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USER: Laporte, Noemi, O-1, 170Navajas/DD01Solaris
Your document request:
	Filed: 3 (three) days ago
	Distribution: U/NFORN
	Stated Reason: Personal inquiry re: health of unit member
has been GRANTED

Document follows.

Fleet Medical Advisories
MD0549-Psychosocial Issues

2-3. TYPES OF STRESS IN COMBAT
	a. Physical/psychological strain. 

	b. Fear/anxiety of pain, mutilation, death.

	c. Fear of failure/disgrace.

	d. Grief, rage (loss of friends, hatred of enemy, incompetent leadership, and so forth).

	e. Ethical limits (killing, firing at noncombatants, leaving patients to die, and so forth). The soldier may feel guilty of his own rage or acts.

	f. Internal conflict (survival vs. mission, loyalty, and ideals [leaving wounded friend behind, short timer, and so forth])


USER COMMAND: move to section 2.4C, SYMPTOMS OF BATTLE FATIGUE
	(1) "Thousand-yard-stare" (normal and common after heavy combat, improves with 1 to 2 days rest).
	
	(2) Hyperalertness.

	3) Tension, startle response, fine tremors (becomes selective in veterans, but increases again with sleep loss and cumulative combat).

	(4) Psychological symptoms (normal and very common).
		(a) Headaches.
		(b) Back pain.
		(c) Nausea, vomiting.
		(d) Bowel and urinary symptoms.
	
	(5) Irritability (warning signs--silent, withdrawn, or "vicious" in own group).

	(6) Inability to concentrate.

	(7) Insomnia, terror dreams (afraid to sleep; therefore, symptoms worsen).

	(8) Inertia, indecision, fatigue (can lead to mistakes and increased stress).

	(9) Depression (motor retardation, crying, survivor guilt).

	(10) Anxiety reactions (gross tremors, extreme startle).

	(11) Memory loss (amnesia, complete or partial; "fugue" flight)

		NOTE:"Fugue" flight individuals perform acts of which they appear to be conscious but, upon recovery, have no recollections of the acts
