Publication year
2014
Citation Title
Trauma, posttraumatic stress disorder, and depression among sexual minority and heterosexual women Veterans.
Journal Name
Journal of Counseling Psychology
Journal Volume
61
Issue Number
3
Page Numbers
392-403
DOI
10.1037/cou0000019
Summary
Female Veterans completed self-report questionnaires about their experiences with trauma and associated mental health outcomes (posttraumatic stress disorder [PTSD] and depression). Analyses examined the associations between traumatic experiences and PTSD or depressive symptomology and to assess differences based on sexual orientation. Regardless of sexual orientation, all female Veterans were more likely to report being the victim of sexual-related trauma during military service, and sexual trauma during service was the strongest predictor of PTSD.
Key Findings
Sexual assault occurring during military service was the strongest predictor of both PTSD and depression.
Both sexual minority and heterosexual women were more likely to be the victims of sexual assault during their military service than at other times; rates declined sharply after service.
Lesbian/bisexual women were more likely than heterosexual women to have been a victim of adult physical victimization during military service.
Regardless of sexual orientation, PTSD was significantly predicted by childhood trauma, physical victimization, sexual assault during the military, and sexist events occurring during the past year. Depression was significantly predicted by childhood trauma.
Implications for Program Leaders
Develop activities and curricula that are responsive to the needs of non-traditional families, including same-sex or sexual minority families
Provide routine screening about current and prior trauma experience and provide referrals to mental health professionals
Disseminate information regarding possible symptoms of mental health problems Service members may face after deployment and where individuals and families can find help for those problems
Implications for Policy Makers
Continue to support the creation of prevention and intervention programs that aim to diminish physical and sexual victimization
Promote reintegration programs that include attention to assisting Service members' family in adjusting to the Service member's return after a traumatic event
Recommend integrating mental health education into existing service delivery systems for military families
Methods
Female Veterans were invited through web-based media to complete an anonymous online survey.
Some participant exclusions were made for being underage, transgender, or failing to answer questions about their birth and current sex, resulting in a final sample of 706 female Veterans.
Participants were asked questions about their demographics, childhood trauma, adult sexual trauma, adult physical victimization, combat exposure, experiences of discrimination during military service, lesbian/bi-sexual anxiety and concealment (only lesbian/bi-sexual women responded to the Lesbian/Bi-sexual Military Stressors Scale), past year sexist events, PTSD, and depression.
Participants
Seven hundred and six female Veterans were included in analyses (lesbian/bisexual = 264, heterosexual = 442). The mean age of the lesbian/bi-sexual group was 47.32 years (SD = 13.76), heterosexual women's mean age was 51.24 years (SD = 13.99).
Participants were from all military branches: Air Force (lesbian/bi-sexual = 15%, heterosexual = 20%), Army (lesbian/bi-sexual = 52%, heterosexual = 40%), Coast Guard (lesbian/bi-sexual = 1%, heterosexual = 1%), Marines (lesbian/bi-sexual = 7%, heterosexual = 6%), Navy (lesbian/bi-sexual = 20%, heterosexual = 25%), and National Guard/Reserves (lesbian/bi-sexual = 5%, heterosexual = 8%).
The majority of women were White (lesbian/bi-sexual = 82%, heterosexual = 86%), and 37% of the sample self-identified as lesbian or bisexual.
Limitations
The cross-sectional nature of this study does not allow for causal inferences to be made.
Self-reports about PTSD and depression are not diagnostic and may not accurately capture these constructs.
The small percentage of racial/ethnic minority women limits the degree to which these findings can be generalized.
Avenues for Future Research
Assess the relations between income, sexual orientation, and mental health status in a longitudinal design to explore potential causal associations
Examine the associations between trauma occurring before the military and trauma occurring during military service, as high life-long rates of trauma may reflect an underlying risk of interpersonal violence, in general
Include a larger and more diverse sample specifically targeting an equal representation from all military branches
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
This study examined the impact of various traumas across the life span on screening positive for current posttraumatic stress disorder (PTSD) and depression among heterosexual and sexual minority women veterans. Women veterans were recruited over the Internet (N = 706, 37% lesbian or bisexual) to participate in an anonymous, online survey. We assessed childhood trauma; adult sexual assault and adult physical victimization before, during, and after the military; combat exposure; perceived sexist discrimination during military service; sexual minority military stressors; past-year sexist events; and whether participants screened positive for PTSD or depression. Binary logistic regressions were used to generate odds ratios and 95% confidence intervals for PTSD and depression, stratified by sexual orientation and controlling for demographic characteristics. Lesbian and bisexual women reported higher rates of trauma across the life span, although in some instances (e.g., sexual assault during and after military service, combat exposure), they did not differ from their heterosexual counterparts. Childhood trauma and traumas that occurred during military service added the most variance to both PTSD and depression models. Sexual assault during military service appeared to be especially harmful with respect to screening positive for PTSD for both sexual orientation groups. Results revealed a number of other predictors of mental health status for women veterans, some of which differed by sexual orientation. Findings indicate a significant burden of interpersonal trauma for both heterosexual and lesbian/bisexual women veterans and provide information on the distinct association of various traumas with current PTSD and depression by sexual orientation.
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