North America

Citation:

Seelig, Amber D., Isabel G. Jacobson, Besa Smith, Tomoko I. Hooper, Gary D. Gackstetter, Margaret A.K. Ryan, Timothy S. Wells, Shelley MacDermid Wadsworth, and Tyler C. Smith. 2012. "Prospective Evaluation of Mental Health and Deployment Experience among Women in the US Military." American Journal of Epidemiology 176 (2): 135-145.

Authors: Amber D. Seelig, Isabel G. Jacobson, Besa Smith, Tomoko I. Hooper, Gary D. Gackstetter, Margaret A. K. Ryan, Timothy S. Wells, Shelley MacDermid Wadsworth, Tyler C. Smith

Abstract:

Previous research has shown that military women often experience potentially severe health outcomes following deployment. Data from the Millennium Cohort Study, a 21-year longitudinal study examining the health effects of military service, were used to examine this issue. In longitudinal analyses (2001–2008) carried out among US military women (n = 17,481), the authors examined positive screens for depression, anxiety, panic, and posttraumatic stress disorder in relation to deployment in support of the operations in Iraq and Afghanistan, while adjusting for relevant baseline and time-varying covariates. Women who were deployed and reported combat-related exposures had greater odds than nondeployed women of reporting symptoms of a mental health condition (odds ratio = 1.91, 95% confidence interval: 1.65, 2.20), after adjustment for demographic, military, and behavioral covariates. In addition, higher stress, problem drinking, and a history of mental illness were significantly associated with increased risk of later mental health conditions. In contrast, women in the Reserves or National Guard and those with higher education were at decreased risk of mental health conditions (all P 's < 0.01). As the roles and responsibilities of women in the military expand and deployments continue, designing better prevention and recovery strategies specifically for women are critical for overall force health protection and readiness.

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

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

Year: 2012

Citation:

Schnurr, Paula P., Matthew J. Friedman, Anjana Sengupta, M. K. Jankowski, and Tamara Holmes. 2000. "PTSD and Utilization of Medical Treatment Services among Male Vietnam Veterans." The Journal of Nervous and Mental Disease 188 (8): 496-504.

Authors: Paula P. Schnurr, Matthew J. Friedman, Anjana Sengupta, M. K. Jankowski, Tamara Holmes

Abstract:

This study investigated the effect of posttraumatic stress disorder (PTSD) on help-seeking for physical problems. Merging two large data sets resulted in a sample of 1773 male Vietnam veterans from white, black, Hispanic, Native Hawaiian, and Japanese American ethnic groups. Predictors of utilization included PTSD, other axis I disorders, and substance abuse. In analyses that adjusted only for age, PTSD was related to greater utilization of recent and lifetime VA medical services, and with recent inpatient care from all sources. Further analysis showed that the increased utilization associated with PTSD was not merely due to the high comorbidity between PTSD and other axis I disorders. The uniqueness of the association between PTSD and medical utilization is discussed in terms of somatization and physical illness. 

Keywords: male veterans, posttraumatic stress disorder, mental health

Topics: Combatants, Male Combatants, Ethnicity, Gender, Men, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Americas, North America, Asia, Southeast Asia Countries: United States of America, Vietnam

Year: 2000

Citation:

Rothman, Gene H. 1984. "Needs of Female Patients in a Veterans Psychiatric Hospital." Social Work 29 (4): 380-385.

Author: Gene H. Rothman

Abstract:

The article elaborates a study, which examined the psychiatric and medical care of female veterans. This article presents findings of a survey of 69 female patients at a Veterans Administration (VA) psychiatric facility. The purpose of the study was to assess the satisfaction with present health and mental health services and the possible need for additional services for females. The study was conducted by a Task Force on the Status of Female Veterans at the facility under the auspices of the hospital director. At a later time, the VA national administration independently called attention to the "special needs and concerns of women veteran patients" in a "Professional Services Letter," which noted that because of the high proportion of male veterans, VA health care programs are typically oriented to male health needs. There are several reasons why female veterans are important to the field of social work at the present time. First, health care for veterans is a major component of the national health care system, and female veterans are an increasing proportion of such patients. Until 1967, law to 2 percent of enlisted strength limited female participation in the armed forces.

