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El. knyga: Gulf War and Health: Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress

  • Formatas: 358 pages
  • Išleidimo metai: 25-Feb-2008
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309659796
  • Formatas: 358 pages
  • Išleidimo metai: 25-Feb-2008
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309659796

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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.





Table of Contents



Front Matter SUMMARY 1 INTRODUCTION 2 CONSIDERATIONS IN IDENTIFYING AND EVALUATING THE LITERATURE 3 DEPLOYMENT-RELATED STRESSORS 4 THE STRESS RESPONSE 5 POSTTRAUMATIC STRESS DISORDER 6 HEALTH EFFECTS 7 PSYCHOSOCIAL EFFECTS 8 CONCLUSIONS AND RECOMMENDATIONS INDEX
Acronyms xiii
Preface xvii
Summary 1(1)
Committee's Interpretation of Its Charge
2(1)
Committee's Approach to Its Charge
2(1)
Evaluation Criteria
3(1)
Categories of Association
4(1)
Limitations of Veteran Studies
5(1)
Deployment-Related Stressors
5(1)
The Stress Response
6(1)
Posttraumatic Stress Disorder
6(1)
Health Effects
7(1)
Summary of Conclusions
7(2)
Recommendations
9(2)
Introduction
11(6)
Demographics
12(1)
Committee's Interpretation of Its Charge
13(1)
Committee's Approach to Its Charge
14(1)
Organization of the Report
15(1)
References
16(1)
Considerations in Identifying and Evaluating the Literature
17(14)
Identification of the Literature
17(1)
Types of Evidence
18(5)
Inclusion Criteria
23(1)
Additional Considerations
24(1)
Considerations in Assessing the Strength of Evidence
25(1)
Categories of Association
26(2)
Limitations of Veteran Studies
28(1)
Summary
28(1)
References
29(2)
Deployment-Related Stressors
31(18)
Stressors During Combat
32(3)
Noncombat Stressors
35(1)
Anticipation of Deployment to a War Zone
36(1)
Military Sexual Assault and Harassment
37(1)
Living Conditions
38(1)
Environmental and Chemical Stressors
39(1)
Reserve and National Guard Troops
39(1)
Peacekeepers
40(1)
Women
41(2)
Conclusions
43(1)
References
43(6)
The Stress Response
49(26)
Central Role of the Brain
50(6)
Modifiers of the Stress Response
56(3)
Chronic Stress and Health
59(7)
Conclusions
66(1)
References
66(9)
Posttraumatic Stress Disorder
75(40)
Diagnosis and Clinical Features
76(2)
Prevalence
78(3)
Course
81(3)
Comorbidity and Disability
84(2)
Risk and Protective Factors
86(8)
Neurobiology
94(6)
Conclusions
100(1)
References
100(15)
Health Effects
115(168)
Organization of This
Chapter
115(2)
Cancer
117(16)
Endocrine Diseases
133(9)
Psychiatric Disorders
142(16)
Substance-Use Disorders
158(9)
Neurobehavioral and Neurocognitive Effects
167(7)
Chronic Fatigue Syndrome
174(5)
Sleep Disturbances
179(4)
Cardiovascular Diseases
183(14)
Respiratory System Diseases
197(7)
Digestive System Disorders
204(10)
Skin Disorders
214(8)
Fibromyalgia and Chronic Widespread Pain
222(7)
Reproductive Effects
229(8)
Suicide and Accidental Death
237(11)
Symptom Reporting
248(13)
References
261(22)
Psychosocial Effects
283(34)
Marital and Family Conflict
283(16)
Homelessness
299(5)
Incarceration
304(4)
Employment
308(4)
References
312(5)
Conclusions and Recommendations
317(6)
Quality of the Studies
317(1)
Overview of Health Effects
318(3)
Recommendations
321(1)
References
321(2)
Index 323
Committee on Gulf War and Health: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress