A significant proportion of U.S. military personnel who served in the Persian Gulf War have reported various health problems following their service, some of which remain unexplained. The conflict presented these veterans with an array of stressful experiences both before, during, and after deployment, and those experiences may have contributed to their reported health difficulties. Research recorded in the general scientific literature has shown that stress can produce myriad health effects, and that these effects can manifest themselves as symptoms and conditions similar to those that the veterans report. Empirical studies of Gulf War veterans indicate that stress may play some role in the etiology or exacerbation of certain of these health problems, yet available research does not conclusively demonstrate the causal role of stress in the unexplained illnesses.
From the Publisher
This literature review, one of eight commissioned by the Special Assistant to theDeputy Secretary of Defense for Gulf War Illnesses, summarizes the existingscientific literature on the health effects of stress that may have affected militarypersonnel who served in Operations Desert Shield and Desert Storm. The eightRAND reviews are intended to complement efforts by the Defense Departmentand other federal agencies in their attempt to understand the full range ofhealth implications of service in that conflict.Many veterans have reported an array of physical and mental health complaintssince the war. Whether veterans are experiencing either higher-than-expectedrates of identifiable illnesses with known etiologies or other illnesses fromunidentified origins is not yet clear.The other seven RAND literature reviews deal with chemical and biologicalwarfare agents, depleted uranium, pesticides, pyridostigmine bromide, immu-nizations,oil well fires, and infectious diseases. These represent plausiblecauses of some of the illnesses Gulf War veterans have reported.The reviews are intended principally to summarize the scientific literature onthe known health effects of given exposures to these risk factors. Where avail-ableevidence permits, the reviews also summarize what is known about therange of actual exposures in the Gulf and assess the plausibility of the risk factorat hand as a cause of illnesses. Statements related to the Gulf War experienceshould be regarded as suggestive rather than definitive, for more research onhealth effects and exposures remains to be completed before definitive state-mentscan be made. Recommendations for additional research where appro-priateare included.These reviews are limited to literature published or accepted for publication inpeer-reviewed journals, books, government publications, and conference pro-ceedings.Unpublished information was occasionally used, but only to develophypotheses.A draft of this monograph was submitted for editorial review in October 1997. Afew articles that appeared in the literature after that date were included in themonograph, principally to accommodate reviewer recommendations.This work is sponsored by the Office of the Special Assistant and was carried outjointly by RAND Health's Center for Military Health Policy Research and theForces and Resources Policy Center of the National Defense Research Institute.The latter is a federally funded research and development center sponsored bythe Office of the Secretary of Defense, the Joint Staff, the unified commands,and the defense agencies.
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