Suicide Ideation in Female Survivors of Military Sexual Trauma: The Trauma Source Matters.

Female veterans who have experienced military sexual trauma (MST) are at elevated suicide risk, yet knowledge is limited regarding correlates of suicide ideation (SI) in this population. MST is associated with a higher risk of posttraumatic stress disorder (PTSD) relative to other trauma types; however, no studies have examined whether experiencing SI differs based on the source of PTSD symptoms (MST-related, non-MST-related). Female service members/veterans (SM/Vs; n = 311) who screened positive for MST and reported exposure to a Criterion A event completed an online survey assessing self-reported demographics, PTSD, depression, the source of their PTSD symptoms, and SI. Ninety-one (29.3%) reported experiencing current SI, and 223 (71.7%) identified MST as the source of their current PTSD symptoms. Participants who identified MST as the source of their PTSD symptoms were over two times more likely to report SI, compared to those who described non-MST-related events as the source of their PTSD symptoms. Compared to those who reported the source of their PTSD symptoms as combat-/deployment-related, those who identified MST as the source were at least three times as likely to report current SI. Results underscore the importance of efforts to address MST-related PTSD symptoms when working with female SM/Vs.

Blais RK ，Monteith LL 《-》

Identifying factors associated with suicidal ideation and suicide attempts following military sexual trauma.

As increasing research demonstrates that military sexual trauma (MST) is associated with suicidal ideation and attempts, discerning factors that place MST survivors at risk for these outcomes is critical. The present study aimed to: (1) characterize suicidal ideation and attempts among MST survivors; (2) identify factors associated with post-MST suicide attempts, post-MST suicidal ideation, and past-week suicidal ideation. A convenience sample of 108 veterans (66 women, 42 men) who reported a history of MST participated in this cross-sectional study. Pre-MST suicidal ideation and attempt, childhood physical and sexual abuse, military sexual assault, institutional betrayal, and posttraumatic cognitions about self, world, and self-blame were examined, with age and gender as covariates. Seventy-five percent of participants reported experiencing post-MST suicidal ideation, and 40.7% reported attempting suicide following MST. Pre-MST suicide attempt and posttraumatic cognitions about self were associated with post-MST suicide attempt. Pre-MST suicidal ideation, military sexual assault, childhood physical abuse, and posttraumatic cognitions about self were associated with post-MST suicidal ideation. Lastly, pre-MST suicidal ideation and posttraumatic cognitions about self were associated with past-week suicidal ideation; results were unchanged when accounting for recent PTSD or depressive symptoms. The cross-sectional design, retrospective self-report, and small sample are limitations. Addressing negative posttraumatic beliefs about self may be important for managing suicide risk among MST survivors. Assessing for pre-MST suicidal ideation and attempt is likely also warranted. Further understanding of the longitudinal impact of posttraumatic beliefs about self on subsequent risk for suicidal ideation and attempt is warranted.

Monteith LL ，Holliday R ，Schneider AL ，Forster JE ，Bahraini NH ... -  《-》

Gender moderates the association of military sexual trauma and risk for psychological distress among VA-enrolled veterans.

Military sexual trauma (MST) is associated with increased risk for posttraumatic stress disorder (PTSD) and depression diagnoses, as well as suicidal ideation/behavior (SI/B). Little is known about the differential effect of gender on the association of MST and the aforementioned mental health outcomes. As females are the fastest growing subpopulation of the Veterans Health Administration (VHA), it is imperative to assess possible between-gender differences in the association of MST with PTSD, depression, and SI/B. Participants were 435,690 (n = 382,021, 87.7% men) 9/11 era veterans seen for care at the VHA between 2004 and 2014. Demographics, gender, PTSD and depression diagnoses, SI/B, and MST screen status were extracted from medical records. Adjusted logistic regression models assessed the moderating effect of gender on the association of MST with PTSD and depression diagnoses, as well as SI/B. Women with MST had a larger increased risk for a PTSD diagnosis (predicted probability =0.56, 95% confidence interval [CI] [0.56, 0.56]) and comparable risk for a depression diagnosis (predicted probability = 0.63, 95% CI [0.63, 0.64]) compared to men with MST. Men were more likely to have evidence of SI/B (predicted probability = 1.07, 95% CI [0.10, 0.11]) relative to women, but the interaction between gender and MST was nonsignificant. Data were limited to veterans seeking care through VHA and the MST screen did not account for MST severity. Non-VHA settings may consider screening for MST in both men and women, given that risk for PTSD and depression is heightened among female survivors of MST.

Tannahill HS ，Livingston WS ，Fargo JD ，Brignone E ，Gundlapalli AV ，Blais RK ... -  《-》

Perceptions of Institutional Betrayal Predict Suicidal Self-Directed Violence Among Veterans Exposed to Military Sexual Trauma.

We examined perceptions of institutional betrayal among Veterans exposed to military sexual trauma (MST) and whether perceptions of institutional betrayal are associated with symptoms of posttraumatic stress disorder (PTSD), depression, and suicidal ideation and attempt after MST. A total of 49 Veterans with MST completed self-report measures and interviews in a Veterans Health Administration setting. Many participants reported perceptions that a military institution created an environment in which MST seemed common, likely to occur, and did not proactively prevent such experiences. Many participants expressed difficulty reporting MST and indicated that the institutional response to reporting was inadequate. Over two-thirds perceived that the institution had created an environment in which they no longer felt valued or in which continued membership was difficult. Perceptions of institutional betrayal were associated with PTSD symptoms, depressive symptoms, and increased odds of attempting suicide after MST. In contrast, perceptions of institutional betrayal were not associated with post-MST suicidal ideation. Among the subsample of Veterans exposed to military sexual assault, the association between institutional betrayal and PTSD symptoms approached significance. Perceptions regarding institutional betrayal appear to be highly relevant to MST and its sequelae. These findings underscore the importance of Veterans' perceptions of the military institution's efforts to prevent and respond to MST to individual recovery from sexual trauma. Additional research regarding the association between institutional betrayal and health-related outcomes is needed.

Monteith LL ，Bahraini NH ，Matarazzo BB ，Soberay KA ，Smith CP ... -  《-》

The Association Between Military Sexual Trauma and Use of VA and Non-VA Health Care Services Among Female Veterans With Military Service in Iraq or Afghanistan.

Calhoun PS ，Schry AR ，Dennis PA ，Wagner HR ，Kimbrel NA ，Bastian LA ，Beckham JC ，Kudler H ，Straits-Tröster K ... -  《-》