Combatants

Citation:

Rona, Roberto J., Nicola T. Fear, Lisa Hull and Simon Wessely. 2007. "Women in Novel Occupational Roles: Mental Health Trends in the UK Armed Forces." International Journal of Epidemiology 36 (2): 319-26.

Authors: Roberto J. Rona, Nicola T. Fear, Lisa Hull, Simon Wessely

Abstract:

Background: There is uncertainty about whether women in the military have more psychological symptoms than men and whether psychological symptoms have increased over time. The aims of this study were to assess changes in psychological symptoms in military women over time, to compare them with men, and assess the effect of deployment.

Methods: Two cross-sectional studies based on random samples of the Armed Forces were used to assess the effects of deployment to the Gulf and Iraq Wars. We selected for the analyses all the women and a 20% random sample of men who completed a questionnaire stratified by rank. We assessed psychological distress, number of symptoms, post-traumatic stress reaction (PTSR), chronic fatigue and alcohol misuse.

Results: There has been an increase in psychological symptoms, including alcohol misuse, in those not deployed to the Gulf or Iraq Wars, especially in women. The odds ratios for PTSR [5.82 (95% CI: 1.27–26.71)], multiple symptoms [8.49 (1.97–36.65)] and alcohol misuse [6.20 (2.09–18.37)] were higher in women than in men in the non-deployed samples. Psychological distress and chronic fatigue was more common in women, and alcohol misuse, was more common in men. In women, psychological symptoms were positively associated with deployment in the Gulf War, but not the Iraq War.

Conclusion: Psychological symptoms in the Armed Forces have increased over time regardless of gender, in those not deployed. The association between gender and psychological symptoms has not changed over time. The deployment effect in women is similar to that described in men. 

Topics: Armed Conflict, Combatants, Female Combatants, Gender, Women, Health, Mental Health, Trauma Regions: Europe Countries: United Kingdom

Year: 2007

Citation:

Pierce, Penny F. 1997. "Physical and Emotional Health of Gulf War Veteran Women." Aviation, Space, and Environmental Medicine 68 (4): 317-321.

Author: Penny F. Pierce

Abstract:

BACKGROUND: Numerous questions have been raised about the health consequences to veterans of the Gulf War but most particularly to issues concerning women, who were deployed in unprecedented numbers. Little is known about the health consequences to women of wartime stressors, in general, or the environmental and job-related exposures specific to the theater of the Gulf War.

METHODS: A stratified sample of 525 women participated in the study following the war and again in a follow-up study 2 yr later. The sampling frame was stratified on component of the U.S. Air Force (active, guard or reserve), deployment (in the theater or elsewhere), and parental status (parent or nonparent). Measures included items concerning general physical health, gender-specific health, the "Gulf War Syndrome," and the emotional responses to war, including symptoms of post-traumatic stress disorder (PTSD).

RESULTS: Multiple statistical analyses were used to describe women's physical and emotional health at two time points following the war. Women deployed to the theater reported significantly more general as well as gender-specific health problems than did women deployed elsewhere. A cluster of common health problems included: skin rash, cough, depression, unintentional weight loss, insomnia, and memory problems. Women serving in the theater also reported a significant increase in several gender-specific problems compared to women deployed elsewhere.

CONCLUSIONS: Findings suggest the need for follow-up of a cluster of specific health effects, including those concerning gynecologic and reproductive health.

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

Topics: Combatants, Female Combatants, Environment, Gender, Women, Health, Mental Health, PTSD, Reproductive Health, Trauma, Military Forces & Armed Groups

Year: 1997

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:

Middleton, Katherine, and Carlton D. Craig. 2012. "A Systematic Literature Review of PTSD among Female Veterans from 1990 to 2010." Social Work in Mental Health 10 (3): 233-52.

