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Olfactory functioning in Gulf War-era veterans: Relationships to war-zone duty, self-reported hazards exposures, and psychological distress

Published online by Cambridge University Press:  25 February 2003

Vasterling Jennifer J.*
Affiliation:
Veterans Affairs Medical Center, New Orleans, Louisiana Tulane University School of Medicine, New Orleans, Louisiana
Brailey Kevin
Affiliation:
Veterans Affairs Medical Center, New Orleans, Louisiana Tulane University School of Medicine, New Orleans, Louisiana
Tomlin Holly
Affiliation:
Veterans Affairs Medical Center, New Orleans, Louisiana
Rice Janet
Affiliation:
Tulane University School of Public Health, New Orleans, Louisiana
Sutker Patricia B.
Affiliation:
Tulane University School of Medicine, New Orleans, Louisiana Texas Tech University Health Sciences Center, Lubbock, Texas
*
Reprint requests to: Jennifer J. Vasterling, Ph.D., Mental Health Service Line (COS6), Veterans Affairs Medical Center, 1601 Perdido Street, New Orleans, Louisiana 70112. E-mail: jennifer.vasterling@med.va.gov

Abstract

To explore possible neurotoxic sequelae of Gulf War (GW) participation, olfactory identification performance, neurocognitive functioning, health perceptions, and emotional distress were assessed in 72 veterans deployed to the GW and 33 military personnel activated during the GW but not deployed to the war zone. Findings revealed that war-zone-exposed veterans reported more concerns about health, cognitive functioning, and depression than did their counterparts who did not see war-zone duty. There was no evidence that performances on olfactory or neurocognitive measures were related to war-zone duty or to self-reported exposure to GW toxicants. However, symptoms of emotional distress were positively correlated with self-report of health and cognitive complaints. Results do not provide support for the hypothesis that objectively-measured sensory (i.e., olfactory) or cognitive deficits are related to war-zone participation but do underscore the increasingly demonstrated association between self-reported health concerns and symptoms of emotional distress. (JINS, 2003, 9, 407–418.)

Type
Research Article
Copyright
Copyright © The International Neuropsychological Society 2003

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References

Anger, W.K., Storzbach, D., Binder, L.M., Campbell, K.A., Rohlman, D.S., McCauley, L., Kovera, C.A., Davis, & K.L., Members of the Portland Environmental Hazards Research Center. (1999). Neurobehavioral deficits in Persian Gulf veterans: Evidence from a population-based study. Journal of the International Neuropsychological Society, 5, 203–212.CrossRefGoogle Scholar
Axelrod, B.N. & Milner, I.B. (1997). Neuropsychological findings in a sample of Operation Desert Storm veterans. Journal of Neuropsychiatry and Clinical Neurosciences, 9, 23–28.Google Scholar
Bartone, P.T., Ursano, R.J., Wright, K.M., & Ingraham, L.H. (1989). The impact of a military air disaster on the health of assistance workers: A prospective study. Journal of Nervous and Mental Disease, 177, 317–328.CrossRefGoogle Scholar
Beck, A., Ward, C.H., Mendolson, M., Mock, J., & Erbaugh, J.K. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle Scholar
Berg, E.A. (1948). A simple objective test for measuring flexibility in thinking. Journal of General Psychology, 39, 15–22.CrossRefGoogle Scholar
Binder, L.M., Storzbach, D., Anger, W.K., Campbell, K.A., Rohlman, & D.S., Members of the Portland Environmental Hazards Research Center. (1999). Subjective cognitive complaints, affective distress, and objective cognitive performance in Persian Gulf War veterans. Archives of Clinical Neuropsychology, 14, 531–536.CrossRefGoogle Scholar
