The treatment of Gulf War syndrome with cognitive behavioral therapy: a case comparison study

Since the late 1990s, researchers have been focused on finding effective treatments for military veterans with Gulf War Syndrome (GWS), a multisymptom (cognitive and physical) illness whose roots have still remained largely unexplained. With the possibility that such war-related syndromes may affect as many as 45-60% of returning soldiers, researchers have recommended that future research on GWS prioritize qualitative work, which has been scarce, to deepen the understanding of this illness in the veteran population -- including their attributions, fears, and concerns -- so that more refined, suitable treatments may be developed to meet their needs. The following paper examines a prior treatment study which evaluated the efficacy of manualized cognitive-behavioral therapy (CBT) to improve physical health and reduce psychological stress in military veterans with GWS. The current analysis is comprised of a cross-case comparison of two soldiers and considers the various factors that may have contributed to the success or failure of this particular CBT treatment for this population. In the original treatment trial, patients were given weekly individual outpatient therapy sessions over a three-month period and were monitored periodically for physical, cognitive, and emotional changes. Two cases were selected for analysis from the original study based on their opposing outcomes: Soldier 2 was successful in achieving a substantial increase in physical functioning, while Soldier 1 was not. Although the CBT treatment yielded positive changes in both patients’ level of self-awareness, and significant improvements in GWS-related psychological and physical stress in Soldier 2's case, the results indicate that additional factors, such as individual personality traits, states of cognitive functioning, and comorbidity need to be more closely examined and considered when designing treatments for veterans with Gulf War Syndrome.Psy.DIncludes bibliographical referencesby Charlotte Alexandra Laby