Is there an assault syndrome?

The clinical syndromes now designated posttraumatic stress disorder (PTSD)I have been discussed in the psychiatric literature for 100 years, beginning with Erichson's description of "railway spine" in 18822 and Page's "nervous shock" in 1883. In the 1880s Oppenheim coined a phrase "traumatic neurosis" which became generally accepted• and even today is frequently found in medical and legal writings. "Compensation neurosis" appeared at the tum of the century with a proliferation of workmen's compensation laws. The two World Wars spawned a variety of appellations such as shell shock, war neurosis, combat exhaustion, flight fatigue, three-day schizophrenia, and prisoner of war syndrome. The post-World War II period contributed concentration camp syndrome and reparation neurosis. In recent years articles have appeared on accident neurosis, disaster syndrome, survivors' syndrome, delayed Vietnam syndrome, and rape trauma syndrome. At The Menninger Clinic, we have seen a number of victims of assault and battery presenting disabling psychiatric symptoms. Each had retained an attorney and was involved in a legal suit. Our clinical observations stimulated thoughts alX>ut the heuristic value of defining an assault syndrome, following the historic precedent of identifying the traumatic agent. Prefacing the remainder of this discussion, I wish to state that I am opposed to burdening the literature with additional jargon that does not deepen medicolegal understanding and facilitate interprofessional communication. A.B., an unmarried 28-year-old Caucasian male, lives with his girl friend and has worked for a company for four years. He drives a city truck route, delivering and picking up packages and occasionally collecting and carrying money. His attorney referred him for medical evaluation of possible untoward psychologic consequences from an assault. A.B., having made a store delivery, was walking through an alley to his truck when he was accosted by two black males, one armed with a revolver. The frightened victim put up his hands and submitted to a search. While bending down, as ordered, to take ofT his pants over his boots, he was struck twice in the face with the handgun and fell flat; whereupon the assailants fled. He staggered back to the store and the police were called. In a hospital emergency room, X-rays disclosed facial and orbital fractures which were surgically repaired one week later. During the week's wait he