Trauma and post-traumatic stress disorder (PTSD) among women veterans: trauma types and PTSD rates

Armand CL, Rodriguez N, Yaeger D. Trauma and post-traumatic stress disorder (PTSD) among women veterans: trauma types and PTSD rates. Paper presented at: VA HSR&D National Meeting; 2002 Feb 1; Washington, DC.

Objectives: Previous trauma studies in women veterans have focused on sexual trauma, but have not evaluated the extent to which women veterans may have experienced multiple types of trauma. Better understanding of multiple trauma types over the life course may have significant therapeutic implications for women veterans with PTSD. In this pilot study, we surveyed women veterans to determine lifetime exposure to trauma, types of trauma experienced, and PTSD diagnosis. Methods: We surveyed a convenience sample of 64 women veterans visiting an urban VAMC. Participants completed a self-report survey assessing health status, stressful life events and healthcare utilization, and a face-to-face interview assessing trauma and mental health status. Validated measures used for depression and trauma included the Stressful Life Events Questionnaire, PTSD Checklist and PTSD Symptom Scale-Interview. Results: 6% of participants never had trauma, 13% experienced one trauma type (out of 13 types) and 59% experienced 3 or more trauma types. Adult sexual assault (SA) was the most common trauma type: 56% (n = 36) had a lifetime exposure. 38% had a lifetime exposure to physical assault. Of participants experiencing SA, 75% experienced military sexual assault (MST) and 59% of those endorsed MST as their most distressing trauma experience. Of the 59% with MST (n = 16), 75% had current PTSD and 93% had lifetime PTSD, independent of time since trauma. Rates among those without MST were 32% current PTSD and 57% lifetime PTSD. Conclusions: Our results suggest that a lifetime history of sexual and physical trauma is common among women veterans visiting this VAMC, and is often but not always associated with a diagnosis of PTSD. The results also suggest that military sexual trauma is particularly likely to be associated with the development of PTSD. Impact statement: 1. Those caring for women veterans should assess trauma history in all women veterans, with or without PTSD symptoms. 2. Women veterans with trauma should be evaluated for PTSD, particularly those with a history of MST 3. Further studies are needed to assess (a) the therapeutic implications of these results, and (b) the finding that many women veterans have experienced multiple types of trauma.