United States of America

Alternative Representations of War Zone Stressors: Relationships to Posttraumatic Stress Disorder in Male and Female Vietnam Veterans

Citation:

King, Daniel W., Lynda A. King, David M. Gudanowski, and Dawn L. Vreven. 1995. "Alternative Representations of War Zone Stressors: Relationships to Posttraumatic Stress Disorder in Male and Female Vietnam Veterans." Journal of Abnormal Psychology 104 (1): 184-96.

Authors: Daniel W. King, Lynda A. King, David M. Gudanowski, Dawn L. Vreven

Abstract:

Four conceptualizations of war zone stressor experiences were defined: traditional combat, atrocities-abusive violence, perceived threat, and malevolent environment. Items from the National Vietnam Veterans Readjustment Study (NVVRS) were reviewed for content, and stressor indexes were created. Using retrospective self-report data from the NVVRS, intercorrelations among stressor scores and between these scores and measures of posttraumatic stress disorder (PTSD) were computed for all veterans and for men and women separately. Structural equation modeling procedures followed. Results indicated that the four stressor indexes were internally consistent, reasonably distinct from one another, and influenced PTSD differentially. Men scored significantly higher than women on all 4 indexes. Whereas the pattern of relationships among the variables was comparable across genders, there was evidence that one path coefficient in the model differed for men and women.

Keywords: fe

Topics: Gender, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 1995

Fathers, Sons, and Vietnam: Masculinity and Betrayal in the Life Narratives of Vietnam Veterans with Post Traumatic Stress Disorder

Citation:

Karner, Tracy. 1996. "Fathers, Sons, and Vietnam: Masculinity and Betrayal in the Life Narratives of Vietnam Veterans with Post Traumatic Stress Disorder." American Studies 37 (1): 63-94.

Author: Tracy Karner

Keywords: masculinity, posttraumatic stress disorder, mental health

Topics: Armed Conflict, Gender, Masculinity/ies, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 1996

The Role of Sexual Assault on the Risk of PTSD among Gulf War Veterans

Citation:

Kang, Han, Nancy Dalager, Clare Mahan, and Erick Ishii. 2005. "The Role of Sexual Assault on the Risk of PTSD among Gulf War Veterans." Annals of Epidemiology 15 (3): 191-95.

Authors: Han Kang, Nancy Dalager, Clare Mahan, Erick Ishii

Abstract:

Purpose: The 1991 Gulf War was the first major military deployment where female troops were integrated into almost every military unit, except for combat ground units. We evaluated the impact of reported sexual trauma during this deployment on the risk of post-traumatic stress disorder (PTSD) after the war.

Methods: A nested case–control analysis was conducted using the data collected in a population-based health survey of 30,000 Gulf War era veterans. A total of 1381 Gulf War veterans with current PTSD were compared with 10,060 Gulf veteran controls without PTSD for self-reported in-theater experiences of sexual harassment/assault and combat exposure.

Results: The adjusted odds ratio (aOR) for PTSD associated with a report of sexual assault was 5.41 (95% confidence interval [CI], 3.19–9.17) in female veterans and 6.21 (95% CI, 2.26–17.04) in male veterans. The aOR for PTSD associated with “high” combat exposure was also statistically significant (aOR, 4.03 [95% CI, 1.97–8.23] for females; aOR, 4.45 [95% CI, 3.54–5.60] for males).

Conclusion: Notwithstanding a possibility of recall bias of combat and sexual trauma, for both men and women, sexual trauma as well as combat exposure appear to be strong risk factors for PTSD.

Keywords: military sexual assault, posttraumatic stress disorder, male veterans, female veterans, mental health

Topics: Combatants, Female Combatants, Male Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Sexual Violence Regions: Americas, North America Countries: United States of America

Year: 2005

The Mental Health Status of Women in the Navy and Marine Corps: Preliminary Findings from the Perceptions of Wellness and Readiness Assessment

Citation:

Hourani, Laurel L., and Huixing Yuan. 1999. "The Mental Health Status of Women in the Navy and Marine Corps: Preliminary Findings from the Perceptions of Wellness and Readiness Assessment." Military Medicine 164 (3): 174- 81.

