No abstract

Objective Preliminary research suggests that perceptions of institutional betrayal are associated with more severe symptoms of posttraumatic stress disorder (PTSD) and depression, as well as suicide attempts in military sexual trauma (MST) survivors. However, results have not been replicated. Additionally, associations of institutional betrayal with specific PTSD symptom clusters or sexual function are understudied. Method Female service members/veterans who reported experiencing MST (N = 679) completed self‐report measures of PTSD and depression symptom severity, suicidal ideation, and sexual function. Institutional betrayal was assessed from free‐text descriptions of self‐reported index traumas. Results Institutional betrayal was significantly associated with more severe depression and PTSD symptoms, including avoidance, negative alterations in cognitions and mood, re‐experiencing, and dysphoric arousal. Conclusions Targeting specific PTSD and depressive symptoms through evidence‐based treatment may be important for managing institutional betrayal sequelae. Future research should identify specific strategies to help support survivors in their recovery following institutional betrayal.

Objective: Recent prevalence estimates indicate 38% of female service members/veterans (SM/Vs) report military sexual trauma (MST). This estimate is higher than Veterans Affairs estimates, which suggest 28% report MST during screening. The discrepant estimate suggests possible barriers to disclosing MST, which are not well-identified in the literature. The current study examined whether being assaulted by a fellow unit member and stigma for seeking help to treat the sequelae of MST from self, unit leader/ command, and romantic partners were correlates of MST nondisclosure among 209 female SM/Vs. Method: Participants completed a self-report questionnaire assessing MST nondisclosure, MST assailant characteristics, and stigma from the aforementioned sources as well as demographic, military, and mental health characteristics. Logistic regression analyses adjusting for military rank, MST severity, age, marital status and satisfaction, and probable mental health diagnoses determined whether being assaulted by a fellow unit member (yes/no) or stigma from various sources were associated with MST nondisclosure. Results: Thirty-seven (17.70%) participants did not disclose MST during a previous screening. At the bivariate level, participants who did not disclose MST reported higher self-stigma and anticipated enacted stigma from unit leader/command and romantic partner. After adjusting for covariates, only higher self-stigma was associated with MST nondisclosure. Conclusions: Female veterans who report higher self-stigma were less likely to disclose their MST during screening. Such findings are consistent with previous literature demonstrating that self-stigma, relative to other forms of stigma, relates to lower help-seeking behaviors. Efforts to increase the disclosure of MST during screening should focus on reducing self-stigma. Clinical Impact StatementMilitary sexual trauma (MST) is associated with poor mental health outcomes. There are discrepant prevalence rates of MST suggesting possible barriers to disclosure in some settings. Barriers to MST disclosure are not well studied. The current study observed that higher self-stigma was associated with MST nondisclosure during a previous screening. Given these findings, it may be helpful to assess for the presence of self-stigma when screening for MST as it might help identify those at greater risk for nondisclosure. Nondisclosure of MST during screening can delay the provision of services to treat the sequelae of MST.

Objective Treatment for posttraumatic stress disorder (PTSD) is a commonly sought mental health service among military service members and veterans (SM/Vs). Such treatment is typically individually‐based, despite many SM/Vs reporting a desire for greater partner involvement in treatment. This review examined couple‐based treatments for PTSD among SM/Vs and their romantic partners. Method A database search conducted in July, 2018 yielded 167 studies, of which 16 (10%) met inclusion criteria. Brief intervention summaries, effect sizes, and distress change scores (where applicable) are reported. Results The 16 studies tested 7 interventions, which showed a reduction in self‐rated and clinician‐rated PTSD symptoms with large effect sizes observed in most studies. Relationship outcomes also improved for SM/Vs and their partners, with effect sizes ranging from small‐to‐medium for SM/Vs and small‐to‐large for partners. Conclusions Couple‐based interventions show success in reducing PTSD symptoms and improving relationship outcomes, offering several alternatives to individual‐based interventions among partnered SM/Vs.

Resident-to-resident bullying has attracted attention in the media, but little empirical literature exists related to the topic of senior bullying. The aim of the current study was to better understand resident-to-resident bullying from the perspective of staff who work with older adults. Forty-five long-term care staff members were interviewed regarding their observations of bullying. Results indicate that most staff members have observed bullying. Verbal bullying was the most observed type of bullying, but social bullying was also prevalent. Victims and perpetrators were reported to commonly have cognitive and physical disabilities. More than one half of participants had not received formal training and only 21% reported their facility had a formal policy to address bullying. The implications of these results support the need for detailed policies and training programs for staff to effectively intervene when bullying occurs. [Journal of Gerontological Nursing, 43(7), 34-41.].