title: Relationship of sexual assault history to somatic symptoms and health anxiety in women.
abstract: Prior reports have pointed to a link between traumatic experiences and health consequences in women. The objective of this study was to determine whether there is an association between sexual assault history and measures of somatic symptoms and illness attitudes in a sample of female Veterans Affairs primary care patients, a group in whom high rates of sexual trauma have been reported. We conducted a cross-sectional study of a representative sample of 219 women in a Veteran's Affairs primary care outpatient clinic. Sexual assault history, somatic symptoms and health anxiety were assessed by self-report questionnaire. Multivariate analyses were used to examine relationships between sexual assault exposure and these outcomes. Ninety-seven women (43.9%) reported experience(s) of sexual assault (i.e., rape, attempted rape or being made to perform any type of sexual act through force or threat of harm). Sexual assault was associated with a significant increase in somatization scores, physical complaints across multiple symptom domains and health anxiety. Sexual assault was also a significant statistical predictor of having multiple sick days in the prior 6 months and of being a high utilizer of primary care visits in the prior 6 months. These data confirm a strong association between sexual trauma exposure and somatic symptoms, illness attitudes and healthcare utilization in women. Causal mechanisms cannot be inferred from these data. Studies in other cohorts are warranted.
authors.affiliation: Veterans Affairs San Diego Healthcare System and the University of California San Diego, La Jolla, CA, USA. mstein@ucsd.edu
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
authors.forename: Ariel J
authors.initials: AJ
authors.lastname: Lang
authors.forename: Charlene
authors.initials: C
authors.lastname: Laffaye
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Satz
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Lenox
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Dresselhaus
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology; D016387:Women's Health