Military Sexual Assault, Gender, and PTSD Treatment Outcomes of U.S. Veterans

Abstract

This study examined whether gender and military sexual assault (MSA) were associated with psychiatric severity differences at initiation of treatment for posttraumatic stress disorder (PTSD) and whether MSA and gender predicted psychiatric treatment outcomes. Male (n = 726) and female (n = 111) patients were recruited from 7 U.S. Department of Veterans Affairs (VA) PTSD specialty intensive treatment programs and completed an intake survey; 69% (n = 574) of the participants completed a 4-month postdischarge follow-up survey. Measures included current PTSD and depressive symptoms, aggressive/violent behaviors, alcohol and drug use severity, and quality of life. Multilevel multivariate regression analyses were conducted to examine the main and interaction effects of gender and MSA on psychiatric treatment outcomes at 4-month follow-up, including demographics, baseline severity, hostile fire, and treatment length of stay. Baseline PTSD severity did not differ by gender or MSA status, but women had more severe depressive symptoms (d = 0.40) and less aggressive/violent symptoms (d = -0.46) than men. Gender, MSA status, and the interaction between gender and MSA did not predict treatment outcomes as hypothesized. Male and female veterans with and without MSA responded equally well to treatment in VA PTSD intensive treatment programs.

Sexual health in the French military: a multidimensional and gendered perspective

“…Lifetime experience of sexual assault is calculated among all males (n = 1268), since 2 of the 18 males who never had sex, reported having been the victims of sexual assault Nevertheless, our results show higher prevalence of sexual dysfunction among women than men, mirroring findings from the 2006 French sexual health survey [21]. The substantial gender gap across a range of sexual health concerns [14,27,28] has led to the development of women health service in the US military, among veterans [29] as well as in the US Navy, through the Sexual health and responsibility program (SHARP) [16]. French Armed forces have yet to develop such a programmatic approach.…”

Evaluating patterns and predictors of symptom change during a three-week intensive outpatient treatment for veterans with PTSD

“…With women having an increasingly larger presence in the military, it is important to evaluate whether intensive PTSD treatment programs work equally well for men and women and for different trauma types (i.e., combat and military sexual trauma [MST]). One large Veteran’s Administration (VA) study combining data across seven different PTSD intensive treatment programs showed that sex and a history of military sexual assault did not predict treatment outcome [ 18 ]. However, this study was limited by the fact that they combined data across very different types of treatment programs and overall the treatment effect sizes were small, suggesting that these programs were not as effective as the intensive outpatient programs [ 16 , 17 ].…”

“Do you expect me to receive PTSD care in a setting where most of the other patients remind me of the perpetrator?”: Home-based telemedicine to address barriers to care unique to military sexual trauma and veterans affairs hospitals

“…Further, female veterans and those with MST histories are more likely to receive pharmacological treatment for mental health conditions through primary care rather than the more effective evidence-based psychosocial treatments for PTSD [i.e., Prolonged Exposure (PE); Foa et al, 2007)], offered through VA specialty care clinics (Chatterjee et al, 2009; Maguen et al, 2010). This represents a missed opportunity since recent data indicate that PTSD treatment outcomes do not differ based on MST status (Tiet, Levya, Blau, Turchik, & Rosen, 2015). Thus, given adequate access to VA care, veterans with MST histories are likely to benefit from treatment.…”