Observed in soldiers for centuries previously called Shell Shock,<unk>  Fatigue, War Neurosis, Battle Fatigue
Normal predictable<unk><unk>  to the horrors of warfare
All military personnel at risk but protective factors can lessen risk
Physical and Mental<unk> ors are often inseparable
Situational
Unclear Rules of Engagement
Prior<unk>  exposure
Military situation- intensity / length of fighting, number killed / wounded
Role in<unk> - support troops may be at higher risk of<unk>  psych<unk> s
Indirect, unexpected fire
Brutality of  enemy
Physical
Environmental
Heat, Cold, Wet
Difficult Terrain
Poisons
NBC Threats
Noise, Vibration
Visibility
Physiological
Fatigue/Sleep Debt
Dehydration
Hunger/Malnutrition
Poor Hygiene
Physical fatigue
Illness and Injury
Mental
INTERpersonal
Poor/Weak Leadership
Unit morale, cohesion
New to unit
Sense of social support/isolation
Loss of a buddy or buddies
Loss of faith in Leadership, self and/or God
Information (Too much/little)
Sensory (Too much/little)
Time (Pressured vs. Waiting)
INTRApersonal
Homefront Worries- threatened relationship, illness or other family<unk> 
Fear of death/maiming
Fear of Cowardice
Loss of belief in cause
Sense of Winning or losing
Isolation/ Loneliness
Loss, Bereavement
Anger, Frustration
Boredom, Inactivity
Unclear Rules of Engagement
Prior<unk>  exposure
Military situation- intensity / length of fighting, number killed / wounded
Role in<unk> - support troops may be at higher risk of<unk>  psych<unk> s
Indirect, unexpected fire
Brutality of  enemy
Environmental
Heat, Cold, Wet
Difficult Terrain
Poisons
NBC Threats
Noise, Vibration
Visibility
Physiological
Fatigue/Sleep Debt
Dehydration
Hunger/Malnutrition
Poor Hygiene
Physical fatigue
Illness and Injury
Heat, Cold, Wet
Difficult Terrain
Poisons
NBC Threats
Noise, Vibration
Visibility
Fatigue/Sleep Debt
Dehydration
Hunger/Malnutrition
Poor Hygiene
Physical fatigue
Illness and Injury
INTERpersonal
Poor/Weak Leadership
Unit morale, cohesion
New to unit
Sense of social support/isolation
Loss of a buddy or buddies
Loss of faith in Leadership, self and/or God
Information (Too much/little)
Sensory (Too much/little)
Time (Pressured vs. Waiting)
INTRApersonal
Homefront Worries- threatened relationship, illness or other family<unk> 
Fear of death/maiming
Fear of Cowardice
Loss of belief in cause
Sense of Winning or losing
Isolation/ Loneliness
Loss, Bereavement
Anger, Frustration
Boredom, Inactivity
Poor/Weak Leadership
Unit morale, cohesion
New to unit
Sense of social support/isolation
Loss of a buddy or buddies
Loss of faith in Leadership, self and/or God
Information (Too much/little)
Sensory (Too much/little)
Time (Pressured vs. Waiting)
Homefront Worries- threatened relationship, illness or other family<unk> 
Fear of death/maiming
Fear of Cowardice
Loss of belief in cause
Sense of Winning or losing
Isolation/ Loneliness
Loss, Bereavement
Anger, Frustration
Boredom, Inactivity
Combat stress reaction
Dehydration
Sedative/hypnotic withdrawal
Hyperthermia/Hypothermia
Opioid withdrawal
Overuse syndromes
Benzodiazepine withdrawal
Rhabdomyolysis