Keywords: female veterans, mental health, sexual assault

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

Year: 1984

Citation:

Rosen, Leora N., Kathleen Wright, David Marlowe, Paul Bartone, and Robert K. Gifford. 1999. "Gender Differences in Subjective Distress Attributable to Anticipation of Combat among U.S. Army Soldiers Deployed to the Persian Gulf during Operation Desert Storm." Military Medicine 164 (11): 753-757.

Authors: Leora N. Rosen, Kathleen Wright, David Marlowe, Paul Bartone, Robert K. Gifford

Abstract:

Compared the perceptions of stress, cohesion, and psychological well-being among army soldiers deployed to the Persian Gulf during Operation Desert Storm. 856 male and 169 female soldiers (mean age 26.3–28.9 yrs) across 48 combat support and combat service support companies were administered surveys on-site concerning anticipation of combat, operational stress, personal stress, and bonding with peers, leaders, and subordinates. Administered tests included the Brief Symptom Inventory (L. R. Derogatis and N. Melisaratos, 1983) and the Measure of Personality Hardiness (S. C. Kobasa, 1979). Results show that females scored higher than males on all 3 stress measures and scored lower in bonding with leaders and subordinates. Anticipation of combat was the most significant discriminator between sexes, and was a significant predictor of increased psychological symptoms for both sexes. Hardiness scores were similar for both sexes, but anticipation of combat had a greater effect on the psychological symptoms of females compared with males.

Keywords: female soldiers, mental health

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

Year: 1999

Citation:

Nilsson, Johanna E., Chris Brown, Emily B. Russell, Supavan Khamphakdy-Brown. 2008. "Acculturation, Partner Violence, and Psychological Distress in Refugee Women from Somalia." Journal of Interpersonal Violence 23 (11): 1654-63.

Authors: Johanna E. Nilsson, Chris Brown, Emily B. Russell, Supavan Khamphakdy-Brown

Abstract:

This study examined the relations among acculturation, domestic violence, and mental health in 62 married refugee women from Somalia. Refugees from Somalia constituted the largest group of refugees entering the United States in 2005, and little is known about the presence of domestic violence in this group. The results showed that women who reported greater ability to speak English also reported more experiences of partner psychological abuse and physical aggression. Experiences of more psychological abuse and physical aggressions also predicted more psychological distress. Implications for future research and psychological services are addressed.

Keywords: mental health, female refugees, domestic violence

Topics: Displacement & Migration, Refugees, Domestic Violence, Gender, Women, Health, Mental Health Regions: Africa, East Africa, Americas, North America Countries: Somalia, United States of America

Year: 2008

Citation:

Murdoch, Maureen, John B. Pryor, Melissa A. Polusny, and Gary D. Gackstetter. 2007. "Functioning and Psychiatric Symptoms among Military Men and Women Exposed to Sexual Stressors." Military Medicine 172 (7): 718-725.

Authors: Maureen Murdoch, John B. Pryor, Melissa A. Polusny, Gary D. Gackstetter

Abstract:

Objective: The goal was to describe military men's and women's functioning and psychiatric symptoms according to their military sexual stressor exposure. 

Method: A cross-sectional survey of 204 Army soldiers and 611 other active duty troops (487 men and 327 women) was performed. 

Results: Forty-five percent of men and 80% of women reported at least one sexual stressor type (i.e., sexual identity challenges, sexual harassment, or sexual assault). After adjustment, subjects reporting more types of sexual stressors had poorer physical, work, role, and social functioning; more-severe post-traumatic stress disorder, depression, and anxiety symptoms; and more somatic concerns, compared with subjects reporting fewer or no sexual stressor types (all p < 0.004). Interactions by gender were insignificant (all p > 0.11). Within sexual stressor category, men and women reported similar mean adjusted functioning and psychiatric symptoms. 

