Psychological Differences Between Veterans With and Without Gulf War Unexplained Symptoms

Objective The objective of this study was to assess measures of psychological and neurobehavioral functioning to determine their association with unexplained symptoms in Gulf War veterans. Methods An epidemiological survey focusing on exposures and symptoms was mailed to a random sample of Gulf War veterans from Oregon and southwestern Washington. Volunteers were recruited from survey respondents who agreed to undergo a thorough medical examination and psychological and neurobehavioral assessment. Persistent symptoms with no medical explanation associated with service in the Persian Gulf (eg, fatigue, muscle pain, and memory deficits) that began during or after the war qualified respondents as cases. The 241 veterans with unexplained symptoms were classified as case subjects, and the 113 veterans without symptoms were classified as control subjects. All veterans completed a battery of computerized assessment tests consisting of 12 psychosocial and 6 neurobehavioral tests. Differences between case and control subjects on neurobehavioral and psychological variables were assessed with univariate and multivariate statistical comparisons. Results Case subjects differed substantially and consistently from control subjects on diverse psychological tests in the direction of increased distress and psychiatric symptoms. Case subjects had small but statistically significant deficits relative to control subjects on some neurobehavioral tests of memory, attention, and response speed. A logistic regression model consisting of four psychological variables but no neurobehavioral variables classified case and control subjects with 86% accuracy. Conclusions Our results revealed that Gulf War veterans who report symptoms associated with that conflict differed on multiple psychological measures in the direction of increased distress and performed more poorly on neurobehavioral measures when compared with control subjects who did not report symptoms. This suggests that psychological differences have a prominent role in investigation of possible explanations of Gulf War symptoms.

目的 本研究的目的是评估心理和神经行为功能的指标，以确定它们与海湾战争退伍军人不明原因症状之间的关联。 方法 一项针对暴露情况和症状的流行病学调查以邮件形式发送给来自俄勒冈州和华盛顿州西南部的海湾战争退伍军人随机样本。从同意接受全面医学检查以及心理和神经行为评估的调查受访者中招募志愿者。在战争期间或之后开始出现的、与在波斯湾服役相关且无医学解释的持续性症状（例如，疲劳、肌肉疼痛和记忆缺陷）使受访者符合病例标准。241名有不明原因症状的退伍军人被归类为病例组，113名无症状的退伍军人被归类为对照组。所有退伍军人都完成了一系列由12项心理社会测试和6项神经行为测试组成的计算机化评估测试。通过单变量和多变量统计比较评估病例组和对照组在神经行为和心理变量上的差异。 结果 在各种心理测试中，病例组在痛苦增加和精神症状方面与对照组存在显著且一致的差异。在一些关于记忆、注意力和反应速度的神经行为测试中，病例组相对于对照组存在较小但具有统计学意义的缺陷。一个由四个心理变量但无神经行为变量组成的逻辑回归模型对病例组和对照组进行分类的准确率为86%。 结论 我们的研究结果显示，报告与海湾战争相关症状的海湾战争退伍军人在多个心理指标上朝着痛苦增加的方向存在差异，并且与未报告症状的对照组相比，在神经行为指标上表现更差。这表明心理差异在对海湾战争症状可能的解释的调查中具有重要作用。