Life Span and Repeated Violence against Women during Military Service: Effects on Health Status and Outpatient Utilization

Sadler, Anne G.; Booth, Brenda M.; Mengeling, Michelle A.; Doebbeling, Bradley N.

doi:10.1089/jwh.2004.13.799

Cited by 132 publications

(127 citation statements)

References 36 publications

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“…The HITS screening tool 13 comprises the following four items: "Over the last 12 months, how often did your partner: (1) physically hurt you, (2) insult you or talk down to you, (3) threaten you with harm, and (4) scream or curse at you?" Responses are scored on a 5-point scale from 1 ("never") to 5 ("frequently") and summed for a total score (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Findings support the concurrent validity of this instrument.…”

Section: Methodsmentioning

confidence: 91%

“…2 Although the reasons for elevated risk among female Veterans remain unknown, some theorize that women's exposure to violence-prone environments, such as violent childhood homes and the military, may elevate women's risk for IPV. 6,7 IPV may be particularly common among women seeking care at Veterans Health Affairs (VHA) health-care facilities. 6,8,9 Studies have found lifetime reports of IPV as high as 74 % among women receiving medical or mental health care at a specialty VHA women's health clinic, 6 and reports of past-year IPV among 24 % of women under 50 years old at one large Midwestern facility.…”

mentioning

confidence: 99%

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Clinical Utility of an Intimate Partner Violence Screening Tool for Female VHA Patients

et al. 2013

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OBJECTIVES: Female Veterans are at high risk for physical, sexual, and psychological forms of intimate partner violence (IPV) victimization. This study evaluated the accuracy of a brief IPV victimization screening tool for use with female Veterans Health Administration (VHA) patients. DESIGN: Participants completed a paper-and-pencil mail survey that included the four-item Hurt/Insult/ Threaten/Scream (HITS) and the 39-item Revised Conflict Tactics Scales (CTS-2). Operating characteristics, including sensitivity and specificity, were calculated using the CTS-2 as the reference standard for pastyear IPV. PARTICIPANTS: Female veterans from a roster of randomly selected female patients of the New England VA Healthcare System. Women must have reported being in an intimate relationship in the past year to be included. MAIN MEASURES: Primary measures included the HITS (index test) and the CTS-2 (reference standard). KEY RESULTS: This study included 160 women. The percentage of women who reported past-year IPV, as measured by any physical assault, sexual coercion, and/or severe psychological aggression on the CTS-2, was 28.8 %. The receiver-operator characteristic curve demonstrated that the HITS cutoff score of 6 maximizes the true positives while minimizing the false positives in this sample. The sensitivity of the optimal HITS cutoff score of 6 was 78 % (95 % CI 64 % to 88 %), specificity 80 % (95 % CI 71 % to 87 %), positive likelihood ratio 3.9 (95 % CI 2.61 to 5.76), negative likelihood ratio 0.27 (95 % CI 0.16 to 0.47), positive predictive value 0.61 (95 % CI 0.47, 0.73), and negative predictive value 0.90 (95 % CI 0.82, 0.95). CONCLUSIONS: For a low-burden screen, the HITS demonstrated good accuracy in detecting past-year IPV relative to the CTS-2 in a sample of female VHA patients with an optimal cutpoint of 6. The HITS may help VHA and other health-care providers detect past-year IPV and deliver appropriate care for female Veterans. I ntimate partner violence (IPV) refers to actual or threatened physical, sexual, and psychological abuse by a current or former intimate partner. 1 IPV is a major public health problem that causes and exacerbates physical health problems, including cardiovascular, respiratory, chronic pain, gynecological disorders, and adverse pregnancy outcomes. [2][3][4] Similarly, IPV increases risk for psychiatric conditions such as posttraumatic stress disorder (PTSD), other anxiety disorders, depression, substance misuse, eating disorders, and suicidality. [3][4][5] Relative to civilians, female veterans are at higher risk for physical and sexual forms of IPV (33.0 % vs. 23.8 % lifetime prevalence). 2 Although the reasons for elevated risk among female Veterans remain unknown, some theorize that women's exposure to violence-prone environments, such as violent childhood homes and the military, may elevate women's risk for IPV. 6,7 IPV may be particularly common among women seeking care at Veterans Health Affairs (VHA) health-care facilities. 6,8,9 Studies have found lifetime reports of IPV a...

