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Goldstein SJ, Scaglione NM, Kan ML, Grimes KEL, Lane ME, Morgan JK, Martin SL. Accuracy, Acceptability, and Burden of an Integrated Screening Approach to Facilitate the Delivery of Tailored Sexual Assault Prevention in the U.S. Air Force. JOURNAL OF CHILD SEXUAL ABUSE 2024:1-21. [PMID: 38874411 DOI: 10.1080/10538712.2024.2364792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/30/2024] [Indexed: 06/15/2024]
Abstract
This paper examines accuracy, acceptability, and respondent burden of integrated screening to facilitate tailored sexual assault (SA) prevention program delivery in a basic military training (BMT) environment. Trainees (n = 5,951) received tailored prevention content based on self-reported sex, sexual orientation, prior SA victimization and perpetration, and past-month post-traumatic stress symptoms. Bivariate analyses examined trainee-reported screener accuracy, acceptability, and burden, including differences by tailoring-targeted subgroups (e.g. men/women). Overall accuracy and acceptability were high (>90%) despite significant subgroup variability. Screening time averaged 10.55 (SD = 1.95) minutes; individuals with prior SA took longer. Missingness increased linearly throughout the screener. Integrated screening is an accurate, acceptable way to deploy tailored SA prevention in BMT. Findings inform data-driven screening improvements and novel applications.
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Affiliation(s)
| | | | - Marni L Kan
- RTI International, Research Triangle Park, NC, USA
| | | | | | | | - Sandra L Martin
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Bulanchuk N, Edwards E, Pietrzak RH, Tsai J. The mediating role of social support in associations between childhood adversity, military sexual trauma, and homelessness in a nationally representative sample of US veterans. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:399-414. [PMID: 38289875 DOI: 10.1002/jcop.23105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/27/2023] [Accepted: 12/17/2023] [Indexed: 02/01/2024]
Abstract
Among veterans, availability of social support and histories of military sexual trauma (MST) and/or adverse childhood experiences (ACEs) are particularly salient correlates of homelessness. Using path analyses, we investigated whether social support (i.e., interpersonal social support and community integration) would at least partially account for the relationships of MST and ACEs with any lifetime homelessness in a large, nationally representative sample of veterans (N = 4069, 9.8% female). Interpersonal social support and community integration partially explained the relationship between ACEs and any lifetime homelessness. However, they did not mediate the relationship between MST and any lifetime homelessness. Female veterans also reported higher trauma rates and lower perceived social support than male counterparts during correlational analyses. These results reinforce existing literature on the importance of research and interventions tailored to veterans with low social support and integration. Results have potential to inform interventions and policy for veterans experiencing and/or at risk for homelessness.
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Affiliation(s)
- Nicole Bulanchuk
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
- Department of Veterans Affairs, VISN 2 MIRECC, Bronx, New York, USA
| | - Emily Edwards
- Department of Veterans Affairs, VISN 2 MIRECC, Bronx, New York, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Robert H Pietrzak
- Department of Veterans Affairs, National Center for PTSD, New Haven, Connecticut, USA
| | - Jack Tsai
- Department of Veterans Affairs, National Center for Homelessness Among Veterans, San Antonio, Texas, USA
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Ceroni TL, Ennis CR, Shapiro MO, Constans JI, Franklin CL, Raines AM. Examining the unique and interactive associations of gender and race on PTSD symptom severity among military sexual trauma survivors. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:1233-1237. [PMID: 35679208 PMCID: PMC10302115 DOI: 10.1037/tra0001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Despite a robust association between military sexual trauma (MST) and posttraumatic stress disorder (PTSD), few studies have examined factors that are associated with increased symptom severity. To this end, the current study was designed to examine the unique and interactive effects of gender and race on PTSD symptoms using a sample of MST survivors. METHOD The sample included 126 veterans (71% Women, 29% Men; 70% Black/African American and 30% White/Caucasian) presenting for psychological services to a MST specialty clinic at a large Southeastern Veterans Affairs (VA) hospital. As part of their intake evaluation, veterans completed a diagnostic interview and battery of self-report questionnaires. RESULTS Results revealed a main effect of gender and race such that veteran men and Black/African American veterans were found to have increased PTSD symptom severity. However, there was not a significant gender by race interaction. CONCLUSION Findings are discussed with regard to previous research and treatment implications. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Taylor L. Ceroni
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119
| | - Chelsea R. Ennis
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112