Authors: Laurel L. Hourani, Huixing Yuan

Abstract:

Examined the most common adult psychiatric disorders of Navy and Marine Corps personnel and compared their military subpopulations. A population-based, multi-stage, cluster sample of 782 active duty Navy and Marine Corps females and males (aged 18–64 yrs) were administered a structured computerized telephone interview to make Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) psychiatric diagnoses. Results indicate that females had about 5 times the risk of experiencing posttraumatic stress disorder (PTSD) than males and about twice the risk of a major depressive episode. Of all personnel meeting diagnostic criteria for an active mental disorder, only 19% sought mental health care in the last year. Females generally sought treatment more readily than males. (Abstract from PsycINFO)

Keywords: mental health, female soldiers, posttraumatic stress disorder, depression

Topics: Gender, Women, Men, Health, Mental Health, PTSD, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 1999

The Use of VA and Non-VA Mental Health Services by Female Veterans

Citation:

Hoff, Rani A., and Robert A. Rosenheck. 1998. "The Use of VA and Non-VA Mental Health Services by Female Veterans." Medical Care 36 (11): 1524-33.

Authors: Rani A. Hoff, Robert A. Rosenheck

Abstract:

Objectives. This study compared Department of Veterans Affairs (VA) and non-VA mental health service use among male and female veterans. Because female veterans are a distinct minority in VA, it was hypothesized that they would be less likely to use VA mental health care than would male veterans.

Methods. Using data from a national sample of Vietnam and Vietnam-era male (n = 1,612) and female (n = 736) veterans, the following were examined: (1) gender differences in use of VA mental health services, (2) gender differences in use of non-VA mental health services, and (3) differences in utilization of mental health services across subgroups defined by psychiatric diagnosis, adjusting for sociodemographic and need variables.

Results. Female veterans were equally likely to use VA mental health services as male veterans, but were substantially more likely to use non-VA mental health services. This suggests that the demand for mental health services overall is substantially greater among female veterans than among male veterans and, by implication, that the equal levels of observed VA service use actually represent underutilization of VA services on the part of female veterans. Logistic regression models showed that these utilization patterns were consistent across diagnostic subgroups.

Conclusions. Special efforts, such as the development of women's specialty mental health clinics, may be needed to enhance the acceptability of VA mental health services to female veterans. This study also highlights the importance of considering overall demand for services in addition to more objective diagnostic data in evaluating the adequacy of service delivery and its accessibility.

Keywords: female veterans, mental health

Topics: Combatants, Female Combatants, Male Combatants, Gender, Women, Health, Mental Health, Military Forces & Armed Groups Regions: Americas, North America Countries: United States of America

Year: 1998

Gender Differences in Rates of Depression, PTSD, Pain, Obesity, and Military Sexual Trauma among Connecticut War Veterans of Iraq and Afghanistan

Citation:

Haskell, Sally G., Kirsha S. Gordon, Dristen Mattocks, Mona Duggal, Joseph Erdos, Amy Justice, and Cynthia A. Brandt. 2010. "Gender Differences in Rates of Depression, PTSD, Pain, Obesity, and Military Sexual Trauma among Connecticut War Veterans of Iraq and Afghanistan." Journal of Women's Health 19 (2): 267-271.

Authors: Sally G. Haskell, Kirsha S. Gordon, Dristen Mattocks, Mona Duggal, Joseph Erdos, Amy Justice, Cynthia A. Brandt

Abstract:

Purpose: The current wars in Iraq and Afghanistan have led to an increasing number of female veterans seeking medical and mental healthcare in the Department of Veterans Affairs (VA) healthcare system. To better understand gender differences in healthcare needs among recently returned veterans, we examined the prevalence of positive screenings for depression, posttraumatic stress disorder (PTSD), military sexual trauma ( MST), obesity, and chronic pain among female and male veterans of Operation Enduring Freedom=Operation Iraqi Freedom (OEF=OIF) receiving care at the VA Connecticut Healthcare System.

