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A PRISONER OF WAR SYNDROME: APATHY AS A REACTION TO SEVERE STRESS
HARVEY D. STRASSMAN; MARGARET B. THALER; EDGAR H. SCHEIN
Am J Psychiatry 1956;112:998-1003.
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Staff physician, Veterans Administration Center, Los Angeles, and instructor in clinical psychiatry, University of California at Los Angeles Medical School, Los Angeles, Calif.

Psychologist, Army Medical Service Graduate School, Walter Reed AMC, Washington, D. C.

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Abstract
We have pointed out that one defensive adjustment of POW's to stress is withdrawal. If the stresses are not too severe the person will withdraw physically if possible, or in any case will refuse to allow himself to become involved with the environment to as great an extent as possible. Certain kinds of overt behavior will be inhibited and most emotional responses will be suppressed. If the environment is severely stressful and physically depriving as well, the individual may regress into a more complete withdrawal and adopt a maladaptive state of dependency in which he ceases to take care of himself even to the point of death. We have labelled this type of defense "apathy" and distinguish it from states like catatonic stupor, or depression. "Apathy" appears not to be a single absolute reaction, but a syndrome which can vary markedly in degree. One major symptom in the syndrome is reduced or modulated affect, but only in extreme cases can one speak of true apathy or affectlessness. Other symptoms are listlessness, uncommunicativeness, lack of spontaneity, indifference, slowed reactions, lack of enthusiasm, and lack of initiative. It is important to note that underlying the overt lack of emotional spontaneity may lie great quantities of pent-up feelings, and that these will continue to be a problem to the individual when he is no longer in the environment that produced the "apathy syndrome."The apathy syndrome serves to maintain personality integration in the face of severe reality and psychological stresses.Abstract Teaser
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