| | - Mary O. Shapiro
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112
| | - Joseph I. Constans
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112
| | - C. Laurel Franklin
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA 70112
| | - Amanda M. Raines
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA 70119
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA 70119
- School of Medicine, Louisiana State University, New Orleans, LA 70112
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Mota N, Sommer JL, Bolton SL, Enns MW, El-Gabalawy R, Sareen J, MacLean MB, Hall AL, Sudom K, Silins S, Garber B, Afifi TO. Prevalence and Correlates of Military Sexual Trauma in Service Members and Veterans: Results From the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:682-690. [PMID: 36124372 PMCID: PMC10585130 DOI: 10.1177/07067437221125292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Military sexual trauma (MST) is an ongoing problem. We used a 2002 population-based sample, followed up in 2018, to examine: (1) the prevalence of MST and non-MST in male and female currently serving members and veterans of the Canadian Armed Forces, and (2) demographic and military correlates of MST and non-MST. METHODS Data came from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (n = 2,941, ages 33 years + ). Individuals endorsing sexual trauma were stratified into MST and non-MST and compared to individuals with no sexual trauma. The prevalence of lifetime MST was computed, and correlates of sexual trauma were examined using multinomial regression analyses. RESULTS The overall prevalence of MST was 44.6% in females and 4.8% in males. Estimates were comparable between currently serving members and veterans. In adjusted models in both sexes, MST was more likely among younger individuals (i.e., 33-49 years), and MST and non-MST were more likely in those reporting more non-sexual traumatic events. Among females, MST and non-MST were more likely in those reporting lower household income, non-MST was less likely among Officers, and MST was more likely among those with a deployment history and serving in an air environment. Unwanted sexual touching by a Canadian military member or employee was the most prevalent type and context of MST. INTERPRETATION A high prevalence of MST was observed in a follow-up sample of Canadian Armed Forces members and veterans. Results may inform further research as well as MST prevention efforts.
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Affiliation(s)
- Natalie Mota
- Departments of Clinical Health Psychology and Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Jordana L. Sommer
- Departments of Psychology and Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Canada
| | - Shay-Lee Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Murray W. Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Renée El-Gabalawy
- Departments of Anesthesiology, Perioperative and Pain Medicine, and Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
| | - Mary Beth MacLean
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Amy L. Hall
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Kerry Sudom
- Canadian Forces Health Services Group, Department of National Defence, Ottawa, Ontario, Canada
| | - Stacey Silins
- Canadian Forces Health Services Group, Department of National Defence, Ottawa, Ontario, Canada
| | - Bryan Garber
- Canadian Forces Health Services Group, Department of National Defence, Ottawa, Ontario, Canada
| | - Tracie O. Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Canada
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Orchowski LM, Berkowitz A, Oesterle D, Berry-Cabán C, Borsari B, Kahler CW, Kazemi DM. Correlates of Bystander Intervention Attitudes and Intentions Among Young Adult Active Duty Male Soldiers. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP23262-NP23280. [PMID: 35331029 DOI: 10.1177/08862605221080151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual assault is a significant problem within the United States military. Bystander intervention skills training is recognized as a promising strategy for sexual assault prevention within both civilian and military populations. Sexual assault prevention programs which include training in bystander intervention teach individuals to notice situations that may pose a risk for harm and safely act to positively influence the outcome. This study examines correlates of bystander intervention attitudes and intentions among young adult active duty male soldiers (N = 282) between the ages of 18 and 24. Positive bystander intervention attitudes and intentions were associated with lower levels of rape myth acceptance, greater discomfort with sexism, lower likelihood of continuing an unwanted sexual advance after verbal resistance from a partner, greater likelihood of gaining verbal consent from a partner, and greater perceived peer approval for bystander intervention. In a multiple regression, perceived peer approval for bystander intervention and self-reported lower likelihood of continuing a sexual advance after verbal resistance from a partner emerged as significant predictors of positive bystander intervention attitudes and intentions (R2 = .41). Given that perceptions of peer norms are modifiable, these findings highlight the importance of addressing peer norms in bystander intervention training programs for military personnel.
