Thirty-one percent of women veterans of Iraq and Afghanistan who were diagnosed with post-traumatic stress disorder reported military sexual trauma (MST), in contrast to one percent of men with PTSD, according to a study led by Shira Maguen, PhD, a psychologist at the San Francisco VA Medical Center.
Both men and women veterans with PTSD who reported MST were more likely to be diagnosed with other mental health disorders. Women were more likely to be diagnosed with depression, anxiety and eating disorders, while men were more likely to be diagnosed with substance use disorders.
After adjusting for demographic and military service characteristics, the researchers determined that women veterans reporting MST were four times more likely to develop PTSD than women not reporting MST.
The authors emphasize that since they investigated health records, rather than conducting a longitudinal study tracking the occurrence of MST and PTSD in people over time, they were not able to identify a cause-and-effect relationship between MST and PTSD.
The study appeared on September 12, 2011 in the online Articles in Press Section of Womens Health Issues.
In the VA system, MST is defined as uninvited and unwanted sexual attention and/or the use of force or threat of force resulting in unwilling sexual contact.
In light of the significant proportion of women with PTSD who report MST, it is fortunate that existing VA protocols for treating PTSD are known to be effective in dealing with sexual trauma, said Maguen, who is also an assistant clinical professor of psychiatry at the University of California, San Francisco. Nonetheless, this is an important public health issue that deserves continued attention in order to ensure the best possible care for returning veterans with PTSD who have experienced MST.
The study authors recommend that the VA continue to develop new treatment protocols that target PTSD, depression and substance use disorders.
The study examined the health records of 213,803 veterans who were first-time users of the VA health care system. Of all the veterans, 74,493 were diagnosed with PTSD. Of the 7,255 women in that group, 2,240 women reported MST.
The authors caution that MST did not necessarily occur during combat, but could have happened at any time during military service, and that perpetrators were not necessarily U.S. military personnel.
A previous study by other researchers showed a 15 percent MST rate among female Iraq and Afghanistan veterans in the VA health care system; that study did not look at MST among veterans diagnosed with PTSD.
Women play an increasingly important role in the US military, Maguen noted, comprising 12 percent of the forces sent to Iraq and Afghanistan, 15 percent of active military personnel and 17 percent of National Guard and Reserve personnel.
Even though women are technically restricted to combat support roles, in practice they see combat, carry weapons, witness killing and are generally exposed to much more trauma than women in earlier wars, said Maguen.
Co-authors of the study are Beth Cohen, MD, MAS, of SFVAMC and UCSF; Li Ren, MS, and Jeane Bosch, MPH, of SFVAMC; Rachel Kimerling, PhD, of VA Palo Alto Health Care System; and Karen Seal, MD, MPH, of SFVAMC and UCSF.
The study was supported by funds from the Department of Defense, the VA, and the National Institutes of Health, some of which were administered by the Northern California Institute for Research and Education.
NCIRE - The Veterans Health Research Institute - is the largest research institute associated with a VA medical center. Its mission is to improve the health and well-being of veterans and the general public by supporting a world-class biomedical research program conducted by the UCSF faculty at SFVAMC.
SFVAMC has the largest medical research program in the national VA system, with more than 200 research scientists, all of whom are faculty members at UCSF.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.