychological traumas transgressed masculine norms that required men to be aggressive, self-reliant, and un-emotional. Using newly available archival records, contemporary medical periodicals, doctors' notes, and patient interview transcripts, this paper examines two crises that arose from this conflict between idealized masculinity and the emotional reality of war trauma. The first came on the battlefield in 1916 when, in some cases, almost half the soldiers evacuated from the front were said to be suffering from emotional breakdowns. The second came later, during the Great Depression, when a significant number of veterans began to seek compensation for their psychological injuries. In both crises, doctors working in the service of the state constructed trauma as evidence of deviance, in order to parry a larger challenge to masculine ideals. In creating this link between war trauma and deviance, they reinforced a residual conception of welfare that used tests of morals and means to determine who was deserving or undeserving of state assistance. At a time when the Canadian welfare state was being transformed in response to the needs of veterans and their families, doctors' denial that "real men" could legitimately exhibit psychosomatic symptoms in combat meant that thousands of legitimately traumatized veterans were left uncompensated by the state and were constructed as inferior, feminized men.

In contemporary culture, soldiers held as prisoners-of-war (POWs) or as hostages are considered at significant risk of mental illness, in particular post-traumatic stress disorder (PTSD). This assumption contrasts with the psychiatric orthodoxy of the First World War when it was concluded in both Britain and Germany that POWs were protected against 'war neurosis'. Although 'barbed wire disease' was identified during time of captivity, post-release effects were not recognized. The repatriation of 'protected' POWs in 1943 prompted a reassessment of the psychological impact of imprisonment when servicemen of previous good character began to behave aberrantly. Rehabilitation programmes were designed to enable soldiers to re-adapt to service or civilian roles. Difficulties of adjustment were cast in social and cognitive terms, and corrective measures were occupational and educational. Psychiatric disorders found in POWs were explained in terms of a pre-conflict predisposition to, or a history of, mental illness. However, retrospective studies of veteran POWs have found a high prevalence of PTSD. A change in attitudes is explored in relation to the advance of medical terminology into the territory of emotions and the attribution of pathological processes to self-recovering mental states. The reclassification of the effects of imprisonment implies that diagnoses in military psychiatry are culturally determined and can be understood only if they are placed in a context that includes changing beliefs about mental illness, the formal development of the psychiatric profession and the immediate needs of the armed forces.

Objective: This paper inquires the hypothesis that Hitler's rise to power was in part due to a hypnotic therapy he had undergone when being treated for hysterical blindness at an army hospital in the town of Pasewalk in October 1918 - as recent contributions have argued. Edmund Forster, his psychiatrist at that time, is supposed to have suggested to Hitler that he would be ordained as Germany's redeemer in times of defeat, thus causing a profound change in his patient's personality., Methods: Following three lines of argument, this paper examines if such an assumption can be made plausible. Firstly, it takes a close look at the main historical source which is the novel THE EYEWITNESS, written in German language by the Czech-Jewish author Ernst Weiss. Then it asks if Forster is likely to have chosen hypnosis as a method of treatment. Finally, it exploits the work of the even lesser known author Alexander Moritz Frey who happened to serve close to Hitler as a medical orderly in WW I, thus trying to validate whether or not Hitler really underwent a change of personality in autumn 1918., Results: Although the eventualities of such a hypnotic treatment or a profound change in Hitler's behaviour in that time cannot be disproved, both seem highly unlikely., Conclusion: S One should altogether abandon the notion of Hitler having suffered a permanent change of personality in 1918, be it due to psychiatric treatment or to psychological trauma itself.

Objective: The authors review the more than 30-year history of the academic affiliation between the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas and the Mental Health Service at the Veterans Affairs North Texas Health Care System., Methods: The authors interviewed individuals involved at various stages in developing this affiliation about decisions and challenges., Results: The academic association has been very successful on the whole, though not consistently so. At this time, a flourishing educational and research program is in place and seems stable., Conclusion: It is not clear how generalizable the Dallas experience is. Both sides of this affiliation have overcome obstacles. Persistence and patience have been crucial, especially when one or the other side produced temporarily insurmountable obstacles. It appears that the decision to pursue the recruitment of both researchers and educators to the North Texas Veterans Health Care System from the beginning may have been crucial in developing a fuller academic collaboration.

The article presents the analyze of the character of delivery of psycho-aid in conditions of wars and armed conflicts of the XXth century. Generalizing of the experience of psycho-aid delivery in conditions of wars of the XXth century showed, that it's basing doctrinal provisions were laid by Russian psychiatrists during the Russian-Japan War. However, in foreign Armies this experience was used and improved (according to now-day's wars and armed conflicts), in our Armed Forces (until the 90th years of the XXth century) it wasn't used in right way. In general, the system of psycho-aid delivery to the staff, consists of 3 provisions: it's approach to the military stage, simplicity and security, existence of movable well-packaged staff structures, which can work optimally in combat conditions and secure necessary treatment-evacuation and rehabilitation measures.

