title: The role of cumulative sexual trauma and difficulties identifying feelings in understanding female veterans' physical health outcomes.
abstract: OBJECTIVE
  To examine the role of alexithymia (difficulties identifying one's emotions) in understanding the link between PTSD symptoms and negative health outcomes in sexually victimized female veterans. We hypothesized that having experienced multiple types of sexual trauma across the lifespan, experiencing greater severity of PTSD symptoms, and reporting difficulties in identifying emotions would be associated with increased negative health outcomes.
  
  
  METHODS
  Anonymous cross-sectional survey of a convenience sample of 456 female veterans enrolled in a VA clinic within the prior year. Data collected included demographics, lifetime trauma exposure, psychological and medical symptoms, emotion recognition problems (alexithymia), health-risk behaviors, and health care utilization.
  
  
  RESULTS
  A total of 57.5% of participants reported a lifetime history of sexual trauma. After controlling for sexual trauma history, PTSD symptoms, and other well-established predictors of health care utilization in the VA medical system such as pre-disposing, enabling and need-based factors, hierarchical regression analyses showed that alexithymia independently explained unique variance in participants' physical health complaints and in their odds of reporting at least one outpatient urgent care visit in the past year.
  
  
  CONCLUSIONS
  These data suggest that emotion recognition problems may contribute to poorer health outcomes in sexually traumatized women veterans beyond what is explained by sexual trauma exposure, health risk behaviors and PTSD. Psychological interventions that enhance emotion identification skills for women who have experienced sexual trauma could improve health perceptions and reduce need for acute health care.
authors.affiliation: Department of Veterans Affairs Medical Center, Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, USA. melissa.polusny@va.gov
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Polusny
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Dickinson
authors.forename: Maureen
authors.initials: M
authors.lastname: Murdoch
authors.forename: Paul
authors.initials: P
authors.lastname: Thuras
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D012742:Sex Offenses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology; D014481:United States; D014728:Veterans / Q000523:psychology*