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Publications

News | Sept. 4, 2025

Evaluating Anomalous Health Incidents of the Havana Syndrome: The Case for a Structured Qualitative and Quantitative Symptom Assessment Instrument

By Dr. James Giordano EC Neurology

Anomalous Health Incidents (AHIs) of the colloquially termed “Havana Syndrome” represent a challenging constellation of subjective and objective neurocognitive, vestibular, and autonomic features, with potential links to directed energy exposure. Diagnostic efforts have been hindered by heterogeneity in symptom reporting and the absence of standardized assessment tools. This paper proposes the development of an Anomalous Health Incident Symptom Questionnaire (AHISQ), modeled in part upon the McGill Pain Questionnaire, to facilitate structured, multidimensional characterization of symptom phenomenology. Integrating qualitative descriptors with quantitative metrics, the AHISQ would support reproducible data collection, epidemiological modeling, differential diagnosis, and forensic analysis. The paper details proposed domains of assessment, including sensory, cognitive-affective, functional, temporal, and contextual parameters, and advocates for digital integration, adaptive questioning, and multimodal validation incorporating neuroimaging, physiological, and biometric data. The AHISQ is presented as a tool to inform causal inference frameworks such as the Bradford-Hill criteria and PECOTS model, while addressing ethical imperatives for rigorous, inclusive, and hypothesis-neutral assessment. Ultimately, this approach aligns with a precision neurophenomenological paradigm, bridging subjective experience with objective analysis, and fostering improved diagnostic fidelity, patient care, and national security readiness.

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Dr. James Giordano is the Director of the INSS Center for Disruptive Technology and Future Warfare.