Veterans of the Persian Gulf War report a variety of physical and psychological symptoms, some of which remain unexplained. In an effort to determine the ex-tent to which these symptoms may be related to Gulf War service and to develop policies to better deal with health risks in future deployments, the Secretary of Defense designated a special assistant to oversee all Department of Defense (DoD) efforts related to the illnesses of Gulf War veterans. The Office of the Special Assistant for Gulf War Illnesses (OSAGWI) is charged to do everything possible to understand and explain the illnesses, to inform veterans and the public of its progress and findings, and recommend changes in DoD policies and procedures to minimize such problems in the future.

Stress was identified as one area of concern related to illnesses among Gulf War veterans. Dr. David Marlowe, who is an expert in the area of stress related disorders, briefed leaders in DoD and other agencies at RAND on the subject. RAND was then asked to work with Dr. Marlowe to prepare a monograph that summarized those views. This monograph presents the views of Dr. Marlowe based on many years of research, including investigations made in the Gulf. The views put forth here are his and are not meant to represent either a complete review of the history of stress or a review of the literature on stress as it relates to the Gulf War. (For a review of the scientific literature as it pertains to stress in the Gulf War, See Marshall, Davis, and Sherbourne, 1999.)

This document should interest anyone involved in the study of Gulf War illnesses, and, more broadly, those who served and the general public. It was sponsored by the Office of the Special Assistant and was carried out jointly by RAND Health�s Center for Military Health Policy Research and the Forces and Resources Policy Center of RAND�s National Defense Research Institute. The latter is a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the unified commands, and the defense agencies.