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Affiliation(s)
- Lindsay M Orchowski
- Department of Psychiatry and Human Behavior, 12321Alpert Medical School of Brown University, RI, USA
| | | | | | | | | | - Christopher W Kahler
- Department of Behavioral and Social Sciences in the Brown University School of Public Health, Brown University Center for Alcohol and Addiction Studies, RI, USA
| | - Donna M Kazemi
- School of Nursing, 14727University of North Carolina Charlotte, NC, USA
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Seng EK, Fenton BT, Wang K, Lipton RB, Ney J, Damush T, Grinberg AS, Skanderson M, Sico JJ. Frequency, Demographics, Comorbidities, and Health Care Utilization by Veterans With Migraine: A VA Nationwide Cohort Study. Neurology 2022; 99:e1979-e1992. [PMID: 36100439 PMCID: PMC9651466 DOI: 10.1212/wnl.0000000000200888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/11/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVE To describe the relative frequency, demographics, comorbidities, and health care utilization of veterans who receive migraine care at the Veteran's Health Administration (VHA) and to evaluate differences by gender. METHODS This study extracted data from VHA administrative sources. Veterans diagnosed with migraine by a health care provider between fiscal year 2008 and 2019 were included. Demographics and military exposures were extracted at cohort entry. Comorbidities were extracted within 18 months of the first migraine diagnosis. Health care utilization and headache comorbidities were extracted across the study period. Differences between men and women were evaluated using χ2 tests and Student t tests. RESULTS More than half a million (n = 567,121) veterans were diagnosed with migraine during the 12-year study period, accounting for 5.3% of the 10.8 million veterans served in the VHA; in the most recent year of the study period (2019), the annual incidence and 1-year period prevalence of medically diagnosed migraine was 2.7% and 13.0% for women and 0.7% and 2.5% for men. In the total cohort diagnosed with migraine, 27.8% were women and 72.2% men. Among those with diagnosed migraine, a higher proportion of men vs women also had a TBI diagnosis (3.9% vs 1.1%; p < 0.001). A higher proportion of women vs men reported military sexual trauma (35.5% vs 3.5%; p < 0.001). Participants with diagnosed migraine had an average of 1.44 (SD 1.73) annual encounters for headache. Primary care was the most common headache care setting (88.1%); almost one-fifth of veterans with diagnosed migraine sought care in the ED at least once during the study period. Common comorbidities were overweight/obesity (80.3%), nonheadache pain disorders (61.7%), and mental health disorders (48.8%). DISCUSSION Migraine is commonly treated in the VHA setting, but likely underascertained. Most people treated for migraine in the VHA are men. Pain comorbidities and psychiatric disorders are common. Future research should identify methods to improve diagnosis and treatment and to reduce use of the emergency department.
