Sexual compulsivity, erectile dysfunction, and suicidality among male survivors of military sexual violence.

Although military sexual trauma (MST) is associated with an increased risk of suicide, suicide attempts, and suicidal ideation among service members and veterans, there is limited knowledge regarding the mechanisms of MST and suicidality among men. The current study examined whether MST was associated with sexual compulsivity and/or erectile dysfunction and if these, in turn, explained elevated suicidal thoughts and the likelihood of engaging in future suicidal behavior after accounting for mental health, military, and demographic characteristics. Service members and veterans who reported their gender as male (N = 508) were recruited via social media and completed online self-report measures assessing MST, erectile dysfunction, sexual compulsivity, suicidal ideation frequency, and the likelihood of engaging in future suicidal behavior. Path analysis was used to examine the study hypotheses. In total, 67 participants (13.2%) reported a history of MST; of these individuals, 27 (40.3%) reported suicidal ideation in the past 12 months, and 29 (43.9%) reported an increased likelihood of engaging in future suicidal behavior. MST was associated with increased sexual compulsivity, which, in turn, predicted more frequent suicidal ideation as well as a higher self-reported likelihood of engaging in future suicidal behavior. MST was associated with higher levels of erectile dysfunction, but erectile dysfunction was not associated with suicidal ideation in the adjusted model. Although the data were cross-sectional, precluding determinations of causality, the results support assessing and intervening with regard to sexual compulsivity to mitigate the risk for suicide-related outcomes among men who experience MST.

[1]  R. Blais,et al.  The association of assault military sexual trauma and sexual function among partnered female service members and veterans: the mediating roles of depression and sexual self-schemas , 2021, European journal of psychotraumatology.

[2]  I. Cifre,et al.  Psychological Distress in Erectile Dysfunction: The Moderating Role of Attachment , 2021, Sexual medicine.

[3]  A. Weinstein,et al.  A study on the relationship between shame, guilt, self-criticism and compulsive sexual behaviour disorder , 2021, Current Psychology.

[4]  Lauren M. Denneson,et al.  A sex-stratified analysis of suicidal ideation correlates among deployed post-9/11 veterans: Results from the survey of experiences of returning veterans. , 2021, Journal of affective disorders.

[5]  J. Fargo,et al.  Gender as a moderator of the association of military sexual trauma and posttraumatic stress symptoms. , 2021, Journal of clinical psychology.

[6]  L. Monteith,et al.  Female Veterans' Willingness to Seek Veterans Health Administration and Non-Veterans Health Administration Services for Suicidal Thoughts and Mental Health Concerns. , 2021, Medical care.

[7]  M. Beymer,et al.  Health Behavior Differences Between Male and Female U.S. Military Personnel by Sexual Orientation: The Importance of Disaggregating Lesbian, Gay, and Bisexual Groups. , 2020, Military medicine.

[8]  D. Carroll,et al.  Addressing Suicide in the Veteran Population: Engaging a Public Health Approach , 2020, Frontiers in Psychiatry.

[9]  P. Batterham,et al.  Physical, mental, and social wellbeing and their association with death by suicide and self‐harm in older adults: a community‐based cohort study , 2020, International journal of geriatric psychiatry.

[10]  R. Blais Screening Positive for Military Sexual Harassment or Assault Is Associated With Higher Compulsive Sexual Behavior in Men Military Service Members/Veterans. , 2020, Military medicine.

[11]  Joshua B. Grubbs,et al.  Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. , 2020, Clinical psychology review.

[12]  A. Gundlapalli,et al.  Comorbid PTSD and Depression Diagnoses Mediate the Association of Military Sexual Trauma and Suicide and Intentional Self-Inflicted Injury in VHA-Enrolled Iraq/Afghanistan Veterans, 2004-2014. , 2020, Journal of affective disorders.

[13]  A. Gundlapalli,et al.  Gender moderates the association of military sexual trauma and risk for psychological distress among VA-enrolled veterans. , 2020, Journal of affective disorders.

[14]  Sheree M. Schrager,et al.  Experiences of Sexual Harassment, Stalking, and Sexual Assault During Military Service Among LGBT and Non-LGBT Service Members. , 2020, Journal of traumatic stress.

[15]  Tuppett M. Yates,et al.  Statistical Approaches for Highly Skewed Data: Evaluating Relations between Maltreatment and Young Adults’ Non-Suicidal Self-injury , 2020, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[16]  C. Meston,et al.  Sexual Shame in the Sexual Excitation and Inhibition Propensities of Men With and Without Nonconsensual Sexual Experiences , 2020, Journal of sex research.

[17]  Georgina M. Gross,et al.  Sex Differences in Military Sexual Trauma and Severe Self-Directed Violence. , 2020, American journal of preventive medicine.

[18]  E. Teng,et al.  Traditional masculinity ideology, posttraumatic stress disorder (PTSD) symptom severity, and treatment in service members and veterans: A systematic review. , 2020 .

[19]  Ateka A. Contractor,et al.  Military Sexual Trauma and Risky Behaviors: A Systematic Review , 2020, Trauma, violence & abuse.

[20]  M. Dretsch,et al.  Assessing the Well-being of Sexual Minority Soldiers at a Military Academic Institution. , 2020, Military medicine.

[21]  R. Blais Lower Sexual Satisfaction and Function Mediate the Association of Assault Military Sexual Trauma and Relationship Satisfaction in Partnered Female Service Members/Veterans. , 2019, Family process.

[22]  T. Bryant-Davis The cultural context of trauma recovery: Considering the posttraumatic stress disorder practice guideline and intersectionality. , 2019, Psychotherapy.

[23]  Simon B. Goldberg,et al.  A positive screen for military sexual trauma is associated with greater risk for substance use disorders in women veterans. , 2019, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[24]  R. Rosen,et al.  The Impact of Assessment Modality and Demographic Characteristics on Endorsement of Military Sexual Trauma. , 2019, Women's health issues.

[25]  L. Monteith,et al.  Identifying factors associated with suicidal ideation and suicide attempts following military sexual trauma. , 2019, Journal of affective disorders.

[26]  L. Monteith,et al.  Suicide Ideation in Female Survivors of Military Sexual Trauma: The Trauma Source Matters. , 2019, Suicide & life-threatening behavior.

[27]  T. Joiner,et al.  Psychometric Properties of Four Commonly Used Suicide Risk Assessment Measures: Applicability to Military Treatment Settings , 2019, Military Behavioral Health.

[28]  L. Monteith,et al.  The Phenomenology of Military Sexual Trauma Among Male Veterans , 2019, Psychology of Men & Masculinities.

[29]  L. Monteith,et al.  Military sexual trauma survivors' perceptions of veterans health administration care: A qualitative examination. , 2020, Psychological services.

[30]  M. Potenza,et al.  A mindful model of sexual health: A review and implications of the model for the treatment of individuals with compulsive sexual behavior disorder , 2018, Journal of behavioral addictions.

[31]  L. Wilson The Prevalence of Military Sexual Trauma: A Meta-Analysis , 2018, Trauma, violence & abuse.

[32]  C. Maynard,et al.  Disability Rating, Age at Death, and Cause of Death in U.S. Veterans with Service-Connected Conditions. , 2018, Military medicine.

[33]  C. Geiser,et al.  Specific PTSD symptom clusters mediate the association of military sexual trauma severity and sexual function and satisfaction in female service members/veterans. , 2018, Journal of affective disorders.

[34]  A. Street,et al.  “Who Are You Going to Tell? Who’s Going to Believe You?” , 2018, Psychology of Women Quarterly.

[35]  C. Castro,et al.  Military Sexual Assault as a Mediator of the Association Between Posttraumatic Stress Disorder and Depression Among Lesbian, Gay, and Bisexual Veterans. , 2018, Journal of traumatic stress.

[36]  Margaret T. Davis,et al.  SUICIDALITY: SEXUAL AND GENDER MINORITY CONSIDERATIONS 1 Relation between Sexual and Gender Minority Status and Suicide Attempts Among Veterans Seeking Treatment for Military Sexual Trauma , 2020 .

[37]  Dan J Stein,et al.  Compulsive sexual behaviour disorder in the ICD‐11 , 2018, World psychiatry : official journal of the World Psychiatric Association.

[38]  Y. Efrati Adolescents with a Disposition toward Compulsive Sexual Behavior: The Role of Shame in Willingness to Seek Help and Treatment , 2018 .

[39]  T. Joiner,et al.  Rumination, Suicidal Ideation, and Suicide Attempts: A Meta-Analytic Review , 2017 .

[40]  J. R. Romaniuk,et al.  Military Sexual Trauma among Men: A Review of the Literature and a Call for Research , 2017 .

[41]  Shane W. Kraus,et al.  Examining Compulsive Sexual Behavior and Psychopathology Among a Sample of Postdeployment U.S. Male and Female Military Veterans , 2017 .

[42]  L. Monteith,et al.  The influence of gender on suicidal ideation following military sexual trauma among Veterans in the Veterans Health Administration , 2016, Psychiatry Research.

[43]  M. McCabe,et al.  Conceptualization of the Sexual Response Models in Men: Are there Differences Between Sexually Functional and Dysfunctional Men? , 2016, The journal of sexual medicine.

[44]  L. Monteith,et al.  A Closer Examination of Sexual Trauma During Deployment: Not all Sexual Traumas are Associated with Suicidal Ideation. , 2016, Suicide & life-threatening behavior.

[45]  M. Etminan,et al.  Persistent Sexual Dysfunction and Suicidal Ideation in Young Men Treated with Low‐Dose Finasteride: A Pharmacovigilance Study , 2015, Pharmacotherapy.

[46]  C. Bryan,et al.  The association of military and premilitary sexual trauma with risk for suicide ideation, plans, and attempts , 2015, Psychiatry Research.

[47]  J. Grant,et al.  Compulsive Sexual Behavior: A Review of the Literature , 2015, Journal of behavioral addictions.

[48]  M. Polusny,et al.  Self-efficacy, male rape myth acceptance, and devaluation of emotions in sexual trauma sequelae: Findings from a sample of male veterans. , 2015, Psychological services.

[49]  T. Fong,et al.  Shame, Rumination, and Self-Compassion in Men Assessed for Hypersexual Disorder , 2014, Journal of psychiatric practice.

[50]  Joseph M. Currier,et al.  Meaning made of stress among veterans transitioning to college: examining unique associations with suicide risk and life-threatening behavior. , 2014, Suicide & life-threatening behavior.

[51]  E. E. Morris,et al.  Unseen Battles , 2014, Trauma, violence & abuse.

[52]  E. D. Klonsky,et al.  Differentiating suicide attempters from suicide ideators: a critical frontier for suicidology research. , 2014, Suicide & life-threatening behavior.

[53]  T. Neylan,et al.  Sexual dysfunction in male Iraq and Afghanistan war veterans: association with posttraumatic stress disorder and other combat-related mental health disorders: a population-based cohort study. , 2014, The journal of sexual medicine.

[54]  Erectile dysfunction among male active component service members, U.S. Armed Forces, 2004-2013. , 2014, MSMR.

[55]  J. Gradus,et al.  Predictors of suicidal ideation in a gender-stratified sample of OEF/OIF veterans. , 2013, Suicide & life-threatening behavior.

[56]  Tim Hoyt,et al.  Military Sexual Trauma in Men Exploring Treatment Principles , 2012 .

[57]  R. Kimerling,et al.  Sexually Transmitted Infections and Sexual Dysfunctions Among Newly Returned Veterans With and Without Military Sexual Trauma , 2012 .

[58]  Frederick J Muench,et al.  Self-Efficacy and Attributions about Change in Persons Attempting to Reduce Compulsive Sexual Behavior with Medication vs. Placebo , 2011 .

[59]  Derek J Burks,et al.  Lesbian, gay, and bisexual victimization in the military: an unintended consequence of "Don't Ask, Don't Tell"? , 2011, The American psychologist.

[60]  C. Bryan,et al.  Reexperiencing symptoms and the interpersonal-psychological theory of suicidal behavior among deployed service members evaluated for traumatic brain injury. , 2011, Journal of clinical psychology.

[61]  M. Beckson,et al.  Male victims of sexual assault: phenomenology, psychology, physiology. , 2011, The journal of the American Academy of Psychiatry and the Law.

[62]  T. Strine,et al.  The PHQ-8 as a measure of current depression in the general population. , 2009, Journal of affective disorders.

[63]  R. Tewksbury Effects of Sexual Assaults on Men: Physical, Mental and Sexual Consequences , 2007 .

[64]  K. Adams,et al.  Clinical Management of Sex Addiction , 2019 .

[65]  A. Osman,et al.  The Suicidal Behaviors Questionnaire-Revised (SBQ-R):Validation with Clinical and Nonclinical Samples , 2001, Assessment.

[66]  J. Cappelleri,et al.  Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction , 1999, International Journal of Impotence Research.

[67]  M. McCabe Intimacy and quality of life among sexually dysfunctional men and women. , 1997, Journal of sex & marital therapy.

[68]  S. Kalichman,et al.  Sexual sensation seeking and Sexual Compulsivity Scales: reliability, validity, and predicting HIV risk behavior. , 1995, Journal of personality assessment.