Gender Differences in Military Sexual Trauma and Mental Health Diagnoses among Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder

Published:September 12, 2011DOI:



      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.


      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.


      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.


      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.
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      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.


      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.


      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.


      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.


      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.


      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.