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Health Services Research & Development

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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

3083 — A Gender-Based Analysis of the Combat Exposure Scale and its Relationship to Posttraumatic Stress

Sternke LM, Ralph H. Johnson VAMC, Charleston, SC;

Objectives:
The purpose of this exploratory study was to examine gender differences in self-report of combat exposure as measured by the Combat Exposure Scale (CES), a well-known and male-normed instrument, and its correlation with reports of posttraumatic stress disorder (PTSD). This study investigated the following research questions: 1) What are the differential relationships between demographic, military and deployment variables, and CES scores? and 2) Does the reported level of combat exposure as documented by the CES predict similar levels of PTSD in men and women?

Methods:
Participants were recruited to a 65-question online survey via email, a social networking utility, and the Internet. The survey remained active for six weeks. Attempts at accessing the online survey totaled 240, and the completion rate was 75.4% (N = 181). Total sample size for the study was 172 (72 women, 100 men).

Results:
The CES was a statistically significant predictor of PTSD in both men and women; however, significance levels were higher for men than women. There was a strong gender by CES interaction effect. For every one point increase in CES score, men’s PTSD scores increased and women’s decreased (except in Afghanistan). There was a moderate correlation between CES scores and PTSD in men (.60), but a low correlation between CES scores and PTSD in women (.38).

Implications:
Results of this study are consistent with past study results indicating men and women Veterans have similar rates of PTSD; however, combat exposure may not be as great a contributor to PTSD in women Veterans as it is in men. The CES either does not appropriately capture the combat experiences of women, or gender plays a role in the perception of combat exposures as traumatic.

Impacts:
This is the first known study addressing the use of a well-established, male-normed combat exposure measurement instrument with women Veterans to predict PTSD. Further gender-based psychometric evaluation of the CES would provide a more definitive understanding of how women and men perceive the traumatic impact of combat or whether it should be measured differently between genders. Improved measurement of exposure could improve assessment and subsequent treatment matching of men and women Veterans in VA services.


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