Veterans at Risk The Health Effects of Mustard Gas and Lewisite (1993) / Chapter Skim
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11 Relationship of Mustard Agent and Lewisite Exposure to Psychological Dysfunction
11 Relationship of Mustard Agent and Lewisite Exposure to Psychological Dysfunction
Pages 199-213
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From page 199... ...
On April 15, 1992, Robert Ursano, who heads the Department of Psychiatry at the Uniformed Services University of the Health Sciences and has studied the psychological effects of chemical and biological warfare environments, presented information about what characteristics of such environments are important in the etiology of stress reactions (see Appendix A)
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From page 200... ...
At present there are four diagnostic criteria for PTSD: · the existence of a recognizable stressor that would evoke significant symptoms of distress in almost anyone and is outside the range of usual human experience; · reexperiencing of the trauma and intensification of symptoms with exposure to events that symbolize or resemble the traumatic event; · numbing of responsiveness to, or reduced involvement with, the world, beginning after the trauma and including avoidance of activities that arouse recollection of the traumatic event; and
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From page 201... ...
Specify delayed onset if the onset of symptoms was at least six months after the trauma. SOURCE: American Psychiatric Association, 1987.
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From page 202... ...
He wrote, "I am curiously weak weak as if I were recovering from a long illness." Later, Dickens developed a phobia of railway travel. Since the late 1800s and early 1900s, industrial accidents, major natural and man-made disasters, concentration camps, terrorist activities, and especially wars have been the source of observations about human responses to major traumatic events.
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From page 203... ...
, writing about his observations on one of the larger samples of men with "traumatic neuroses" from WWI, attempted to distinguish between "toxic sequelae" and "psychic or psychogenic sequelae." Without achieving the separation, yet in the best tradition of clinical observation, he described clearly and convincingly in men exposed to toxic gases, those behaviors and responses that are now termed PTSD. There was little understanding of combat stress reactions in WWI, however, and many of the disagreements about labels were really disagreements about whether or not certain individuals were "predisposed" to develop adverse psychological effects following traumatic events (Horowitz, 1976~.
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From page 204... ...
It was not until 1980, with the release of DSM-III, that stress response syndromes, called PTSD for the first time, became a diagnostic category once again. This category and its accompanying criteria represented a landmark in the development of the concept of PTSD in that the first criterion, "existence of a recognizable stressor that would evoke significant symptoms of distress in almost anyone and is outside the range of usual human experience," clearly indicates that all individuals are at risk, not just those with pre-existing emotional problems.
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From page 205... ...
A number of recommendations from the USUHS project are interesting when viewed in reference to the handling of subjects in earlier CBW testing programs. Under the category of command issues, recommendations were made about the value of effective communications between command levels and troops to reduce the likelihood of adverse psychological and behavioral responses to stress.
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From page 206... ...
A1though no direct statements are made regarding the long-term effects of such stress reactions, some of the characteristics of CBW environments fall into the description of experiences "outside the usual human experience .
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From page 207... ...
have compared Vietnam veterans with WWII and Korean War veterans on measures of depression, anxiety, severity and types of symptoms, and intensity and nature of combat experiences. The two groups of veterans were generally the same in terms of the sequential emergence of diagnoses and the age of onset of diagnoses: PTSD was followed by a general anxiety, which was then followed by panic disorder, major depression, and intermittent depressions.
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From page 208... ...
The differences in the veterans' reports of intensity of their experiences were interesting: WWII and Korean War veterans were most upset by general fear, fear of physical injury, and fear of incapacitation; Vietnam veterans, on the other hand, were traumatized most by witnessing brutality, sight of mutilated bodies, and loss of a friend in combat. That stress reactions can set the stage for lifetime psychological difficulties is important in view of the nearly 50 years that have passed since the WWII testing programs with mustard agents and Lewisite.
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From page 209... ...
Blood pressure measurements in the TMI group, assessed by examination of personal physician records from before the accident, show increases by one year after the accident and have remained high; 10 to 15 percent have developed hypertension since the accident, a percentage not explained by smoking or other controlled variables. Compared to other groups studied, the TMI population also exhibits higher concentrations of urinary catecholamines, which are indicative of physiological stress responses.
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From page 210... ...
The interplay of such variables has been the subject of Henry Vyner's 1988 analysis of the psychosocial correlates of exposure to toxic chemicals and radiation, so-called invisible environmental contaminants. In his book, Vyner analyzed numerous studies done with various "exposed" populations, including people living at Love Canal, veterans exposed to radiation during the A-bomb tests, people in Michigan who were affected when a toxic chemical known as PBB was mistakenly put into cattle feed, and the TMI community.
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From page 211... ...
These effects may be highly individual, but diagnosable, and may include long-term mood and anxiety disorders, PTSD, or other traumatic stress disorder responses. In addition, some of the experiences of those who worked with chemical warfare agents or who were exposed to sulfur mustard at Bari harbor, such as explosions, injuries, and witnessing of injury and death, may also have resulted in development of such adverse psychological effects.
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From page 212... ...
A Conference to Explore the Psychological Effects of Chemical and Biological Warfare. Bethesda, Maryland: Uniformed Services University of the Health Sciences.
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From page 213... ...
1988d. Psychological and Behavioral Responses to a Chemical and Biological Warfare Environment: Final Recommendations.
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