Military Sexual Trauma and Menopause Symptoms Among Midlife Women Veterans.

Sexual assault and/or sexual harassment during military service (military sexual trauma (MST)) can have medical and mental health consequences. Most MST research has focused on reproductive-aged women, and little is known about the long-term impact of MST on menopause and aging-related health. Examine associations of MST with menopause and mental health outcomes in midlife women Veterans. Cross-sectional. Women Veterans aged 45-64 enrolled in Department of Veterans Affairs (VA) healthcare in Northern California between March 2019 and May 2020. Standardized VA screening questions assessed MST exposure. Structured-item questionnaires assessed vasomotor symptoms (VMS), vaginal symptoms, sleep difficulty, depressive symptoms, anxiety symptoms, and posttraumatic stress disorder (PTSD) symptoms. Multivariable logistic regression analyses examined associations between MST and outcomes based on clinically relevant menopause and mental health symptom thresholds. Of 232 participants (age = 55.95 ± 5.13), 73% reported MST, 66% reported VMS, 75% reported vaginal symptoms, 36% met criteria for moderate-to-severe insomnia, and almost half had clinically significant mental health symptoms (33% depressive symptoms, 49% anxiety, 27% probable PTSD). In multivariable analyses adjusted for age, race, ethnicity, education, body mass index, and menopause status, MST was associated with the presence of VMS (OR 2.44, 95% CI 1.26-4.72), vaginal symptoms (OR 2.23, 95% CI 1.08-4.62), clinically significant depressive symptoms (OR 3.21, 95% CI 1.45-7.10), anxiety (OR 4.78, 95% CI 2.25-10.17), and probable PTSD (OR 6.74, 95% CI 2.27-19.99). Results did not differ when military sexual assault and harassment were disaggregated, except that military sexual assault was additionally associated with moderate-to-severe insomnia (OR 3.18, 95% CI 1.72-5.88). Exposure to MST is common among midlife women Veterans and shows strong and independent associations with clinically significant menopause and mental health symptoms. Findings highlight the importance of trauma-informed approaches to care that acknowledge the role of MST on Veteran women's health across the lifespan.

Travis KJ ，Huang AJ ，Maguen S ，Inslicht S ，Byers AL ，Seal KH ，Gibson CJ ... -  《-》

Association of psychiatric diagnoses and military sexual trauma type with denied posttraumatic stress disorder service connection.

Annually, thousands of Veterans file Department of Veterans Affairs' (VA) disability claims ("service connection") for posttraumatic stress disorder (PTSD) related to military sexual trauma (MST). Service connection provides free covered healthcare and compensation. To qualify, Veterans must meet PTSD diagnostic criteria, have sufficient evidence of the MST, and establish a link between their PTSD symptoms and MST. Among VA-enrolled Veterans who filed for MST-related PTSD service connection between 2017 and 2022 (N = 19,509), we modeled the probability of denied PTSD service connection as a function of MST type (i.e., assault versus harassment) and any instance of a psychiatric diagnosis in the VA electronic health record prior to PTSD claim decision, while controlling for demographics, PTSD diagnosis, and VA MST screen. Veterans with sexual harassment claims had 2.86 times (d = 0.37) higher odds of being denied (42.7 %) compared to those with sexual assault claims (20.7 %). Diagnoses of personality disorders, anxiety disorders, substance use disorders, bipolar disorders, and schizophrenia spectrum disorders were associated with increased odds of PTSD claims being denied (OR = 1.20-2.01). While the full population of Veterans filing MST claims during this timeframe, the sample included relatively few harassment-only claims and was limited to demographic information in VA records, possibly resulting in overlooked confounders or determinants. Skilled claims assistance and equitable evidentiary requirements for MST-related PTSD claims compared to PTSD claims not related to MST, and for any trauma claims for a non-PTSD diagnosis (e.g., anxiety or depression) may reduce disparities in service connection.

Webermann AR ，Coppola EC ，Lazar C ，Rosen MI ，Murdoch M ，Portnoy GA ，Black AC ... -  《-》

Military Sexual Trauma in Older Women Veterans: Prevalence and Comorbidities.

Gibson CJ ，Maguen S ，Xia F ，Barnes DE ，Peltz CB ，Yaffe K ... -  《-》

Prevalence and Mental Health Correlates of Insomnia in First-Encounter Veterans with and without Military Sexual Trauma.

There is limited information about prevalence of insomnia in general populations of veterans of recent wars in Iraq and Afghanistan. No studies have examined insomnia in veterans with military sexual trauma (MST). We assess prevalence of insomnia, identify types of services sought by veterans with insomnia, and examine correlates of insomnia in veterans with and without MST. A cross-sectional study of first-encounter veterans registering to establish care. Veteran Affairs San Diego Healthcare System. Nine hundred seventeen veterans completed questionnaires assessing insomnia, MST, service needs, traumatic brain injury, resilience, and symptoms of depression, posttraumatic stress disorder (PTSD), pain, alcohol misuse, and hypomania. N/A. 53.1% of veterans without MST and 60.8% of veterans with MST had clinically significant insomnia symptoms, with the MST subsample reporting more severe symptoms, P < 0.05. Insomnia was more prevalent than depression, hypomania, PTSD, and substance misuse. Veterans with insomnia were more likely to seek care for physical health problems and primary care versus mental health concerns, P < 0.001. For the veteran sample without MST, age, combat service, traumatic brain injury, pain, and depression were associated with worse insomnia, P < 0.001. For the MST subsample, employment status, pain, and depression were associated with worse insomnia, P < 0.001. Study findings indicate a higher rate of insomnia in veterans compared to what has been found in the general population. Insomnia is more prevalent, and more severe, in veterans with military sexual trauma. Routine insomnia assessments and referrals to providers who can provide evidence-based treatment are crucial.

Jenkins MM ，Colvonen PJ ，Norman SB ，Afari N ，Allard CB ，Drummond SP ... -  《-》

Electronic Health Record Concordance with Survey-Reported Military Sexual Trauma Among Younger Veterans: Associations with Health Care Utilization and Mental Health Diagnoses.

Gaffey AE ，Burg MM ，Skanderson M ，Deviva JC ，Brandt CA ，Bastian LA ，Haskell SG ... -  《-》