Methods: We performed a retrospective, cross-sectional data analysis of OEF=OIF veterans at VA Connecticut who received services in either Primary Care or the Women’s Health Clinic between 2001 and 2006. 

Results: In this study, 1129 electronic medical records (1032 men, 197 women) were examined. Female veterans were more likely to screen positive for MST (14% vs. 1%, p < 0.001) and depression (48% vs. 39%, p ¼ 0.01) and less likely to screen positive for PTSD (21% vs. 33%, p ¼ 0.002). There was no significant gender difference in clinically significant pain scores. Men were more likely than women to have body mass index (BMI) >30 kg=m2 (21% vs. 13%, p ¼ 0.008).

Conclusions: These results suggest that important gender differences exist in the prevalence of positive screenings for MST, depression, obesity, and PTSD. As the VA continues to review and improve its services for women veterans, clinicians, researchers, and senior leaders should consider innovative ways to ensure that female veterans receive the health services they need within the VA system.

Keywords: depression, posttraumatic stress disorder, obesity, military sexual assault, female veterans, male veterans

Topics: Armed Conflict, Combatants, Female Combatants, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Sexual Violence Regions: MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2010

Prevalence of Depressive and Alcohol Abuse Symptoms among Women VA Outpatients Who Report Experiencing Sexual Assault While in the Military

Citation:

Hankin, Cheryl S., Katherine Skinner, Lisa M. Sullivan, Donald R. Miller, Susan Frayne, and Tara J. Tripp. 1999. "Prevalence of Depressive and Alcohol Abuse Symptoms among Women VA Outpatients Who Report Experiencing Sexual Assault While in the Military." Journal of Traumatic Stress 12 (4): 601-612.

Authors: Cheryl S. Hankin, Katherine Skinner, Lisa M. Sullivan, Donald R. Miller, Susan Frayne, Tara J. Tripp

Abstract:

Among a national sample of 3,632 women VA outpatients, we determined self-reported prevalence of sexual assault experienced during military service and compared screening prevalence for current symptoms of depression and alcohol abuse between those who did and did not report this history. Data were obtained by mailed questionnaire. Military-related sexual assault was reported by 23%. Screening prevalence for symptoms of current depression was 3 times higher and for current alcohol abuse was 2 times higher among those who reported experiencing military-related sexual assault. Recent mental health treatment was reported by 50% of those who reported experiencing sexual assault during military service and screened positive for symptoms of depression, and by 40% of those who screened positive for symptoms of alcohol abuse.

Keywords: depression, substance abuse, female veterans, military sexual assault

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, Military Forces & Armed Groups, Sexual Violence, SV against Men Regions: Americas, North America Countries: United States of America

Year: 1999

Underdiagnosis of PTSD and Substance Use Disorders in Hospitalized Female Veterans

Citation:

Grossman, Linda S., Janet K. Willer, Jeffrey G. Stovall, Sandra G. McRae, Sarz Maxwell, and Rebecca Nelson. 1997. "Underdiagnosis of PTSD and Substance Use Disorders in Hospitalized Female Veterans." Psychiatric Services 48 (3): 393-95.

Authors: Linda S. Grossman, Janet K. Willer, Jeffrey G. Stovall, Sandra G. McRae, Sarz Maxwell, Rebecca Nelson

Abstract:

Discharge diagnoses of 31 female veterans and 31 male veterans hospitalized at a large urban VA medical center were examined to elucidate possible biases in clinicians' diagnostic practices. Only one woman in the sample was diagnosed as having posttraumatic stress disorder, compared with seven men. All men given this diagnosis were combat veterans. Although about half of each group had a drug-positive urine screen on admission, only 11 women received a diagnosis of a substance use disorder, compared with 24 men. VA clinicians may need further training and experience assessing the presentation of PTSD and substance use disorders in women.

