“Combat/ Operational Stress Reaction” (COSR) is an issue that will likely affect every Marine unit. Left unaddressed, the effects of combat and operational stress can lead to long-term psychological injuries. Although not as visible as physical trauma, psychological injuries have been a significant portion of total casualties in any conflict. In the American military, combat stress reactions were noted as early as the Civil War. After the First World War, large numbers of combatants suffering from “shell shock” sought medical attention. Combat stress reactions were observed in more than 20% of US troops in World War II, and in the Korean War, 10% of medical evacuations were attributable to combat stress. Some estimate that as many as 30% of Vietnam veterans suffer from the long-term effects of untreated COSR. Approximately 15% of long term casualties after the Gulf War were psychological in nature. Effectively addressing the psychological effects of such stress both before and after it occurs can greatly improve a unit's readiness status.
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