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Military Sexual Assault

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Military and Veteran Mental Health

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Abstract

Military sexual assault (MSA) remains a persistent problem with substantial public health ramifications. This chapter reviews the history of military and Veterans Affairs (VA) responses to MSA, as well as the complex web of administrative, legal, and medical aspects that complicate societal responses to this crime. Survivors of MSA underreport medical problems while on active duty yet increasingly utilize VA services for a host of associated medical and psychological concerns. MSA survivors have heightened rates of medical comorbidity in a variety of bodily systems, beyond just the psychological, to include muscular, cardiovascular, gastrointestinal, sexual, respiratory, and neurological systems. Public outcry and congressional intervention have resulted in substantial modification of military law and novel response interventions to encourage reporting and treatment of MSA. To improve low reporting rates and low conviction rates, the military has greatly broadened sexual assault laws to include nonresisting, incapacitated, and same-sex victims. The military now offers treatment and legal counsel without requiring survivors to report to law enforcement. Larger numbers of survivors may choose to pursue prosecution after interacting with these resources, while others may receive superior alleviation of stress when compared with going through a courtroom process. The VA now allows for free lifetime medical service for any MSA survivor. Overall, the requirements of proof beyond a reasonable doubt in criminal court may never allow for 100% conviction in MSA cases, but the military and VA strive to achieve alternative means to provide comfort to MSA survivors.

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References

  • Artime TM, Peterson ZD (2015) Feelings of wantedness and consent during nonconsensual sex: implications for posttraumatic cognitions. Psychol Trauma: Theor Res Pract Policy 7(6):570–577

    Article  Google Scholar 

  • Black MC, Merrick MT (2013) Prevalence of intimate partner violence, stalking, and sexual violence among active duty women and wives of active duty men – comparisons with women in the US general population, 2010. Centers for Disease Control and Prevention. http://www.sapr.mil/public/docs/research/2010_National_Intimate_Partner_and_Sexual_Violence_Survey-Technical_Report.pdf. Accessed 13 Apr 2016

  • Breiding MJ (2014) Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization—National Intimate Partner and Sexual Violence Survey, United States, 2011. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm?s_cid=ss6308a1_e. Accessed 10 Sep 2016

  • Campbell R, Patterson D, Bybee D (2012) Prosecution of adult sexual assault cases: a longitudinal analysis of the impact of a sexual assault nurse examiner program. Violence Against Women 18(2):223–244

    Article  PubMed  Google Scholar 

  • Castro CA, Kintzle S, Schuyler AC et al (2015) Sexual assault in the military. Curr Psychiatry Rep 17(7):1–13

    Article  Google Scholar 

  • Classen CC, Palesh OG, Aggarwal R (2005) Sexual revictimization: a review of the empirical literature. Trauma Violence Abuse 6(2):103–129

    Article  PubMed  Google Scholar 

  • Cleere C, Lynn SJ (2013) Acknowledged versus unacknowledged sexual assault among college women. J Interpers Violence 28:2593–2611

    Article  PubMed  Google Scholar 

  • Creamer M, Burgess P, McFarlane AC (2001) Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-being. Psychol Med 31(7):1237–1247

    Article  CAS  PubMed  Google Scholar 

  • Department of Defense 2013) Special victim counsel handbook. http://responsesystemspanel.whs.mil/public/docs/meetings/sub_committee/20140226_vs/materials_related/03a_usa_specialvictimsconsel_handbook.pdf. Accessed 31 Aug 2016

  • Department of Defense (2014) Report to the President of the United States on sexual assault prevention and response, Appendix A. http://sapr.mil/public/docs/reports/ FY14_POTUS/FY14_DoD_Report_to_POTUS_Full_Report.pdf. Accessed on 1 Sep 2016

  • Department of Defense (2015) Department of Defense Instruction (DoDI) 6495.02: sexual assault prevention and response (SAPR) program procedures. Government Printing Office, Washington, DC

    Google Scholar 

  • Department of Defense (2016) Manual for courts-martial. http://jsc.defense.gov/Portals/99/Documents/MCM2016.pdf?ver=2016-12-08-181411-957. Accessed 1 Nov 2016