Authors: Katherine Middleton, Carlton D. Craig

Abstract:

This article reviews literature over the past twenty years concerning female veterans and posttraumatic stress disorder (PTSD). The literature identified sexual trauma, pre-military sexual trauma, combat exposure, substance misuse, and gender difference in the development of PTSD among female veterans from the Gulf War to the current conflicts. Also incorporated in the review are evidence-based and other promising treatment options for female veterans suffering from PTSD. Based on the review, female veterans experience higher rates of military sexual trauma and much of the current research on female veteran related PTSD is focused on sexual trauma that occurs while in the military. As the number of females serving in the military grows, there needs to be a continued effort in understanding the multiple issues they experience before, during, and after their time in the military. Researchers need to continue to address sexual traumas, the disparity in the diagnosis of PTSD, effective treatment options, and further understand the dynamics of comorbidity of other mental health disorders with PTSD. In addition, more research needs to be conducted on how trauma and PTSD impacts family and occupational functioning for female veterans after both their return from operational deployment and completion of military service.

Topics: Combatants, Female Combatants, Gender, Women, Health, PTSD, Military Forces & Armed Groups, Sexual Violence, Sexual Exploitation and Abuse

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

Citation:

Magley, Vicki J., Craig R. Waldo, Fritz Drasgow, and Louise F. Fitzgerald. 1999. "The Impact of Sexual Harassment on Military Personnel: Is it the Same for Men and Women?" Military Psychology 11 (3): 283-302.

Authors: Vicki J. Magley, Craig R. Waldo, Fritz Drasgow, Louise F. Fitzgerald

Abstract:

Research in the civilian workplace has documented the serious psychological, health-related, and job-related outcomes of sexual harassment of women by men. The question of whether men experience sexual harassment similarly has more recently been proposed (Berdahl, Magley, & Waldo, 1996; Popovich, Campbell, Everton, Mangan, & Godinho, 1994; Vaux, 1993; Waldo, Berdahl, & Fitzgerald, 1998; Waldo & Magley, 1996), resulting in considerable debate regarding not only the extent of the outcomes of such experiences but also the sex of the offender. This study directly compared outcomes of sexual harassment for men and women utilizing data from the U.S. Department of Defense's (1995) recent gender issues survey. The results of both linear and quadratic regression analyses indicate that within the range of similar experiences, sexual harassment exerts a negative effect on male and female personnel in similar ways on 3 sets of outcomes: psychological, health, and job-related. Three differences emerged, however, suggesting differential experiences of sexual harassment for men and women. First, women were more likely to have been sexually harassed than were men. Second, women experienced sexual harassment at higher frequencies than did men; the negative impact on women, both individually and as a group, is thus considerably more pronounced. Finally, women almost always experienced sexual harassment from men; men were somewhat more likely to experience such behaviors from men than from women.

Keywords: military sexual assault, female soldiers, male soldiers, mental health

Topics: Combatants, Female Combatants, Male Combatants, Gender, Women, Men, Health, Mental Health, Sexual Violence, SV against Men, SV against Women Regions: Americas, North America Countries: United States of America

Year: 1999

Citation:

Kimerling, Rachel, Gretchen A. Clum, and Jessica Wolfe. 2000. "Relationships Among Trauma Exposure, Chronic Post-Traumatic Stress Disorder Symptoms, and Self-reported Health in Women: Replication and Extension." Journal of Traumatic Stress 13 (1): 115-28.

Authors: Rachel Kimerling, Gretchen A. Clum, Jessica Wolfe

Abstract:

Fifty-two women who served during the Vietnam era were assessed for war-zone exposure, traumatic life events, posttraumatic stress disorder (PTSD), and self-reported health status. Symptoms of PTSD were examined as mediators in the relationship between traumatic exposure and subsequent reports of health problems. Results showed that PTSD symptoms accounted significantly for variance in health problems reported by women with prior traumatic stressor exposure. When the cardinal symptom domains of PTSD (reexperiencing, numbing, avoidance, hyperarousal) were analyzed separately, the symptom cluster representing hyperarousal accounted uniquely for the variance associated with health complaints, beyond that contributed by other symptom clusters. Discussion of the results focuses on mechanisms underlying the relationship between specific symptoms of PTSD and self-reported health. Implications for intervention within the medical system are also considered.

Keywords: trauma, post, mental health, female veterans

Topics: Combatants, Female Combatants, Gender, Women, Health, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Asia, Southeast Asia Countries: Vietnam

Year: 2000

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