Unwanted sexual experiences and retraumatization: Predictors of mental health concerns in veterans.

Abstract

Objective: Repeated exposure to traumatic events has consistently been shown to negatively impact mental health functioning; however, the role of timing of such events has received less attention. The present study evaluated the role of trauma that has occurred prior to military service, during service, and across both points in contributing to the most common and deleterious mental health concerns experienced by military personnel: posttraumatic stress, depression, suicide ideation, and suicide attempts. Method: Utah and Idaho National Guard personnel (n = 997) completed online self-report questionnaires of their current posttraumatic stress and depression symptoms, as well as history of potentially traumatic experiences, suicidal thoughts, and actions. Results: Results indicated that history of trauma across time points is associated with negative outcomes across each of these outcomes, with the exception of suicide attempts. Exploratory analyses further revealed that unwanted or uncomfortable sexual experiences (not sexual assault) is the most robust predictor of negative outcomes, with approximately 2 to 7.5 times increased risk for PTSD, depression, suicide ideation, and suicide attempts. Conclusions: The present findings suggest that individuals with history of trauma prior to military service are at increased risk for developing clinically significant mental health problems if exposed to additional potentially traumatic experiences. Further, other unwanted sexual experiences appear to be particularly detrimental to mental health functioning. Potential implications for military recruitment and conceptualization of traumatic events are discussed.

Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization

“…In this context, it makes sense that the subgroup that suffered sexual abuse (as opposed to injury or death of a loved one) would experience the greatest coping difficulties, because sexual abuse consequences are often hidden and processed alone; it is possible these individuals had never learned to share their early feelings of grief and pain with others, and so did not see this as a potential coping response in the face of collective trauma. Interestingly, another paper examining retraumatization in veterans also found that sexual assault was the most robust predictor of increased risk for depression, PTSD, and suicidality (7). This is an issue worthy of continued investigation.…”

“…Given these neural changes, retraumatization-a condition in which an individual with pre-existing trauma is triggered by a new stressor, presumably responding more quickly or intensely-is a potential outcome. Indeed, a number of studies appear to confirm that an earlier trauma carries repercussions for how one reacts to later trauma (7,8), potentially suggesting changes in stress reactivity (5). What has been less recognized is the propensity for these kinds of underlying issues to inform how one responds in a mass trauma situation, in which it is unclear exactly which individuals are at increased risk for retraumatization.…”

Predicting response to cognitive processing therapy: Does trauma history matter?

“…Although more recent investigations have recruited samples with various trauma types, there is currently less evidence to demonstrate the efficacy of CPT in populations with noninterpersonal violence traumas. Indeed, some preliminary evidence suggests that patients with combat-related trauma do not respond as well to CPT as those with other trauma types (e.g., Bradley, Greene, Russ, Dutra, & Westen, 2005; Schumm et al, 2013), and symptom presentation has been shown to vary by traumatic event type (Amir, Kaplan, & Kotler, 1996; Cougle, Feldner, Keough, Hawkins, & Fitch, 2010; Kelly, Weathers, McDevitt-Murphy, Eakin, & Flood, 2009; McFarlane et al, 2009; Rasmussen, Smith, & Keller, 2007; Read et al, 2012; Roberge et al, 2019; Smith, Summers, Dillon, & Cougle, 2016).…”

“…Another relevant risk factor for developing PTSD is history of trauma exposure, more broadly. Individuals reporting history of more traumatic experiences in their lifetimes appear to be at higher risk for developing PTSD (Donovan, Padin-Rivera, Dowd, & Blake, 1996; Schnurr, Friedman, & Rosenberg, 1993; Scott, 2007) and history of multiple traumatic experiences is more common than not (Roberge et al, 2019; Scott, 2007). Additionally, repeated traumatic event exposure is predictive of PTSD severity and comorbid disorders (Cloitre et al, 2009; Schumm, Briggs-Phillips, & Hobfoll, 2006).…”

“…Posttraumatic stress disorder (PTSD) is a mental illness that may result after experiencing a traumatic event (Criterion A) that involved actual or threatened death, serious injury, or sexual violence (American Psychological Association [APA], 2013). Although approximately 70 -77% of adults report history of exposure to a traumatic event (Benjet et al, 2016;Roberge et al, 2019), only about 9% of people will meet criteria for PTSD at some point in their lifetimes (APA, 2013). However, service members are significantly more likely to experience PTSD than civilians, with an estimated lifetime prevalence of 13.8% (Gradus, 2017).…”