Background The

psychologic effects of trauma have been described throughout military history. Da Costa syndrome (“soldier’s heart”), which is characterized by cardiac symptoms associ-ated with irritability and increased arousal, was described in veterans of the American Civil War. During World War I, it was hypoth-esized that “shell shock ” resulted from brain trauma caused by exploding shells. During World War II, terms such as “combat neuro-sis ” and “operational fatigue ” were used to describe combat-related symptoms. The Vietnam War significantly influenced the current concept of PTSD. In 1980, th