Abstract
Objective
We examined correlates of posttraumatic stress disorder (PTSD), including military
sexual trauma (MST), in Iraq and Afghanistan veterans. We also compared mental health
comorbidities by gender among veterans with PTSD, with and without MST.
Methods
Retrospective data analyses were conducted using Department of Veterans Affairs (VA)
administrative data from 213,803 Iraq and Afghanistan veterans and the subset diagnosed
with PTSD from April 1, 2002, to October 1, 2008. We used descriptive statistics and
multivariate logistic regression compared by gender to investigate independent correlates
and mental health comorbidities associated with PTSD, with and without MST.
Results
Among women with PTSD, 31% screened positive for MST; 1% of men with PTSD screened
positive for MST. Among those with PTSD, veterans with MST had more comorbid mental
health diagnoses than those without MST. Women with PTSD and MST were more likely
to receive comorbid depression, anxiety, and eating disorder diagnoses, and men were
more likely to receive comorbid substance use disorder diagnoses.
Conclusions
MST is associated with an increased prevalence of mental health disorders comorbid
with PTSD. Better understanding comorbidity patterns will allow for targeted evaluation
and treatment of returning veterans with MST.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Women's Health IssuesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Chronic PTSD in Vietnam combat Veterans: Course of illness and substance abuse.American Journal of Psychiatry. 1996; 153: 369-375
- Posttraumatic stress disorder and drug disorders.Archives of General Psychiatry. 1998; 55: 913-917
- The Women’s War.New York Times, 2007, March 18 (Retrieved from)
- Association of trauma exposure with psychiatric morbidity in military Veterans who have served since September 11, 2001.Journal of Psychiatric Research. 2009; 43: 830-836
- Prevalence of depressive and alcohol abuse symptoms among women VA outpatients who report experiencing sexual assault while in the military.Journal of Traumatic Stress. 1999; 12: 601-612
- Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care.New England Journal of Medicine. 2004; 351: 13-22
- Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan.JAMA. 2006; 295: 1023-1032
- Risk of suicide among US Veterans after returning from the Iraq or Afghanistan war zones.JAMA. 2008; 300: 652-653
- The role of sexual assault on the risk of PTSD among Gulf War Veterans.Annals of Epidemiology. 2005; 15: 191-195
- Mental health care needs among recent war Veterans.New England Journal of Medicine. 2005; 352: 1289
- The Veterans Health Administration and military sexual trauma.American Journal of Public Health. 2007; 97: 2160-2166
- Military-related sexual trauma among VHA patients returning from Afghanistan and Iraq.American Journal of Public Health. 2010; 100: 1409-1412
- Trauma and the Vietnam war generation: Report of the findings from the National Vietnam Veterans Readjustment Study.Brunner/Mazel, New York1990
- Posttraumatic stress and depression symptoms in soldiers returning from combat operation in Iraq and Afghanistan.Journal of Traumatic Stress. 2007; 20: 933-943
- Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in VA healthcare.American Journal of Public Health. 2010; 100: 2450-2456
- Women in the military: Where they stand.Women’s Research and Education Institute, Arlington, VA2008
- Validation of a trauma questionnaire in Veteran women.Journal of General Internal Medicine. 1999; 14: 186-189
- Current and lifetime psychiatric disorders among Veterans with war-zone related posttraumatic stress disorder.Journal of Nervous and Mental Disorders. 1996; 184: 307-313
- Bringing the war back home: Mental health disorders among 103,788 US Veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities.Archives of Internal Medicine. 2007; 167: 476-482
- Sexual assault in women Veterans: An examination of PTSD risk, healthcare utilization and cost of care.Psychosomatic Medicine. 2004; 66: 749-756
- Military sexual trauma: A review of the prevalence and associated health consequences in Veterans.Trauma Violence Abuse. 2008; 9: 250-269
- Invisible wounds of war: Summary and recommendations for addressing psychological and cognitive injuries.RAND Corporation, Santa Monica, CA2008
U.S. Department of Defense, Defense Manpower Data Center: Contingency Tracking System Deployment File, data as of March 31, 2011.
VA Office of Quality and Performance: Technical Manual for the VHA Performance Measurement System, http://vaww.oqp.med.va.gov/programs/pm/pmPolicyTechManual.aspx, data last retrieved May 18, 2011.
- Course and predictors of posttraumatic stress disorder among Gulf War Veterans: A prospective analysis.Journal of Consulting and Clinical Psychology. 1999; 67: 520-528
- Epidemiology of trauma, Post-traumatic stress disorder (PTSD), and co-morbid disorders in Chile.Psychological Medicine. 2006; 36: 1523-1533
Biography
Shira Maguen is a Research Psychologist at the San Francisco VA Medical Center and Assistant Professor in the Department of Psychiatry at the University of California, San Francisco. She specializes in PTSD research, with an interest in women veterans' mental health.
Biography
Beth Cohen is a Staff Physician at the San Francisco VA Medical Center and Assistant Professor in the Department of Medicine at the University of California, San Francisco. Her research focuses on the effects of PTSD on physical health.
Biography
Li Ren was a Data Analyst at the San Francisco VA Medical Center with an expertise in quantitative methods and analysis. She is now employed at Stanford University.
Biography
Jeane Bosch is a Research Associate at the San Franisco VA Medical Center. Her research interests include PTSD, sexual assault, and multicultural issues in mental health.
Biography
Rachel Kimerling is a Clinical Psychologist at the National Center for Posttraumatic Stress Disorder, Dissemination and Training Division and an Investigator at the Center for Health Care Evaluation, VA Palo Alto Health Care System. She specializes in sexual trauma research.
Biography
Karen Seal is an Associate Professor of Medicine and Psychiatry at the University of California, San Francisco. As Co-Director of the Iraq/Afghanistan Veteran Integrated Care Clinic at the San Francisco VA Medical Center, she investigates primary care-mental health integration.
Article info
Publication history
Published online: September 12, 2011
Accepted:
July 25,
2011
Received in revised form:
June 15,
2011
Received:
January 11,
2011
Footnotes
Supported by Department of Defense Concept Award Grant (Maguen), VA Health Sciences Research and Development (HSR&D) Career Development Award (Maguen), and National Institutes of Health grant K23 HL 094765-01 (Cohen).
Identification
Copyright
Published by Elsevier Inc.
