Military Sexual Trauma in Older Women Veterans: Prevalence and Comorbidities

Gibson, Carolyn J.; Maguen, Shira; Feng, Xiaoyuan; Barnes, Deborah E.; Peltz, Carrie; Yaffe, Kristine

doi:10.1007/s11606-019-05342-7

Cited by 34 publications

(16 citation statements)

References 53 publications

(93 reference statements)

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“…A limited number of previous studies have examined these traumas in relationship to hypertension using cross‐sectional designs. 7 , 8 , 31 , 32 , 33 , 34 , 35 As hypertension is a major risk factor for CVD 53 , 54 the present findings highlight the importance of considering these measures of sexual violence for women’s cardiovascular health.…”

Section: Discussionmentioning

confidence: 70%

“… 7 , 8 , 31 , 32 These studies did not investigate potential joint effects of sexual assault and workplace sexual harassment and used cross‐sectional designs, with many studies also using samples of female veterans. 7 , 8 , 31 , 32 , 33 , 34 , 35 , 36 Another limitation of these prior studies is that they did not account for other traumatic experiences in the absence of sexual violence, such as accidents, disasters, or unexpected death of a loved one, that are also common and have been linked to adverse mental and physical health. 37 , 38 , 39 , 40 …”

mentioning

confidence: 99%

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Sexual Violence and Risk of Hypertension in Women in the Nurses’ Health Study II: A 7‐Year Prospective Analysis

Lawn

Nishimi

Sumner

et al. 2022

JAHA

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Background Hypertension is a prevalent condition in women and an important modifiable risk factor for cardiovascular disease. Despite women’s experiences of sexual violence being common, no prospective studies have examined lifetime sexual assault and workplace sexual harassment in relationship to hypertension in large civilian samples with extended follow‐up. Here, we examined whether these experiences were prospectively associated with greater risk of developing hypertension over 7 years. Methods and Results Data are from a substudy of the Nurses’ Health Study II and include women free of hypertension at the time of sexual assault and workplace sexual harassment assessment in 2008 (n=33 127). Hypertension was defined as self‐reported doctor diagnosis or initiating antihypertensive medication use, assessed biennially through 2015. We performed Cox proportional hazards regression models to predict time to developing hypertension associated with sexual violence exposure, adjusting for relevant covariates. Over follow‐up, 7096 women developed hypertension. Sexual assault and workplace sexual harassment were prevalent (23% and 12%, respectively; 6% of women experienced both). Compared with women with no exposure, women who experienced both sexual assault and workplace sexual harassment had the highest risk of developing hypertension (hazard ratio [HR], 1.21; 95% CI, 1.09–1.35), followed by women who experienced workplace sexual harassment (HR, 1.15; 95% CI, 1.05–1.25) and then by women who experienced sexual assault (HR, 1.11; 95% CI, 1.03–1.19), after adjusting for relevant covariates. Conclusions Sexual assault and workplace sexual harassment are prospectively associated with greater risk of hypertension. Reducing such violence is important in its own right and may also improve women’s cardiovascular health.

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Section: Discussionmentioning

confidence: 70%

mentioning

confidence: 99%

Sexual Violence and Risk of Hypertension in Women in the Nurses’ Health Study II: A 7‐Year Prospective Analysis

Lawn

Nishimi

Sumner

et al. 2022

JAHA

View full text Add to dashboard Cite

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“…Notably, sexual violence is highly prevalent in the United States (US), with 44% of women having experienced sexual assault in their lifetime (Smith et al, 2018). A limited literature has linked sexual assault to cerebrovascular health, with one study nding a history of sexual assault was associated with increased risk of self-reported stroke (Santaularia et al, 2014), and another nding military sexual assault (sexual assault or repeated, threatening sexual harassment in the context of military service) linked to medical record-documented cerebrovascular disease (Gibson et al, 2020). However, no prior literature has examined sexual assault in relation to WMHs.…”