  • Department of Defense Sexual Assault and Prevention Office (2012) Workplace and gender relations survey of active duty members. http://www.sapr.mil/public/docs/research/WGR_ActiveDuty_2012_Report.pdf. Accessed on 4 Sep 2016

  • Department of the Army (2014) Army regulation 600-20: Army command policy. Government Printing Office, Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2010a) VHA directive 2010-014: assessment and management of veterans who have been victims of alleged acute sexual assault. Government Printing Office, Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2010b) VHA directive 2010-033: military sexual trauma (MST) programming. Government Printing Office, Washington, DC

    Google Scholar 

  • Department of Veterans Affairs (2015a) Military sexual trauma (MST). http://www.mentalhealth.va.gov/msthome.asp. Accessed 20 Aug 2016

  • Department of Veterans Affairs (2015b) Military sexual trauma (MST) general fact sheet. http://www.mentalhealth.va.gov/docs/mst_general_factsheet.pdf. Accessed 20 Aug 2016

  • Desai S, Arias I, Thompson MP et al (2002) Childhood victimization and subsequent revictimization assessed in a nationally representative sample of women and men. Violence Vict 17(6):639–653

    Article  PubMed  Google Scholar 

  • Dinos S, Burrowes N, Hammond K et al (2015) A systematic review of juries’ assessment of rape victims: do rape myths impact on juror decision-making? Int J Law Crime Justice 43(1):36–49

    Article  Google Scholar 

  • DuMont J, White D, McGregor M (2009) Investigating the medical forensic examination from the perspective of sexually assaulted women. Soc Sci Med 68:774–780

    Article  Google Scholar 

  • Elliott DM, Mok DS, Briere J (2004) Adult sexual assault: prevalence, symptomatology, and sex differences in the general population. J Trauma Stress 17(3):203–211

    Article  PubMed  Google Scholar 

  • Executive Order No. 13, 140, 64 (1999) Fed Reg 55:115

    Google Scholar 

  • Federal Bureau of Investigation (2016) Frequently asked questions about the change in the UCR definition of rape. In: CJIS, UCR, recent program updates. Federal Bureau of Investigation. https://www.fbi.gov/about-us/cjis/ucr/recent-program-updates/new-rape-definition-frequently-asked-questions. Accessed 21 Sep 2016

  • Finkelhor D, Hotaling G, Lewis I et al (1990) Sexual abuse in a national survey of adult men and women: prevalence, characteristics, and risk factors. Child Abuse Negl 14(1):19–28

    Article  CAS  PubMed  Google Scholar 

  • Fisher RP, Geiselman RE (2010) The cognitive interview method of conducting police interviews: eliciting extensive information and promoting therapeutic jurisprudence. Int J Law Psychiatry 33:321–328

    Article  PubMed  Google Scholar 

  • Fisher BS, Cullen FT, Turner MG (2000) The sexual victimization of college women. https://www.ncjrs.gov/pdffiles1/nij/182369.pdf. Accessed 3 Aug 2016

  • Fishman CS (2007) Defense access to a prosecution witness’s psychotherapy or counseling records. Or L Rev 86:1

    Google Scholar 

  • Frayne SM et al (1999) Medical profile of women Veterans Administration outpatients who report a history of sexual assault occurring while in the military. J Womens Health Gend Based Med 8(6):835–845

    Article  CAS  PubMed  Google Scholar 

  • Heidt JM, Marx BP, Forsyth JP (2005) Tonic immobility and childhood sexual abuse: a preliminary report evaluating the sequela of rape-induced paralysis. Behav Res Ther 43:1157–1171

    Article  PubMed  Google Scholar 

  • Humphreys J, Cooper BA, Miaskowski C (2010) Differences in depression, posttraumatic stress disorder, and lifetime trauma exposure in formerly abused women and mild versus moderate to severe chronic pain. J Interpers Violence 25(12):2316–2338

    Article  PubMed  Google Scholar 

  • Inspector General of the United States Department of Defense (2013) Report No. DODIG-2013-043: evaluation of the military criminal investigative organizations’ sexual assault investigation training. Government Printing Office, Washington, DC

    Google Scholar 

  • Institute on Domestic Violence & Sexual Assault (2016) The blueprint for campus police: responding to sexual assault. http://sites.utexas.edu/idvsa/title-blueprint-for-campus-police-responding-to-sexual-assault. Accessed 14 Aug 2016

