Stress and Arousal Symptoms in Individuals and Groups - Persian Gulf War Symptoms as a Paradigm

摘要

This volume is a final report for the grant, Stress and Arousal Symptoms in Individuals and Groups - The Persian Gulf War Symptoms as a Paradigm. This report makes a series of recommendations, some general, and some quasi-specific for future patterns of research into the somatic and other consequences of combat stress, deployment stress and other stresses of military life. It is our conclusion that the time has come to move away from the general and only partially meaningful definitions of 'stress' to more tightly operational and measurable ones. We also believe that the time has come to initiate research with techniques that will stand the tests of measuring short, mid and long term outcomes replacing present modes of intervention and treatment, which have often been rooted in unproved concepts and psychiatric folklore. Much of the earlier research into the somatic consequences of stress and indeed into medicine as a whole, was correlational in nature. The value of correlational research and findings remains unchallenged as an indicator and guide to general areas in which causality can be discovered and effective treatment devised. Its utility, however, is limited when it comes to specific preventive or therapeutic interventions. Because correlational research was directed at single levels of the biological hierarchy and unitary causal agents, it has been central to the 'medical model' for some generations. The implicit radical reductionism underlying this model has been the source of the greatest success of medicine when dealing with both the elucidation of cause and the treatment of diseases traceable to single pathogens or toxins. Yet even when the single pathogen of a disease is uncovered, the issue of prevention often requires the integration of multiple factors from the molecular to the socio- cultural. Cholera is an apt illustration of the problem of the integration of multiple factors into the treatment and prevention of an illness.