Section: Discussionmentioning

confidence: 99%

Sexual assault and white matter hyperintensities among midlife women

Thurston

Jakubowski

et al. 2021

Brain Imaging and Behavior

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BackgroundTraumatic experiences have been linked to poor mental and physical health. However, there has been little examination of their relationship to neuroimaging markers of cerebrovascular risk. White matter hyperintensities (WMHs) are markers of brain small vessel disease. WMHs can be detected decades before the onset of dementia and other disorders and can serve as early markers for these brain disorders. We tested whether traumatic experiences were associated with brain WMH volume among midlife women. MethodsIn the MsBrain study, 145 women (mean age = 59 years) without cardiovascular disease, stroke, or dementia were recruited. Women completed questionnaires [trauma checklist, depression, post-traumatic stress measures]; physical measures [body mass index (BMI), blood pressure (BP)]; phlebotomy; actigraphy sleep measurement, and 3 Tesla magnetic resonance brain imaging for WMHs. Crosssectional associations between traumatic experiences and WMH volume were assessed in linear regression models. Covariates were age, race/ethnicity, education, BMI, BP, lipids, preeclampsia, sleep, and additionally depressive and post-traumatic stress disorder symptoms. Results68% of women endorsed at least one of the traumas assessed. The most common trauma was sexual assault (23% of women). Women with trauma exposure had greater WMH volume than women without trauma [B(SE) = .24 (.09), p = .01, multivariable]. The single trauma most associated with WMH was sexual assault [B(SE) = .25 (.11), p = .02, multivariable]. Results persisted adjusting for depressive or posttraumatic stress symptoms. ConclusionsA trauma history, particularly sexual assault, was associated with greater WMH volume controlling for covariates, including depressive and post-traumatic symptoms. Sexual assault may place women at risk for poor brain health.

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“…2 MST experiences are associated with increased risks for chronic conditions and mental health conditions, with posttraumatic stress disorder (PTSD) and depression among the most frequent mental health consequences of MST. 3,4 To promote access to care for MST-related conditions, the VHA has implemented universal screening for MST and provides care for related conditions without co-pay. VHA surveillance data for fiscal year 2020 indicate that 63.4% of women and 53.6% of men with newly detected MST accessed mental health care related to the MST.…”

Section: Introductionmentioning

confidence: 99%

Mental Health Beliefs, Access, and Engagement with Military Sexual Trauma–Related Mental Health Care

2022

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Background Military sexual trauma (MST) is associated with negative mental health outcomes. Mental health beliefs, such as stigma or secondary victimization, have been identified as possible barriers to care; however, it is unclear whether such beliefs impact receiving care. Objective To assess if mental health beliefs impact MST-related mental health care access and engagement. Design Veterans completed a survey following detection of MST. Survey data were linked to Veteran's Health Administration administrative data in order to examine associations with outpatient MST-related care in the year following MST detection. Participants A national sample of women and men Veterans (N = 1,185) with newly detected MST who reported a perceived need for MST-related mental health treatment. Main Measures Building on prior work that identified four latent classes of mental health beliefs (Hahn et al., J Trauma Stress 34:394–404, 2020; low barrier, stigma-related beliefs, negative perceptions of care, high barrier), we examined associations with outpatient mental health care indicated by a provider as related to MST. Care was examined in total, as well as the specific categories of medication management, individual psychotherapy, and group psychotherapy. Key Results Access to care following MST detection was high: most (71.6%) Veterans had an MST-related mental health visit within 30 days, and nearly all (83.6%) within 180 days, with the median number of days to receiving care being 2. Negative perceptions of care predicted a lower likelihood of treatment engagement (3+ encounters) with MST-related individual psychotherapy (OR = 0.65, 95% CI (0.43–0.96)), whereas the stigma-related beliefs and high barrier classes did not. Conclusions There appears to be excellent access to mental health care among Veterans with a perceived need for MST-related mental health treatment. However, treatment beliefs that represented negative perceptions of care may serve as barriers to engagement. Interventions targeting negative perceptions of care during early encounters could help promote subsequent engagement.

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Military Sexual Trauma in Older Women Veterans: Prevalence and Comorbidities

Cited by 34 publications

References 53 publications

Sexual Violence and Risk of Hypertension in Women in the Nurses’ Health Study II: A 7‐Year Prospective Analysis

Sexual Violence and Risk of Hypertension in Women in the Nurses’ Health Study II: A 7‐Year Prospective Analysis

Sexual assault and white matter hyperintensities among midlife women

Mental Health Beliefs, Access, and Engagement with Military Sexual Trauma–Related Mental Health Care

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