title: The Association Between Military Sexual Trauma and Use of VA and Non-VA Health Care Services Among Female Veterans With Military Service in Iraq or Afghanistan.
abstract: Military sexual trauma (MST) has been linked with increased rates of mental health disorders among veterans. Few studies have addressed how MST is related to use of VA and non-VA health care. The purpose of the current study was to (a) examine the association between MST, combat experiences, and mental health outcomes (i.e., posttraumatic stress disorder [PTSD] and depression) and (b) examine the association of MST and use of VA and non-VA health care services among female veterans who served in Iraq and Afghanistan. Female respondents to a survey assessing Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) veterans' needs and health ( N = 185) completed measures of demographic variables, military history, combat exposure, MST, PTSD, and depression symptoms, and use of VA and non-VA health care. Overall, 70% of the sample experienced one or more combat-related experiences and 15.7% endorsed MST during deployment to Iraq or Afghanistan. MST and combat exposure were both positively associated with PTSD and depression symptoms even after controlling for the effects of demographic and military history variables. MST was associated with increased use of VA mental health services in bivariate results but was not independently related to VA service utilization after accounting for PTSD and depression symptoms. Approximately half of the women who reported MST had not used VA health care. Continued outreach and education initiatives may be needed to ensure veterans understand the resources available to address MST-related mental and physical health problems through the VA.
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|2 Durham VA Medical Center, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.|4 VA Center of Excellence for Health Services Research in Primary Care, Durham, NC, USA.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Calhoun
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|2 Durham VA Medical Center, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.
authors.forename: Amie R
authors.initials: AR
authors.lastname: Schry
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|2 Durham VA Medical Center, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Dennis
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|2 Durham VA Medical Center, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.
authors.forename: H Ryan
authors.initials: HR
authors.lastname: Wagner
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|2 Durham VA Medical Center, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Kimbrel
authors.affiliation: 5 University of Connecticut Health Center, Farmington, CT, USA.|6 VA Connecticut Healthcare System, West Haven, CT, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|2 Durham VA Medical Center, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|2 Durham VA Medical Center, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.
authors.forename: Harold
authors.initials: H
authors.lastname: Kudler
authors.affiliation: 1 VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA.|3 Duke University School of Medicine, Durham, NC, USA.|7 Phoenix VA Healthcare System, AZ, USA.
authors.forename: Kristy
authors.initials: K
authors.lastname: Straits-Tröster
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D054542:Iraq War, 2003-2011; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
keywords: OEF; Operation Iraqi Freedom (OIF); military sexual trauma; service use; veterans