Conclusions: For both men and women, impaired functioning and more severe psychiatric symptoms were more common among those reporting more types of sexual stressors.

Keywords: sexual assault, mental health, female soldiers, male soldiers, posttraumatic stress disorder, depression, anxiety

Topics: Combatants, Gender, Women, Men, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Sexual Violence, Sexual Exploitation and Abuse, Sexuality Regions: Americas, North America Countries: United States of America

Year: 2007

Citation:

Murdoch, Maureen, Melissa A. Polusny, James Hodges, and Nancy O'Brien. 2004. "Prevalence of In-Service and Post-Service Sexual Assault among Combat and Noncombat Veterans Applying for Department of Veterans Affairs Posttraumatic Stress Disorder Disability Benefits." Military Medicine 169 (5): 392-395.

Authors: Maureen Murdoch, Melissa A. Polusny, James Hodges, Nancy O'Brien

Abstract:

Objective: To describe the prevalence of in-service and post-service sexual assault among combat and noncombat veterans seeking Veteran’s Affairs disability benefits for posttraumatic stress disorder (PTSD). 

Methods: Cross-sectional survey of 4,918 veterans. 

Results: Surveys were returned by 3,337 veterans (effective response rate, 68%). Among men, 6.5% of combat veterans and 16.5% of noncombat veterans reported in-service or post-service sexual assault. Among women, 69% of combat veterans and 86.6% of noncombat veterans reported in-service or post-service sexual assault. 

Conclusions: Reported rates of sexual assault were considerably higher among veterans seeking Veteran’s Affairs disability benefits for PTSD than historically reported rates for men and women in the general population. In this population, male gender and veterans’ combat status should not dissuade clinicians from screening for sexual traumas.

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

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

Year: 2004

Citation:

Murdoch, Maureen, James Hodges, Carolyn Hunt, Diane Cowper, Nancy Kressin, and Nancy O'Brien. 2003. "Gender Differences in Service Connection for PTSD." Medical Care 41 (8): 950-961.

Authors: Maureen Murdoch, James Hodges, Carolyn Hunt, Diane Cowper, Nancy Kressin, Nancy O'Brien

Abstract:

Background. Mentally ill female veterans obtain a smaller proportion of their care from Department of Veterans Affairs (VA) facilities than mentally ill male veterans do, possibly because women are less likely than men to be service connected for psychiatric disabilities. "Service connected" veterans have documented, compensative conditions related to or aggravated by military service, and they receive priority for enrollment into the VA healthcare system.

Objectives. To see if there are gender discrepancies in rates of service connection for posttraumatic stress disorder (PTSD) and, if so, to see if these discrepancies could be attributed to appropriate subject characteristics (eg, differences in symptom severity or impairment).

Research Design. Mailed survey linked to administrative data. Claims audits were conducted on 11% of the sample.

Subjects. Randomly selected veterans seeking VA disability benefits for PTSD. Women were oversampled to achieve a gender ratio of 1:1.

Results. A total of 3337 veterans returned usable surveys (effective response rate, 68%). Men's unadjusted rate of service connection for PTSD was 71%; women's, 52% (P < 0.0001). Adjustment for veterans' PTSD symptom severity or functional impairment did not appreciably reduce this discrepancy, but adjustment for dissimilar rates of combat exposure did. Estimated rates of service connection were 53% for men and 56% for women after adjusting for combat exposure. This combat preference could not be explained by more severe PTSD symptoms or greater functional impairment.

Conclusions. Instead of a gender bias in awards for PTSD service connection, we found evidence of a combat advantage that disproportionately favored men. The appropriateness of this apparent advantage is unclear and needs further investigation. 

