Military Sexual Trauma Interacts With Combat Exposure to Increase Risk for Posttraumatic Stress Symptomatology in Female Iraq and Afghanistan Veterans

The Journal of Clinical Psychiatry (Impact Factor: 5.5). 06/2014; 75(6):637-643. DOI: 10.4088/JCP.13m08808
Source: PubMed


Sexual trauma during military service is increasingly recognized as a substantial public health problem and is associated with detrimental effects on veteran mental health. In this study, we examined associations between childhood trauma, military sexual trauma (MST), combat exposure, and military-related posttraumatic stress symptomatology (PTSS) in the Women Veterans Cohort Study (WVCS), a community-based sample of veterans who served in the recent conflicts in Iraq and Afghanistan.

From July 2008 to December 2011, 365 female veterans completed a survey that assessed combat exposure, military sexual trauma, military-related PTSS (assessed using the PTSD [posttraumatic stress disorder] Checklist-Military Version), and demographic, life history, and other psychopathology variables.

High rates of childhood trauma (59.7%) and MST (sexual assault = 14.7%; sexual harassment = 34.8%) were observed in this sample. A hierarchical regression revealed that active duty status, childhood trauma, combat exposure, and MST were independently associated with increased severity of military-related PTSS (Ps < .05). Moreover, a significant interaction emerged between MST and combat exposure in predicting military-related PTSS (P = .030), suggesting that the relationship between combat exposure and PTSS was altered by MST status. Specifically, under conditions of high combat exposure, female veterans with MST had significantly higher PTSS compared to female veterans without MST.

Taken together, results suggest that exposure to multiple traumas during military service may have synergistic effects on posttraumatic stress symptoms in female veterans. Moreover, our findings highlight the importance of prevention efforts to protect female veterans from the detrimental effects of MST, particularly those who are exposed to high levels of combat.

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    • "Hierarchical moderated regression analysis was used to test the main hypothesis. The models were constructed to be as similar as possible to Scott et al. (2014) "
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    ABSTRACT: The present research sought to replicate the finding that military sexual trauma (MST) moderates the effect of critical warzone experiences on mental health outcomes in a sample of male veterans. One-hundred eighty-one male veterans completed measures of MST, critical warzone experiences, and mental health symptoms. The hypothesized interaction was not significant, nor was a significant main effect observed for MST. In contrast, both critical warzone experiences and childhood maltreatment had significant main effects. Copyright © 2015. Published by Elsevier Ireland Ltd.
    Full-text · Article · Jul 2015 · Psychiatry Research
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    ABSTRACT: To the Editor: The important recent article by Scott et al examined associations between military sexual trauma (MST), childhood trauma, combat exposure, and military-related posttraumatic stress symptomatology in women who served in the recent conflicts in Iraq and Afghanistan. The authors concluded that under conditions of high combat exposure, female veterans with MST had significantly higher posttraumatic stress symptomatology compared to female veterans without MST. Multiple publications have documented that a substantial number of women who served in Iraq and Afghanistan had exposure to trauma as children and while in the military. © Copyright 2014 Physicians Postgraduate Press, Inc.
    Preview · Article · Dec 2014 · The Journal of Clinical Psychiatry
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    ABSTRACT: Multi-site evaluations, particularly of federally funded service programs, pose a special set of challenges for program evaluation. Not only are there contextual differences related to project location, there are often relatively few programmatic requirements, which results in variations in program models, target populations and services. The Jail Diversion and Trauma Recovery-Priority to Veterans (JDTR) National Cross-Site Evaluation was tasked with conducting a multi-site evaluation of thirteen grantee programs that varied along multiple domains. This article describes the use of a mixed methods evaluation design to understand the jail diversion programs and client outcomes for veterans with trauma, mental health and/or substance use problems. We discuss the challenges encountered in evaluating diverse programs, the benefits of the evaluation in the face of these challenges, and offer lessons learned for other evaluators undertaking this type of evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Feb 2015 · Evaluation and Program Planning
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