Sexual Trauma and Adverse Health and Occupational Outcomes Among Men Serving in the U.S. Military

Millegan, Jeffrey; Wang, Lawrence; LeardMann, Cynthia A.; Miletich, Derek M.; Street, Amy E.

doi:10.1002/jts.22081

Cited by 43 publications

(39 citation statements)

References 30 publications

(38 reference statements)

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“…We did not find an association between reported history of sexual trauma and persistent PTSD in adjusted models, though there was an association in unadjusted models. Sexual assault has been shown to be one of the most significant types of traumatic events in predicting PTSD and other mental health outcomes [ 50 , 51 ]. In our analysis, the null association with sexual assault may be attributable to the small number of sexual assault cases or high correlation with other statistically significant variables such as physical assault.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with persistent posttraumatic stress disorder among U.S. military service members and veterans

et al. 2018

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BackgroundPosttraumatic stress disorder (PTSD) can have long-term and far-reaching impacts on health and social and occupational functioning. This study examined factors associated with persistent PTSD among U.S. service members and veterans.MethodsUsing baseline and follow-up (2001–2013) questionnaire data collected approximately every 3 years from the Millennium Cohort Study, multivariable logistic regression was conducted to determine factors associated with persistent PTSD. Participants included those who screened positive for PTSD using the PTSD Checklist–Civilian Version at baseline (N = 2409). Participants were classified as having remitted or persistent PTSD based on screening negative or positive, respectively, at follow-up.ResultsAlmost half of participants (N = 1132; 47%) met criteria for persistent PTSD at the first follow-up; of those, 804 (71%) also screened positive for PTSD at the second follow-up. Multiple factors were independently associated with persistent PTSD in an adjusted model at the first follow-up, including older age, deployment with high combat exposure, enlisted rank, initial PTSD severity, depression, history of physical assault, disabling injury/illness, and somatic symptoms. Among those with persistent PTSD at the first follow-up, additional factors of less sleep, separation from the military, and lack of social support were associated with persistent PTSD at the second follow-up.ConclusionsCombat experiences and PTSD severity were the most salient risk factors for persistent PTSD. Comorbid conditions, including injury/illness, somatic symptoms, and sleep problems, also played a significant role and should be addressed during treatment. The high percentage of participants with persistent PTSD supports the need for more comprehensive and accessible treatment, especially after separation from the military.

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Section: Discussionmentioning

confidence: 99%

Factors associated with persistent posttraumatic stress disorder among U.S. military service members and veterans

et al. 2018

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“…Covariates were included based on factors associated with PTSD and MDD identified in prior research [17, 35–38].…”

Section: Methodsmentioning

confidence: 99%

Longitudinal trajectories of comorbid PTSD and depression symptoms among U.S. service members and veterans

et al. 2019

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BackgroundPosttraumatic stress disorder (PTSD) often co-occurs with other psychiatric disorders, particularly major depressive disorder (MDD). The current study examined longitudinal trajectories of PTSD and MDD symptoms among service members and veterans with comorbid PTSD/MDD.MethodsEligible participants (n = 1704) for the Millennium Cohort Study included those who screened positive at baseline for both PTSD (PTSD Checklist–Civilian Version) and MDD (Patient Health Questionnaire). Between 2001 and 2016, participants completed a baseline assessment and up to 4 follow-up assessments approximately every 3 years. Mixture modeling simultaneously determined trajectories of comorbid PTSD and MDD symptoms. Multinomial regression determined factors associated with latent class membership.ResultsFour distinct classes (chronic, relapse, gradual recovery, and rapid recovery) described symptom trajectories of PTSD/MDD. Membership in the chronic class was associated with older age, service branch, deployment with combat, anxiety, physical assault, disabling injury/illness, bodily pain, high levels of somatic symptoms, and less social support.ConclusionsComorbid PTSD/MDD symptoms tend to move in tandem, and, although the largest class remitted symptoms, almost 25% of participants reported chronic comorbid symptoms across all time points. Results highlight the need to assess comorbid conditions in the context of PTSD. Future research should further evaluate the chronicity of comorbid symptoms over time.

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“…Because the items do not ask whether the sexual trauma occurred while in the military we restricted the sample to those who were in the military when they submitted their questionnaire, ensuring that the participant was in the military for the full 3‐year period that was reported on. Consistent with previous Millennium Cohort studies (Millegan et al., ; Millegan, Wang, LeardMann, Miletich, & Street,2016), responses to these items were coded as a 3‐level variable: no report of sexual harassment or sexual assault (referent group), report of sexual harassment only, and report of sexual assault with or without sexual harassment. Sexual trauma was measured at study baseline, but was allowed to vary over the study time when additional follow‐up was available; however, once someone indicated that he or she had experienced a sexual trauma, that exposure carried forward.…”

Section: Methodsmentioning

confidence: 99%

Patterns of Smoking and Unhealthy Alcohol Use Following Sexual Trauma Among U.S. Service Members

Seelig

Rivera

Powell

et al. 2017

Journal of Traumatic Stress

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In the first known longitudinal study of the topic, we examined whether experiencing sexual assault or sexual harassment while in the military was associated with increased risk for subsequent unhealthy alcohol use and smoking among U.S. service members in the Millennium Cohort Study (2001-2012). Adjusted complementary log-log models were fit to estimate the relative risk of (a) smoking relapse among former smokers (men: n = 4,610; women: n = 1,453); (b) initiation of unhealthy alcohol use (problem drinking and/or drinking over recommended limits) among those with no known history of unhealthy alcohol use (men: n = 8,459; women: n = 4,816); and (c) relapse among those previously reporting unhealthy alcohol use (men: n = 3,487; women: n = 1,318). Men who reported experiencing sexual assault while in the military had sixfold higher risk for smoking relapse: relative risk (RR) = 6.62; 95% confidence interval (CI) [2.34, 18.73], than men who did not. Women who reported experiencing sexual assault while in the military had almost twice the risk for alcohol relapse: RR = 1.73; 95% CI [1.06, 2.83]. There were no other significant associations. These findings suggest that men and women may respond differently following sexual trauma, and support future concerted policy efforts by military leadership to prevent, detect, and intervene on sexual assault.

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Sexual Trauma and Adverse Health and Occupational Outcomes Among Men Serving in the U.S. Military

Cited by 43 publications

References 30 publications

Factors associated with persistent posttraumatic stress disorder among U.S. military service members and veterans

Factors associated with persistent posttraumatic stress disorder among U.S. military service members and veterans

Longitudinal trajectories of comorbid PTSD and depression symptoms among U.S. service members and veterans

Patterns of Smoking and Unhealthy Alcohol Use Following Sexual Trauma Among U.S. Service Members

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