Binder, L.M., Storzbach, D., Campbell, K.A., Rohlman, D.S., Anger, & W.K., Members of the Portland Environmental Hazards Research Center. (2001). Neurobehavioral deficits associated with chronic fatigue syndrome in veterans with Gulf War unexplained illnesses. Journal of the International Neuropsychological Society, 7, 835–839.CrossRefGoogle Scholar
Brailey, K., Vasterling, J.J., & Sutker, P.B. (1998). Psychological aftermath of Persian Gulf War participation. In A. Lundberg (Ed.), The environment and mental health (pp. 83–102). Hillsdale, NJ: Erlbaum.Google Scholar
Bremner, J.D., Scott, T.M., Delaney, R.C., Southwick, S.M., Mason, J.W., Johnson, D.R., Innis, R.B., McCarthy, G., & Charney, D.S. (1993). Deficits in short-term memory in posttraumatic stress disorder. American Journal of Psychiatry, 150, 1015–1019.CrossRefGoogle Scholar
Buckley, L.A., Morgan, K.T., Swenberg, J.A., James, R.A., Hamm, T.E., & Barrow, C.S. (1985). The toxicity of dimethylamine in F-344 rats and B6C3F1 mice following a 1-year exposure. Fundamentals of Applied Toxicology, 5, 341–352.10.1016/0272-0590(85)90082-XCrossRefGoogle Scholar
Burr, R.G., Woodruff, S.I., & Banta, G.R. (1993). Associations between mood and specific health composites during U.S. Navy Persian Gulf operations. Journal of Psychosomatic Research, 37, 291–297.CrossRefGoogle Scholar
Cohen, S. & Williamson, G.M. (1991). Stress and infectious disease in humans. Psychological Bulletin, 109, 5–24.CrossRefGoogle Scholar
Doty, R.L. (1995). The Smell Identification Test administration manual (3rd ed.). Haddon Heights: Sensonics, Inc.Google Scholar
Doty, R.L. (1997). Studies of human olfaction from the University of Pennsylvania Smell and Taste Center. Chemical Senses, 22, 565–586.CrossRefGoogle Scholar
Doty, R.L., Newhouse, M.G., & Azzalina, J.D. (1985). Internal consistency and short-term test–retest reliability of the University of Pennsylvania Smell Identification Test. Chemical Senses, 10, 297–300.CrossRefGoogle Scholar
Doty, R., Shaman, P., & Dann, W. (1984). Development of the University of Pennsylvania Smell Test: Standardized micro encapsulated test of olfactory function. Physiological Behavior, 32, 489–502.CrossRefGoogle Scholar
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1996). Structured Clinical Interview for DSM–IV. New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Flaxman, N.A. (1999). Gulf War illness: Does anticholinesterase exposure play a role? Federal Practitioner, 17, 13–16.Google Scholar
Frances, A. & Beckham, J.C. (1998). Identifying illness: Pitfalls and discoveries. Psychosomatic Medicine, 60, 669–670.CrossRefGoogle Scholar
Friedman, M.J. & Schnurr, P.P. (1995). The relationship between PTSD, trauma, and physical health. In M.J. Friedman, D.S. Charney, & A.Y. Deutch (Eds.), Neurobiological and clinical consequences of stress: From normal adaptation to PTSD (pp. 507–524). New York: Raven.Google Scholar
Frye, R., Schwartz, B., & Doty, R. (1990). Dose related effects of cigarette smoking on olfactory function. Journal of the American Medical Association, 263, 1233–1236.CrossRefGoogle Scholar
Fukuda, K., Nisenbaum, R., Stewart, G., Thompson, W.W., Robin, L., Washko, R.M., Noah, D.L., Barrett, D.H., Randall, B., Herwaldt, B.L., Mawle, A.C., & Reeves, W.C. (1998). Chronic multisymptom illness affecting Air Force veterans of the Gulf War. Journal of the American Medical Association, 280, 981–988.10.1001/jama.280.11.981CrossRefGoogle Scholar
Gass, C.S. & Apple, C. (1997). Cognitive complaints in closed head injury: Relationship to memory test performance and emotional disturbance. Journal of Clinical and Experimental Neuropsychology, 19, 290–299.CrossRefGoogle Scholar
