Abstract
Objectives
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.
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
- The menopausal transition and cardiovascular risk.Obstetrics and Gynecology Clinics of North America. 2011; 38: 477-488
- Developmental and contextual factors and mental health among lesbian, gay, and bisexual youths.in: Omoto A.M. Kurtzman H.S. Sexual orientation and mental health: examining identity and development in lesbian, gay, and bisexual people. American Psychological Association, Washington, DC2005
- Mortality prediction with a single general self-rated health question. A meta-analysis.Journal of General Internal Medicine. 2006; 21: 267-275
- The relationship between experiences of discrimination and mental health among lesbians and gay men: An examination of internalized homonegativity and rejection sensitivity as potential mechanisms.Journal of Consulting and Clinical Psychology. 2012; 80: 917-927
- Sourcebook: Women veterans in the Veterans Health Administration. Volume 3. Sociodemographics, utilization, costs of care, and health profile.Women's Health Evaluation Initiative, Women's Health Services, Veterans Health Administration, Department of Veterans Affairs, Washington, DC2014
- Sexual assault while in the military: Violence as a predictor of cardiac risk?.Violence and Victims. 2003; 18: 219-225
- Medical profile of women Veterans Administration outpatients who report a history of sexual assault occurring while in the military.Journal of Women's Health & Gender-Based Medicine. 1999; 8: 835-845
- Health care-seeking for menopausal problems.Climacteric. 2003; 6: 112-117
- Posttraumatic stress disorder in female veterans with military and civilian sexual trauma.Journal of Traumatic Stress. 2006; 19: 837-846
- The Veterans Health Administration and military sexual trauma.American Journal of Public Health. 2007; 97: 2160-2166
- Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq.American Journal of Public Health. 2010; 100: 1409-1412
- Military sexual trauma in US veterans: Results from the National Health and Resilience in Veterans Study.Journal of Clinical Psychiatry. 2014; 75: e1133-e1139
- Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization.Psychology of Women Quarterly. 2007; 31: 357-370
- Examining sexual orientation disparities in alcohol misuse among women veterans.American Journal of Preventive Medicine. 2014; 47: 554-562
- The impact of minority stress on mental health and substance use among sexual minority women.Journal of Consulting and Clinical Psychology. 2011; 79: 159-170
- Sexual victimization, health status, and VA healthcare utilization among lesbian and bisexual OEF/OIF veterans.Journal of General Internal Medicine. 2013; 28: S604-S608
- Military sexual trauma among homeless veterans.Journal of General Internal Medicine. 2013; 28: S536-S541
- Cardiovascular risk in menopausal women and prevalent related co-morbid conditions: Facing the post-Women's Health Initiative era.Fertility and Sterility. 2009; 92: 1171-1186
- A systematic review of publications assessing reliability and validity of the Behavioral Risk Factor Surveillance System (BRFSS), 2004-2011.BMC Medical Research Methodology. 2013; 13: 49
- Psychological effects of sexual harassment, appraisal of harassment, and organizational climate among U.S. Army soldiers.Military Medicine. 1998; 163: 63-67
- The military environment: Risk factors for women's non-fatal assaults.Journal of Occupational and Environmental Medicine/American College of Occupational and Environmental Medicine. 2001; 43: 325-334
- Life span and repeated violence against women during military service: Effects on health status and outpatient utilization.Journal of Women's Health (2002). 2004; 13: 799-811
- The prevalence of military sexual assault among female Veterans' administration outpatients.Journal of Interpersonal Violence. 2000; 15: 291-300
- Posttraumatic stress symptomatology as a mediator of the association between military sexual trauma and post-deployment physical health in women.Journal of Trauma & Dissociation. 2011; 12: 275-289
- Gender differences among veterans deployed in support of the wars in Afghanistan and Iraq.Journal of General Internal Medicine. 2013; 28: S556-S562
- Sexual harassment and assault experienced by reservists during military service: Prevalence and health correlates.Journal of Rehabilitation Research and Development. 2008; 45: 409-419
- Military sexual trauma: A review of prevalence and associated health consequences in veterans.Trauma, Violence & Abuse. 2008; 9: 250-269
The National Survey of Veterans, Active Duty Service Members, Activated National Guard and Reserve Members, Family Members and Survivors (2010). Prepared by Westat for the Department of Veterans Affairs. Available at: http://www.va.gov/vetdata/docs/SurveysAndStudies/NVSSurveyFinalWeightedReport.pdf.
- The association of menopause status with physical function: The Study of Women's Health Across the Nation.Menopause (New York, N.Y.). 2012; 19: 1186-1192
- Veterans Health Administration mental health treatment settings of patients who report military sexual trauma.Journal of Trauma & Dissociation. 2011; 12: 232-243
- Deployment stressors, gender, and mental health outcomes among Gulf War I veterans.Journal of Traumatic Stress. 2005; 18: 272-284
- Sexual violence and mental health symptoms among National Guard and Reserve soldiers.Journal of General Internal Medicine. 2014; 29: 104-109
- A manual for users of the SF-8 health survey.QualityMetric Incorporated, Lincoln, RI2001
- Women veterans' healthcare delivery preferences and use by military service era: Findings from the National Survey of Women Veterans.Journal of General Internal Medicine. 2013; 28: S571-S576
- Sexual harassment and assault as predictors of PTSD symptomatology among U.S. Female Persian Gulf War military personnel.Journal of Interpersonal Violence. 1998; 13: 40-57
- DSM-IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma.Journal of General Internal Medicine. 2006; 21: S65-S69
Biography
Carolyn J. Gibson, PhD, MPH, is an Advanced Fellow in Women's Health at the San Francisco VA Medical Center. Her research focuses on women's mental health, the menopausal transition, and healthy aging.
Biography
Kristen E. Gray, PhD, is a Post-doctoral Fellow in Health Services Research & Development at the VA Puget Sound Health Care System. Her research focuses on chronic disease and health disparities among women veterans.
Biography
Jodie G. Katon, PhD, is a Health Science Research Specialist at VA Puget Sound Health Care System and Senior Epidemiology Consultant for VA Office of Women's Health Services. Her research focuses on reproductive health of women veterans.
Biography
Tracy L. Simpson, PhD, is a Clinician Investigator, VA Puget Sound Health Care System, and Associate Professor, University of Washington Department of Psychiatry and Behavioral Sciences. Her work focuses on PTSD and substance use comorbidity and randomized clinical trials.
Biography
Keren Lehavot, PhD, is Core Investigator at the Health Services Research & Development, Center of Innovation, VA Puget Sound, and Assistant Professor, University of Washington Department of Psychiatry and Behavioral Sciences. Her research focuses on women veterans' mental health and health disparities.
Article info
Publication history
Published online: November 26, 2015
Accepted:
September 23,
2015
Received in revised form:
September 22,
2015
Received:
June 11,
2015
Identification
Copyright
Published by Elsevier Inc.
