Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder.

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.

[1]  Coady B Lapierre,et al.  Posttraumatic stress and depression symptoms in soldiers returning from combat operations in Iraq and Afghanistan. , 2007, Journal of traumatic stress.

[2]  C. Hoge,et al.  Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. , 2004, U.S. Army Medical Department journal.

[3]  Donald R. Miller,et al.  Prevalence of Depressive and Alcohol Abuse Symptoms Among Women VA Outpatients Who Report Experiencing Sexual Assault While in the Military , 1999, Journal of traumatic stress.

[4]  Shira Maguen,et al.  Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in veterans affairs health care. , 2010, American journal of public health.

[5]  Han K. Kang,et al.  The role of sexual assault on the risk of PTSD among Gulf War veterans. , 2005, Annals of epidemiology.

[6]  B. Litz,et al.  Current and Lifetime Psychiatric Disorders among Veterans with War Zone‐Related Posttraumatic Stress Disorder , 1996, The Journal of nervous and mental disease.

[7]  K. Taber,et al.  Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001. , 2009, Journal of psychiatric research.

[8]  Vanessa R. Wight,et al.  Women in the military : where they stand , 2000 .

[9]  Lynda A. King,et al.  Course and predictors of posttraumatic stress disorder among Gulf War veterans: a prospective analysis. , 1999, Journal of consulting and clinical psychology.

[10]  Rachel Kimerling,et al.  Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq. , 2010, American journal of public health.

[11]  S. Southwick,et al.  Chronic PTSD in Vietnam combat veterans: course of illness and substance abuse. , 1996, The American journal of psychiatry.

[12]  Christine Eibner,et al.  Invisible Wounds of War. Summary and Recommendations for Addressing Psychological and Cognitive Injuries , 2008 .

[13]  Han K. Kang,et al.  Risk of suicide among US veterans after returning from the Iraq or Afghanistan war zones. , 2008, JAMA.

[14]  R. Kimerling,et al.  The Veterans Health Administration and military sexual trauma. , 2007, American journal of public health.

[15]  Jennifer E. Johnson,et al.  Epidemiology of trauma, post-traumatic stress disorder (PTSD) and co-morbid disorders in Chile , 2006, Psychological Medicine.

[16]  K. Stechuchak,et al.  Validation of a trauma questionnaire in veteran women , 1999, Journal of general internal medicine.

[17]  Charles W Hoge,et al.  Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. , 2006, JAMA.

[18]  Patricia D. Borman,et al.  Sexual Assault in Women Veterans: An Examination of PTSD Risk, Health Care Utilization, and Cost of Care , 2004, Psychosomatic medicine.

[19]  A. Surís,et al.  Military Sexual Trauma , 2008, Trauma, violence & abuse.

[20]  N. Breslau,et al.  Posttraumatic stress disorder and drug disorders: testing causal pathways. , 1998, Archives of general psychiatry.

[21]  Charles R. Marmar,et al.  Trauma and the Vietnam War generation: Report of findings from the National Vietnam Veterans Readjus , 1990 .

[22]  Han K. Kang,et al.  Mental health care needs among recent war veterans. , 2005, The New England journal of medicine.

[23]  Charles Marmar,et al.  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. , 2007, Archives of internal medicine.