Topics: Combatants, Female Combatants, Male Combatants, Gender, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries Regions: Americas, North America Countries: United States of America

Year: 1997

Southeast Asian Refugee Women and Depression: A Nursing Intervention

Citation:

Fox, P.G., J.M. Cowell, A.C. Montgomery, and M.A. Willgerodt. 1998. "Southeast Asian Refugee Women and Depression: A Nursing Intervention." The International Journal of Psychiatric Nursing Research 4 (1): 423-32.

Authors: P.G. Fox, J.M. Cowell, A.C. Montgomery, M.A. Willgerodt

Abstract:

Globally, conflicts continue to result in large numbers of refugees and displaced persons, the majority are women. At present, there is scant literature on the mental health status of refugee women following resettlement in countries that grant asylum. We do know that adaptation following migration is a complex cultural, psychological and social process. Some studies have suggested a high prevalence of depression symptoms related to premigration and post-migration experiences. The purpose of this paper will be to describe the mental health status of Southeast Asian (S.E.A.) refugee women in the United States, before home visit interventions by school nurses and bilingual teachers, and at 10, 20 and 33 weeks following the intervention. A comparison group of S.E.A. refugee women, who did not receive the intervention, were evaluated for mental health status on two occasions ten weeks apart. The identified needs and problems identified by the women, the interventions implemented by the school nurses and the success of the interventions will also be discussed. The underlying problem for the majority of women was poverty and social isolation. The study demonstrates that indeed, refugee women in the U.S., are experiencing needs and problems related to basic survival issues in multiple areas of their lives. The findings suggest that home visit interventions by nurses may be a valuable means of reducing depression in S.E.A. refugee women.

Keywords: female refugees, depression, mental health, counseling

Topics: Displacement & Migration, Refugees, Economies, Poverty, Gender, Women, Health, Mental Health Regions: Americas, North America, Asia, Southeast Asia Countries: United States of America

Year: 1998

Focus on Women: Duty-Related and Sexual Stress in the Etiology of PTSD among Women Veterans Who Seek Treatment

Citation:

Fontana, Alan, and Robert Rosenheck. 1998. "Focus on Women: Duty-Related and Sexual Stress in the Etiology of PTSD among Women Veterans Who Seek Treatment." Psychiatric Services 49 (5): 658-662.

Authors: Alan Fontana, Robert Rosenheck

Abstract:

Objective: The stressful experiences of women serving in the military have been a focus of increasing concern. A model of the impact of stress related to military duty and stress related to sexual abuse and harassment on the development of posttraumatic stress disorder (PTSD) among female veterans was evaluated. 

Methods: Structural equation modeling was applied to data from 327 women treated in a VA clinical program for women with stress disorders. The model was a chronological one and included variables related to the women's premilitary experience, their military service, and their postmilitary experience.

Results: Altogether 48 percent of the sample served overseas, and 12 percent were exposed to enemy fire. A total of 63 percent reported experiences of physical sexual harassment during military service, and 43 percent reported rape or attempted rape. Both duty-related and sexual stress were found to contribute separately and significantly to the development of PTSD. Sexual stress was found to be almost four times as influential in the development of PTSD as duty-related stress. Postmilitary social support played a highly significant mediational role between sexual stress during military service and development of PTSD.

Conclusions: Women's exposure to sexual stress in the military is much more prevalent than previously believed. It is particularly toxic for the development of PTSD. Correct assessment is essential to effective treatment.

Keywords: female veterans, posttraumatic stress disorder, mental health, counseling, sexual assault

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Sexual Violence, Rape, SV against Women Regions: Americas, North America Countries: United States of America

Year: 1998

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