Keywords: posttraumatic stress disorder, mental health, male soldiers, female soldiers, trauma

Topics: Armed Conflict, 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: 2003

Citation:

Mota, Natalie P., Maria Medved, JianLi Wang, Gordon J.G.  Asmundson, Debbie Whitney, and Jitender Sareen. 2012. " Stress and Mental Disorders in Female Military Personnel: Comparisons between the Sexes in a Male Dominated Profession." Journal of Psychiatric Research 46 (2): 159-67.

Authors: Natalie P. Mota, Maria Medved, JianLi Wang, Gordon J.G. Asmundson, Debbie Whitney, Jitender Sareen

Abstract:

The proportion of women in militaries is growing; however, many studies in the area of military mental health have been conducted with majority male samples. The present study examined sex differences in trauma exposure, work stress, and mental disorders in the Canadian Community Health Survey – Canadian Forces Supplement, a representative sample of 5155 regular force personnel and 3286 reservists ages 16–54. Past-year DSM-IV mental disorders (depression, generalized anxiety disorder, panic disorder, social phobia, PTSD, and alcohol dependence), lifetime exposure to 28 traumatic events, and work stress were assessed. Regular and reserve female personnel were less likely than males to experience deployment-related traumas, accidents, and several events involving violence (adjusted odds ratio [AOR] range 0.10–0.62). Women were more likely to endorse sexual trauma, partner abuse, and being stalked (AOR range 3.60–13.63). For work stress, regular force women reported higher levels of job demand and stress around social support than men, whereas regular and reserve force women reported less physical exertion. After adjusting for a range of covariates, regular female personnel were more likely than males to have PTSD (AOR 1.88, 99% CI 1.01–3.50), while reservist women were more likely than men to have depression, panic disorder, and any mood or anxiety disorder (AOR range 1.87–6.98). Both regular and reservist women had lower rates of alcohol dependence (AOR range 0.30–0.34). Clinicians working with female personnel should screen for trauma/stressors and mental disorders that are particularly common in this population. 

Keywords: mental health, female soldiers, anxiety, substance abuse, depression, posttraumatic stress disorder

Topics: Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, Militaries, Sexual Violence Regions: Americas, North America Countries: Canada

Year: 2012

Citation:

Maguen, Shira, Beth Cohen, Greg Cohen, Erin Madden, Daniel Bertenthal, and Karen Seal. 2012. "Gender Differences in Health Service Utilization among Iraq and Afghanistan Veterans with Posttraumatic Stress Disorder." Journal of Women's Health 21(6): 666-673.

Authors: Shira Maguen, Beth Cohen, Greg Cohen, Erin Madden, Daniel Bertenthal, Karen Seal

Abstract:

Background: Little is known about gender differences in healthcare use among newly returning veterans with posttraumatic stress disorder (PTSD). We investigated gender differences in Veterans Affairs (VA) medical center health service use among Iraq and Afghanistan veterans with PTSD with and without comorbid depression and alcohol use disorders (AUD).

Methods: Using VA administrative data, bivariate and multivariate statistics were used to examine gender differences in health service use among 159,705 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with PTSD seeking VA healthcare from October 7, 2001, to December 31, 2010.

Results: Female veterans with PTSD were more likely to be black and single and to have higher mental health, primary care, and emergency care use compared to men with PTSD. Men were more likely to have higher mental health inpatient use compared to women. Women and men with comorbid PTSD and depression or comorbid PTSD and AUD were more likely to have higher use in all domains compared to their counterparts with PTSD without these comorbid disorders. Women with comorbid PTSD and depression were 12.5 times more likely to have a mental health inpatient hospitalization compared to their female counterparts without depression and twice as likely to have a mental health hospitalization compared to men with comorbid PTSD and depression.

Conclusions: Women with PTSD had higher use than men in almost all areas, as did all veterans with comorbid PTSD and depression and comorbid PTSD and AUD, regardless of gender. Better understanding these health service use differences will allow for targeted evaluation and integrated treatment interventions in veterans with PTSD.

Keywords: female veterans, male veterans, posttraumatic stress disorder, mental health

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

Year: 2012