Features of prolonged combat stress reaction:
(1) experience of war trauma
(2) development of the acute combat stress reaction (CSR)
(3) failure to resolve the acute CSR
(4) subsequent (may be delayed) onset of:
(4a) symptoms of autonomic arousal
(4b) difficulty falling asleep
(4c) recurrent nightmares
(4d) avoidance of situations or activities that may trigger recollection of traumatic events
(4e) relatively intense form of chronic post-traumatic stress disorder (PTSD), which may include anxiety, phobias and/or depression
Prolonged CSR:
(1) can be difficult to diagnose initially, especially if there is masking
(2) is often resistant to therapy
(3) usually requires a combined approach that includes psychotherapy and medications