Purpose of Review: The purpose of this review is to highlight recent English language literature in the cultural and social history of psychiatry. It considers publications from 2007 and early 2008, as well as a few important older works that have not yet been reviewed in this journal., Recent Findings: Cultural and social historians of psychiatry are incorporating a growing number of historical objects into their narratives and developing new methodological techniques that can accommodate the full diversity of psychiatry's hybrid past. Increasingly, these histories are coming to be written in terms of multilateral and multivalent interactions with various other disciplines and organizations. In crafting these new narratives, historians face a confusing panoply of historical agents and events, reminding them that like the discipline of psychiatry itself, theirs too is a heterologic undertaking, grappling to understand and explain the otherness of psychiatry's past., Summary: This review surveys the scholarly literature in several specific areas that have attracted the attention of historians of psychiatry in recent years. In particular, it considers work in the history of psychiatric institutions, borderline disorders, 20th-century somatic therapies, military psychiatry, and colonial psychiatry.

During World War II, psychiatric nurses learned valuable lessons on how to deal with the traumas of war. Using psychohistorical inquiry, this historian examined primary and secondary sources, beyond the facts and dates associated with historical events, to understand why and how psychiatric nurse pioneers developed therapeutic techniques to address the psychosocial and physical needs of combatants. Not only is the story told about the hardships endured as nurses ministered to soldiers, but their attitudes, beliefs, and emotions, that is, how they felt and what they thought about their circumstances, are explored. In this study the lived experiences of two psychiatric nurses, Votta and Peplau, are contrasted to explicate how knowledge development improved care and how this knowledge had an impact on the home front in nursing practice and education, as well as in mental institutions and society, long after the war was won.

Involvement in warfare can have dramatic consequences for the mental health and well-being of military personnel. During the 20th century, US military psychiatrists tried to deal with these consequences while contributing to the military goal of preserving manpower and reducing the debilitating impact of psychiatric syndromes by implementing screening programs to detect factors that predispose individuals to mental disorders, providing early intervention strategies for acute war-related syndromes, and treating long-term psychiatric disability after deployment. The success of screening has proven disappointing, the effects of treatment near the front lines are unclear, and the results of treatment for chronic postwar syndromes are mixed. After the Persian Gulf War, a number of military physicians made innovative proposals for a population-based approach, anchored in primary care instead of specialty-based care. This approach appears to hold the most promise for the future.

This article examines the psychiatric screening of U.S. soldiers during the Second World War, established by psychiatrist Harry Stack Sullivan (1892-1949), as a key moment in the public application of clinical psychiatry, as well as a turning point in Sullivan's intellectual and professional career. After a brief look at the ideas and expectations Sullivan brought to the screening system, I discuss a major problem of the screening: the mismatch between the medical concept of disease prevention and the realities of the mass screening as a public policy. As a way to highlight this mismatch, I focus on Sullivan's failure to protect homosexual men from medical and social stigmatization by screening them out of the armed forces. Despite his liberal approach to the issue of homosexuality before the war, which he had created in his clinical practice, Sullivan was unable to persuade the military and the public of gay men's right to serve the nation. The examination of how his sympathetic view of homosexuality became circumscribed reveals not only the gap between clinical insights and public policy, but also how tentative views of homosexuality in public debate among liberal psychiatrists during the decade preceding the war contributed to the failure to make non-homophobic policy in the 1940s. This article shows that the relative conservatism in the politics of sexuality among liberal psychiatrists, as well as the intransigent conservatism as seen in homophobic tradition of the Army, contributed to the discriminatory screening criteria.

This article discusses the psychiatric therapeutics of Northfield military psychiatric hospital and suggests that treatment in Northfield was characterised by ideals of citizenship typical of the period and inextricably linked to the military. The two Northfield experiments, for which Northfield has become famous, glorified the group as a social unit and promoted adaptation to the needs and values of society as the route to mental health. In the context of the Second World War, such adaptation meant accepting the duties of a soldier. In the published writings regarding the first Northfield experiment, the psychiatrist Wilfred Bion emphasised his military role in returning patients to their units, a job which he thought was best conducted by men like himself who had experience of leading men into battle. Writing about the second experiment, Tom Main emphasised the importance of including military staff in every aspect of the hospital life from therapy to administration. Some Northfield psychiatrists were less content with this strongly military approach and this led to the conflict which ended the first experiment and continued to spark disagreements throughout the hospital's existence.