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Affiliation(s)
- Elizabeth K Seng
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis.
| | - Brenda T Fenton
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
| | - Kaicheng Wang
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
| | - Richard B Lipton
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
| | - John Ney
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
| | - Teresa Damush
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
| | - Amy S Grinberg
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
| | - Melissa Skanderson
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
| | - Jason J Sico
- From the VA Connecticut Healthcare System (B.T.F., K.W., A.S.G., M.S., J.J.S.), West Haven; Yeshiva University (A.S.G.), Bronx; Albert Einstein College of Medicine (R.B.L.), Bronx; Montefiore Medical Center (R.B.L.), Bronx, NY; Yale School of Medicine (B.T.F., K.W., M.S., J.J.S.), New Haven; Yale School of Public Health (K.W.), New Haven, CT; Bedford VA Medical Center (J.N.); Boston University School of Medicine (J.N.), MA; Richard L. Roudebush VA Medical Center (T.D.), Indianapolis; and Indiana University School of Medicine (T.D.), Indianapolis
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Grau PP, Valentine LM, Vuper TC, Rogers TA, Wong JD, Sexton MB. Military sexual trauma in context: Ethnoracial differences in ecological resources among treatment-seeking veterans. J Trauma Stress 2022; 35:1535-1545. [PMID: 35819929 DOI: 10.1002/jts.22859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/05/2022]
Abstract
Veterans who have experienced military sexual trauma (MST) are at increased risk for a host of negative outcomes, including posttraumatic stress disorder, depressive disorders, and substance use disorders. Previous studies have shown racial differences in MST exposure, namely that Black veterans experience MST more frequently than White veterans. One way to help clinicians and researchers understand the impact of these ethnoracial differences in MST exposure is through an applied theory of ecological resources, which has demonstrated ecological factors (e.g., aspects of identity, beliefs, and environmental stressors) contribute to veteran well-being in the aftermath of MST. The present study aimed to examine ethnoracial differences in ecological resources (i.e., available social support, spiritual coping, past-year interpersonal violence, financial sufficiency, and stable living environment). Participants (N = 505) were U.S. veterans who sought care at a Veterans Healthcare Administration clinic in the midwestern United States for mental health issues related to MST. Results demonstrated Black veterans were more likely than White veterans to report being financially insecure, U = 18,091.50, z = -2.04, p = .042, r = .10. Black veterans were also more likely to report spiritual beliefs that assisted with coping, Cramer's V = .19, but less likely to report having a social support system, Cramer's V = .16. These findings highlight the importance of assessing and addressing disparities illuminated by ethnoracial differences in ecological resources and barriers in veterans seeking care for MST.
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Affiliation(s)
- Peter P Grau
- VA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), Ann Arbor, Michigan, USA.,VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Lisa M Valentine
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Tessa C Vuper
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Travis A Rogers
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jennifer D Wong
- New Mexico Veterans Affairs Healthcare System, Albuquerque, New Mexico, USA
| | - Minden B Sexton
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Patel TA, Mann AJ, Nomamiukor FO, Blakey SM, Calhoun PS, Beckham JC, Pugh MJ, Kimbrel NA. Correlates and clinical associations of military sexual assault in Gulf War era U.S. veterans: Findings from a national sample. J Trauma Stress 2022; 35:1240-1251. [PMID: 35355332 PMCID: PMC9357137 DOI: 10.1002/jts.22825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/18/2022] [Accepted: 02/17/2022] [Indexed: 11/09/2022]
Abstract
Military sexual assault (MSA) is a prevalent issue among military personnel that can have direct implications on postmilitary mental health. Gulf War era U.S. veterans represent the first cohort in which women veterans were integrated into most aspects of military service except for combat. The present study sought to build on prior studies by identifying characteristics associated with the occurrence of MSA and clinical correlates of MSA and examining how these differ between men and women. This study analyzed cross-sectional survey data from a national sample of treatment-seeking Gulf War era veterans. Participants (N = 1,153) reported demographic information, clinical outcomes, military background, and history of MSA. MSA was more common among female veterans (n = 100, 41.3%) than male veterans (n = 32, 3.6%). The odds of experiencing MSA were approximately 19 times higher for female veterans relative to their male peers, OR = 18.92, p < .001. Moreover, as expected, MSA was robustly associated with probable current posttraumatic stress disorder, probable current depression, and past-year suicidal ideation in female veterans, whereas combat exposure was robustly associated with these sequelae in male veterans. The present findings confirm that a large proportion of female veterans from the Gulf War era experienced MSA and highlight the deleterious correlates of MSA on veterans' mental health. Sex differences of correlates of MSA and subsequent clinical associations are highlighted.
