Study Shows Women Veterans with History of Sexual Abuse at Higher Risk for Substance Use Disorder
BACKGROUND:
Multiple reports have documented a high prevalence of rape and sexual harassment among military women and women Veterans. Research also has shown that women’s experiences of sexual assault or rape are associated with the development of substance use disorders; moreover, adult female victims of rape who experience additional instances of rape show a higher risk of problem substance use. This retrospective cohort study examined the associations between rape history and substance use disorders among 1,004 women Veterans (age <51 years) who received care at two Midwestern VAMCs. Using data from a telephone survey, investigators assessed: demographics, rape history, substance abuse and dependence, depression, and PTSD. Another variable was sexual partnership, which included "men only," "women only," "both men and women," and "no partners." "Women only" and "both men and women" were classified as sexual partnerships with women.
FINDINGS:
- Lifetime substance abuse disorder was higher for women Veterans with a history of rape.
- Two-thirds (62%) of study participants reported lifetime sexual assault, including 11% reporting attempted rape and 51% reporting at least one completed rape. Women with women as sex partners had significantly higher rates of rape and lifetime substance use disorder (73% of women with women as sex partners reported lifetime rape vs. 48% of exclusively heterosexual women).
- Almost the entire study population (97%) reported lifetime use of alcohol, and 77% reported using alcohol in the past year. However, women with lifetime rape were more likely to report abstinence from drinking (50%) than women with no rape (41%).
- Fewer women Veterans (47%) reported lifetime use of illicit drugs, mainly marijuana (45%), cocaine (16%), hallucinogens (13%), and amphetamines (10%).
- Women reported the highest rates of rape during childhood and military service (51% and 25%, respectively), and those reporting rape in any period of their lives were significantly more likely to report rape in other periods. For example, women Veterans reporting in-military rape were significantly more likely to report post-military rape (18% vs. 9%).
LIMITATIONS:
- Only 43% of eligible women who received care at two medical centers were located and participated. Therefore, results may not be generalizeable to all female patients under age 51 or women at other VA medical centers.
- This was a retrospective study that did not include detailed diagnostic interviews. For example, investigators did not conduct an extensive assessment of the timing between substance abuse and rape self-reports.
- Investigators relied on validity of alcohol and drug self-report via telephone interviews.
AUTHOR/FUNDING INFORMATION:
This study was funded through HSR&D (NRI 04-194). Dr. Booth is part of HSR&D’s Center for Mental Healthcare and Outcomes Research, Little Rock, AR. Drs. Mengeling and Sadler are part of HSR&D’s Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City, IA.
Booth B, Mengeling M, Torner J, and Sadler A. Rape, Sex Partnership, and Substance Use Consequences in Women Veterans. Journal of Traumatic Stress 2011 Jun;24(3):287-94.
