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Women Veterans: Combat, Sexual Assault, PTSD, and Depression in Reserve & National Guard Compared to Regular Military Members

Sadler AG, Torner J, Booth BM. Women Veterans: Combat, Sexual Assault, PTSD, and Depression in Reserve & National Guard Compared to Regular Military Members. Paper presented at: VA HSR&D Field-Based Women's Health Meeting; 2010 Jul 16; Washington, DC.

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Objectives: Identify differences in current PTSD and depression between military women by service type (Reserve or National Guard, Regular Military, both), deployment (combat or not) and sexual assault histories (lifespan and in-military). Methods: 1004 women participated in a retrospective cohort study of current health, assault history and care utilization. PTSD and depression were assessed using the Post-Traumatic Stress Diagnostic Scale and CIDI, respectively. Results: Most participants served in the regular military (RM) (60%, n = 598), 12% were Reserve or National Guard (R/NG) (n = 123), and 23% served in both (28%, n = 282). Almost two thirds (62%) acknowledged one or more sexual assaults (SA, attempted and/or completed) during their lifetime; 28% acknowledged SA during military. R/NG servicewomen reported no SA during military service. Deployment to a combat zone was experienced by 29%; 17% of RM vs 74% R/NG. Of deployed RM, 21% experienced SA during military compared to 32% of those not combat deployed (p = .0007). One-fourth met criteria for a current PTSD, and 30% for depression. There was no difference in PTSD or depression between those who had served in combat or not, or by service type. PTSD and depression rates were greater for women experiencing SA in comparison to un-assaulted peers (p < .0001). These rates were even higher for those experiencing SA during military (PTSD: 33% v 11%; depression: 39% v 16%; p < .0001). Conclusions: Service women's lifetime SA exposure is a more useful marker of current PTSD and depression compared to deployment or SA during military. Deployment did not elevate rates of SA in RM, and R/NG reported no SA during military. R/NG were generally healthier with lower rates of PTSD and depression despite high rates of combat deployment. Impacts: Although deployment and SA are common experiences in military women, service type (RM, R/NG or both) results in both different exposures and mental health outcomes and should be routine clinical and research considerations. Current VA practice focuses on military SA screening whereas lifespan SA must also be assessed. High rates of PTSD and depression found have implications for mental health services unique to military women, and consequently resource allocation. Further study of health risks and outcomes by service type is indicated.

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