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Affiliation(s)
- Tapan A. Patel
- Florida State University, Department of Psychology, Tallahassee, Florida, USA
| | - Adam J. Mann
- University of Toledo, Department of Psychology, Toledo, Ohio, USA
| | - Faith O. Nomamiukor
- University of North Carolina at Greensboro, Department of Psychology, Greensboro, North Carolina, USA
| | - Shannon M. Blakey
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, USA,Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, North Carolina, USA
| | - Jean C. Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, USA,Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, North Carolina, USA
| | - Mary J. Pugh
- Informatics Decision-Enhancement and Analytic Center of Innovation, VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA,University of Utah, School of Medicine, Department of Medicine, Salt Lake City, Utah, USA
| | - Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, USA,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, USA,Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, North Carolina, USA
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Metzger EC, Bennett JN, Berry-Cabán CS, Allan EJ, Guenthner CJ, Meerhaeghe BM, Borsari B, Kazemi DM, Orchowski LM. Perceptions of hazing among young male United States military service members: A qualitative analysis. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2083864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Elizabeth C. Metzger
- Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, NC, USA
| | - Jasmin N. Bennett
- 2d Operational Medical Readiness Squadron, Barksdale Air Force Base, Bossier, LA, USA
| | | | - Elizabeth J. Allan
- Doctoral Program in Higher Education, University of Maine, Orono, ME, USA
| | | | - Bryce M. Meerhaeghe
- Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, NC, USA
| | - Brian Borsari
- San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Donna M. Kazemi
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Lindsay M. Orchowski
- Department of Psychiatry and Human Behavior Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
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10
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Moreau C, Duron S, Bedretdinova D, Bohet A, Panjo H, Bajos N, Meynard JB. Mental health consequences of military sexual trauma: results from a national survey in the French military. BMC Public Health 2022; 22:214. [PMID: 35109815 PMCID: PMC8812201 DOI: 10.1186/s12889-022-12545-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Military sexual trauma (MST) is a major public health concern, given its prevalence and mental health sequelae. This phenomenon is particularly prevalent among women in the US military, although more cases involve men given their overrepresentation. Little is known about MST and its consequences in other military settings, including in Europe. METHODS This study draws from a national survey in the French military, including 1268 servicemen and 232 servicewomen. We conducted bivariate and multivariate analysis, using simple and multinomial logistic regressions to evaluate the associations between different forms of MST (repeated sexual comments alone/one form of sexual oppression (coercion, repeated verbal unwanted attention or assault)/ several sexual stressors) and symptoms of depression and of positive post-traumatic stress disorder (PTSD) screening scores. RESULTS Women were both more likely to experience MST and to experience more severe forms of MST than men. Women were also more likely than men to report mental health symptoms (31% versus 18% for symptoms of depression and 4.0% versus 1.8% for positive PTSD screening scores). Different forms of MST were associated with different levels of psychological distress. Women reporting repeated sexual comments alone had higher odds of depressive symptoms (OR=3.1 [1.7, 5.5]) relative to women with no MST. Likewise, the odds of depressive symptoms were 6.5 times higher among women and 8.0 times higher among men who experienced several sexual stressors relative to those who reported no MST. We also found higher relative risk of subthreshold PTSD screening scores among women reporting any form of sexual stressor, including sexual comments alone (RRR = 4.5 [2.8, 7.4]) and an elevenfold increase in the relative risk of positive PTSD screen scores (RRR = 11.3 [2.3, 55.6]) among women who experienced several sexual stressors relative to women with no MST. CONCLUSION MST is associated with mental health distress among service members in the French military, especially for women. The heightened risk of MST coupled with psychological sequelae call for preventive programs to reduce MST and for screening programs to provide adequate psychological support.
