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2023 HSR&D/QUERI National Conference Abstract

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1130 — Resilience and employment among post-9/11 Veterans with and without military sexual trauma exposure

Lead/Presenter: Mary Jo Pugh,  COIN - Salt Lake City
All Authors: Pugh MJ (IDEAS Center, VA Salt Lake City), Kroll-Desrosiers AR (VA Central Western Massachusetts Healthcare System) Bouldin E (IDEAS Center, VA Salt Lake City) Kalvesmaki A (IDEAS Center, VA Salt Lake City) Trevino A (IDEAS Center, VA Salt Lake City) Peterson K (IDEAS Center, VA Salt Lake City) Charron E (University of Utah, Salt Lake City)

Objectives:
The fiscal year (FY) 2021 National Defense Authorization Act (NDAA) required the Center for Women Veterans to identify factors affecting Post-9/11 women Veteran’s unemployment. Given the significant concern regarding military sexual trauma (MST) and related comorbidities (e.g., post-traumatic stress disorder [PTSD], depression), we used data from a national survey to examine the association of resilience on employment accounting for childhood sexual trauma (CST), PTSD, and depression comorbidity among Veterans with MST.

Methods:
1,185 Veterans completed a survey between October 2021–January 2022. The survey collected information on military experiences, transition, employment, resilience, and various health conditions. Employment was defined as working for pay among those participating in the labor force (working for pay and/or looking for paid work). MST and CST were defined as unwanted sexual attention found to be threatening (e.g., touching, cornering, pressure for sexual favors, sexual texts) or sexual contact in which the survivor is unable to provide consent that occurred during military service and childhood, respectively. We also measured resilience (Response to Stressful Experiences Scale) PTSD (5-item Primary Care PTSD Screen) and depression (2-item Patient Health Questionnaire). We compared characteristics between women and men Veterans with and without MST exposure. Multivariable logistic regression models identified gender-specific associations of resilience with employment among those exposed (MST[+]) and not exposed (MST[-]) to MST, adjusting for CST, PTSD, and depression. We report results significant at p < .05.

Results:
Respondents included 324 women and 246 men post-9/11 Veterans; 86.5% were employed full or part time. MST was reported by 31.4% (n = 101) of women and 16.9% (n = 41) of men. MST(+) women were more likely to report CST (35.6% vs 14.5%), PTSD (36.3% vs 21.7%), and depression (47.5% vs 27.6%) than MST(-) women. MST(+) men were more likely to report CST (22.0% vs 11.0%), PTSD (51.2% vs 30.2%), and depression (60.0% vs 34.2%) than MST(-) men. MST(+) women and men reported similar levels of resilience to their MST(-) counterparts (women: 11.1 vs 11.0; men: 11.5 vs 12.0). Each unit increase in resilience was associated with a 36% increase in odds of employment among MST(+) women (OR: 1.36, 95% CI: 1.08-1.71); resilience was not associated with increased odds of employment among MST(-) women. Among MST(+) men, each unit increase in resilience was associated with a 71% increase in odds of employment (OR: 1.71, 95% CI:1.08-2.71); resilience was not associated with employment among MST (-) men.

Implications:
This study, mandated by the FY21 NDAA, demonstrated that military exposures such as MST have impacts beyond health and that resilience may partially mitigate these effects in women and men. Among MST(+) women and men post-9/11 Veterans, higher resilience was associated with increased odds of employment, while resilience was not associated with employment in MST(-) Veterans.

Impacts:
These findings suggest that using evidence-based approaches to increase resilience among Veterans exposed to MST may be an important avenue to increasing employment in this vulnerable population. Moreover, all Veterans with MST exposure may benefit from trauma-informed care as a substantial proportion of these individuals also report exposure to CST, PTSD, and depression.