  • Judicial Proceedings Panel (2015) Report of the judicial proceedings since fiscal year 2012 Amendments Panel. http://jpp.whs.mil/public/docs/08-Panel_Reports/01_JPP_InitialReport_Final_20150204.pdf. Accessed 6 Sep 2016

  • Kang H, Dalager N, Mahan C et al (2005) The role of sexual assault on the risk of PTSD among Gulf War veterans. Ann Epidemiol 15(3):191–195

    Article  PubMed  Google Scholar 

  • Kastenberg LRM V (2013) 72 M.J. 364

    Google Scholar 

  • Kels CG (2012) Military medical malpractice and “the right to sue”. Clin Dermatol 30(2):181–187

    Article  PubMed  Google Scholar 

  • Kilpatrick DG, Resnick HS, Ruggiero KJ et al (2007) Drug-facilitated, incapacitated, and forcible rape: a national study. National Institute of Justice, Washington, DC

    Google Scholar 

  • Kimerling R, Gima K, Smith MW et al (2007) The Veterans Health Administration and military sexual trauma. Am J Public Health 97(12):2160–2166

    Article  PubMed  PubMed Central  Google Scholar 

  • Kimerling R, Street AE, Gima K et al (2008) Evaluation of universal screening for military-related sexual trauma. Psychiatr Serv 59:635–640

    Article  PubMed  Google Scholar 

  • Koss MP, Woodruff WJ, Koss PG (1991) Criminal victimization among primary care medical patients: prevalence, incidence, and physician usage. Behav Sci Law 9(1):85–96

    Article  CAS  PubMed  Google Scholar 

  • Krebs CP, Lindquist CH, Warner TD et al (2011) Comparing sexual assault prevalence estimates obtained with direct and indirect questioning techniques. Violence Against Women 17:219–235

    Article  PubMed  Google Scholar 

  • Lalor K, McElvaney R (2010) Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs. Trauma Violence Abuse 11(4):159–177

    Article  PubMed  Google Scholar 

  • Logan TK, Walker R, Cole J (2013) Silenced suffering: the need for a better understanding of partner sexual violence. Trauma Violence Abuse 16(2):111–136

    Article  PubMed  Google Scholar 

  • Lonsway KA, Archambault J (2012) The “justice gap” for sexual assault cases future directions for research and reform. Violence Against Women 18(2):145–168

    Article  PubMed  Google Scholar 

  • McFarlane AC (2013) The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry 9:3–10

    Article  Google Scholar 

  • McKimmie BM, Masser BM, Bongiorno R (2014) What counts as rape? The effect of offense prototypes, victim stereotypes, and participant gender on how the complainant and defendant are perceived. J Interpers Violence 29(12):2273–2303

    Article  PubMed  Google Scholar 

  • Millegan J, Milburn EK, LeardMann CA et al (2015) Recent sexual trauma and adverse health and occupational outcomes among US service women. J Trauma Stress 28(4):298–306

    Article  PubMed  Google Scholar 

  • Millegan J, Wang L, LeardMann CA et al (2016) Recent sexual trauma and adverse health and occupational outcomes among men serving in the U.S. military. J Trauma Stress 29(2):132–140

    Article  PubMed  Google Scholar 

  • Morral AR, Gore KL, Schell T et al (2015a) Sexual assault and sexual harassment in the U.S. military, annex to volume 2, tabular results from the 2014 RAND Military Workplace Study for Department of Defense service members. RAND Corporation. http://www.rand.org/pubs/research_reports/RR870z3.html. Accessed 30 Aug 2016

  • Morral AR, Gore KL, Schell T et al (2015b) Sexual assault and sexual harassment in the military, top-line estimates for active duty service members from the 2014 RAND Military Workplace Study. RAND Corporation. http://www.rand.org/pubs/research_reports/RR870.html. Accessed 30 Aug 2016

  • Morral AR, Gore KL, Schell T et al (2015c) Sexual assault and sexual harassment in the U.S. military, highlights from the 2014 RAND Military Workplace Study. RAND Corporation. http://www.rand.org/pubs/research_briefs/RB9841.html. Accessed 30 Aug 2016

  • Muehlenhard CL, Humphreys TP, Jozkowski KN et al (2016) The complexities of sexual consent among college students: a conceptual and empirical review. J Sex Res 53(4–5):457–487

