Faculty Articles

ORCID

Jeffrey Kibler 0000-0002-9295-0649

Stephen Craig Messer 0000-0003-0503-9695

Nancy Klimas 0000-0003-1459-3268

Travis Craddock 0000-0001-7244-6317

Document Type

Article

Publication Title

BMC Psychology

ISSN

2050-7283

Publication Date

4-20-2021

Abstract

Background: Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder affecting an estimated 25–32% of the returning military veterans of the 1990–1991 Persian Gulf War. GWI presents with a wide range of symptoms including fatigue, muscle pain, cognitive problems, insomnia, rashes and gastrointestinal issues and continues to be a poorly understood illness. This heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. Defining subgroups of the illness may help alleviate these complications. Our aim is to determine if GWI can be divided into distinct subgroups based on PTSD symptom presentation.

Methods: Veterans diagnosed with GWI (n = 47) and healthy sedentary veteran controls (n = 52) were recruited through the Miami Affairs (VA) Medical Health Center. Symptoms were assessed via the RAND short form health survey (36), the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson Trauma Scale value and performing heteroscedastic t-tests across all measures.

Results: Overall analyses returned two symptom-based subgroups differing significantly across all health and trauma symptoms. These subgroups supported PTSD symptomatology as a means to subgroup veterans. Hierarchical models showed that GWI and levels of PTSD symptoms both impact measures of physical, social, and emotional consequences of poor health (ΔR2 = 0.055–0.316). However, GWI appeared to contribute more to fatigue measures. Cut-point analysis retained worse health outcomes across all measures for GWI with PTSD symptoms compared to those without PTSD symptoms, and healthy controls. Significant differences were observed in mental and emotional measures.

Conclusions: Therefore, this research supports the idea that comorbid GWI and PTSD symptoms lead to worse health outcomes, while demonstrating how GWI and PTSD symptoms may uniquely contribute to clinical presentation.

DOI

10.1186/s40359-021-00561-2

Volume

9

Document Number

57

Funding Information

Funding for this research came from the US Department of Defense Congressionally Directed Medical Research Program (CDMRP) awards (http://cdmrp.army.mil/) W81XWH-16-1-0632 (Craddock—PI), and W81XWH-16-1-0552 (Craddock—PI), and a Veterans Affairs Merit Award to Dr. Nancy Klimas. The Funders had no role in the design of the study, collection, analysis and interpretation of data, or in the writing of the manuscript. The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Funders.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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