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The sixth in a series of congressionally mandated reports on Gulf War veterans' health, this volume evaluates the health effects associated with stress. Since the launch of Operation Desert Storm in 1991, there has been growing concern about the physical and psychological health of Gulf War and other veterans. In the late 1990s, Congress responded by asking the National Academy of Sciences (NAS) to review and evaluate the scientific and medical literature regarding associations between illness and exposure to toxic agents, environmental or wartime hazards, and preventive medicines or vaccines in members of the armed forces who were exposed to such agents. Deployment to a war zone has a profound impact on the lives of troops and on their family members. There are a plethora of stressors associated with deployment, including constant vigilance against unexpected attack, difficulty distinguishing enemy combatants from civilians, concerns about survival, caring for the badly injured, and witnessing the death of a person. Less traumatic but more pervasive stressors include anxiety about home life, such as loss of a job and income, impacts on relationships, and absence from family. The focus of this report, by the Institute of Medicine (IOM) Committee on Gulf War and Health: Physiologic, and Psychosocial Effects of Deployment-Related Stress, is the long-term effects of deployment-related stress. Gulf War and Health: Volume 6. Physiologic, and Psychosocial Effects of Development Related Stress evaluates the scientific literature regarding association between deployment-related stressors and health effects, and provides meaningful recommendations to remedy this problem.
Emotional Aftermath of the Persian Gulf War explores the impact of war from a unique perspective -- it addresses not only the effect of trauma on soldiers in combat but also the toll war takes on families and communities as a whole. In this book, experts from the Department of Defense (including Dick Cheney, former Secretary of Defense, who provides the preface), the Veterans Administration, the National Institute of Mental Health, Israel Defense Forces, and academia provide an integrated look at the psychiatric and psychological effects of war and the treatment of war-related stress and psychiatric disorders. The authors focus on the experience of servicemembers and of their families in response to deployment, separation, and loss, and reintegration after the war. They discuss the treatment of combat casualties, those with and without psychiatric illness, who were rapidly returned home still in the acute stage of their injuries. The authors emphasize providing the best support, both medically and psychologically, for military personnel and their families for the essential mental health and effectiveness of the fighting force and the improved quality of life of individual people. The special needs of families and of reserve and guard members are considered, and models of community outreach programs for coping with the stressors of war are discussed. Unique in terms of the role that technology played -- including live TV coverage, Patriot missiles, and "smart" bombs -- the Gulf War was a part of the day-to-day lives of the fighting forces and their families, communities, and nations.
The application of psychiatry to war and terrorism is highly topical and a source of intense media interest. Shell Shock to PTSD explores the central issues involved in maintaining the mental health of the armed forces and treating those who succumb to the intense stress of combat. Drawing on historical records, recent findings and interviews with veterans and psychiatrists, Edgar Jones and Simon Wessely present a comprehensive analysis of the evolution of military psychiatry. The psychological disorders suffered by servicemen and women from 1900 to the present are discussed and related to contemporary medical priorities and health concerns. This book provides a thought-provoking evaluation of the history and practice of military psychiatry, and places its findings in the context of advancing medical knowledge and the developing technology of warfare. It will be of interest to practicing military psychiatrists and those studying psychiatry, military history, war studies or medical history.
Combat Stress Injury represents a definitive collection of the most current theory, research, and practice in the area of combat and operational stress management, edited by two experts in the field. In this book, Charles Figley and Bill Nash have assembled a wide-ranging group of authors (military / nonmilitary, American / international, combat veterans / trainers, and as diverse as psychiatrists / psychologists / social workers / nurses / clergy / physiologists / military scientists). The chapters in this volume collectively demonstrate that combat stress can effectively be managed through prevention and training prior to combat, stress reduction methods during operations, and desensitization programs immediately following combat exposure.