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Affiliation(s)
- Caroline Moreau
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France. .,Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
| | - Sandrine Duron
- French Military Center for Epidemiology and Public Health, Marseille, France.,INSERM, UMR S912, « Economic & Social Sciences for Health and Processing of Medical Information » (SESSTIM), F-13385, Marseille, France
| | - Dina Bedretdinova
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France
| | - Aline Bohet
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France
| | - Henri Panjo
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France
| | - Nathalie Bajos
- IRIS Interdisciplinary Research Institute on Social Issues Social Sciences Politics Health, U997 Inserm - EHESS, F-93322, Aubervilliers, France
| | - Jean Baptiste Meynard
- French Military Center for Epidemiology and Public Health, Marseille, France.,INSERM, UMR S912, « Economic & Social Sciences for Health and Processing of Medical Information » (SESSTIM), F-13385, Marseille, France.,French Military Medical Academy, Ecole du Val-de-Grâce, Paris, France
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11
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Liu JJW, Nazarov A, Easterbrook B, Plouffe RA, Le T, Forchuk C, Brandwood A, St Cyr K, Auger E, Balderson K, Bilodeau M, Burhan AM, Enns MW, Smith P, Hosseiny F, Dupuis G, Roth M, Mota N, Lavoie V, Richardson JD. Four Decades of Military Posttraumatic Stress: Protocol for a Meta-analysis and Systematic Review of Treatment Approaches and Efficacy. JMIR Res Protoc 2021; 10:e33151. [PMID: 34694228 PMCID: PMC8576591 DOI: 10.2196/33151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Over 85% of active members of the Canadian Armed Forces have been exposed to potentially traumatic events linked to the development of posttraumatic stress disorder (PTSD). At the time of transition to civilian life, as high as 1 in 8 veterans may be diagnosed with PTSD. Given the high prevalence of PTSD in military and veteran populations, the provision of effective treatment considering their unique challenges and experiences is critical for mental health support and the well-being of these populations. OBJECTIVE This paper presents the protocol for a meta-analysis and systematic review that will examine the effectiveness of treatment approaches for military-related PTSD. METHODS This PROSPERO-preregistered meta-analysis is being conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. A comprehensive search of the literature was conducted using the databases PsycInfo, Medline, Embase, CINAHL, and ProQuest Dissertation & Theses. Effect sizes will be computed based on changes in PTSD symptom scores over time across studies using validated PTSD scales. A multilevel meta-analysis will examine the overall effects, between-study effects, and within-study effects of available evidence for PTSD treatments in military populations. Effect sizes will be compared between pharmacotherapeutic, psychotherapeutic, and alternative/emerging treatment interventions. Finally, meta-regression and subgroup analyses will explore the moderating roles of clinical characteristics (eg, PTSD symptom clusters), treatment approaches (eg, therapeutic orientations in psychotherapy and alternative therapies and classifications of drugs in pharmacotherapy), as well as treatment characteristics (eg, length of intervention) on treatment outcomes. RESULTS The literature search was completed on April 14, 2021. After the removal of duplicates, a total of 12,002 studies were screened for inclusion. As of July 2021, title and abstract screening has been completed, with 1469 out of 12,002 (12.23%) studies included for full-text review. Full review is expected to be completed in the summer of 2021, with initial results expected for publication by early winter of 2021. CONCLUSIONS This meta-analysis will provide information on the current state of evidence on the efficacy and effectiveness of various treatment approaches for military-related PTSD and identify factors that may influence treatment outcomes. The results will inform clinical decision-making for service providers and service users. Finally, the findings will provide insights into future treatment development and practice recommendations to better support the well-being of military and veteran populations. TRIAL REGISTRATION PROSPERO CRD42021245754; https://tinyurl.com/y9u57c59. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/33151.