Gilbertson, M.W., Gurvits, T.V., Lasko, N.B., Orr, S.P., & Pitman, R.K. (2001). Multivariate assessment of explicit memory function in combat veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 14, 413–432.CrossRefGoogle Scholar
Goldstein, G., Beers, S.R., Morrow, L.A., Shemanski, W.J., & Steinhauer, S.R. (1996). A preliminary neuropsychological study of Persian Gulf War veterans. Journal of the International Neuropsychological Society, 2, 368–371.CrossRefGoogle Scholar
Haley, R.W., Fleckenstein, J.L., Marshall, W.W., McDonald, G.G., Kramer, G.L., & Petty, F. (2000). Effect of basal ganglia injury on central dopamine activity in Gulf War syndrome: Correlation of proton magnetic resonance spectroscopy and plasma homovanillic acid levels. Archives of Neurology, 57, 1280–1285.CrossRefGoogle Scholar
Haley, R.W. & Kurt, T.L. (1997). Self-reported exposure to neurotoxic chemical combinations in the Gulf War: A cross-sectional epidemiologic study. Journal of the American Medical Association, 277, 231–237.CrossRefGoogle Scholar
Hartman, D.E. (1995). Neuropsychological toxicology: Identification and assessment of human neurotoxic syndromes (2nd ed.). New York: Plenum.CrossRefGoogle Scholar
Heaton, R.K. (1981). Wisconsin Card Sorting Test manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Hom, J., Haley, R.W., & Kurt, T.L. (1997). Neuropsychological correlates of Gulf War Syndrome. Archives of Clinical Neuropsychology, 12, 531–544.CrossRefGoogle Scholar
Hyams, K.C., Wignall, F.S., & Roswell, R. (1996). War syndromes and their evaluation: From the U.S. Civil War to the Persian Gulf War. Annals of Internal Medicine, 125, 398–405.CrossRefGoogle Scholar
Iowa Persian Gulf Study Group. (1997). Self-reported illness and health status among Gulf War veterans. Journal of the American Medical Association, 277, 238–245.Google Scholar
Ishey, T., Suadicani, P., Guldager, B., Appleyard, M., Hein, H., & Gyntelberg, F. (1999). State of health after deployment in the Persian Gulf: The Danish Gulf War study. Danish Medical Bulletin, 46, 416–419.Google Scholar
Ismail, K., Everitt, B., Blatchley, N., Hull, L., Unwin, C., David, A., & Wessely, S. (1999). Is there a Gulf War syndrome? Lancet, 353, 179–182.Google Scholar
Jenkins, M.A., Langlais, P.J., Delis, D., & Cohen, R. (1998). Learning and memory in rape victims with posttraumatic stress disorder. American Journal of Psychiatry, 155, 278–279.Google Scholar
Jiang, X.Z., Buckley, L.A., & Morgan, K.T. (1974). Pathology of toxic responses to the RD50 occupation of chlorine gas in the nasal passages of rats and mice. Toxicology and Applied Pharmacology, 71, 225–236.CrossRefGoogle Scholar
Joseph, S.C. (1997). A comprehensive evaluation of 20,000 Persian Gulf War veterans. Military Medicine, 162, 149–155.CrossRefGoogle Scholar
Kang, H.K., Mahan, C.M., Lee, K.Y., Magee, C.A., & Murphy, F.M. (2000). Illnesses among United States veterans of the Gulf War: A population-based survey of 30,000 veterans. Journal of Occupational and Environmental Medicine, 42, 491–501.10.1097/00043764-200005000-00006CrossRefGoogle Scholar
Keane, T.M., Caddell, J.M., & Taylor, K.L. (1988). Mississippi scale for combat-related posttraumatic stress disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85–90.CrossRefGoogle Scholar
Keeler, J.R., Hurst, C.G., & Dunn, M.A. (1991). Pyridostigmine used as a nerve agent pretreatment under wartime conditions. Journal of the American Medical Association, 266, 696–695.Google Scholar
Khavari, K.A. & Farber, P.D. (1978). A profile instrument for the quantification and assessment of alcohol consumption: The Khavari Alcohol test. Journal of Studies on Alcohol, 47, 1525–1539.CrossRefGoogle Scholar
Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B.K., Marmar, C.R., & Weiss, D.S. (1990). Trauma and the Vietnam War generation. New York: Brunner/Mazel.Google Scholar
McCauley, L.A., Joos, S.K., Lazarus, M.R., Storzbach, D., & Bourdette, D.N. (1999a). Gulf War unexplained illnesses: Persistence and unexplained nature of self-reported symptoms. Environmental Research, 81, 215–223.CrossRefGoogle Scholar
McCauley, L.A., Joos, S.K., Spencer, P.S., Lasarev, M., Shuell, & T., Members of the Portland Environmental Hazards Research Center. (1999b). Strategies to assess validity of self-reported exposures during the Persian Gulf War. Environmental Research, 81, 195–205.CrossRefGoogle Scholar
McLellan, A.T., Luborsky, L., Cacciola, J., Griffith, J., McGahan, P., & O'Brien, C.P. (1985). Guide to the Addiction Severity Index: Background, administration, and field testing results. (DHHS Publication No. ADM 85-1419). Washington, DC: Government Printing Office.Google Scholar
Murphy, F.M. (1999). Gulf War syndrome: There may be no specific syndrome, but troops suffer after most wars. British Medical Journal, 318, 274–275.CrossRefGoogle Scholar
National Institutes of Health Technology Assessment Workshop Panel. (1994). The Persian Gulf experience and health. Journal of the American Medical Association, 272, 391–396.CrossRefGoogle Scholar
Nisenbaum, R., Barrett, D.H., Reyes, M., & Reeves, W.C. (2000). Development of stressors and chronic multisymptom illness among Gulf War veterans. Journal of Nervous and Mental Disease, 188, 259–266.CrossRefGoogle Scholar
Persian Gulf Veterans Coordinating Board. (1995). Unexplained illnesses among Desert Storm veterans: A search for causes, treatment, and cooperation. Archives of Internal Medicine, 155, 262–268.CrossRefGoogle Scholar
Proctor, S.P., Heeren, T., White, R.F., Borgos, M.S., Davis, J.D., Pepper, L., Clapp, R., Sutker, P.B., Vasterling, J.J., & Ozonoff, D. (1998). Health status of Persian Gulf War veterans: Self-reported symptoms, environmental exposures, and the effect of stress. International Journal of Epidemiology, 27, 1000–1010.CrossRefGoogle Scholar
Purdon, S.E. & Flor-Henry, P. (2000). Asymmetrical olfactory acuity and neuroleptic response in schizophrenia. Schizophrenia Research, 44, 221–232.CrossRefGoogle Scholar
Rey, A. (1964). L'examen clinique en psychologie [The clinical examination in psychology]. Paris: Presses Universitaires de France.Google Scholar
Reynolds, L.K., O'Koon, J.H., Papdemetriou, E., Szczygiel, S., & Grant, K.E. (2001). Stress and somatic complaints in low-income urban adolescents. Journal of Youth and Adolescence, 30, 499–514.CrossRefGoogle Scholar
Ritsner, M., Ponizovsky, A., Kurs, R., & Modai, I. (2000). Somatization in an immigrant population in Israel: A community survey of prevalence, risk factors, and help-seeking behavior. American Journal of Psychiatry, 157, 385–392.CrossRefGoogle Scholar
Rose, C.S., Heywood, P.G., & Costanzo, R.M. (1992). Olfactory impairment after chronic occupational cadmium exposure. Journal of Occupational Medicine, 34, 600–605.Google Scholar
Rosenheck, R. (1992). Overview of findings. In VA Persian Gulf Returnees Working Group (Eds.), Returning Persian Gulf troops: First year findings (pp. 1–18). West Haven, CT: VA Northeast Program Evaluation Center.Google Scholar
Rosner, B. (2000). Fundamentals of biostatistics (5th ed.). Pacific Grove, CA: Duxbury.Google Scholar
Sandmark, B., Broms, I., Lofgret, L., & Ohlson, C.-G. (1989). Olfactory function in painters exposed to organic solvents. Scandinavian Journal of Work and Environmental Health, 15, 60–63.10.5271/sjweh.1881CrossRefGoogle Scholar
Schwartz, B.S., Doty, R.L., Monroe, C.B., Frye, R., & Barker, S. (1989). Olfactory function in chemical workers exposed to acrylate and methacrylate vapors. American Journal of Public Health, 79, 613–618.10.2105/AJPH.79.5.613CrossRefGoogle Scholar