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Section: Methodsmentioning

confidence: 91%

mentioning

confidence: 99%

Clinical Utility of an Intimate Partner Violence Screening Tool for Female VHA Patients

et al. 2013

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“…9,11 Similar findings have been observed for women veterans who use VHA care. 7,[12][13][14] Research has also shown that female survivors of military sexual assault often experience more distrust and blame directed at medical staff, depression/anxiety, and reduced willingness to seek further help at military/VHA health care settings compared to women who have sought treatment for sexual assault at civilian facilities. 15 However, few studies have addressed how the experience of military sexual assault affects perceptions of specific health care-related dimensions (e.g., perceptions of medical professionals, characteristics of the health care setting) that may influence women veterans' use and satisfaction with VHA care.…”

Section: 2mentioning

confidence: 99%

Effects of Military Trauma Exposure on Women Veterans’ Use and Perceptions of Veterans Health Administration Care

et al. 2008

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“…[14][15][16] ACEs are also associated with risk behaviors (sexual risk behavior, substance use), which may be maladaptive behavioral responses to early childhood trauma resulting in later poor adult health. 17,18 Because multiple traumatic experiences can have particularly deleterious impacts on health, [19][20][21] early-life traumas like ACEs are important to consider among populations with high risks of adulthood trauma. Previous research documents high rates of unique forms of adulthood trauma among women veterans, including combat exposure, military sexual trauma, and intimate partner violence.…”

Section: Introductionmentioning

confidence: 99%

Adverse Childhood Experiences and Adult Health Outcomes Among Veteran and Non-Veteran Women

McCauley

Blosnich

Dichter

2015

Journal of Women's Health

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Background: Women veterans represent a vulnerable population with unique health needs and disparities in access to care. One constellation of exposures related to subsequent poor health includes adverse childhood experiences (ACEs; e.g., physical and sexual child abuse), though research on impacts of ACEs among women veterans is limited. Methods: Data were drawn from the 2010 Behavioral Risk Factor Surveillance System for the 11 states that included the ACE module (n = 36,485). Weighted chi-squared tests and multivariable logistic regression were used to assess the prevalence of ACEs among women veterans compared with women non-veterans and differences in the following outcomes, controlling for ACEs: social support, inadequate sleep, life satisfaction, mental distress, smoking, heavy alcohol use, obesity, diabetes, cardiovascular disease symptoms, asthma, and disability. Results: Women veterans (1.6% of the total sample) reported a higher prevalence of 7 out of 11 childhood adversities and higher mean ACE score than women non-veterans. Women veterans were more likely to be current smokers and report a disability, associations which were attenuated when controlling for ACE. Conclusions: Despite women veterans' higher prevalence of ACE, their health outcomes did not differ substantially from non-veterans. Further research is needed to understand the intersections of traumatic experiences and sources of resilience over the lifecourse among women veterans.

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Life Span and Repeated Violence against Women during Military Service: Effects on Health Status and Outpatient Utilization

Abstract: Repeated violence exposure is a relatively common experience among women in the military, and this has substantial implications for their health.

Cited by 132 publications

References 36 publications

Clinical Utility of an Intimate Partner Violence Screening Tool for Female VHA Patients

Clinical Utility of an Intimate Partner Violence Screening Tool for Female VHA Patients

Effects of Military Trauma Exposure on Women Veterans’ Use and Perceptions of Veterans Health Administration Care

Adverse Childhood Experiences and Adult Health Outcomes Among Veteran and Non-Veteran Women

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