Military Sexual Trauma Associated with Increased Rate of Mental Health Disorders among Male and Female Veterans with Comorbid PTSD
Currently, women represent 12% of the total number of military personnel who have served in Iraq and Afghanistan. The rising prevalence of service-related mental health disorders in OEF/OIF Veterans has been well documented, yet relatively little is known about how gender and military service-related risk factors, such as military sexual trauma (MST), impact risk for mental health disorders in newly returning Veterans. This study examined correlates of PTSD in OEF/OIF Veterans, as well as mental health comorbidities by gender among Veterans with PTSD – with and without MST. Using VA data, investigators identified 213,803 OEF/OIF Veterans (12% were women), who’d had at least one primary care or mental health visit to a VA facility between 4/02 and 10/08, and were new users of VA healthcare. Of these Veterans, 74,493 had received a diagnosis of PTSD, and 2,954 of those reported a history of MST (mainly women). Study variables included demographics, military characteristics (e.g., active duty vs. National Guard, branch of service, number of deployments), MST, and mental health diagnoses (e.g., PTSD, depression, anxiety disorders, substance use disorders, eating disorders).
- Overall, military sexual trauma (MST) was associated with a nearly three-fold increase in odds of PTSD in men, and more than a four-fold increase in women Veterans. Among women Veterans with PTSD, 31% screened positive for MST, and 1% of men with PTSD screened positive for MST.
- Among Veterans with PTSD, those with military sexual trauma also had more comorbid mental health diagnoses than those without MST.
- Three-quarters of women Veterans with PTSD and MST had comorbid depression, more than one-third had another anxiety disorder, and 4% were diagnosed with eating disorders. Male Veterans with PTSD and MST were more likely to have comorbid depression and substance use than male Veterans with PTSD, but without MST.
- Those Veterans who never sought VA care were not included in this study.
- These results may not be generalizable to Veterans of other eras.
- Diagnoses came from administrative health records and were not verified with standardized diagnostic measures.
This study was funded by an HSR&D Career Development Award to Dr. Maguen (RCD 06-042). Drs. Maguen, Cohen, and Seal are part of HSR&D’s Program to Improve Care for Veterans with Complex Comorbid Conditions, San Francisco, CA. Dr. Kimerling is part of HSR&D’s Center for Health Care Evaluation in Palo Alto, CA.
Maguen S, Cohen B, Ren L, Bosch J, Kimerling R, and Seal K. Gender Differences in Military Sexual Trauma and Mental Health Diagnoses among Iraq and Afghanistan Veterans with Post-Traumatic Stress Disorder. Women’s Health Issues September 8, 2011;e-pub ahead of print.