The study of the disorders of the mind at the turn of the twentieth century offered useful knowledge about the psyche and the First World War (FWW) provided an avalanche of case studies. Prior to the war the mentally ill were treated with disdain and the social distrust of individuals who did not present as 'normal' was high. The level of diagnostic expertise of psychiatric illness by doctors and nurses was low and as a consequence medicine and nursing was ill-equipped to deal with the phenomenon initially referred to as 'shell shock'. However, the soldiers of the FWW who endured the varied and seemingly unrelated symptoms of shell-shock were respected men - occasional heroes - who were reduced to the status of 'mentals'. There is evidence that civilian trained health professionals altered their views about mental illness during the FWW but initially, the military imperatives inherent in a global conflict perpetuated the notion that mental illness was linked with defective morality. This paper provides an historical account of changes in attitude toward the mentally ill as a consequence of the FWW. The interregnum (1918-39) was a period of advancement in the field of mental health within the civilian sector. However, the imperatives of war negated these developments and there is evidence that the management of soldiers suffering from post-traumatic stress disorders in the Second World War did not benefit from the lessons learnt in the FWW.

Some studies in the sociology of stress conceptualize their outcome variables as distress, while others treat the same outcomes as mental disorder. This article focuses on the importance of distinguishing between the two. It argues that there are fundamental differences between distress that arises in non-disordered persons and genuine mental disorder but that studies of stress typically fail to distinguish between these conditions. The article outlines the historical developments that led the field to conflate distress and disorder. Finally, it indicates some advantages for research, treatment and policy that can accrue when distress that is initiated and maintained by social conditions is distinguished from mental disorders that are dysfunctions of internal psychological mechanisms.

The controversial crowd psychology of Gustave Le Bon has been both praised as an incisive contribution to social theory and also condemned as a doctrine of irrationality and mass manipulation associated with fascism. New archival documentation now demonstrates that Le Bon exercised significant influence on U.S. military thinking and practice through World War II. Army writings and officer training on morale, leadership, and battlefield psychology rested substantially on his theory of crowds, particularly regarding races and panic. Le Bon's racial psychology took on additional importance when the African-American 92 nd Infantry Division panicked during combat in Italy. This new evidence offers an excellent case study of the direct and enduring impact of a peculiar type of social psychology on the institutional culture of the army from the classrooms at the Army War College to the battlefield itself., ((c) 2007 Wiley Periodicals, Inc.)

Through a long career that spanned three wars and important changes in patterns of health care, Franklin Delano Jones (1935-2005) provided medical and psychiatric care to the most vulnerable members of our society, civilian as well as military. Recognizing that individuals tend to forget lessons learned in stressful situations, he compiled and codified the essential practices of wartime psychiatry into comprehensive and accessible texts. His neutrality, persistence, and sharp intellect stabilized and strengthened American military psychiatry in the post-Vietnam era. His culminating achievement, War Psychiatry, which is the codified clinical intelligence of several generations of military psychiatrists, is an essential foundation for clinical practice and for research. This article explores Jones'ss contributions, particularly the variations in the presentation of combat stress, the efficacy of the principles of forward treatment, and a comprehensive understanding of posttraumatic stress disorder.

Through the stimulus of war and concerns about neuropsychiatric disability, the U.S. military developed methods to rapidly screen the mental health of World War I and II draftees. Intelligence testing and brief psychiatric screening expanded the accession physical examination and underwent revision to identify only gross mental health disability. Supplemental psychiatric evaluations and written psychological screening tools were abandoned after postwar assessments; they demonstrated poor predictive power in evaluating recruit service capacity for combat environments. Currently, only three mental health accession tools are used to screen applicants before their entrance into military service, namely, educational achievement, cognitive testing, and a cursory psychiatric evaluation. The Navy and Air Force use a fourth screening measure during entry-level training. Educational attainment with high school graduation has been the strongest predictor of finishing a service term. The purpose of this article is to provide both a historical review and a review of testing efforts.

This autobiographical essay describes my career as a psychodiagnostician, which began at the City College of New York in 1941 and ended in the late 1970s when I became a full-time psychoanalyst in Manhattan. As a green, 20-year-old psychology undergraduate, I was picked by Gardner Murphy to assist David Rapaport at the Menninger Clinic in Topeka, Kansas, who was developing new methods for using psychological tests to diagnose and treat soldiers during World War II. Our findings were presented in the classic, two volume work, Diagnostic Psychological Testing, published in 1945-1946 (Rapaport, Gill, & Schafer, 1945-1946; 1968), to which I added two clinically enriched monographs: The Clinical Application of Psychological Tests, published in 1948 (Schafer, 1948/1995), and Psychoanalytic Interpretation in Rorschach Testing (Schafer, 1954), published in 1954. After the Menninger Clinic, I continued to hone my assessment expertise at the Austen Riggs Center and Yale University, but I also sought opportunities to develop psychotherapy skills. I completed psychoanalytic training in 1960 at the Western New England Institute for Psychoanalysis and thereafter sought positions that would offer more time for treating patients. A notable highpoint in my testing career was assessing Jack Ruby, killer of Lee Harvey Oswald. I look back fondly at my years as an assessment psychologist, which produced nearly 4 decades of great memories.