title: Predicting utilization of healthcare services in the veterans health administration by returning women veterans: The role of trauma exposure and symptoms of posttraumatic stress.
abstract: Combat exposure and military sexual trauma (MST) are prevalent among returning women veterans and are associated with increased alcohol use and psychological distress. However, it remains unclear the extent to which combat exposure and MST are associated with utilization of health care in the Veterans Health Administration (VHA). The current study explored the relationships among alcohol use and distress in women who deployed in support of Operations Enduring Freedom, Iraqi Freedom, and New Dawn. It was hypothesized that increased posttraumatic stress disorder (PTSD) and depression symptomatology and trauma exposure would be related to greater VHA utilization, whereas alcohol misuse would predict lower VHA use. Participants (N = 133) completed an Internet-based survey of deployment experiences, substance use, mental health, and utilization of VHA services. In this sample, 33% endorsed MST exposure, 64% endorsed combat exposure, and 78% indicated exposure to the aftermath of battle. Multiple regression models found combat exposure-but not MST or aftermath-to be significantly associated with alcohol use and symptoms of PTSD and depression. Only 37% of participants reported use of VHA services, and logistic regression models indicated that PTSD symptomatology was the only unique predictor of VHA use. Findings suggest potential barriers for women who endured sexually based trauma in a military setting in seeking treatment at the VHA.
authors.affiliation: Providence VA Medical Center.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Ryan
authors.affiliation: Providence VA Medical Center.
authors.forename: Ashlee C
authors.initials: AC
authors.lastname: McGrath
authors.affiliation: Providence VA Medical Center.
authors.forename: Suzannah K
authors.initials: SK
authors.lastname: Creech
authors.affiliation: Providence VA Medical Center.
authors.forename: Brian
authors.initials: B
authors.lastname: Borsari
mesh_terms: D000437:Alcoholism / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008889:Military Personnel / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D000067073:Psychological Trauma / Q000453:epidemiology*; D012742:Sex Offenses / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data*