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2019 HSR&D/QUERI National Conference Abstract

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4018 — Gender Moderates the Association of Military Sexual Trauma and Risk for Depression and PTSD Diagnoses Among VHA-Enrolled Veterans

Lead/Presenter: Hallie Tannahill,  Utah State University, Department of Psychology
All Authors: Tannahill HS (Utah State University, Department of Psychology), Livingston, WS (Utah State University, Department of Psychology), Fargo, JD (Utah State University, Department of Psychology) Brignone, E (Utah State University, Department of Psychology) Suo, Y (VA Salt Lake City Health Care System, Infromatics, Decision Enhancement, and Analytic Sciences Center) Gundlapalli, AV (VA Salt Lake City Health Care System, Infromatics, Decision Enhancement, and Analytic Sciences Center) Blais, RK (Utah State University, Department of Psychology)

Objectives:
Military sexual trauma (MST) includes instances of unwanted sexual attention or sexual assault that occurred during military service. MST is associated with risk for posttraumatic stress disorder (PTSD) and depression diagnoses, as well as increased risk for suicidal ideation/behavior (SI/B). Little is known about the differential effect of gender on these mental health outcomes, as extant studies model gender separately without a direct comparison of differences. The current study addresses this gap in a national sample of Veterans Health Administration (VHA)-enrolled veterans.

Methods:
Participants were 435,690 (n = 382,021, 87.7% male) Operations Enduring Freedom/Iraqi Freedom veterans seen for care at the VHA between 2004-2014. Gender, PTSD and depression diagnoses, SI/B, and MST screen status were extracted from medical records.

Results:
MST was reported by 23.0% (n = 12,362) of female and 1.1% (n = 4,222) of male veterans. PTSD diagnosis, depression diagnosis, and SI/B were observed among 39.3% (n = 171,195), 36.6% (n = 159,577), and 3.7% (n = 16,149) of veterans, respectively. After adjusting for age, race, military branch, and combat exposure, logistic regression analyses showed females with a positive screen for MST had a larger increased risk for a PTSD diagnosis relative to males with a positive screen for MST (AOR = 1.46, 95% CI[1.35, 1.58]), though males had a higher overall risk for a PTSD diagnosis than females (AOR = 0.51, 95% CI[0.50, 0.52]). Conversely, males with a positive screen for MST had a larger increased risk for a depression diagnosis relative to females with MST (AOR = 0.84, 95% CI[0.77, 0.91]), though females had a higher overall risk for a depression diagnosis than males (AOR = 1.68, 95% CI[1.64, 1.72]). Finally, males were more likely to have evidence of SI/B (AOR = 0.71, 95% CI[0.66, 0.76]) relative to females, though no significant interaction between sex and positive screen for MST was observed (AOR = 0.91, 95% CI[0.79, 1.05]).

Implications:
Results highlight the importance of continued screening for MST and suggest a need for gender-specific interventions. Information about frequency and severity of MST experiences may be helpful in further understanding this association.

Impacts:
Females are the fastest growing population within the military. As such, it is imperative to better understand mental health outcomes that are unique to this gender.