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Affiliation(s)
- Jenny J W Liu
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Anthony Nazarov
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Bethany Easterbrook
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Rachel A Plouffe
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Tri Le
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
| | - Callista Forchuk
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
| | - Alec Brandwood
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
| | - Kate St Cyr
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Edouard Auger
- Clinique pour traumatismes liés au stress opérationnel, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Ken Balderson
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- St. Joseph's Operational Stress Injury Clinic, Toronto, ON, Canada
| | - Mathieu Bilodeau
- Clinique pour traumatismes liés au stress opérationnel, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Amer M Burhan
- Ontario Shores Centre of Mental Health Sciences, Whitby, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Murray W Enns
- Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Winnipeg Operational Stress Injury Clinic, Winnipeg, ON, Canada
| | - Patrick Smith
- Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions, Ottawa, ON, Canada
| | - Fardous Hosseiny
- Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions, Ottawa, ON, Canada
| | - Gabrielle Dupuis
- Centre of Excellence on Post-Traumatic Stress Disorder and Related Mental Health Conditions, Ottawa, ON, Canada
| | - Maya Roth
- St. Joseph's Operational Stress Injury Clinic, Toronto, ON, Canada
- Yeates School of Graduate Studies, Ryerson University, Toronto, ON, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, ON, Canada
| | - Vicky Lavoie
- Clinique pour traumatismes liés au stress opérationnel, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - J Don Richardson
- The MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- St. Joseph's Operational Stress Injury Clinic, London, ON, Canada
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12
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Military Sexual Trauma: An Update for Nurse Practitioners. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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13
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Lee CA. The Identification and Management of Military Sexual Trauma in Veterans: Ask the Question! J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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Andresen FJ, Monteith LL, Kugler J, Cruz RA, Blais RK. Institutional betrayal following military sexual trauma is associated with more severe depression and specific posttraumatic stress disorder symptom clusters. J Clin Psychol 2019; 75:1305-1319. [DOI: 10.1002/jclp.22773] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/08/2019] [Accepted: 02/23/2019] [Indexed: 11/09/2022]
Affiliation(s)
| | - Lindsey L. Monteith
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide PreventionDenver Colorado
- Department of PsychiatryUniversity of Colorado Anschutz Medical CampusAurora Colorado
| | - Jordan Kugler
- Department of PsychologyUtah State UniversityLogan Utah
| | - Rick A. Cruz
- Department of PsychologyUtah State UniversityLogan Utah
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Frankfurt SB, DeBeer BB, Morissette SB, Kimbrel NA, La Bash H, Meyer EC. Mechanisms of Moral Injury Following Military Sexual Trauma and Combat in Post-9/11 U.S. War Veterans. Front Psychiatry 2018; 9:520. [PMID: 30450058 PMCID: PMC6225808 DOI: 10.3389/fpsyt.2018.00520] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/02/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: Moral injury may result from perpetration-based and betrayal-based acts that violate deeply held norms; however, researchers and clinicians have little guidance about the moral injury syndrome's specific developmental pathways following morally injurious events. The present study's objective was to examine the direct and indirect pathways proposed in a frequently cited model of moral injury (1) in relation to two types of military-related traumas [experiencing military sexual trauma (MST) and combat exposure]. Methods: Secondary analyses were conducted within a sample of post-9/11 veterans at a Southwestern Veterans Health Care System (N = 310) across two time-points. Structural equation modeling tested the direct and indirect pathways from MST and combat to a PTSD-depression factor via betrayal, perpetration, guilt, and shame. Results: Betrayal accounted for the association between MST and PTSD-depression (β = 0.10, p < 0.01, 95% CI = 0.01 - 0.11) and perpetration accounted for the association between combat and PTSD-depression (β = 0.07, p < 0.05, 95% CI = 0.02 - 0.14). The indirect path from combat to shame to PTSD-depression was significant (β = 0.16, p < 0.01, 95% CI = 0.07 - 0.28) but the path through guilt was not. The specific indirect paths through perpetration or betrayal to shame or guilt were non-significant. Conclusions: Betrayal and perpetration are associated with PTSD-depression following MST and combat. Results suggest multiple pathways of moral injury development following different military traumas and morally injurious events. Implications for moral injury conceptualization and treatment are discussed.
