Military sexual trauma in US veterans: results from the National Health and Resilience in Veterans Study.
OBJECTIVE
To evaluate the prevalence of military sexual trauma (MST) among US veterans, identify sociodemographic and military characteristics of MST, and examine the relationships between MST and psychiatric comorbidities, functioning/quality of life, and mental health treatment utilization.


METHODS
Data were analyzed from the National Health and Resilience in Veterans Study, a contemporary, nationally representative survey of 1,484 US veterans conducted September-October 2013. Poststratification weights were applied to analyses to permit generalizability of results to the US veteran population. Outcomes measured include history of MST, trauma histories, lifetime and current DSM-IV mental disorders, functioning and quality of life, and utilization of mental health treatment.


RESULTS
The overall prevalence of MST was 7.6% and was higher among female than male veterans (32.4% vs 4.8%) and younger than older veterans (22.8% among veterans aged 18-29 years vs 4.5% among veterans aged 60+ years). After adjustment for sociodemographic and military characteristics, MST was associated with elevated rates of current major depressive disorder, posttraumatic stress disorder, and generalized anxiety disorder (adjusted odds ratio [aOR] range, 2.19-3.12); past history of suicide attempt (aOR = 2.78) and current suicidal ideation (aOR = 2.19); and decreased mental and cognitive functioning and quality of life (Cohen d, 0.23-0.38). MST was also associated with increased current utilization of psychotropic medication (aOR = 3.70) and psychotherapy or counseling (aOR = 2.41), independent of psychiatric morbidities.


CONCLUSIONS
7.6% of US veterans screen positive for MST, with substantially higher rates among female and younger veterans. MST is associated with elevated rates of several psychiatric morbidities and suicidality, reduced functioning and quality of life, and increased mental health treatment utilization, independent of other sociodemographic, military, and mental health factors. These results suggest that MST is prevalent among US veterans and associated with elevated health burden. Findings can help inform efforts to identify at-risk veterans and characterize the concomitant health burden and needs associated with MST in this population.
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Katherine
K
Klingensmith
Jack
J
Tsai
Natalie
N
Mota
Steven M
SM
Southwick
Robert H
RH
Pietrzak
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D055500:Resilience, Psychological; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D040921:Stress Disorders, Traumatic / Q000150:complications / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult