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Rønning L, Shor R, Anyan F, Hjemdal O, Jakob Bøe H, Dempsey CL, Espetvedt Nordstrand A. The Prevalence of Sexual Harassment and Bullying Among Norwegian Afghanistan Veterans: Does Workplace Harassment Disproportionately Impact the Mental Health and Life Satisfaction of Female Soldiers? JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241248432. [PMID: 38686604 DOI: 10.1177/08862605241248432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Experiencing sexual harassment and bullying during military service can lead to negative consequences for a soldier's mental health and life satisfaction, including increased risk of depression, anxiety, and posttraumatic stress. No studies have to date investigated the prevalence and correlates of sexual harassment and bullying among Norwegian Afghanistan veterans, despite the increased global focus on these topics. In 2020, 6,205 Norwegian Afghanistan veterans (8.3% women) completed an online post-deployment survey, including questions about experiences of sexual harassment, bullying, mental health, and life satisfaction. Compared to their male counterparts, female veterans experienced significantly more sexual harassment and bullying during Afghanistan deployment (3.2% vs. 0.04% for experiencing sexual harassment, and 4.0% vs. 1.0% for bullying) and during other military services (14.3% vs. 0.4% for sexual harassment, and 15.9% vs. 3.7% for bullying). Sexual harassment was associated with younger age and experiencing childhood sexual harassment for both women and men, with men also having longer deployments. Bullying was associated with longer deployments and childhood sexual harassment for women, while men who reported bullying more often had longer deployments, held an officer rank, were less inclined to have a spouse/intimate partner, and reported childhood sexual harassment and bullying. Both sexual harassment and bullying were associated with increased risk of mental health problems and reduced life satisfaction for women, but this was only true for bullying among men. Despite lower reported rates of workplace harassment compared to studies from other cultures, this study demonstrates that sexual harassment and bullying in the military can negatively impact soldiers' mental health and life satisfaction. Notably, female veterans' mental health and life satisfaction appear to be particularly affected by sexual harassment during military service, an association not seen in males. This underscores the need for gender-specific, cultural, and context-sensitive prevention and support for workplace harassment experiences.
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Affiliation(s)
- Line Rønning
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rachel Shor
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans Jakob Bøe
- Institute of Military Psychiatry, Norwegian Armed Forces Joint Medical Services, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Catherine L Dempsey
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Andreas Espetvedt Nordstrand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Institute of Military Psychiatry, Norwegian Armed Forces Joint Medical Services, Oslo, Norway
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Lai K, Jameson JT, Russell DW. Prevalence and correlates of destructive behaviors in the US Naval Surface Forces from 2010-2020. BMC Psychol 2023; 11:103. [PMID: 37029407 PMCID: PMC10080869 DOI: 10.1186/s40359-023-01134-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/21/2023] [Indexed: 04/09/2023] Open
Abstract
PURPOSE To estimate the prevalence of domestic violence, sexual assault, and suicide for United States Navy (USN) personnel between 2010 and 2020 and identify potential associated factors. METHODS Official report data were used to calculate prevalence rates and odds ratios, accounting for sample and general USN population demographic data to assess differences in over- or underrepresentation of destructive behaviors. RESULTS Domestic violence and sexual assault offenders tended to be younger lower-ranked males. For sexual assaults, offenders were three times more likely to be senior to the victim, which was not the case for domestic violence. Females were overrepresented in terms of suicidal ideation and attempts relative to the USN population, while males accounted for more actual suicides. The relative rates of suicidal ideation and attempts for females exceeded those for males (i.e., comparing the sample rate against the USN male and female populations), but the sample proportion for completed suicides (compared to the USN population) were greater for males than for females. Those in the junior enlisted (E1-E3) paygrades exhibited greater odds of suicide attempts versus suicidal ideations relative to those in the Petty Officers (E4-E6) paygrades, although E4-E6s completed more suicides. CONCLUSION The descriptive profile of destructive behaviors in a representative sample of USN personnel provides an overview of the possible factors associated with destructive behaviors and includes an exploration of the relational dynamics and nature of the incidents. The results suggest that sexual assault and domestic violence are characterized by unique relational dynamics and that these destructive behaviors should not necessarily be classified together as male-oriented aggressions (i.e., mainly perpetrated by males against female victims). Those in the E1-E3 and E4-E6 paygrades displayed different patterns in suicidal ideation, attempts, and actual suicides. The results highlight individual characteristics to help inform the development of targeted policies, practices, and interventions for military and other hierarchical organizations (e.g., police).
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Affiliation(s)
- Kevin Lai
- Leidos, Naval Health Research Center, 329 Ryne Road, San Diego, CA, 92152, USA
| | - Jason T Jameson
- Leidos, Naval Health Research Center, 329 Ryne Road, San Diego, CA, 92152, USA
| | - Dale W Russell
- Commander, Naval Surface Force, U.S. Pacific Fleet, Coronado, CA, USA.
- Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Smith CJ, Dupré KE, Dionisi AM. Sexual misconduct reporting: the silencing effects of hegemonic masculinity. EQUALITY, DIVERSITY AND INCLUSION: AN INTERNATIONAL JOURNAL 2022. [DOI: 10.1108/edi-07-2022-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PurposeDrawing on hegemonic masculinity theory, this study provides evidence supporting how gender, race and sexual identity, may shape the rates of sexual misconduct reporting, by keeping those targets who traditionally enjoy positions of power (i.e. white, cisgender men) silent.Design/methodology/approachAcross 3,230 gender harassment, 890 sexual advance harassment and 570 sexual assault incidents that occurred within a traditionally masculine organization, the authors conducted tests of independence and hierarchical regression analyses to examine whether targets' social identity characteristics (i.e. sex, race, sexuality and gender alignment), predicted the reporting of sexual misconduct.FindingsAlthough reporting rates varied based on the type of incident, white men were less likely than their colleagues to report workplace sexual misconduct. In general, men were approximately half as likely as women to report. Lower rates of reporting were similarly seen among all white (vs BIPOC) targets and all cisgender and heterosexual (vs LGBT) targets, when controlling for other identity characteristics.Originality/valueResearch on sexual misconduct has largely privileged the experiences of (white, heterosexual) women, despite knowledge that men, too, can experience this mistreatment. This research broadens this lens and challenges the notion that sexual misconduct reporting rates are uniform across employee groups. By articulating how the pressures of hegemonic masculinity serve to silence certain targets – including and especially white, cisgender men – the authors provide means of better understanding and addressing workplace sexual misconduct underreporting.
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Gaffey AE, Rosman L, Sico JJ, Haskell SG, Brandt CA, Bathulapalli H, Han L, Dziura J, Skanderson M, Burg MM. Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women. J Hypertens 2022; 40:2307-2315. [PMID: 35983872 DOI: 10.1097/hjh.0000000000003267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Veterans, especially women, are three times more to experience sexual harassment and assault [military sexual trauma (MST)] than civilians. As trauma is associated with elevated cardiovascular risk, we investigated whether MST independently contributes to risk for incident hypertension and whether the effects are distinct among women. METHODS We assessed 788 161 post-9/11 Veterans ( Mage = 32.14 years, 13% women) who were free of hypertension at baseline, using nationwide Veterans Health Administration data collected 2001-2017. Time-varying, multivariate Cox proportional hazard models were used to examine the independent contribution of MST to new cases of hypertension while sequentially adjusting for demographics, lifestyle and cardiovascular risk factors, including baseline blood pressure, and psychiatric disorders including posttraumatic stress disorder. We then tested for effect modification by sex. RESULTS Over 16 years [mean = 10.23 (SD: 3.69)], 35 284 Veterans screened positive for MST (67% were women). In the fully adjusted model, MST was associated with a 15% greater risk of hypertension [95% confidence interval (95% CI) 1.11-1.19]. In sex-specific analyses, men and women with a history of MST showed a 6% (95% CI, 1.00-1.12, P = 0.042) and 20% greater risk of hypertension (95% CI, 1.15-1.26, P < 0.001), respectively. CONCLUSION In this large prospective cohort of young and middle-aged Veterans, MST was associated with incident hypertension after controlling for established risk factors, including trauma-related psychiatric disorders. Although MST is disproportionately experienced by women, and the negative cardiovascular impact of MST is demonstrated for both sexes, the association with hypertension may be greater for women. Subsequent research should determine if early MST assessment and treatment attenuates this risk.
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Affiliation(s)
- Allison E Gaffey
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, Connecticut
| | - Lindsey Rosman
- Division of Cardiology, Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Jason J Sico
- VA Connecticut Healthcare System, West Haven
- Department of Neurology and Center for NeuroEpidemiological and Clinical Neurological Research
| | - Sally G Haskell
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (General Medicine)
| | - Cynthia A Brandt
- VA Connecticut Healthcare System, West Haven
- Department of Emergency Medicine
- Yale Center for Medical Informatics
| | - Harini Bathulapalli
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (General Medicine)
| | - Ling Han
- Department of Internal Medicine, Program on Aging
| | - James Dziura
- VA Connecticut Healthcare System, West Haven
- Department of Emergency Medicine
| | | | - Matthew M Burg
- VA Connecticut Healthcare System, West Haven
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, Connecticut
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
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5
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Galovski TE, Street AE, McCaughey VK, Archibald EA, Wachen JS, Chan AC. WoVeN, the Women Veterans Network: an Innovative Peer Support Program for Women Veterans. J Gen Intern Med 2022; 37:842-847. [PMID: 36042082 PMCID: PMC9427174 DOI: 10.1007/s11606-022-07579-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Tara E Galovski
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA. .,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
| | - Amy E Street
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Virginia K McCaughey
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA.,Psychology Department, Suffolk University, Boston, MA, USA
| | - Emma A Archibald
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA
| | - Jennifer Schuster Wachen
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Aimee C Chan
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA
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Zhang R, Liang Y, Cao W, Zeng L, Tang K. Sex and Urban–Rural Differences in the Relationship between Childhood Sexual Abuse and Mental Health among Chinese College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159225. [PMID: 35954586 PMCID: PMC9368484 DOI: 10.3390/ijerph19159225] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022]
Abstract
This study aimed to reveal sex and urban–rural differences in the association between childhood sexual abuse (CSA) and mental health among Chinese college students. The study used data from the “National College Student Survey on Sexual and Reproductive Health 2019”, a cross-sectional study conducted in all 31 provinces of mainland China. Weighted logistic regression analysis was conducted to determine the association between CSA (noncontact CSA, contact CSA, and penetrative CSA) and mental health (suicide attempts and mental disorders). Among 49,728 students, 39.42% of the male participants and 43.55% of the female participants had ever experienced CSA. According to the OR results of logistic regression analysis, compared to females, males in the contact CSA group (AOR: 3.49, 95% CI: 1.95–6.23) and the penetrative CSA group (AOR: 8.79, 95% CI: 3.15–24.52) had higher odds of suicide attempts. Participants from rural and suburban areas that were categorized in the penetrative CSA group were more likely to report suicide attempts (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban AOR: 4.86, 95% CI: 2.52–9.36) and mental disorders (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban: AOR: 4.86, 95% CI: 2.52–9.36). In conclusion, the findings revealed a high prevalence of CSA in both sexes and reported that males are more vulnerable to the adverse effects of CSA. In addition, we also found that undergraduates growing up in rural and suburban areas are more vulnerable to the adverse psychological effects of CSA. Policymakers should pay more attention to this vulnerable population and implement effective measures to alleviate mental trauma.
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Affiliation(s)
- Rudong Zhang
- Vanke School of Public Health, Tsinghua University, Beijing 100083, China; (R.Z.); (Y.L.)
| | - Yun Liang
- Vanke School of Public Health, Tsinghua University, Beijing 100083, China; (R.Z.); (Y.L.)
| | - Wenzhen Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou 325035, China;
| | - Leixiao Zeng
- School of Journalism and Communication, Renmin University of China, Beijing 100872, China;
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100083, China; (R.Z.); (Y.L.)
- Correspondence:
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7
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Moreau C, Duron S, Bedretdinova D, Bohet A, Panjo H, Bajos N, Meynard JB. Mental health consequences of military sexual trauma: results from a national survey in the French military. BMC Public Health 2022; 22:214. [PMID: 35109815 PMCID: PMC8812201 DOI: 10.1186/s12889-022-12545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Military sexual trauma (MST) is a major public health concern, given its prevalence and mental health sequelae. This phenomenon is particularly prevalent among women in the US military, although more cases involve men given their overrepresentation. Little is known about MST and its consequences in other military settings, including in Europe. METHODS This study draws from a national survey in the French military, including 1268 servicemen and 232 servicewomen. We conducted bivariate and multivariate analysis, using simple and multinomial logistic regressions to evaluate the associations between different forms of MST (repeated sexual comments alone/one form of sexual oppression (coercion, repeated verbal unwanted attention or assault)/ several sexual stressors) and symptoms of depression and of positive post-traumatic stress disorder (PTSD) screening scores. RESULTS Women were both more likely to experience MST and to experience more severe forms of MST than men. Women were also more likely than men to report mental health symptoms (31% versus 18% for symptoms of depression and 4.0% versus 1.8% for positive PTSD screening scores). Different forms of MST were associated with different levels of psychological distress. Women reporting repeated sexual comments alone had higher odds of depressive symptoms (OR=3.1 [1.7, 5.5]) relative to women with no MST. Likewise, the odds of depressive symptoms were 6.5 times higher among women and 8.0 times higher among men who experienced several sexual stressors relative to those who reported no MST. We also found higher relative risk of subthreshold PTSD screening scores among women reporting any form of sexual stressor, including sexual comments alone (RRR = 4.5 [2.8, 7.4]) and an elevenfold increase in the relative risk of positive PTSD screen scores (RRR = 11.3 [2.3, 55.6]) among women who experienced several sexual stressors relative to women with no MST. CONCLUSION MST is associated with mental health distress among service members in the French military, especially for women. The heightened risk of MST coupled with psychological sequelae call for preventive programs to reduce MST and for screening programs to provide adequate psychological support.
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Affiliation(s)
- Caroline Moreau
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France. .,Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
| | - Sandrine Duron
- French Military Center for Epidemiology and Public Health, Marseille, France.,INSERM, UMR S912, « Economic & Social Sciences for Health and Processing of Medical Information » (SESSTIM), F-13385, Marseille, France
| | - Dina Bedretdinova
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France
| | - Aline Bohet
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France
| | - Henri Panjo
- Soins et Santé Primaire, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Villejuif, France
| | - Nathalie Bajos
- IRIS Interdisciplinary Research Institute on Social Issues Social Sciences Politics Health, U997 Inserm - EHESS, F-93322, Aubervilliers, France
| | - Jean Baptiste Meynard
- French Military Center for Epidemiology and Public Health, Marseille, France.,INSERM, UMR S912, « Economic & Social Sciences for Health and Processing of Medical Information » (SESSTIM), F-13385, Marseille, France.,French Military Medical Academy, Ecole du Val-de-Grâce, Paris, France
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8
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Moore BA, Straud CL, Hale WJ, Baker MT, Gardner CL, Judkins JL, Shinn AM, Savell SW, Cigrang JA, Mintz J, Rouska A, McMahon C, Lara-Ruiz JM, Young-Mccaughan S, Peterson AL. Post-9/11 service members: Associations between gender, marital status, and psychiatric aeromedical evacuations from combat zones. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1962192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Brian A. Moore
- Department of Psychological Science, Kennesaw State University, Kennesaw, Georgia, USA
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Casey L. Straud
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
- Department of Psychology, University of Texas, San Antonio, Texas, USA
- Office of Research and Development, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Willie J. Hale
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
- Department of Psychology, University of Texas, San Antonio, Texas, USA
| | - Monty T. Baker
- Wilford Hall Ambulatory Surgical Center, San Antonio, Texas, USA
| | - Cubby L. Gardner
- Wilford Hall Ambulatory Surgical Center, San Antonio, Texas, USA
| | - Jason L. Judkins
- United States Army Institute of Environmental Medicine, Natick, Massachusetts, USA
| | | | | | - Jeffery A. Cigrang
- School of Professional Psychology, Wright State University, Dayton, Ohio, USA
| | - Jim Mintz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
- Office of Research and Development, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Ashton Rouska
- Uniformed Services University of the Health Sciences, Naval Support Activity Bethesda, Bethesda, Maryland, USA
| | - Chelsea McMahon
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
- Department of Psychology, University of Texas, San Antonio, Texas, USA
| | - Jose M. Lara-Ruiz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Stacey Young-Mccaughan
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
- Office of Research and Development, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Alan L. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, Texas, USA
- Department of Psychology, University of Texas, San Antonio, Texas, USA
- Office of Research and Development, South Texas Veterans Health Care System, San Antonio, Texas, USA
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9
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Walter KH, Kohen CB, McCabe CT, Watrous JR, Campbell JS. Overcoming Adversity and Stress Injury Support (OASIS): Evaluation of Residential Treatment Outcomes for U.S. Service Members with Posttraumatic Stress Disorder. J Trauma Stress 2021; 34:551-562. [PMID: 33513298 PMCID: PMC8247997 DOI: 10.1002/jts.22652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/16/2020] [Accepted: 01/03/2021] [Indexed: 11/09/2022]
Abstract
Research on residential posttraumatic stress disorder (PTSD) treatment has predominantly focused on the U.S. veteran population, whereas limited research exists regarding active duty service members. The present study evaluated outcomes among service members who received treatment in the Department of Defense's only residential PTSD program, Overcoming Adversity and Stress Injury Support (OASIS). Over a 5-year period, 289 male service members with combat-related PTSD received treatment in the program. Service members completed an initial assessment and weekly PTSD and depression self-report measures during the 10-week program. Multilevel modeling results demonstrated statistically significant reductions in PTSD. On average, participants reported a 0.76-point reduction on the PTSD Checklist, B = -0.76, p < .001, for each additional week of treatment. Pretreatment symptom scores and fitness-for-duty status predicted PTSD symptoms across time. Weekly changes in depression symptoms were not statistically significant; however, a significant Time × Pretreatment Depression Severity interaction emerged. Service members with higher baseline levels of depression severity showed larger reductions in depression symptom severity than those with lower levels, B = -0.02, p = .020, although a sizeable minority continued to retain symptoms at diagnostic levels. Depression symptom change was not related to any other treatment- or service-related variables. Differing trajectories were found between service members whose symptoms improved over the course of residential treatment and those who did not. The results indicate that there were larger improvements in PTSD than depression symptoms and highlight the need to optimize care provision for service members with severe PTSD or comorbid symptoms.
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Affiliation(s)
- Kristen H. Walter
- Health and Behavioral Sciences DepartmentNaval Health Research CenterSan DiegoCaliforniaUSA
| | - Casey B. Kohen
- Health and Behavioral Sciences DepartmentNaval Health Research CenterSan DiegoCaliforniaUSA
- LeidosRestonVirginiaUSA
| | - Cameron T. McCabe
- LeidosRestonVirginiaUSA
- Medical Modeling, Simulation, & Mission SupportNaval Health Research CenterSan DiegoCaliforniaUSA
| | - Jessica R. Watrous
- LeidosRestonVirginiaUSA
- Medical Modeling, Simulation, & Mission SupportNaval Health Research CenterSan DiegoCaliforniaUSA
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10
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Cortina LM, Areguin MA. Putting People Down and Pushing Them Out: Sexual Harassment in the Workplace. ANNUAL REVIEW OF ORGANIZATIONAL PSYCHOLOGY AND ORGANIZATIONAL BEHAVIOR 2021. [DOI: 10.1146/annurev-orgpsych-012420-055606] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Sexual harassment was once conceptualized solely as a sexual problem: coercive sexual advances that spring from natural feelings of sexual desire or romance. Research has since shown that by far the most common manifestation of sexual harassment is gender harassment, which has contempt at its core; this conduct aims to put people down and push them out, not pull them into sexual activity. With findings such as these, we have made many strides in the scientific study of sexual harassment. That body of scholarship is the focus of this article, which is organized around the following questions: What is sexual harassment, both behaviorally and legally? How common is this conduct in work organizations, and what are its consequences? What features of the social/organizational context raise the risk for sexual harassment? What are some promising (and not-so-promising) solutions to this pervasive problem? And finally, what are important directions for this area of research moving forward?
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Affiliation(s)
- Lilia M. Cortina
- Department of Psychology, Department of Women's and Gender Studies, University of Michigan, Ann Arbor, Michigan 48109, USA;,
| | - Maira A. Areguin
- Department of Psychology, Department of Women's and Gender Studies, University of Michigan, Ann Arbor, Michigan 48109, USA;,
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11
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Zalta AK, Tirone V, Orlowska D, Blais RK, Lofgreen A, Klassen B, Held P, Stevens NR, Adkins E, Dent AL. Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis. Psychol Bull 2021; 147:33-54. [PMID: 33271023 PMCID: PMC8101258 DOI: 10.1037/bul0000316] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Social support is one of the most robust predictors of posttraumatic stress disorder (PTSD). Yet, little is known about factors that moderate the relationship between social support and PTSD symptom severity. This meta-analysis estimated the overall effect size of the relationship between self-reported social support and PTSD severity and tested meaningful demographic, social support, and trauma characteristics that may moderate this association using both cross-sectional and longitudinal effect sizes. A comprehensive search identified 139 studies with 145 independent cross-sectional effect sizes representing 62,803 individuals and 37 studies with 38 independent longitudinal effect sizes representing 25,792 individuals. Study samples had to comprise trauma-exposed, nonclinical adult populations to be included in the analysis. Cross-sectional and longitudinal analyses revealed a near medium overall effect size (rcross = -.27; 95% CI [-.30, -.24]; rlong = -.25; 95% CI [-.28, -.21]) with a high degree of heterogeneity (cross-sectional I2 = 91.6, longitudinal I2 = 86.5). Both cross-sectional and longitudinal moderator analyses revealed that study samples exposed to natural disasters had a weaker effect size than samples exposed to other trauma types (e.g., combat, interpersonal violence), studies measuring negative social reactions had a larger effect size than studies assessing other types of social support, and veteran samples revealed larger effect sizes than civilian samples. Several other methodological and substantive moderators emerged that revealed a complex relationship between social support and PTSD severity. These findings have important clinical implications for the types of social support interventions that could mitigate PTSD severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Vanessa Tirone
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI
| | | | - Ashton Lofgreen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Brian Klassen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Elizabeth Adkins
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Amy L. Dent
- Department of Psychological Science, University of California, Irvine, Irvine, CA
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12
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Blais RK, Tirone V, Orlowska D, Lofgreen A, Klassen B, Held P, Stevens N, Zalta AK. Self-reported PTSD symptoms and social support in U.S. military service members and veterans: a meta-analysis. Eur J Psychotraumatol 2021; 12:1851078. [PMID: 34992740 PMCID: PMC8725779 DOI: 10.1080/20008198.2020.1851078] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The mental health burden of posttraumatic stress disorder (PTSD) is high in U.S. military samples. Social support is one of the most robust protective factors against PTSD and a recent meta-analysis indicates that this relationship is even stronger in military samples compared to civilian samples. Yet no meta-analyses have explored factors impacting this association in veterans and military service members (VSMs). Objective: The current meta-analysis examined demographic, social support, and military characteristics that may moderate the relationship of PTSD severity and social support among U.S. VSMs. Method: A search identified 37 cross-sectional studies, representing 38 unique samples with a total of 18,766 individuals. Results: The overall random effects estimate was -.33 (95% CI: -.38, -.27, Z = -10.19, p <.001), indicating that lower levels of social support were associated with more severe PTSD symptoms. PTSD measures based on the Diagnostic and Statistical Manual (DSM)-III had a larger effect size than measures based on DSM-IV or DSM-5. The social support source was a significant moderator such that support perceived from non-military sources was associated with a larger effect size than support perceived from military sources. This finding held after accounting for covariates. Deployment-era, timing of social support, and age were also significant moderators, but were no longer significantly associated with effect size after adjusting for covariates. Although previous meta-analyses have shown social negativity to be more impactful than positive forms of social support, there were too few studies conducted to evaluate social negativity in moderator analyses. Conclusion: Results suggest that social support received from civilians and in the home environment may play a greater protective role than social support received from military sources on long-term PTSD symptom severity. The literature on social support and PTSD in U.S. VSMs would be strengthened by studies examining the association of social negativity and PTSD symptoms.
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Affiliation(s)
- Rebecca K Blais
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Vanessa Tirone
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI, USA
| | - Ashton Lofgreen
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Brian Klassen
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Philip Held
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Natalie Stevens
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Alyson K Zalta
- Department of Psychological Science, University of California Irvine, Irvine, CA, USA
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13
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Goetter EM, Hoeppner SS, Khan AJ, Charney ME, Wieman S, Venners MR, Avallone KM, Rauch SAM, Simon NM. Combat-Related Posttraumatic Stress Disorder and Comorbid Major Depression in U.S. Veterans: The Role of Deployment Cycle Adversity and Social Support. J Trauma Stress 2020; 33:276-284. [PMID: 32216142 PMCID: PMC7995446 DOI: 10.1002/jts.22496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/23/2019] [Accepted: 10/12/2019] [Indexed: 12/22/2022]
Abstract
Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur in combat veterans, and this comorbidity has been associated with higher levels of distress and more social and economic costs compared to one disorder alone. In a secondary analysis of a multisite randomized controlled trial of a sample of veterans with combat-related PTSD, we examined the associations among pre-, peri-, and postdeployment adversity, social support, and clinician-diagnosed comorbid MDD. Participants completed the Deployment Risk and Resilience Inventory and the Beck Depression Inventory-II as well as structured clinical interviews for diagnostic status. Among 223 U.S. veterans of the military operations in Iraq and Afghanistan (86.9% male) with primary combat-related PTSD, 69.5% had current comorbid MDD. After adjustment for sex, a linear regression model indicated that more concerns about family disruptions during deployment, f2 = 0.065; more harassment during deployment, f2 = 0.020; and lower ratings of postdeployment social support, f2 = 0.154, were associated with more severe self-reported depression symptoms. Interventions that enhance social support as well as societal efforts to foster successful postdeployment reintegration are critical for reducing the mental health burden associated with this highly prevalent comorbidity in veterans with combat-related PTSD.
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Affiliation(s)
- Elizabeth M. Goetter
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Susanne S. Hoeppner
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Amanda J. Khan
- San Francisco VA Medical Center, San Francisco, California, USA,Department of Psychology, Suffolk University, Boston, Massachusetts, USA
| | - Meredith E. Charney
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Sarah Wieman
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychology, Suffolk University, Boston, Massachusetts, USA
| | | | | | - Sheila A. M. Rauch
- VA Atlanta Healthcare System, Atlanta, Georgia, USA,Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Naomi M. Simon
- Department of Psychiatry, New York University School of Medicine, New York, New York, USA,NYU Langone Health, New York, New York, USA
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14
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Tannahill HS, Livingston WS, Fargo JD, Brignone E, Gundlapalli AV, Blais RK. Gender moderates the association of military sexual trauma and risk for psychological distress among VA-enrolled veterans. J Affect Disord 2020; 268:215-220. [PMID: 32217254 DOI: 10.1016/j.jad.2020.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Military sexual trauma (MST) is associated with increased risk for posttraumatic stress disorder (PTSD) and depression diagnoses, as well as suicidal ideation/behavior (SI/B). Little is known about the differential effect of gender on the association of MST and the aforementioned mental health outcomes. As females are the fastest growing subpopulation of the Veterans Health Administration (VHA), it is imperative to assess possible between-gender differences in the association of MST with PTSD, depression, and SI/B. METHODS Participants were 435,690 (n = 382,021, 87.7% men) 9/11 era veterans seen for care at the VHA between 2004 and 2014. Demographics, gender, PTSD and depression diagnoses, SI/B, and MST screen status were extracted from medical records. Adjusted logistic regression models assessed the moderating effect of gender on the association of MST with PTSD and depression diagnoses, as well as SI/B. RESULTS Women with MST had a larger increased risk for a PTSD diagnosis (predicted probability =0.56, 95% confidence interval [CI] [0.56, 0.56]) and comparable risk for a depression diagnosis (predicted probability = 0.63, 95% CI [0.63, 0.64]) compared to men with MST. Men were more likely to have evidence of SI/B (predicted probability = 1.07, 95% CI [0.10, 0.11]) relative to women, but the interaction between gender and MST was nonsignificant. LIMITATIONS Data were limited to veterans seeking care through VHA and the MST screen did not account for MST severity. CONCLUSIONS Non-VHA settings may consider screening for MST in both men and women, given that risk for PTSD and depression is heightened among female survivors of MST.
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Affiliation(s)
- Hallie S Tannahill
- Department of Psychology, Utah State University, 2800 Old Main Hill, Logan, UT 84321, United States; Informatics, Decision Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Dr., Salt Lake City, UT 84148, United States.
| | - Whitney S Livingston
- Department of Psychology, Utah State University, 2800 Old Main Hill, Logan, UT 84321, United States; Informatics, Decision Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Dr., Salt Lake City, UT 84148, United States
| | - Jamison D Fargo
- Department of Psychology, Utah State University, 2800 Old Main Hill, Logan, UT 84321, United States; Informatics, Decision Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Dr., Salt Lake City, UT 84148, United States
| | - Emily Brignone
- Department of Psychology, Utah State University, 2800 Old Main Hill, Logan, UT 84321, United States; Informatics, Decision Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Dr., Salt Lake City, UT 84148, United States
| | - Adi V Gundlapalli
- Informatics, Decision Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Dr., Salt Lake City, UT 84148, United States; Departments of Internal Medicine and Biomedical Informatics, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT 84132, United States
| | - Rebecca K Blais
- Department of Psychology, Utah State University, 2800 Old Main Hill, Logan, UT 84321, United States; Informatics, Decision Enhancement, and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Dr., Salt Lake City, UT 84148, United States
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15
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Reed-Fitzke K, Lucier-Greer M. The Buffering Effect of Relationships on Combat Exposure, Military Performance, and Mental Health of U.S. Military Soldiers: A Vantage Point for CFTs. JOURNAL OF MARITAL AND FAMILY THERAPY 2020; 46:321-336. [PMID: 31436335 DOI: 10.1111/jmft.12402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examined the role of cumulative combat experiences with regard to military performance and conduct and mental health among a sample of young soldiers from the Army STARRS dataset (N = 5,283). Higher levels of cumulative combat experiences were directly related to poorer performance and conduct and a greater likelihood of anxiety, depression, and post-traumatic stress disorder (PTSD). Military performance and conduct served as a linking mechanism between combat experiences and mental health. Using moderated mediation structural equation modeling, relationship disruptions were found to exacerbate the adverse effects of combat experiences; conversely, unit cohesion buffered the impact of combat experiences. Implications for military helping professionals include identifying leverage points for intervention, particularly strengthening the social connections of service members within and outside the military.
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16
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Balwant PT, Jueanville O, Ramdeo S. "I've had enough!" Mental health as a mechanism in the relationship between sexual harassment and organizational commitment. Work 2019; 64:439-451. [PMID: 31683497 DOI: 10.3233/wor-193006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Research on workplace sexual harassment has focused largely on its direct antecedents and consequences. In contrast, few studies unravel mechanisms through which sexual harassment is related to organizational outcomes. OBJECTIVE Following affective events theory, the purpose of this paper is to investigate mental health as a mechanism in the relationship between sexual harassment and organizational commitment. METHODS Quantitative data were collected using a survey design for which 249 employees responded. RESULTS Structural equation modeling showed that the mediation model was partially supported for the overall sample because mental health was a partial and not full mediator. However, post-hoc analysis revealed that the mediation model was suited to men, but not women. CONCLUSIONS This study contributes to sexual harassment research by (a) investigating a novel mechanism in the sexual harassment to organizational commitment relationship and (b) highlighting the importance of gender differences when attempting to unravel the sexual harassment causal chain. Implications for organizations regarding the development of sexual harassment policies, complaint procedures, and training are explained.
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Affiliation(s)
- Paul T Balwant
- Department of Management Studies, The University of the West Indies, St. Augustine, Trinidad
| | - Odell Jueanville
- Department of Management Studies, The University of the West Indies, St. Augustine, Trinidad
| | - Shalini Ramdeo
- Department of Management Studies, The University of the West Indies, St. Augustine, Trinidad
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17
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Welsh JA, Olson JR, Perkins DF. Gender Differences in Post-deployment Adjustment of Air Force Personnel: The Role of Wartime Experiences, Unit Cohesion, and Self-efficacy. Mil Med 2019; 184:e229-e234. [PMID: 30371812 DOI: 10.1093/milmed/usy261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Janet A Welsh
- Bennett Pierce Prevention Research Center, Pennsylvania State University, 320 H Biobehavioral Health Building, University Park, PA
| | - Jonathan R Olson
- Department of Counseling and Health Psychology, Bastyr University, 14500 Juanita Dr. NE, Kenmore, WA
| | - Daniel F Perkins
- Clearinghouse for Military Family Readiness, Pennsylvania State University, 305 Marion Building, University Park, PA
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18
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Portnoy GA, Relyea MR, Decker S, Shamaskin-Garroway A, Driscoll M, Brandt CA, Haskell SG. Understanding Gender Differences in Resilience Among Veterans: Trauma History and Social Ecology. J Trauma Stress 2018; 31:845-855. [PMID: 30431668 DOI: 10.1002/jts.22341] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 11/10/2022]
Abstract
A social-ecological framework for resilience underscores the importance of conceptualizing individuals embedded within their context when evaluating a person's vulnerability and adaptation to stress. Despite a high level of trauma exposure, most veterans exhibit psychological resilience following a traumatic event. Interpersonal trauma is associated with poorer psychological outcomes than noninterpersonal trauma and is experienced more frequently across the lifespan by women as compared to men. In the present study, we examined gender differences in trauma exposure, resilience, and protective factors among veterans. Participants included 665 veterans who completed a baseline survey assessing traumatic events; 544 veterans (81.8%) completed a 1-year follow-up survey assessing resilience, combat exposure, deployment social support, deployment preparedness, and military sexual trauma (MST). Principal component analyses revealed the Traumatic Life Events Questionnaire categorized into four meaningful components: sexual abuse, interpersonal violence, stranger violence, and accidents/unexpected trauma. Women reported greater exposure to sexual abuse, d = 0.76; interpersonal violence, d = 0.31; and MST, Cramer's V = 0.54; men reported greater exposure to stranger violence, accidents/unexpected trauma, and combat exposure, ds = 0.24-0.55. Compared to women, men also reported greater social support during deployment, d = 0.46. Hierarchical linear regression indicated that men's resilience scores were higher than women's, β = .10, p = .032, yet this association was no longer significant once we accounted for trauma type, β = .07, p = .197. Results indicate that trauma type is central to resilience and suggest one must consider the social-ecological context that can promote or inhibit resilient processes.
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Affiliation(s)
- Galina A Portnoy
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, Department of Psychiatry, New Haven, Connecticut, USA
| | - Mark R Relyea
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, Center for Medical Informatics, New Haven, Connecticut, USA
| | - Suzanne Decker
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, Department of Psychiatry, New Haven, Connecticut, USA
| | - Andrea Shamaskin-Garroway
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Mary Driscoll
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, Department of Psychiatry, New Haven, Connecticut, USA
| | - Cynthia A Brandt
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, Emergency Medicine, Center for Medical Informatics, New Haven, Connecticut, USA
| | - Sally G Haskell
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, Department of Internal Medicine, New Haven, Connecticut, USA
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19
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Lehavot K, Goldberg SB, Chen JA, Katon JG, Glass JE, Fortney JC, Simpson TL, Schnurr PP. Do trauma type, stressful life events, and social support explain women veterans' high prevalence of PTSD? Soc Psychiatry Psychiatr Epidemiol 2018; 53:943-953. [PMID: 29936598 PMCID: PMC6521967 DOI: 10.1007/s00127-018-1550-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/14/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To examine factors that account for women veterans' higher prevalence of past-year DSM-5 posttraumatic stress disorder (PTSD) compared to women civilians and men veterans. METHODS Cross-sectional analyses of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Face-to-face interviews with 379 women veterans, 20,007 women civilians, and 2740 men veterans were conducted. Trauma type (child abuse, interpersonal violence, combat or war zone, and other), number of trauma types, past-year stressful life events, current social support, and DSM-5 PTSD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Generalized linear models were used that accounted for the complex survey design. RESULTS Women veterans had a higher unadjusted prevalence of past-year PTSD (11.40%) compared to their civilian (5.96%) and male (5.19%) counterparts. Individual predictor models indicated that the difference between women veterans' and civilians' prevalence of PTSD was attenuated when adjusting for number of trauma types, whereas the difference between men and women veterans was attenuated when adjusting for child abuse, interpersonal violence, and stressful life events. Nonetheless, while full adjustment in a multiple predictor model accounted for the difference in PTSD between women veterans and civilians, gender differences between men and women veterans remained. CONCLUSIONS Number of trauma types, type of trauma, and social factors may together help explain women veterans' higher PTSD prevalence compared to women civilians, but do not fully account for differences between men and women veterans. Results highlight a need to explore additional explanatory factors and evaluate associations with longitudinal data.
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Affiliation(s)
- Keren Lehavot
- Health Services Research and Development (HSR&D) Center of Innovation (COIN), VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA. .,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. .,Department of Health Services, University of Washington, Seattle, Washington, USA.
| | - Simon B. Goldberg
- Health Services Research & Development (HSR&D) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington,Department of Health Services, University of Washington, Seattle, Washington
| | - Jessica A. Chen
- Health Services Research & Development (HSR&D) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington,Department of Health Services, University of Washington, Seattle, Washington
| | - Jodie G. Katon
- Health Services Research & Development (HSR&D) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington,Department of Health Services, University of Washington, Seattle, Washington
| | - Joseph E. Glass
- Kaiser Permanente Washington Health Research Institute; Seattle, Washington
| | - John C. Fortney
- Health Services Research & Development (HSR&D) Center of Innovation (COIN), VA Puget Sound Health Care System, Seattle, Washington,Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington,Department of Health Services, University of Washington, Seattle, Washington
| | - Tracy L. Simpson
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington,Center of Excellence in Substance Abuse and Treatment (CESATE), VA Puget Sound Health Care System, Seattle, Washington
| | - Paula P. Schnurr
- National Center for PTSD, White River Junction, Vermont,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
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20
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Weiss BJ, Azevedo K, Webb K, Gimeno J, Cloitre M. Telemental Health Delivery of Skills Training in Affective and Interpersonal Regulation (STAIR) for Rural Women Veterans Who Have Experienced Military Sexual Trauma. J Trauma Stress 2018; 31:620-625. [PMID: 30070399 DOI: 10.1002/jts.22305] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 01/18/2023]
Abstract
This pilot study assessed the feasibility, acceptability, and initial efficacy of a skills-focused treatment delivered via video teleconferencing (VTC) to women veterans living in rural areas who had experienced military sexual trauma (MST). The Skills Training in Affective and Interpersonal Regulation (STAIR) program focuses on teaching emotion management and interpersonal skills in 8 to 10 sessions. The STAIR program may be a good fit for individuals in rural areas for whom social isolation and low social support are particularly problematic. Clinic-to-clinic VTC was used to connect a STAIR therapist with veterans for weekly individual therapy sessions. The participants (n = 10) reported high satisfaction with the intervention and would recommend the program to others. There were significant pretreatment to posttreatment improvements in social functioning, Hedge's g = 1.41, as well as in posttraumatic stress disorder symptoms, Hedge's g = 2.35; depression, Hedge's g = 1.81; and emotion regulation, Hedge's g = 2.32. This is the first report of the successful application of a skills-focused treatment via VTC for women veterans.
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Affiliation(s)
- Brandon J Weiss
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.,California School of Professional Psychology (CSPP), Alliant International University, San Francisco, California, USA
| | - Kathryn Azevedo
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Katie Webb
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Julia Gimeno
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA.,Department of Psychiatry and Child & Adolescent Psychiatry, New York University Medical Center, New York City, New York, USA
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21
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Bøg M, Filges T, Jørgensen AMK. Deployment of personnel to military operations: impact on mental health and social functioning. CAMPBELL SYSTEMATIC REVIEWS 2018; 14:1-127. [PMID: 37131363 PMCID: PMC8427986 DOI: 10.4073/csr.2018.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This Campbell systematic review examines the effects of deployment on mental health. The review summarizes evidence from 185 studies. All studies used observational data to quantify the effect of deployment. This review includes studies that evaluate the effects of deployment on mental health. A total of 185 studies were identified. However, only 40 of these were assessed to be of sufficient methodological quality to be included in the final analysis. The studies spanned the period from 1993 to 2017 and were mostly carried out in the USA, UK and Australia. The studies all had some important methodological weaknesses. None of the included studies used experimental designs (random assignment). Deployment to military operations negatively affects the mental health functioning of deployed military personnel. For assessments taken more than 24 months since exposure, we consistently found adverse effects of deployment on all mental health domains (PTSD, depression, substance abuse/dependence, and common mental disorders), particularly on PTSD. For assessments taken less than 24 months (or a variable number of months since exposure) the evidence was less consistent and in many instances inconclusive. Plain language summary Deployment to military operations negatively affects the mental health functioning of deployed military personnel: While additional research is needed, the current evidence strongly supports the notion that deployment negatively affects mental health functioning of deployed military personnel.What is this review about?: When military personnel are deployed to military operations abroad they face an increased risk of physical harm, and an increased risk of adverse shocks to their mental health.The primary condition under consideration is deployment to an international military operation. Deployment to a military operation is not a uniform condition; rather, it covers a range of scenarios. Military deployment is defined as performing military service in an operation at a location outside the home country for a limited time period, pursuant to orders.The review included studies that reported outcomes for individuals who had been deployed. This review looked at the effect of deployment on mental health outcomes. The mental health outcomes are: post-traumatic stress disorder (PTSD), major depressive disorder (MDD), common mental disorders (depression, anxiety and somatisation disorders) and substance-related disorders.By identifying the major effects of deployment on mental health and quantifying these effects, the review can inform policy development on deployment and military activity as well as post-deployment support for veterans. In this way the review enables decision-makers to prioritise key areas.What are the main findings of this review?: What studies are included?: This review includes studies that evaluate the effects of deployment on mental health. A total of 185 studies were identified. However, only 40 of these were assessed to be of sufficient methodological quality to be included in the final analysis. The studies spanned the period from 1993 to 2017 and were mostly carried out in the USA, UK and Australia. The studies all had some important methodological weaknesses. None of the included studies used experimental designs (random assignment).Does deployment have an effect on mental health?: Deployment to military operations negatively affects the mental health functioning of deployed military personnel. For assessments taken more than 24 months since exposure, we consistently found adverse effects of deployment on all mental health domains (PTSD, depression, substance abuse/dependence, and common mental disorders), particularly on PTSD. For assessments taken less than 24 months (or a variable number of months since exposure) the evidence was less consistent and in many instances inconclusive.What do the findings of this review mean?: The odds of screening positive for PTSD and depression were consistently high in the longer term. This suggests that efforts should be increased to detect and treat mental disorders, as effects may be long-lasting.Overall the risk of bias in the majority of included studies was high. While it is difficult to imagine a randomised study design to understand how deployment affects mental health, other matters such as changes to personnel policy, or unanticipated shocks to the demand for military personnel, could potentially be a rich source of quasi-experimental variation.How up-to-date is this review?: The review authors searched for studies up to 2017. This Campbell systematic review was published in March 2018. Executive summary BACKGROUND: When military personnel are deployed to military operations abroad they face an increased risk of physical harm, and an increased risk of adverse shocks to their mental health. Research suggests that the increased risk to mental health is mainly due to the hazards of war, combat exposure: firing weapons, road side bombs, seeing fellow soldiers, friends, civilians, and enemies being injured, maimed or killed. These experiences may lead to severe mental stress. The adverse impact on mental health is the psychological cost of war, and it is of interest to policymakers to learn the magnitude of these effects. This review sets out to synthesise available evidence about the consequences of deployment for deployed military personnel in the mental health and social functioning domains.OBJECTIVES: The objective of this review isto synthesise the consequences of deployment to military operation on the mental health and social functioning of deployed military personnel.SEARCH METHODS: We searched electronic databases, grey literature, and references from primary studies and related reviews. No language or date restrictions were applied to the searches. We searched the following electronic databases: Academic Search Elite, Cochrane Library, EMBASE, ERIC, MEDLINE, PsycINFO, Science Citation Index, Social Science Citation Index, SocINDEX, as well as the Nordic platforms: bibliotek.dk, BIBSYS, and LIBRIS. The conclusions of this review are based on the most recent searches performed. The last search was performed in April 2017.SELECTION CRITERIA: Primary studies had to meet the following inclusion criteria: Participants: The participants should be military personnel.Intervention: The condition should be deployment to a military operation.Comparison: The relevant comparisons were either comparing a) deployed military personnel to non-deployed military personnel, b) deployed military personnel to military personnel deployed elsewhere, for example personnel deployed to non-combat operations, c) military personnel deployed to the same operation but stratified by combat exposure.Outcomes: The study should report on one or more mental health outcomes, and/or social functioning for the deployed participants. In particular studies should report on one or more of the following mental health outcomes: PTSD, major depression, substance abuse or dependence (including alcohol), and common mental disorders (depression and anxiety disorders). The following social functioning outcomes were relevant: employment, and homelessness.Study Designs: Both experimental and quasi-experimental designs with a comparison group were eligible for inclusion in the review. Studies were excluded if they: Reported on deployments taking place before 1989.Used a within group pre-post study design.Did not report on at least one of the mental health or social functioning outcomes. DATA COLLECTION AND ANALYSIS: The total number of potentially relevant studies constituted31,049records. A total of 185 studies met the inclusion criteria and were critically appraised by the review authors. The final selection of 185 studies was from 13 different countries.Forty eight of the 185 studies did not report effect estimates or provide data that would allow the calculation of an effect size and standard error. Fifty four studies were excluded because of overlapping samples. The majority of those studies were from USA but the main reason for not using studies from USA in the synthesis was lack of information to calculate an effect size. Nearly half the studies from the UK could not be used in the synthesis due to overlap of data samples. Forty three studies were judged to have a very high risk of bias (5 on the scale) and, in accordance with the protocol, we excluded these from the data synthesis on the basis that they would be more likely to mislead than inform., Thus a total of 40 studies, from five different countries, were included in the data synthesis.Random effects models were used to pool data across the studies. We used the odds ratio. Pooled estimates were weighted with inverse variance methods, and 95% confidence intervals were calculated. The meta-analyses were carried out by time since exposure (short, medium, long, and other time since exposure) and by type of comparison (deployed versus non-deployed, all deployed but stratified by either combat operations versus non-combat operations, or stratified by combat exposure). We performed single factor subgroup analysis. The assessment of any difference between subgroups was based on 95% confidence intervals. Funnel plots were used to assess the possibility of publication bias. Sensitivity analysis was used to evaluate whether the pooled effect sizes were robust across components of methodological quality.MAIN RESULTS: The findings were mixed, depending on the outcome, the time since exposure and the approach (deployed versus non-deployed termed absolute or stratified by extent of combat termed relative) used to investigate the effect. It was not possible to analyse the outcomes homelessness and employment. All studies that could be used in the data synthesis reported on the impact of deployment on mental health; PTSD, depression, substance use or common mental disorder.For assessments taken less than 24 months since exposure the evidence was inconclusive either because too few studies reported results in the short and medium term and/or the degree of heterogeneity between studies was large.For assessments taken at other time points (a variable number of months since exposure) the evidence was inconclusive for the relative comparisons due to either too few studies or a substantial degree of heterogeneity between studies. For the absolute comparison the analysis of common mental disorder was inconclusive, whereas the average effects of PTSD and depression were positive and statistically significant (PTSD odds ratio (OR) was 1.91 (95% confidence interval (CI): 1.28 to 2.85) and OR=1.98 (95% CI: 1.05 to 3.70) for depression). The analysis concerning substance use indicated that deployed participants did not have higher odds of screening positive for substance use compared to non-deployed participants (OR=1.15 (95% CI: 0.98 to 1.36)).For assessments taken more than 24 months post exposure, meta-analyses indicated that the odds of screening positive for PTSD, depression, substance use and common mental disorder were higher for participants in the deployed group compared to participants in the group that were not deployed (PTSD OR=3.31 (95% CI: 2.69 to 4.07), OR=2.19 (95% CI: 1.58 to 3.03) for depression, OR=1.27 (95% CI: 1.15 to 1.39) for substance use, and OR=1.64 (95% CI: 1.38 to 1.96) for common mental disorder). Likewise, participants reporting high combat exposure had higher odds of screening positive for PTSD and depression than participants reporting lower exposure for long term assessments (PTSD OR=3.05 (95% CI: 1.94 to 4.80) and OR=1.81 (95% CI: 1.28 to 2.56) for depression). The analyses of substance use and common mental disorder were inconclusive due to too few studies.On the basis of the prevalence of mental health problems in pre-deployed or non-deployed population based comparison sampleswe would therefore expect the long term prevalence of PTSD in post-deployed samples to be in the range 6.1 - 14.9%, the long term prevalence of depression to be in the range from 7.6% to 18%, the long term prevalence of substance use to be in the range from 2.4% to 17.5% and the prevalence of common mental disorder to be in the range from 10% to 23%.Sensitivity analyses resulted in no appreciable change in effect size, suggesting that the results are robust.It was only possible to assess the impact of two types of personnel characteristics (branch of service and duty/enlistment status) on the mental health outcomes. We found no evidence to suggest that the effect of deployment on any outcomes differ between these two types of personnel characteristics.AUTHORS' CONCLUSIONS: Deployment to military operations negatively affects the mental health functioning of deployed military personnel. We focused on the effect of deployment on PTSD (post-traumatic stress disorder), depression, substance abuse/dependence, and common mental disorders (depression and anxiety disorders). For assessments taken less than 24 months (or a variable number of months since exposure) the evidence was less consistent and in many instances inconclusive. For assessments taken more than 24 months since exposure, we consistently found adverse effects of deployment on all domains, particularly on PTSD. There is increased political awareness of the need to address post deployment mental health problems. The odds of screening positive for PTSD and depression were consistently high in the longer term. This suggests that efforts should be increased to detect and treat mental disorders, as effects may be long lasting. Mental illness is of particular concern in the military for operational reasons, but they may be hard to detect in the military setting because a military career is intimately linked with mental and physical strength.It was not possible to examine a number of factors which we had reason to expect would impact on the magnitude of the effect. This would have been particularly relevant from a policy perspective because these are direct parameters that one could use to optimally "organize" deployment in order to minimize impacts on mental health functioning.While additional research is needed, the current evidence strongly supports the notion that deployment negatively affects mental health functioning of deployed military personnel. The next step is to begin to examine preventive measures and policies for organizing deployment, in order to minimize the effects on mental health.
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Bell ME, Dardis CM, Vento SA, Street AE. Victims of sexual harassment and sexual assault in the military: Understanding risks and promoting recovery. MILITARY PSYCHOLOGY 2018. [DOI: 10.1037/mil0000144] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Margret E. Bell
- National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
| | - Christina M. Dardis
- National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
| | - Stephanie A. Vento
- National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
| | - Amy E. Street
- National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
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Eichler M, Smith-Evans K. Gender in Veteran reintegration and transition: a scoping review. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2018. [DOI: 10.3138/jmvfh.2017-0004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Maya Eichler
- Department of Political and Canadian Studies and Department of Women's Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Kimberley Smith-Evans
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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Lubens P, Bruckner TA. A Review of Military Health Research Using a Social–Ecological Framework. Am J Health Promot 2018; 32:1078-1090. [DOI: 10.1177/0890117117744849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: We aim to contextualize the growing body of research on the sequelae of military service in the wars in Afghanistan and Iraq. We employ a social–ecological (SE) framework for the taxonomy of military health research and classify risk as arising from the individual, family, community, and the institutional levels. We intend for this review to inform enhanced health promotion efforts in military communities. Data Source: Articles reviewed were extracted from Web of Science, PubMed, and Scopus. Inclusion and Exclusion Criteria: Research focused on somatic and psychological sequelae of combat deployment published from 2001—the year the war in Afghanistan began—through the end of 2014. We excluded studies of non-US military personnel, other systematic reviews, meta-analyses, book chapters, and theoretical papers. Data Extraction: We examined and summarized the aims, participants, methods, study design, SE framework tier, risk factors, and health outcomes. Data Synthesis: Studies were categorized according to SE tier, whether they focused on somatic, behavioral, or psychological outcomes, and by risk factor. Results: Of the 352 peer-reviewed papers, 84% focused on war’s sequelae on the index military personnel, and 75% focused on mental or behavioral health outcomes—mostly on post-traumatic stress disorder. We find comparatively little research focusing on the family, community, or institutional tiers. Conclusions: We know relatively little about how family and community respond to the return of personnel from combat deployment; how family resources affect the health of returning military personnel; and how a war’s persistence presents challenges for federal, state, and local agencies to meet military health-care needs. Such work is especially salient as US troops return home from war—particularly in communities where there are substantial military populations.
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Affiliation(s)
- Pauline Lubens
- Program in Public Health, University of California, Irvine, CA, USA
| | - Tim A. Bruckner
- Program in Public Health, University of California, Irvine, CA, USA
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Fillo J, Heavey SC, Homish DL, Homish GG. Deployment-Related Military Sexual Trauma Predicts Heavy Drinking and Alcohol Problems Among Male Reserve and National Guard Soldiers. Alcohol Clin Exp Res 2018; 42:111-119. [PMID: 29171862 PMCID: PMC5750106 DOI: 10.1111/acer.13528] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 10/07/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Military sexual trauma (MST) is associated with a range of deleterious mental and physical health consequences; however, far less attention has been paid to the associations between MST and negative health behaviors, such as substance abuse. This study examined 2 focal research questions: (i) What is the prevalence of experiencing MST during deployment among male Reserve and National Guard soldiers? and (ii) to what extent is the degree of MST exposure during deployment associated with frequent heavy drinking and alcohol problems postdeployment? METHODS Data from male soldiers who had been deployed (N = 248) were drawn from the baseline wave of Operation: SAFETY (Soldiers And Families Excelling Through the Years) an ongoing study examining health among U.S. Army Reserve and National Guard and their partners. Participants were recruited over a 15-month period (Summer 2014 to Fall 2015) from units in New York State. Deployments occurred prior to the baseline wave of the study. Analyses examined the relation between degree of MST exposure during soldiers' most recent deployment and (i) frequent heavy drinking and (ii) alcohol problems, measured at baseline, controlling for posttraumatic stress disorder symptoms and age. RESULTS 17.3% of the male service members reported experiencing MST during their most recent deployment. Further, greater MST exposure was associated with a greater likelihood of engaging in frequent heavy drinking (adjusted risk ratio [aRR] = 1.03, 95% CI [1.01, 1.05]) and experiencing alcohol problems (aRR = 1.03, 95% CI [1.01, 1.06]) at baseline. CONCLUSIONS Findings demonstrate that MST rates are high among male Reserve and National Guard soldiers, and greater MST exposure is associated with an increased likelihood of engaging in frequent heavy drinking and experiencing alcohol problems among a population already at risk for problematic alcohol use.
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Affiliation(s)
| | | | - D. Lynn Homish
- Department of Community Health & Health Behavior, University at Buffalo
| | - Gregory G. Homish
- Department of Community Health & Health Behavior, University at Buffalo
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Combat Exposure and Posttraumatic Stress Disorder Among Portuguese Special Operation Forces Deployed in Afghanistan. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/h0094758] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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A nociceptive stress model of adolescent physical abuse induces contextual fear and cingulate nociceptive neuroplasticities. Brain Struct Funct 2017; 223:429-448. [PMID: 28861709 DOI: 10.1007/s00429-017-1502-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 08/18/2017] [Indexed: 10/19/2022]
Abstract
Adolescent physical abuse impairs emotional development and evokes cingulate pathologies, but its neuronal and circuit substrates are unknown. Conditioning adolescent rabbits with noxious colorectal distension for only 2 h over 3 weeks simulated the human child abuse in amplitude, frequency, and duration. Thermal withdrawal thresholds were unchanged suggesting that sensitized spinal mechanisms may not be operable. Unchanged weight, stools, colorectal histology, and no evidence of abdominal pain argue against tissue injury or irritable bowel syndrome. Contextual fear was amplified as they avoided the site of their abuse. Conditioning impacted anterior cingulate and anterior midcingulate (ACC, aMCC) neuron excitability: (1) more neurons responded to cutaneous and visceral (VNox) noxious stimuli than controls engaging latent nociception (present but not manifest in controls). (2) Rear paw stimulation increased responses over forepaws with shorter onsets and longer durations, while forepaw responses were of higher amplitude. (3) There were more VNox responses with two excitatory phases and longer durations. (4) Some had unique three-phase excitatory responses. (5) Long-duration VNox stimuli did not inhibit neurons as in controls, suggesting the release of an inhibitory circuit. (6) aMCC changes in cutaneous but not visceral nociception confirmed its role in cutaneous nociception. For the first time, we report neuroplasticities that may be evoked by adolescent physical abuse and reflect psychogenic pain: i.e., no ongoing peripheral pain and altered ACC nociception. These limbic responses may be a cognitive trace of abuse and may shed light on impaired human emotional development and sexual function.
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Military nurse deployments: Similarities, differences, and resulting issues. Nurs Outlook 2017; 65:S100-S108. [PMID: 28789770 DOI: 10.1016/j.outlook.2017.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 07/07/2017] [Accepted: 07/11/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Military nurses have a long history of deploying to combat and disaster. Much can be gleaned from their experiences. PURPOSE The purpose of this secondary analysis was to explore military nurses' perceptions of similarities, differences, and resulting issues of military deployments from narratives of three previous studies. METHODS Secondary analysis of interviews from 65 U.S. military nurses (Air Force, Army, Navy) was conducted. Line-by-line readings and Nvivo8 qualitative software were used. DISCUSSION Seven themes emerged. Similarities: We Have Suffered, Support Really Matters, The Chaos Is Real, and I'm a Different Person Now; Differences: We Didn't Know, The Structure Is Missing, and Disasters and War Are Not Equal. CONCLUSION Findings indicated potential areas for improvement in behavioral health, support, and preparedness. Nurses noted they had changed; that they were a different person, and were having difficulty fitting into postdeployment roles. Positive experiences included personal growth and pride.
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Wooten NR, Adams RS, Mohr BA, Jeffery DD, Funk W, Williams TV, Larson MJ. Pre-deployment Year Mental Health Diagnoses and Treatment in Deployed Army Women. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2017; 44:582-594. [PMID: 27368233 PMCID: PMC5203968 DOI: 10.1007/s10488-016-0744-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We estimated the prevalence of select mental health diagnoses (MHDX) and mental health treatment (MHT), and identified characteristics associated with MHT during the pre-deployment year (365 days before deployment) in active duty Army women (N = 14,633) who returned from Iraq or Afghanistan deployments in FY2010. Pre-deployment year prevalence estimates were: 26.2 % for any select MHDX and 18.1 % for any MHT. Army women who had physical injuries since FY2002 or any behavioral health treatment between FY2002 and the pre-deployment year had increased odds of pre-deployment year MHT. During the pre-deployment year, a substantial percentage of Army women had MHDX and at least one MHT encounter or stay. Future research should determine if pre-deployment MHDX among Army women reflect vulnerability to future MHDX, or if pre-deployment MHT results in protection from chronic symptoms.
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Affiliation(s)
- Nikki R Wooten
- College of Social Work, University of South Carolina, Columbia, SC, 29208, USA.
| | - Rachel Sayko Adams
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS035, Waltham, MA, 02454-9110, USA
| | - Beth A Mohr
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS035, Waltham, MA, 02454-9110, USA
| | - Diana D Jeffery
- Clinical Support Division, Healthcare Operations Directorate, Defense Health Agency (DHA), Office of the Assistant Secretary of Defense (Health Affairs), Department of Defense, Falls Church, VA, 22042, USA
| | - Wendy Funk
- Kennell and Associates, Incorporated, Falls Church, VA, 22041, USA
| | - Thomas V Williams
- Defense Health Agency, Department of Defense, Falls Church, VA, 20042, USA
| | - Mary Jo Larson
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS035, Waltham, MA, 02454-9110, USA
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Cobb AR, Lancaster CL, Meyer EC, Lee HJ, Telch MJ. Pre-deployment trait anxiety, anxiety sensitivity and experiential avoidance predict war-zone stress-evoked psychopathology. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2017.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Rebeira M, Grootendorst P, Coyte P. Factors associated with mental health in Canadian Veterans. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2017. [DOI: 10.3138/jmvfh.4098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Mayvis Rebeira
- Canadian Centre for Health Economics, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul Grootendorst
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Peter Coyte
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Jones GL, Hanley T. The psychological health and well-being experiences of female military veterans: a systematic review of the qualitative literature. J ROY ARMY MED CORPS 2017; 163:311-318. [DOI: 10.1136/jramc-2016-000705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/07/2017] [Accepted: 01/26/2017] [Indexed: 11/04/2022]
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Goldstein LA, Dinh J, Donalson R, Hebenstreit CL, Maguen S. Impact of military trauma exposures on posttraumatic stress and depression in female veterans. Psychiatry Res 2017; 249:281-285. [PMID: 28135599 DOI: 10.1016/j.psychres.2017.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/28/2016] [Accepted: 01/03/2017] [Indexed: 11/26/2022]
Abstract
Previous research has demonstrated the deleterious effects of traumatic military experiences on symptoms of posttraumatic stress disorder (PTSD) and depression in female veterans. However, more research is needed to identify the unique predictors of distressing psychological symptoms when both combat-related and sexual trauma are considered, particularly as women's combat exposure in the military increases. Female veterans who had attended at least one appointment at a large Veterans Health Administration medical center were invited to complete questionnaires about traumatic military exposures and psychiatric symptoms. A total of 403 veterans responded, with 383 respondents' data used in analyses. Multiple regression analyses were conducted with trauma exposure items entered simultaneously to determine their association with symptoms of (1) PTSD and (2) depression. Sexual assault had the strongest relationship with both posttraumatic and depressive symptoms. Sexual assault, sexual harassment, feeling in danger of being killed, and seeing others killed/injured were associated with symptoms of PTSD, but only sexual assault and sexual harassment were associated with symptoms of depression, even when accounting for several aspects of combat exposure. Improving assessment for trauma exposure and developing treatments personalized to type of trauma experienced are important clinical research priorities as female service members' roles in the military expand.
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Affiliation(s)
- Lizabeth A Goldstein
- San Francisco VA Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
| | - Julie Dinh
- San Francisco VA Medical Center, San Francisco, CA, USA
| | | | - Claire L Hebenstreit
- San Francisco VA Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Shira Maguen
- San Francisco VA Medical Center, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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MacGregor AJ, Clouser MC, Mayo JA, Galarneau MR. Gender Differences in Posttraumatic Stress Disorder Among U.S. Navy Healthcare Personnel. J Womens Health (Larchmt) 2017; 26:338-344. [PMID: 28410014 DOI: 10.1089/jwh.2014.5130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The role of women in the U.S. military has changed markedly over the course of 20th- and 21st-century conflicts. Although women frequently occupy healthcare positions in the military, little is known about gender differences in posttraumatic stress disorder (PTSD) within this occupational subgroup. MATERIALS AND METHODS A total of 4275 (667 women and 3608 men) U.S. Navy healthcare personnel supporting military operations in Iraq and Afghanistan were identified from electronic deployment records. Data from Post-Deployment Health Assessments were abstracted to identify PTSD screen positives, and to adjust for self-reported combat exposure and other deployment experiences. RESULTS The prevalence of PTSD screen positive in the sample was 8.2% (n = 351/4275). After adjusting for combat exposure, previous psychiatric history, and demographics, women had significantly higher odds of screening positive for PTSD than did men (odds ratio = 1.99, 95% confidence interval 1.34-2.96). Interactions between gender and combat exposure, and between gender and previous psychiatric history were not statistically significant. CONCLUSIONS This is one of the first studies to examine gender differences in PTSD among military healthcare personnel. Future research should account for additional stressors, such as long work hours, disrupted sleep patterns, and number of casualties treated. As women are further integrated into military occupations that may lead to different exposures, knowledge of gender differences in the manifestation of PTSD is paramount for prevention and treatment purposes.
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Affiliation(s)
- Andrew J MacGregor
- Department of Medical Modeling, Simulation and Mission Support, Naval Health Research Center , San Diego, California
| | - Mary C Clouser
- Department of Medical Modeling, Simulation and Mission Support, Naval Health Research Center , San Diego, California
| | - Jonathan A Mayo
- Department of Medical Modeling, Simulation and Mission Support, Naval Health Research Center , San Diego, California
| | - Michael R Galarneau
- Department of Medical Modeling, Simulation and Mission Support, Naval Health Research Center , San Diego, California
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Maung J, Nilsson JE, Berkel LA, Kelly P. Women in the National Guard: Coping and Barriers to Care. JOURNAL OF COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jcad.12118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Joanna Maung
- Department of Counseling and Educational Psychology; University of Missouri-Kansas City
| | - Johanna E. Nilsson
- Department of Counseling and Educational Psychology; University of Missouri-Kansas City
| | - LaVerne A. Berkel
- Department of Counseling and Educational Psychology; University of Missouri-Kansas City
| | - Patricia Kelly
- School of Nursing and Health Studies; University of Missouri-Kansas City
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Sheffler JL, Rushing NC, Stanley IH, Sachs-Ericsson NJ. The long-term impact of combat exposure on health, interpersonal, and economic domains of functioning. Aging Ment Health 2016; 20:1202-1212. [PMID: 26241200 DOI: 10.1080/13607863.2015.1072797] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Wartime combat exposure is linked to a broad array of negative outcomes. The current study identified potential differences between middle-to-older aged men exposed to combat and those not exposed for physical health, interpersonal, and economic functioning over 10 years. Post-traumatic stress disorder (PTSD) and social support were examined as moderators between combat exposure and outcomes. METHODS Data from the National Comorbidity Survey, baseline and 10-year follow-up, were utilized. Only men aged 50-65 at follow-up (N = 727) were included. Group differences between combat and non-combat men were examined. Regression analyses were performed to examine relationships between earlier combat and health, interpersonal, and economic outcomes over time, while controlling for important covariates. RESULTS Combat-exposed men were at increased risk for asthma, arthritis/rheumatism, lung diseases, headaches, and pain; they also had greater marital instability. However, combat-exposed men reported economic advantages, including higher personal earnings at follow-up. For combat-exposed men, PTSD did not increase risk for headaches; however, PTSD in non-combat men was associated with increased risk for headaches at follow-up. Whereas combat-exposed men with higher levels of social support were less likely to report chronic pain at follow-up, there were no group differences in pain at lower levels of social support. IMPLICATIONS Individuals who experience combat may be susceptible to later health and marital problems; however, as combat-exposed men age, they demonstrate some resilience, including in economic domains of life. Given that consequences of combat may manifest years after initial exposure, knowledge of combat exposure is necessary to inform treatments and the delivery of disability benefits.
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Affiliation(s)
- Julia L Sheffler
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Nicole C Rushing
- b Department of Psychology , Coastal Carolina University , Columbia , SC , USA
| | - Ian H Stanley
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
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Clarke HM, Ford DP, Sulsky LM. Moderating effects of harasser status and target gender on the relationship between unwanted sexual attention and overall job satisfaction. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2016. [DOI: 10.1111/jasp.12408] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Heather M. Clarke
- Austin E. Cofrin School of Business, University of Wisconsin - Green Bay
| | - Dianne P. Ford
- Faculty of Business Administration, Memorial University of Newfoundland
| | - Lorne M. Sulsky
- Faculty of Business Administration, Memorial University of Newfoundland
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Brickell TA, Lippa SM, French LM, Kennedy JE, Bailie JM, Lange RT. Female Service Members and Symptom Reporting after Combat and Non-Combat-Related Mild Traumatic Brain Injury. J Neurotrauma 2016; 34:300-312. [PMID: 27368356 DOI: 10.1089/neu.2016.4403] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Females are often excluded from military-related mild traumatic brain injury (mTBI) research because of its relatively low prevalence in this population. The purpose of this study was to focus on outcome from mTBI in female service members, compared with males. Participants were 172 United States military service members selected from a larger sample that had sustained an mTBI, and were evaluated within 24 months of injury (Age: mean = 28.9, SD = 8.1) at one of six military medical centers. Eighty-six women were matched to 86 men on nine key variables: TBI severity, mechanism of injury, bodily injury severity, days post-injury, age, number of deployments, theater where wounded, branch of service, and rank. Participants completed the Neurobehavioral Symptom Inventory (NSI) and the Posttraumatic Stress Disorder Checklist (PCL-C). There were no meaningful gender differences across all demographic and injury-related variables (p > 0.05). There were significant group differences and medium effect sizes for the NSI total score and all four NSI cluster scores. Symptoms most affected related to nausea, sensitivity to light, change in taste/smell, change in appetite, fatigue, and poor sleep. There were significant group differences and small-medium effect sizes for the PCL-C total score and two of the three PCL-C cluster scores. Symptoms most affected related to poor concentration, trouble remembering a stressful event, and disturbing memories/thoughts/images. Females consistently experienced more symptoms than males. As females become more active in combat-related deployments, it is critical that future studies place more emphasis on this important military population.
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Affiliation(s)
- Tracey A Brickell
- 1 Defense and Veterans Brain Injury Center , Silver Spring, Maryland
- 2 Walter Reed National Military Medical Center , Bethesda, Maryland
- 3 National Intrepid Center of Excellence , Bethesda, Maryland
- 4 Uniformed Services University of the Health Sciences , Bethesda, Maryland
| | - Sara M Lippa
- 1 Defense and Veterans Brain Injury Center , Silver Spring, Maryland
- 2 Walter Reed National Military Medical Center , Bethesda, Maryland
- 3 National Intrepid Center of Excellence , Bethesda, Maryland
| | - Louis M French
- 1 Defense and Veterans Brain Injury Center , Silver Spring, Maryland
- 2 Walter Reed National Military Medical Center , Bethesda, Maryland
- 3 National Intrepid Center of Excellence , Bethesda, Maryland
- 4 Uniformed Services University of the Health Sciences , Bethesda, Maryland
- 5 Center for Neuroscience and Regenerative Medicine , Bethesda, Maryland
| | - Jan E Kennedy
- 1 Defense and Veterans Brain Injury Center , Silver Spring, Maryland
- 6 San Antonio Military Medical Center , San Antonio, Texas
| | - Jason M Bailie
- 1 Defense and Veterans Brain Injury Center , Silver Spring, Maryland
- 7 Naval Hospital Camp Pendleton , San Diego, California
| | - Rael T Lange
- 1 Defense and Veterans Brain Injury Center , Silver Spring, Maryland
- 2 Walter Reed National Military Medical Center , Bethesda, Maryland
- 3 National Intrepid Center of Excellence , Bethesda, Maryland
- 8 University of British Columbia , Vaucouver, British Columbia, Canada
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39
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Smith BN, Wang JM, Vaughn-Coaxum RA, Di Leone BAL, Vogt D. The role of postdeployment social factors in linking deployment experiences and current posttraumatic stress disorder symptomatology among male and female veterans. ANXIETY STRESS AND COPING 2016; 30:39-51. [DOI: 10.1080/10615806.2016.1188201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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40
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Studzinska AM, Hilton D. Minimization of Male Suffering: Social Perception of Victims and Perpetrators of Opposite-Sex Sexual Coercion. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2016; 14:87-99. [PMID: 28133492 PMCID: PMC5233731 DOI: 10.1007/s13178-016-0226-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Studies show equal impact of sexual harassment (SH) on men and women, whereas lay perceptions are that women suffer more. We identify the phenomenon of minimization of male suffering (MMS), which occurs when people assume that SH has less effect on men's well-being and which results in the perpetrators of SH on men being evaluated less harshly. To verify whether these effects occur, we conducted two studies in which we presented stories describing acts of sexual coercion (SC, study 1) and SC or financial coercion (FC, study 2) and measured the perceived suffering of victims and the perception of the perpetrators. Both studies showed that female victims were perceived to suffer more from SC and FC and that perpetrators of both acts on women were evaluated more negatively. The results support our hypothesis that the suffering of male victims is minimized as they are perceived to suffer less than women.
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Affiliation(s)
- Anna Magda Studzinska
- Université Toulouse Jean Jaurès, 5, Allées Antonio Machado, F-31058 Toulouse Cedex 9, France
- SWPS University of Social Sciences and Humanities, Campus in Sopot, Polna 16/20, 81-745 Sopot, Poland
| | - Denis Hilton
- Université Toulouse Jean Jaurès, 5, Allées Antonio Machado, F-31058 Toulouse Cedex 9, France
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41
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Wagner CA, Dichter ME, Mavandadi S, Klaus J, Oslin DW. Gender Differences in Social Relationships and Mental Health Among Veterans Affairs Patients. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/21635781.2016.1153531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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42
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Henschel AV, McDevitt-Murphy ME. How Do Aftermath of Battle Experiences Affect Returning OEF/OIF Veterans? ACTA ACUST UNITED AC 2016; 4:345-350. [PMID: 30505629 DOI: 10.1080/21635781.2016.1181583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aftermath of battle experiences (ABE) may contribute to adverse mental and physical health outcomes. This study examined ABE and their effect on health functioning and posttraumatic stress disorder (PTSD) in 66 OEF/OIF/OND Veterans. Bivariate correlations were conducted to investigate the contribution of ABE to PTSD and health functioning, after controlling for combat experiences. Additionally, a mediation analyses was conducted on Role Limitations due to Emotional Problems. Results suggested that the association between ABE and Role Limitations due to Emotional Problems was mediated by PTSD. These initials findings suggest the need for more research on differences in deployment experiences.
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Affiliation(s)
| | - Meghan E McDevitt-Murphy
- Department of Psychology, The University of Memphis, Memphis, Tennessee.,Memphis Veterans' Affairs Medical Center, Memphis, Tennessee
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43
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Piccirillo AL, Packnett ER, Boivin MR, Cowan DN. Epidemiology of psychiatric disability without posttraumatic stress disorder among U.S. Army and Marine Corps personnel evaluated for disability discharge. J Psychiatr Res 2015; 71:56-62. [PMID: 26522872 DOI: 10.1016/j.jpsychires.2015.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/05/2015] [Accepted: 09/10/2015] [Indexed: 10/23/2022]
Abstract
Psychiatric disorders are a common reason for disability discharge from the U.S. military. Research on psychiatric disorders in military personnel evaluated for disability discharge has historically focused on posttraumatic stress disorder (PTSD), yet 40% of service members evaluated for a psychiatric-related disability do not have PTSD. This study's objective was to describe characteristics and correlates of disability in Army and Marine Corps personnel diagnosed with psychiatric disorders other than PTSD. In this cross-sectional study, the chi-square and Wilcoxon-Mann-Whitney tests compared the distribution of demographic, disability and deployment characteristics between those evaluated for non-PTSD psychiatric disability (N = 9125) versus those evaluated for any other non-psychiatric condition (N = 78,072). Multivariate logistic regression examined associations between disability retirement and demographic and disability characteristics. Results show a significantly higher prevalence of disability retirement, deployment, and comorbidity among Army and Marine Corps personnel evaluated for disability discharge related to a non-PTSD psychiatric disorder. Mood disorders, anxiety disorders and dementia were the most commonly evaluated psychiatric disorders. Characteristics associated with increased odds of non-PTSD psychiatric-related disability retirement includes being in the Marine Corps (OR = 1.24), being black (OR = 1.29) or other race (OR = 1.33), having a combat-related condition (OR = 2.50), and older age. Service members evaluated for a non-PTSD psychiatric disability have similar rates of disability retirement as those evaluated for PTSD, suggesting non-PTSD psychiatric disorders cause a severe and highly compensated disability. Additional research is needed describing the epidemiology of specific non-PTSD psychiatric disorders, such as depression, in service members evaluated for disability discharge.
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Affiliation(s)
- Amanda L Piccirillo
- Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA.
| | - Elizabeth R Packnett
- Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA
| | - Michael R Boivin
- Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - David N Cowan
- Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, Health and Life Sciences, 13755 Sunrise Valley Drive, Herndon, VA 20171, USA
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44
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Kachadourian LK, Smith BN, Taft CT, Vogt D. The Impact of Infidelity on Combat-Exposed Service Members. J Trauma Stress 2015; 28:418-25. [PMID: 26397362 DOI: 10.1002/jts.22033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study examined relationships between combat-exposed Operation Enduring Freedom/Operation Iraqi Freedom veterans' experiences related to infidelity during deployment (i.e., indicating that a partner was unfaithful or reporting concern about potential infidelity) and postdeployment mental health, as well as the role of subsequent stress exposure and social support in these associations. The sample consisted of 571 individuals (338 men). There were 128 participants (22.2%) who indicated that their partners were unfaithful during their most recent deployment. Of the remaining 443 participants, 168 (37.8%) indicated that they were concerned that their partners might have been unfaithful. Individuals who indicated that their partners were unfaithful exhibited higher levels of posttraumatic stress symptomatology (β = .08; f(2) = .18) and depression symptom severity (β = .09; f(2) = .14), compared to individuals who did not indicate that their partners were unfaithful. For both men and women, reported infidelity was associated with mental health indirectly via postdeployment life stressors, whereas infidelity concerns were indirectly associated with mental health via postdeployment life stressors for men only. Findings suggested that infidelity can have a significant impact on combat-exposed veterans' mental health and highlight the need for additional research on this understudied topic within the military population.
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Affiliation(s)
- Lorig K Kachadourian
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut, USA
| | - Brian N Smith
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts, USA
| | - Casey T Taft
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts, USA
| | - Dawne Vogt
- National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts, USA
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45
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Posttraumatic Stress Disorder Symptom Severity and Socioeconomic Factors Associated with Veterans Health Administration Use among Women Veterans. Womens Health Issues 2015; 25:535-41. [DOI: 10.1016/j.whi.2015.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 04/23/2015] [Accepted: 05/11/2015] [Indexed: 11/19/2022]
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46
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McCallum EB, Murdoch M, Erbes CR, Arbisi P, Polusny MA. Impact of Deployment-Related Sexual Stressors on Psychiatric Symptoms After Accounting for Predeployment Stressors: Findings From a U.S. National Guard Cohort. J Trauma Stress 2015; 28:307-13. [PMID: 26184776 DOI: 10.1002/jts.22019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study used a longitudinal research design to examine the impact of predeployment stressors and deployment-related sexual stressors on self-reported psychiatric symptoms of U.S. National Guard soldiers returning from deployments to Iraq or Afghanistan. Prior to deployment, participants completed measures of depression and posttraumatic stress symptoms, along with an inventory of predeployment stressor experiences. At 3-months postdeployment, participants (468 men, 60 women) again completed self-report measures of psychiatric symptoms, along with an inventory of sexual stressors experienced during deployment. We compared a cross-sectional model of sexual stressors' impact on psychiatric symptoms, in which only postdeployment reports were considered, to a longitudinal model in which we adjusted for participants' predeployment stressors and psychiatric symptoms. No participants reported sexual assault during deployment, though sexual harassment was common. The cross-sectional model suggested that deployment-related sexual stressors were significantly associated with postdeployment depression (R(2) = .11) and posttraumatic stress symptoms (R(2) = .10). Once predeployment factors were taken into consideration, however, sexual stressors were no longer significant. The results did not support the notion of lasting negative impact for low-level sexual stressors (e.g., sexual harassment) during deployment after predeployment stressors are accounted for. Future studies of sexual stressors should consider longitudinal designs.
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Affiliation(s)
- Ethan B McCallum
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Maureen Murdoch
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.,Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Christopher R Erbes
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.,Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Paul Arbisi
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Melissa A Polusny
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.,Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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47
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Davy CP, Lorimer M, McFarlane A, Hodson S, Crompvoets S, Lawrence-Wood E, Neuhaus SJ. The Well-Being of Australian Service Mothers. Women Health 2015; 55:737-53. [PMID: 25996528 DOI: 10.1080/03630242.2015.1050541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In recent years servicewomen with dependent children have for the first time in history been deployed into conflict zones in support of Australian Defence Force operations. This represents a significant social change, and the implications of deployment on the health of these service mothers are not fully understood. Data from women who participated in the Middle East Area of Operations Census study were analyzed to compare the psychological and physical symptoms reported by service mothers with service women who had no dependent children at the time of deploying to Afghanistan and/or Iraq. Of the 921 women who were included in this analysis, 235 had dependent children and 686 had no dependent children (comparison group). Service mothers were significantly older and were more likely to have served in the Air Force than women in the comparison group. Findings demonstrate that serving mothers were not at any significantly higher risk of psychological distress, post-traumatic stress symptoms, alcohol misuse, or reporting of somatic symptoms, than women who had no dependent children. A number of possible explanations for these findings are discussed, including the healthy soldier/mother effect, support from partners and extended family members, and collegial networks.
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Affiliation(s)
- Carol P Davy
- a South Australian Health and Medical Research Institute , Adelaide , South Australia , Australia.,b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
| | - Michelle Lorimer
- c Data Management and Analysis Centre , University of Adelaide, Adelaide, South Australia, Australia
| | - Alexander McFarlane
- b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
| | - Stephanie Hodson
- d Department of Veterans' Affairs, Canberra, Australian Capital Territory , Australia
| | - Samantha Crompvoets
- e College of Medicine, Biology and Environment , Australian National University, Canberra, Australia Capital Territory , Australia
| | - Ellie Lawrence-Wood
- b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
| | - Susan J Neuhaus
- b Centre for Traumatic Stress Studies , University of Adelaide , Adelaide , South Australia, Australia
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48
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Murdoch M, Polusny MA, Street A, Noorbaloochi S, Simon AB, Bangerter A, Grill J, Voller E. Sexual assault during the time of Gulf War I: a cross-sectional survey of U.S. service men who later applied for Department of Veterans Affairs PTSD disability benefits. Mil Med 2015; 179:285-93. [PMID: 24594463 DOI: 10.7205/milmed-d-12-00513] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To estimate the cumulative incidence of sexual assault during the time of Gulf War I among male Gulf War I Veterans who later applied for Department of Veterans Affairs (VA) post-traumatic stress disorder disability benefits and to identify potential risk and protective factors for sexual assault within the population. METHOD Mailed, national, cross-sectional survey supplemented with VA administrative and clinical data. RESULTS Of 2,415 Veterans sampled, 1,700 (70%) responded. After adjusting for nonignorable missing data, the cumulative incidence of sexual assault during Gulf War I in this population ranged from 18% [95% confidence intervals (CI): 5.0%-51.9%] to 21% (95% CI: 20.0-22.0). Deployment was not associated with sexual assault [Odds Ratio (OR), 0.96; 95% CI: 0.75-1.23], but combat exposure was (OR, 1.80; 95% CI: 1.52-2.10). Other correlates of sexual assault within the population included working in a unit with greater tolerance of sexual harassment (OR, 1.80; 95% CI: 1.52-2.10) and being exposed to more sexual identity challenges (OR, 1.76; 95% CI: 1.55-2.00). CONCLUSIONS The 9-month cumulative incidence of sexual assault in this particular population exceeded the lifetime cumulative incidence of sexual assault in U.S. civilian women. Although Persian Gulf deployment was not associated with sexual assault in this population, combat exposure was.
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Affiliation(s)
- Maureen Murdoch
- Center for Chronic Disease Outcomes Research, VA Health Services Research and Development (HSR&D) Service Center of Excellence, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Melissa A Polusny
- Center for Chronic Disease Outcomes Research, VA Health Services Research and Development (HSR&D) Service Center of Excellence, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Amy Street
- National Center for PTSD, VA Boston Healthcare System, 150 Huntington Avenue, Boston, MA 02130
| | - Siamak Noorbaloochi
- Center for Chronic Disease Outcomes Research, VA Health Services Research and Development (HSR&D) Service Center of Excellence, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Alisha B Simon
- Center for Chronic Disease Outcomes Research, VA Health Services Research and Development (HSR&D) Service Center of Excellence, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Ann Bangerter
- Center for Chronic Disease Outcomes Research, VA Health Services Research and Development (HSR&D) Service Center of Excellence, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Joseph Grill
- Center for Chronic Disease Outcomes Research, VA Health Services Research and Development (HSR&D) Service Center of Excellence, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Emily Voller
- Departments of Psychiatry and Psychology, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
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Associations between race-based and sex-based discrimination, health, and functioning: a longitudinal study of Marines. Med Care 2015; 53:S128-35. [PMID: 25767966 DOI: 10.1097/mlr.0000000000000300] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Only a few studies have examined race-based discrimination (RBD) and sex-based discrimination (SBD) in military samples and all are cross-sectional. OBJECTIVES The current study examined associations between both RBD and SBD experienced during Marine recruit training and several health and functioning outcomes 11 years later in a racially/ethnically diverse sample of men and women. RESEARCH DESIGN Linear multiple regression models were used to examine associations between sex, race/ethnicity, RBD and SBD, and later outcomes (physical health, self-esteem, and occupational/vocational functioning), accounting for baseline levels and covariates. SUBJECTS Data were drawn from a larger longitudinal investigation of US Marine Corps recruits. The sample (N=471) was comprised of white men (34.6%), white women (37.6%), racial/ethnic minority men (12.7%), and racial/ethnic minority women (15.1%). MEASURES Self-report measures of sex and race (T1), RBD and SBD (T2), social support (T2), mental health (T2), physical health (T2 and T5), self-esteem (T2 and T5), and occupational/vocational functioning (T5) were included. RESULTS Over a decade later, experiences of RBD were negatively associated with physical health and self-esteem. Social support was the strongest predictor of occupational/vocational functioning. Effects of sex, SBD, and minority status were not significant in regressions after accounting for other variables. CONCLUSIONS Health care providers can play a key role in tailoring care to the needs of these important subpopulations of veterans by assessing and acknowledging experiences of discrimination and remaining aware of the potential negative associations between discrimination and health and functioning above and beyond the contributions of sex and race/ethnicity.
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50
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Burkhart L, Hogan N. Being a Female Veteran: A Grounded Theory of Coping With Transitions. SOCIAL WORK IN MENTAL HEALTH 2015; 13:108-127. [PMID: 25745366 PMCID: PMC4337746 DOI: 10.1080/15332985.2013.870102] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Female veterans, the fastest growing segment in the military, have unique pre-military histories and military experiences that are associated with post-military physical and mental health service needs. Successful treatment is contingent on a clearer understanding of the processes underlying these experiences. Data from 20 female veterans who served post-Gulf War were analyzed to generate a substantive theory of the process of women who entered, served in, and transitioned out of the military. Coping with transitions emerged as the basic psychosocial process used by female veterans. The Coping with transitions process is comprised of seven categories: Choosing the Military, Adapting to the Military, Being in the Military, Being a Female in the Military, Departing the Military, Experiencing Stressors of Being a Civilian, and Making Meaning of Being a Veteran-Civilian. The results of this study provide a theoretical description of the process female veterans experience when transitioning from a civilian identity, through military life stressors and adaptations, toward gaining a dual identity of being a veteran-civilian.
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Affiliation(s)
- Lisa Burkhart
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, Illinois, USA
- Research Health Scientist, Center of Innovation for Complex Chronic Healthcare (CINNCH) at Hines VA Hospital, Hines, Illinois, USA
| | - Nancy Hogan
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, Illinois, USA
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