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Affiliation(s)
- Sheila B. Frankfurt
- VISN 17 Center of Excellence for Research on Returning War Veterans, United States Department of Veterans Affairs, Waco, TX, United States
- Central Texas Veterans Health Care System, Temple, TX, United States
- College of Medicine, Texas A&M University Health Science Center, College Station, TX, United States
| | - Bryann B. DeBeer
- VISN 17 Center of Excellence for Research on Returning War Veterans, United States Department of Veterans Affairs, Waco, TX, United States
- Central Texas Veterans Health Care System, Temple, TX, United States
- College of Medicine, Texas A&M University Health Science Center, College Station, TX, United States
| | | | - Nathan A. Kimbrel
- Durham VA Medical Center, Durham, NC, United States
- Mental Illness Research, Education and Clinical Centers MIRECC (VA), Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Heidi La Bash
- National Center for PTSD, VA Palo Alto Healthcare System, Palo Alto, CA, United States
| | - Eric C. Meyer
- VISN 17 Center of Excellence for Research on Returning War Veterans, United States Department of Veterans Affairs, Waco, TX, United States
- Central Texas Veterans Health Care System, Temple, TX, United States
- College of Medicine, Texas A&M University Health Science Center, College Station, TX, United States
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
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16
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Post-traumatic stress disorder in combat veterans. JAAPA 2018; 31:11. [DOI: 10.1097/01.jaa.0000546487.96721.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Carroll KK, Lofgreen AM, Weaver DC, Held P, Klassen BJ, Smith DL, Karnik NS, Pollack MH, Zalta AK. Negative posttraumatic cognitions among military sexual trauma survivors. J Affect Disord 2018; 238:88-93. [PMID: 29864715 PMCID: PMC6063798 DOI: 10.1016/j.jad.2018.05.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/12/2018] [Accepted: 05/18/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Unique aspects of military sexual trauma (MST) may result in specific maladaptive cognitions among survivors. Understanding which posttraumatic cognitions are particularly strong among MST survivors could help clinicians target and improve treatment for these individuals. This study explored the impact of experiencing MST on posttraumatic cognitions among veterans with posttraumatic stress disorder (PTSD). METHODS Veterans enrolled in an Intensive Outpatient Program for PTSD (N = 226) were assessed for MST, PTSD severity, depression severity, and posttraumatic cognitions as part of a standard clinical intake. Multivariate analyses examined differences in posttraumatic cognitions between veterans who did and did not experience MST. RESULTS MST survivors (n = 88) endorsed significantly stronger posttraumatic cognitions related to self-blame compared to non-MST counterparts (n = 138), even when accounting for current symptom severity. Specifically, MST predicted the following cognitions: "The event happened to me because of the sort of person I am," "Somebody else would have stopped the event from happening," "Somebody else would not have gotten into this situation," and "There is something about me that made the event happen," after controlling for severity of PTSD and depression. LIMITATIONS Study population was a treatment-seeking sample of veterans diagnosed with PTSD from a non-VA clinic. Veterans in MST group endorsed either sexual harassment, sexual assault, or both. Sample size of males who endorsed MST (n = 21) may be too small to generalize to all males. CONCLUSIONS Beliefs related to self-blame may be important treatment targets for MST survivors.
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Affiliation(s)
| | | | | | - Philip Held
- Rush University Medical Center, United States
| | | | - Dale L Smith
- Rush University Medical Center, United States; Olivet Nazarene University, United States
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