More than military sexual trauma: interpersonal violence, PTSD, and mental health in women veterans.

Military sexual trauma (MST) is reported by 20-40% of female veterans. The purpose of this study of female veterans referred for MST treatment was to examine the relationships between lifetime trauma (physical, sexual, and psychological) and posttraumatic stress disorder (PTSD), depression, physical health, and quality of life using retrospective cross-sectional data from medical records. Of the 135 participants, 95.4% reported at least one trauma in addition to MST, most notably sexual abuse as adult civilians (77.0%) and as children (52.6%). PTSD, depression, and sleep difficulty rates were clinically significant. Chronic pain (66.4%) was associated with childhood abuse, physical health, sleep difficulties, and coping. Integrating mental and physical health treatment is necessary to treat MST and PTSD in female veterans.

Kelly UA ，Skelton K ，Patel M ，Bradley B ... -  《-》

Posttraumatic sequelae associated with military sexual trauma in female veterans enrolled in VA outpatient mental health clinics.

Luterek JA ，Bittinger JN ，Simpson TL 《-》

Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder.

We examined correlates of posttraumatic stress disorder (PTSD), including military sexual trauma (MST), in Iraq and Afghanistan veterans. We also compared mental health comorbidities by gender among veterans with PTSD, with and without MST. Retrospective data analyses were conducted using Department of Veterans Affairs (VA) administrative data from 213,803 Iraq and Afghanistan veterans and the subset diagnosed with PTSD from April 1, 2002, to October 1, 2008. We used descriptive statistics and multivariate logistic regression compared by gender to investigate independent correlates and mental health comorbidities associated with PTSD, with and without MST. Among women with PTSD, 31% screened positive for MST; 1% of men with PTSD screened positive for MST. Among those with PTSD, veterans with MST had more comorbid mental health diagnoses than those without MST. Women with PTSD and MST were more likely to receive comorbid depression, anxiety, and eating disorder diagnoses, and men were more likely to receive comorbid substance use disorder diagnoses. MST is associated with an increased prevalence of mental health disorders comorbid with PTSD. Better understanding comorbidity patterns will allow for targeted evaluation and treatment of returning veterans with MST.

Maguen S ，Cohen B ，Ren L ，Bosch J ，Kimerling R ，Seal K ... -  《-》

The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: a mediational model of posttraumatic stress disorder and physical health outcomes.

This study examined the co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment in a predominantly African American sample of 268 female veterans, randomly sampled from an urban Veterans Affairs hospital women's clinic. A combination of hierarchical and iterative cluster analysis was used to identify 4 patterns of women's lifetime experiences of violence co-occurrence. The 1st cluster experienced relatively low levels of all 4 forms of violence; the 2nd group, high levels of all 4 forms; the 3rd, sexual revictimization across the lifespan with adult sexual harassment; and the 4th, high intimate partner violence with sexual harassment. This cluster solution was validated in a theoretically driven model that examined the role of posttraumatic stress disorder (PTSD) as a mediator of physical health symptomatology. Structural equation modeling analyses revealed that PTSD fully mediated the relationship between violence and physical health symptomatology. Consistent with a bio-psycho-immunologic theoretical model, PTSD levels more strongly predicted pain-related physical health symptoms compared to nonpain health problems. Implications for clinical interventions to prevent PTSD and to screen women for histories of violence in health care settings are discussed.

Campbell R ，Greeson MR ，Bybee D ，Raja S ... -  《JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY》

Veterans Health Administration mental health treatment settings of patients who report military sexual trauma.

Valdez C ，Kimerling R ，Hyun JK ，Mark HF ，Saweikis M ，Pavao J ... -  《-》