title: Sexual Assault, Sexual Harassment, and Physical Victimization during Military Service across Age Cohorts of Women Veterans.
abstract: OBJECTIVE
  Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts.
  
  
  METHODS
  Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined.
  
  
  RESULTS
  The sample included 781 women veterans. Compared with the oldest age group (≥ 65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77-6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25-7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32-9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64.
  
  
  CONCLUSIONS
  Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care.
authors.affiliation: Medical Service Line, San Francisco VA Medical Center, San Francisco, California. Electronic address: Carolyn.Gibson2@va.gov.
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Gibson
authors.affiliation: Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Gray
authors.affiliation: Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington; Women's Health Services, Office of Patient Care Services, Veterans Health Administration, Department of Veterans Affairs, Washington, DC.
authors.forename: Jodie G
authors.initials: JG
authors.lastname: Katon
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington; Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington; Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Health Care System, Seattle, Washington.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Simpson
authors.affiliation: Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington; Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington.
authors.forename: Keren
authors.initials: K
authors.lastname: Lehavot
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D058445:Bullying / Q000706:statistics & numerical data*; D019548:Crime Victims / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D012742:Sex Offenses / Q000706:statistics & numerical data*; D017406:Sexual Harassment / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*