Schwartz, B.S., Ford, P., Bolla, K.I., Agnew, J., Rothman, N., & Bleecker, M.L. (1990). Solvent-associated decrements in olfactory function in paint manufacturing workers. American Journal of Industrial Medicine, 18, 697–706.CrossRefGoogle Scholar
Sillanpaa, M.C., Agar, L.M., Milner, I.B., Podany, E.C., Axelrod, B.N., & Brown, G.G. (1997). Gulf War veterans: A neuropsychological examination. Journal of Clinical and Experimental Neuropsychology, 19, 211–219.CrossRefGoogle Scholar
Sutker, P.B., Uddo, M., Brailey, K., & Allain, A.N., Jr. (1993). War-zone trauma and stress-related symptoms in Operation Desert Shield/Storm (ODS) returnees. Journal of Social Issues, 49, 33–49.CrossRefGoogle Scholar
Sutker, P.B., Vasterling, J.J., Brailey, K., & Allain, A.N., Jr. (1995). Memory, attention, and executive deficits in POW survivors: Contributing biological and psychological factors. Neuropsychology, 9, 118–125.CrossRefGoogle Scholar
Tiffin, J. (1968). Purdue Pegboard: Examiner manual. Chicago: Science Research Associates.Google Scholar
Trahan, D.E. & Larrabee, G.J. (1988). Continuous Visual Memory Test professional manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Unwin, C., Blatchley, N., Coker, W., Ferry, S., Hotopf, M., Hull, L., Ismail, K., Palmer, I., David, A., & Wessely, S. (1999). Health of UK servicemen who served in the Persian Gulf War. Lancet, 353, 169–178.CrossRefGoogle Scholar
van der Kolk, B.A., Pelcovitz, D., Roth, S., Mandel, F., McFarlane, A., & Herman, J.L. (1996). Dissociation, somatization, and affect dysregulation: The complexity of adaptation to trauma. American Journal of Psychiatry, 153, 83–93.CrossRefGoogle Scholar
Vandana, S. & Zzaman, S. (1997). Phorate-induced enzymological alterations in mouse olfactory bulb. Brain Research Bulletin, 44, 247–252.CrossRefGoogle Scholar
Vasterling, J.J., Brailey, K., Constans, J.I., & Sutker, P.B. (1998). Attention and memory dysfunction in posttraumatic stress disorder. Neuropsychology, 12, 125–133.CrossRefGoogle Scholar
Vasterling, J.J., Duke, L.M., Brailey, K., Constans, J.I., Allain, A.N., & Sutker, P.B. (2002). Attention, learning, and memory performances and intellectual resources in Vietnam veterans: PTSD and no disorder comparisons. Neuropsychology, 16, 5–14.CrossRefGoogle Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale–Revised. New York: The Psychological Corporation.Google Scholar
White, R.F., Feldman, R.G., & Proctor, S.P. (2000). Neurotoxicology. In R.B. Schiffer & S.M. Rao (Eds.), Synopsis of neuropsychiatry (pp. 503–510). Lippincott, Williams, & Wilkins: Philadelphia.Google Scholar
White, R.F., Proctor, S.P., Heeren, T., Wolfe, J., Krengel, M., Vasterling, J., Lindem, K., Heaton, K.J., Sutker, P., & Ozonoff, D.M. (2001). Neuropsychological function in Gulf War veterans: Relationships to self-reported toxicant exposures. American Journal of Industrial Medicine, 40, 42–54.CrossRefGoogle Scholar
Williams, J.M., Little, M.M., Scates, S., & Blockman, N. (1987). Memory complaints and abilities among depressed older adults. Journal of Consulting and Clinical Psychology, 55, 595–598.CrossRefGoogle Scholar
Wolfe, J., Proctor, S.P., Erickson, D.J., Heeren, T., Friedman, M.J., Huang, M.T., Sutker, P.B., Vasterling, J.J., & White, R.F. (1999). Relationship of psychiatric status to Gulf War Veterans' health problems. Psychosomatic Medicine, 61, 532–540.CrossRefGoogle Scholar
Yehuda, R., Keefe, R.S.E., Harvey, P.D., Levengood, R.A., Gerber, D.K., Geni, J., & Seiver, L.J. (1995). Learning and memory in combat veterans with posttraumatic stress disorder. American Journal of Psychiatry, 152, 137–139.CrossRefGoogle Scholar