Why people believe they were exposed to biological or chemical warfare: a survey of Gulf War veterans

The symmetry rule: a seven-year study of symptoms and explanatory labels among Gulf War veterans

Noticing medical symptoms can cause one to search for explanatory labels such as "ate bad food" or even "exposed to anthrax," and perhaps these labels may cause new symptom reports. The present study examined whether there is empirical support for this symptom-label "symmetry rule." We interviewed veterans (N= 362) from the Gulf War Registry in 1995 and 2002 about their medical symptoms and about their exposure to war-related hazards and stressors. Health symptom reports were strongly correlated between the two time periods and showed relatively stable mean levels, whereas recall of war-related exposures was notably unstable. Veterans starting with fewer medical symptoms recalled fewer war-related exposures seven years later. Initial recollection of chemical and biological warfare exposure (but not other exposures) longitudinally predicted novel medical symptoms. The findings generally support the symmetry rule hypotheses, although the evidence for the label to symptom link was less strong. The findings account for some variability in symptoms and exposure recall over time, but they do not, on their own, account for the Gulf War veterans' elevated number of unexplained medical symptoms.

Psychological effects of chemical weapons: a follow-up study of First World War veterans

BACKGROUND

Chemical weapons exercise an enduring and often powerful psychological effect. This had been recognized during the First World War when it was shown that the symptoms of stress mimicked those of mild exposure to gas. Debate about long-term effects followed the suggestion that gassing triggered latent tuberculosis.

METHOD

A random sample of 103 First World War servicemen awarded a war pension for the effects of gas, but without evidence of chronic respiratory pathology, were subjected to cluster analysis using 25 common symptoms. The consistency of symptom reporting was also investigated across repeated follow-ups.

RESULTS

Cluster analysis identified four groups: one (n=56) with a range of somatic symptoms, a second (n=30) with a focus on the respiratory system, a third (n=12) with a predominance of neuropsychiatric symptoms, and a fourth (n=5) with a narrow band of symptoms related to the throat and breathing difficulties. Veterans from the neuropsychiatric cluster had multiple diagnoses including neurasthenia and disordered action of the heart, and reported many more symptoms than those in the three somatic clusters.

CONCLUSIONS

Mild or intermittent respiratory disorders in the post-war period supported beliefs about the damaging effects of gas in the three somatic clusters. By contrast, the neuropsychiatric group did not report new respiratory illnesses. For this cluster, the experience of gassing in a context of extreme danger may have been responsible for the intensity of their symptoms, which showed no sign of diminution over the 12-year follow-up.

Belief in exposure to chemical and biological agents in Persian Gulf War soldiers

This is the first longitudinal cohort study of Persian Gulf War US soldiers to examine belief in exposure to chemical and biological weapons before and shortly after combat. A longitudinal sample of n = 1250 male Persian Gulf War US Army soldiers were surveyed 3 to 4 months before and 6 to 10 months after the 1991 War. Six to 10 months after combat, 4.6% of the cohort believed they had been exposed to chemical and biological weapons. Adjusting for demographics only, those who reported a greater number of combat exposures (odds ratio, OR: 18.8), or higher combat stress (OR: 12.27) were more likely to believe they were exposed. Adjusting for all variables soldiers who reported higher combat stress continued to be most likely (OR: 6.58) to believe they had been exposed to chemical and biological weapons. Individuals reporting higher combat stress are at substantially greater risk of reporting they have been exposed to chemical or biological weapons.

Enduring beliefs about effects of gassing in war: qualitative study

OBJECTIVES

To discover the content of enduring beliefs held by first world war veterans about their experience of having been gassed.

DESIGN

Collection and thematic analysis of written and reported statements from a sample of veterans about gassing.

SUBJECTS

103 veterans with a war pension.

RESULTS

Twelve themes were identified, which were related to individual statements. The systemic nature of chemical weapons played a key part in ideas and beliefs about their capacity to cause enduring harm to health. Unlike shrapnel or a bullet that had a defined physical presence, gas had unseen effects within the body, while its capacity to cause damage was apparent from vesicant effects to skin and eyes. The terror inspired by chemical weapons also served to maintain memories of being gassed, while anti-gas measures were themselves disconcerting or a source of discomfort.

CONCLUSIONS

Chronic symptoms and work difficulties maintained beliefs about the potency of chemical weapons. In the period after the war, gas continued to inspire popular revulsion and was associated with a sense of unfairness.

Viewpoint: Terrorism and Dispelling the Myth of a Panic Prone Public

Governments and commentators perceive the public to be prone to panic in response to terrorist attacks--conventional or involving chemical, biological or radiological weapons. Evidence from five such incidents suggests that the public is not prone to panic, although people can change their behaviours and attitudes to reduce the risk of themselves being exposed to a terrorist incident. Behavioural responses may be divided into acts of omission, such as not making unnecessary journeys, and acts of commission, such as taking prophylactic medication despite the inherent risk of side effects. Evidence suggests that the public are aware of these differences, and tend to adopt responses proportionate to the risk. Drawing upon the literature in the social and natural sciences, our discussion encompasses differing risk perceptions of terrorist threats and consequences of attacks. How do fear and anxiety interact with behavioural responses to amplify or attenuate perceptions that can be modified through risk communication undertaken by authorities?