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Research in the neurosciences has demonstrated that the boundary between the external world (its events, pressures, concerns and stress) and the brain and body has been broken. The concept of anything being all in the mind is scientifically and intellectually dead. While some data remain ambiguous and direct causal effect cannot be given to stress per se, the overall patterns of research findings demonstrate that stress is a contributing factor to many illnesses, including somatic and psychological symptoms. Therefore, very real consequences attend those who experience prolonged subacute chronic stress, which characterized in the Gulf deployment, combat, and return home. It is feasible that the effects of these stresses made some soldiers more vulnerable to environmental pathogens, both in the theater and at home, than they would otherwise have been. The symptoms of such insults, nested in sociocultural beliefs about illness and the Gulf, might well have amplified deleterious somatic consequences. Like many illnesses, those pertaining to service in the Gulf have been culturally shaped. An illness narrative describes the causes of the illness as perceived by the patient and is most often constructed out of the assertions, metaphors, folklore, causal attributions, and adduced causes common in the patient’s culture. Other agents of a presumed authorities, the Internet, and support and self-help groups. Such illness narratives can become an important factor in shaping both the nature and interpretation of symptoms by the patient. A cogent, widespread, and widely shared illness narrative is certainly a characteristic development of Gulf War illness. The threads of combat and deployment stress and the side spectrum of possible responses, as demonstrated throughout history, weaves into the matrix of possible illness causation. It is also possible that a subset of the population is (in some ways, not yet understood) vulnerable and predisposed to injurious responses to the multiple stressors experienced in deployment and combat. This book argues that, to be most helpful to veterans, we must deal with this issue of complexity and not simply focus on a hypothecated or hoped for singular cause of Gulf War illness.

Table of Contents

  • Preface PDF

  • Tables PDF

  • Foreword PDF

  • Summary PDF

  • Acknowledgements

    Acknowledgments PDF

  • Chapter One

    Introduction PDF

  • Chapter Two

    Historical Overview: Psychological Consequences of Battle Stress PDF

  • Chapter Three

    Modern War: The American Civil War PDF

  • Chapter Four

    Conceptual and Theoretical Medical Developments in the 19th and Early 20th Centuries PDF

  • Chapter Five

    World War I PDF

  • Chapter Six

    1919-1941: The Interwar Years PDF

  • Chapter Seven

    World War II PDF

  • Chapter Eight

    Post-World War II Conceptual Developments PDF

  • Chapter Nine

    Vietnam PDF

  • Chapter Ten

    The Gulf War: Operations Desert Shield and Desert Storm PDF

  • Chapter Eleven

    Return from the Persian Gulf and Its Consequences PDF

  • Chapter Twelve

    Conclusions PDF

  • Bibliography PDF

This research was sponsored by the RAND National Security Research Division and RAND Health.

This report is part of the RAND Corporation monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.