Except in rare instances when one side has had a technological advantage over the other, man has always been the limiting factor I combat. He will continue to be the limiting factor. The relationship of combat effectiveness to personal and unit factors has been a focus of military thought since ancient times. As an organized discipline involving physicians specializing in psychiatry and other specialists trained in mental health, combat psychiatry began its evolution in the early part of this century. From contemporary wars and from retrospective analyses of previous wars, we can conclude, first, that heroism, effective performance, ineffective performance, and psychiatric casualties form a continuum and, second, that any factor that decreases heroism and effective performance increases ineffective performance and psychiatric casualties. The objective circumstances of battle coupled with unit and personal factors determine the movement of an individual and his unit along the continuum. Personality, except at the extremes of deviance, plays a limited role in psychiatric risk. Particularly potent in inducing shock and demoralization is surprise, whether at the strategic, operational, or tactical level. The present volume presents contributions from many parts of the world. The chapters in the first part demonstrate the remarkable cross-cultural homogeneity in human reactions to combat experience and further support the idea that group and personal (as opposed to personality) factors are second only to battle stress in determining effectiveness sin combat. The second part, focusing on the effects of sleep loss and the effects of chemical weapons and their antidotes upon soldier performance, serves as an introduction to the study of the neurobiological underpinnings of effective performance in combat. The third part describes the broad psychosocial context of individual and unit effectiveness in combat and suggests that contemporary warfare is evolving toward warfare based upon maneuver as opposed to attrition.

Introduction: combat psychiatry - an evolving field /Gregory Belenky and Franklin D. Jones -- Part I. The role of group cohesion and personality in maintaining effective performance in combat. Battle stress, morale, cohesion, combat effectiveness, heroism, and psychiatric causalities: the Israeli experience / Gregory Belenky, Shabtai Noy, and Zahava Solomon -- Stress and personality as factors in the causation and prognosis of combat reaction / Shabtai Noy -- Combat stress as an opportunity: the case of heroism / Reuven Gal -- An investigation into the value of unit cohesion in peacetime / Frederick J. Manning and Larry H. Ingraham -- Combat psychiatry: the American and Israeli experience / Shabtai Noy -- Stress breakdown in the Wehrmacht: implications for today's army / Robert J. Schneider -- Trauma and personality in the causation of war neuroses / Louis Crocq and Marc-Antoine Crocq -- Psychodynamic considerations in the adaptation to combat / Jon A. Shaw -- Experience of a non-military psychiatrist during the 1966-70 Nigerian Civil War in the war-affected area of 'Biafra' / Ariwodo Kalunta -- Psychiatric causalities after a war: the Nigerian experience after the 1966-70 Nigerian Civil War / Olukayode Adelaja -- Egyptian psychiatric casualties in the Arab-Israeli wars / Fuad Mansour -- part II. The neurobiology of military and combat stress. Sleep loss and military performance / Diana R. Haslam and Peter Abraham -- Neuropsychiatric aspects of chemical warfare / Paul Newhouse -- part III. The broad psychosocial context of performance in combat. Combat motivation / Anthony Kellett -- The Soviet attitude toward stress in battle / Christopher N. Donnelly ; Conclusion: the future of combat psychiatry / Gregory Belenky.