Combat Stress is the mental, emotional or physical tension,
strain, or distress resulting from exposure to combat and
combat-related conditions. Controlling combat stress is a command
In terms of Service members lost from action and
reduced performance, combat stress seriously affects mission
accomplishment. It is a leader's responsibility to take action to
strengthen Service members’ tolerance to combat stress and manage it
in his or her unit.
Combat stress reactions are the result of exposure to
the same conditions during military actions that cause physical injury
and disease in battle or its immediate aftermath, and many combat
stress reactions occur in persons who are also wounded or ill with
Rates of combat stress casualties vary greatly, with
higher ratios during lengthy periods of intense combat. In Okinawa
1945, during a peak month of battle, the combat stress casualties
among Marine Forces were reported as high as one for every two wounded
in action (WIA). Under less lengthy periods, as suggested by data
acquired from the Israeli Defense Forces fighting in Lebanon 1982, the
ratio of combat stress casualties to WIA in small units can be as high
as one to one. In the past, we have generally suffered as many as one
battle stress casualty for every three to five WIA in heavy fighting.
However, highly trained units with strong leadership and high esprit
de corps have fewer combat stress casualties.
While this manual focuses on combat-induced stress
reactions, it is important to emphasize that “combat stress” is not
restricted only to combat, but may also arise from combat-like
conditions present during military operations other than war. In an
area of operations characterized by continuous action and high danger,
our forces may experience high rates of stress casualties unless
small-unit leaders are trained and prepared to manage stress.
This publication is written to inform small-unit
leaders of stress characteristics and management techniques in order