248072 LONG-TERM PSVCHOLOSiCAL AND PHYSICAL EFFECTS OF THE POW EXPERIENCE : A REVIEW OF THE LITERATURE 0 0 * * !

The problem of what peyahologioal and physical effects can be expected to remain or to appear over time ae a result of a prolonged captivity experience is addressed, A review of the existing literature is presented to delineate major findings which appear relevant in dealing with the long-term effects to be expected among prisoners of war returned from Southeast Asia, The cumulative weight of the findings3 largely gathered from existing follow-up studier; of concentration camp survivors, indicated that the extraordinary stresses of incarceration are related to a heightened vulnerability to physical and psychological problems over time. The need for more comprehensive and definitive long-term follow-up studies of former United States prisoner of war populations is discussed. Although the medical and psychological literature includes a variety of studies designed to assess prison populations soon after their release, considerably fewer follow-up studies of former prisoners of war (POWs) have been completed. Like any long-term, longitudinal studies, such analyses are not only difficult to accomplish technically, but they are costly in terms both of time and money. Nevertheless, despite the relative paucity of available data, it is important to focus on the issue of long-term effects an issue that, in human terms, is as important as any that now surrounds the POWs returned from captivity in Southeast Asia. The problem may be simply stated: What psychological and physical effects can be expected to remain or to appear over time as a result of the captivity experience? Although the focused public attention given the status of the American POW has continued for a time immediately after their return, it is questionable whether the years following repatriation will be merked by comparably intense attitudes. Indeed, it is not unlikely that the men, recently so much the centev of the Nation's consciousness, will soon lose their Identity as ROMs. It Is Important now, therefore, to consider the potential sequelae of their experience, and thus to anticipate potential treatment and rehabilitation needs over time. This paper Is not Intended as a fully comprehensive theoretical review of the effects, both physical and psychological, of any and all Incarceration experiences. It', focus Is more specific: the review is Intended to incorporate from the existing literature those major and typical findings which appear to be relevant In dealing with long-term effects to be expected among prisoners of war returned from Southeast Asia. The references utilized may not be complete, therefore, by standards other than those suggested by the circumscribed focus of this paper. The Distinction Between Physical and Psyahologiaal Stresses In considering both the shortand long-term effects of incarceration, it must be acknowledged at the outset that the dichotomy drawn by many between physical and psychological phenomena is often an arbitrary one. Contemporary concepts of human behavior are based increasingly on the awareness that earlier distinctions between body and mind between soma and psyche are of little practical relevance. A given psychological stress, such as the overhanging threat of death, may result in either psychological or physical symptoms (for example, either anxiety or hypertension), or both. Similarly, physical stresses such as hunger or beatings may result not only in physical complaints such as weakness and weight loss, but also in psychological problems such as depression and apathy. The issue of body-mind relationships is not raised here simply in academic, theoretical terms. It is instructive that even today, well over a quarter century after their occurrence, the experiences of physical and psychological abuse suffered by concentration camp victims are not uniformly interpreted by investigators studying the results of that episode. There are those who view the lingering symptoms seen today among concentration camp survivors as the result primarily of physical trauma, while others discount the effects of tissue damage, and emphasize instead the psychodynamics of the concentration