Chronic multisymptom illness (CMI) is a serious condition that imposes an enormous burden of suffering on our nation's veterans. Veterans who have CMI often have physical symptoms (such as fatigue, joint and muscle pain, and gastrointestinal symptoms) and cognitive symptoms (such as memory difficulties). For the purposes of this report, the committee defined CMI as the presence of a spectrum of chronic symptoms experienced for 6 months or longer in at least two of six categories-fatigue, mood, and cognition, musculoskeletal, gastrointestinal, respiratory, and neurologic-that may overlap with but are not fully captured by known syndromes (such as CFS, fibromyalgia, and IBS) or other diagnoses. Despite considerable efforts by researchers in the United States and elsewhere, there is no consensus among physicians, researchers, and others as to the cause of CMI. There is a growing belief that no specific causal factor or agent will be identified. Many thousands of Gulf War veterans1 who have CMI live with sometimes debilitating symptoms and seek an effective way to manage their symptoms. Estimates of the numbers of 1991 Gulf War veterans who have CMI range from 175,000 to 250,000 (about 25-35% of the 1991 Gulf War veteran population), and there is evidence that CMI in 1991 Gulf War veterans may not resolve over time. Preliminary data suggest that CMI is occurring in veterans of the Iraq and Afghanistan wars as well. In addition to summarizing the available scientific and medical literature regarding the best treatments for chronic multisymptom illness among Gulf War veterans, Gulf War and Health: Volume 9: Treatment for Chronic Multisymptom Illness recommends how best to disseminate this information throughout the VA to improve the care and benefits provided to veterans, recommends additional scientific studies and research initiatives to resolve areas of continuing scientific uncertainty and recommends such legislative or administrative action as the IOM deems appropriate in light of the results of its review.
The brief, successful Gulf War resulted in few casualties, but there were still recognizable pockets of trauma. This study examines the Mental Health Services available in the theater of operations, the preparations made to train the soldiers for the stress of combat, and details of how they coped with the experience of combat. It assesses the Gulf War in terms of mental health. Some attention is also given to the phenomenon named Gulf War Syndrome. The authors conclude that United States Military Forces were not prepared for the mental health requirements of combat.
For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the Institute of Medicine (IOM) has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes. The fourth volume in the series, released in 2006, summarizes the long-term health problems seen in Gulf War veterans. In 2010, the IOM released an update that focuses on existing health problems and identifies possible new ones, considering evidence collected since the initial summary. Gulf War and Health: Volume 10 is an update of the scientific and medical literature on the health effects associated with deployment to the Gulf War that were identified in Volumes 4 and 8. This report reviews and evaluates the associations between illness and exposure to toxic agents, environmental or wartime hazards, or preventive measures and vaccines associated with Gulf War service, and provides recommendations for future research efforts on Gulf War veterans.
For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the IOM is conducting an ongoing review of the evidence to determine veterans' long-term health problems and what might be causing those problems. The fourth volume in the series, released in 2006, summarizes the long-term health problems seen in Gulf War veterans. In 2008, the IOM began an update to look at existing health problems and identify possible new ones, considering evidence collected since the initial summary. In this report, the IOM determines that Gulf War service causes post-traumatic stress disorder (PTSD) and that service is associated with multisymptom illness; gastrointestinal disorders such as irritable bowel syndrome; alcohol and other substance abuse; and anxiety disorders and other psychiatric disorders. To ensure that our veterans receive the best possible care, now and in the future, the government should continue to monitor their health and conduct research to identify the best treatments to assist Gulf War veterans still suffering from persistent, unexplained illnesses.
Environmental illness is a concept of growing concern to all health professionals. Patients with problems presumably caused by sick buildings, electromagnetic fields and hypersensitivity to chemicals--to name a few--are often referred to psychologists, psychiatrists, and other counselors. The battery worker with fatigue, headaches, abdominal pain and an elevated lead level...the assembly worker with pain and numbness in her hand and delayed median nerve conduction...the patient who develops typical contact dermatitis after working with epoxies..., these are straightforward cases. But they are in the minority. In many cases, needy, demanding, and difficult patients present complex and challenging psychological issues. Practitioners often lack the training or wisdom to handle these issues effectively. We know that exposure to lead, mercury, and PCBs affect psychological development and behavior; we know much less about the effects of thousands of other chemicals in the environment. In addition, global climate change, social disruption, and the spread of infections will--in the near future--expose people to novel environmental threats. Symptoms caused by toxins can overlap those caused by fear, stress, and depression, and the clinical picture can mimic a variety of other mental disorders. On the other hand, the natural environment can also be a healer. Research shows that hospital stays are shortened and the need for pain medication reduced for patients exposed to nature, even in images, or to the company of animals. Nursing home patients live longer if allowed to keep pets, and one controlled study shows that caring for animals reduces disruptive behavior in even the most difficult ADD children. This book offers the first overview of the many ways the environment can affect mental health and illness. It will prove to be an important and valuable resource for physicians in psychiatry, public health, and environmental medicine; for clinical and counseling psychologists and social workers; and for environmental researchers and advocates worldwide.
... Is a unique collection of authoritative briefings from over 90 countries around the world. Each chapter covers a particular country's demographics, mental health resources, undergraduate education, postgraduate training in psychiatry, research activities, mental health legislation, and policy and development strategies.