The Department of Defense announced today the release of a RAND Institute scientific literature review that researched the relationship of stress to illnesses experienced by Gulf War veterans.
"A Review of the Scientific Literature as it Pertains to Illnesses, Volume 4: Stress" is the latest RAND report released that was commissioned by the Office of the Special Assistant for Gulf War Illnesses," said Bernard Rostker, the special assistant for Gulf War illnesses. "The report provides an independent examination of the historical body of scientific evidence relating to the effects of stress on health in the general population as well as specific studies of stress and Gulf War veterans."
The RAND authors identified 15 studies that evaluated the relationship between exposure to stress during the Gulf War and the development of symptoms of Post-Traumatic Stress Disorder (PTSD). All 15 studies demonstrated a modest correlation between stress and PTSD. The correlation between stress and health problems was stronger in persons exposed to very high stress levels (such as actual combat, a SCUD missile attack, or graves registration duties).
Ten studies reported on the relationship between stress exposure and mental health problems such as depression or anxiety. Most of these studies provided evidence of a modest correlation between stress exposure and psychological distress.
RAND researchers found extensive evidence of stress resulting in physical symptoms in the general population including depression, anxiety, fatigue, impaired memory and concentration, headaches, back and neck aches, gastrointestinal complaints, and breathing difficulty. One or more of these symptoms are prevalent in undiagnosed Gulf War illnesses. However, the studies that evaluated a link between stress exposure during the Gulf War and physical symptoms, such as headaches or joint pains, were too limited to draw definitive conclusions.
"Although it is inappropriate to rely upon stress exposure as a default explanation for the myriad health problems reported by Gulf War veterans in the absence of a thorough review of research concerning all plausible causes," said RAND, " we think it equally inappropriate to assume that stress played no role. To do so would ignore what the scientific literature shows about the relationship between stress and health."
The report describes in depth the stresses most commonly cited by Gulf War veterans in surveys taken before, during, and after the war. Combat-related stresses were sometimes evident, but the stress of deployment itself was common to all that deployed.
RAND also reports that a problem still exists with popular perceptions of stress. In many instances, stress as an explanation of poor health casts a stigma on the afflicted. There is also a perception that if stress exposure were assigned any role in the health problems of Gulf War veterans, a failure to vigorously pursue other possible causes would result.
RAND is a nonprofit institution with a long history of independent research. RAND experts reviewing the literature included Grant Marshall, a clinical psychologist and an expert in psychometric evaluation and multivariate data analysis; Dr. Lois Davis, a health policy analyst and an expert in military medical readiness and mental health policy; and Dr. Cathy Donald Sherbourne, a medical sociologist and an expert in health outcome measurement. Their review encompassed scientific literature, surveys and empirical data published in peer-reviewed journals, books, government publications and conference proceedings.
This paper, as well as the RAND literature reviews on oil well fires and depleted uranium are posted on the GulfLINK website, at http//www.gulflink.osd.mil.