Military sexual assault linked to depression, mother-baby bonding problems among veterans

Military sexual assault and harassment are linked to higher rates of depression among new moms and a negative effect on mother-baby bonding, according to a new study published in the journal Depression and Anxiety.

Researchers at Dell Medical School at The University of Texas at Austin and the U.S. Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans used self-reported data from a nationally representative sample of 697 pregnant veterans using Veterans Health Administration (VHA) maternity care benefits at 15 VHA medical centers between 2016 and 2020. The study showed that female veterans who had experienced sexual trauma while serving in the military had significantly higher rates of depression around the time during or after pregnancy, and that higher depression among new moms was associated with poorer bonding between mother and child.

"This is a landmark study for women veterans," said study author Suzannah Creech, a research psychologist and associate professor in the Department of Psychiatry and Behavioral Sciences at Dell Med. "Childbearing and parenting experiences have been ignored for so long in the context of the military, and yet we are talking about a group of children potentially at risk for serious psychiatric disorders throughout their lifetimes," she said.

Understanding the long-term impacts of military sexual trauma opens the possibility of mitigating eventual risks among future generations, according to Creech. About 1 in 4 female veterans experience sexual assault during military service, compared with about 1 in 5 U.S. women overall.

Creech points to previous findings indicating that children of military parents are more likely to join the military themselves.

"These children could be joining the armed forces with a risk factor already sparked by their own parents' military experience, resulting in cycles of familial mental health problems," she said.

Although previous research has focused on understanding the links between maternal depression and impaired bonding, less research has examined the emotional health and mother-infant bonding among women who have experienced trauma in adulthood, according to Creech.

The research was conducted using data from the Center for Maternal and Infant Outcomes and Research in Translation (COMFORT) veterans study conducted out of the VA Central Western Massachusetts. Moms responded to telephone surveys during the first three months of pregnancy and again during the first three months after giving birth. Scientists used a standardized parent-infant bonding measurement tool to gage the degree of mother-baby attachment.

Although the exact mechanism ultimately connecting military sexual trauma to parent-baby bonding is not fully understood, previous research suggests that past trauma increases rates of depression during and around pregnancy.

The good news is that barriers to maternal-infant bonding can be removed as part of a manageable intervention, said Creech. She recommends that new mothers who are screened for postpartum depression also receive screening for signs of inadequate bonding with infants. New moms can receive bonding interventions such as parent-infant massage to improve connection with the baby, which might also help with depression.

"The female veteran population is growing, and research related to women veterans is critical in effectively addressing the gender-specific needs of the population," said Stacy Ritz, associate chief of staff for mental health and behavior medicine of the Central Texas Veterans Health Care System. "This study highlights the necessity of viewing the issues facing women veterans in a larger societal context rather than simply focusing on the individual impact. This has large implications for how we address mental health needs for expecting and new mothers."

The current study is part of a greater body of studies produced by Dell Med's Institute for Early Life Adversity Research, of which Creech is a faculty member. The institute was created to better understand the lifelong effects of medical and psychiatric effects of childhood trauma. Future institute research by Creech will include a line of investigation about trauma-informed parent-infant bonding support for female veterans with children ages birth to 3.

During the spring, Creech provided expert testimony to the U.S. Department of Defense's Independent Review Commission on Sexual Assault in the Military, a special commission ordered by President Joe Biden. The goal of the commission was to make recommendations for actions to address sexual assault and harassment in the military.