    Article  PubMed  Google Scholar 

  • Redmond JV (1996) 116 S.Ct. 1923

    Google Scholar 

  • Rosenstein JE, Carroll MH (2015) Male rape myths, female rape myths, and intent to intervene as a bystander. Violence Gender 2(4):204–208

    Article  Google Scholar 

  • Sadler AG, Booth BM, Cook BL et al (2003) Factors associated with women’s risk of rape in the military environment. Am J Ind Med 43:262–273

    Article  PubMed  Google Scholar 

  • Sameit MD (2013) When a convicted rape is not really a rape: the past, present, and future ability of Article 120 convictions to withstand legal and factual sufficiency reviews. Mil L Rev 216:77

    Google Scholar 

  • Schultz JR, Bell KM, Naugle AE et al (2006) Child sexual abuse and adulthood sexual abuse among military veteran and civilian women. Mil Med 171(8):723–728

    Article  PubMed  Google Scholar 

  • Settles IH, Buchanan NT, Yap SCY et al (2014) Sex differences in outcomes and harasser characteristics associated with frightening sexual harassment appraisals. J Occup Health Psychol 19(2):133–142

    Article  PubMed  Google Scholar 

  • Shotland RL, Goodstein L (1992) Sexual precedence reduces the perceived legitimacy of sexual refusal: an examination of attributions concerning date rape and consensual sex. Personal Soc Psychol Bull 18(6):756–764

    Article  Google Scholar 

  • Skinner KM, Kressin N, Frayne S et al (2000) The prevalence of military sexual assault among female Veterans’ Administration outpatients. J Interpers Violence 15(3):291–310

    Article  Google Scholar 

  • Stander VA, Thomsen CJ (2016) Sexual harassment and assault in the U.S. military: a review of policy and research trends. Mil Med 181(1 Supplement):20–27

    Article  PubMed  Google Scholar 

  • Street AE, Bell ME, Ready CB (2011) Sexual assault. In: Benedek DM, Wynn GH (eds) Clinical manual for management of PTSD. American Psychiatric Publishing, Washington, DC, pp 325–348

    Google Scholar 

  • Suris A, Lind L (2008) Military sexual trauma a review of prevalence and associated health consequences in veterans. Trauma Violence Abuse 9(4):250–269

    Article  PubMed  Google Scholar 

  • Suris A, Lind L, Kashner TM et al (2007) Mental health, quality of life, and health functioning in women veterans. J Interpers Violence 22(2):179–197

    Article  PubMed  Google Scholar 

  • TeBockhurst SF, O’Halloran MS, Nyline BN (2015) Tonic immobility among survivors of sexual assault. Psychol Trauma: Theor Res Practice Policy 7(2):171–178

    Article  Google Scholar 

  • The Management of Post-Traumatic Stress Working Group (2010) VA/DoD clinical practice guideline: management of post-traumatic stress, version 2.0. http://www.healthquality.va.gov/guidelines/MH/ptsd/. Accessed 12 Aug 2016

  • The White House (2014) Not alone: the first report of the White House Task Force to protect students from sexual assault. https://www.justice.gov/ovw/page/file/905942/download. Accessed 9 Aug 2016

  • Tjaden P, Thoennes N (1998) Prevalence, incidence, and consequences of violence against women: findings from the national violence against women survey. Research in Brief. Available at https://www.ncjrs.gov/pdffiles/172837.pdf

  • Tsolaki M (2010) Posttraumatic stress disorder (PTSD) and Alzheimer’s disease (AD). In: Sher L, Vilens A (eds) Neurobiology of post-traumatic stress disorder. Nova Science Publishers, New York, pp 201–216

    Google Scholar 

  • Turner C, Frayne S (2004) Military sexual trauma. Department of Veterans Affairs. http://www.publichealth.va.gov/docs/vhi/military_sexual_trauma.pdf. Accessed on 5 Sep 2016

  • United States Army Medical Department (2015) Sexual assault medical forensic examiner adult and adolescent (SAMFE-A) curriculum. Available by email request to the authors

    Google Scholar 

  • United States Department of Justice Office of Violence Against Women (2013) A national protocol for sexual assault medical forensic examinations – adults/adolescents, 2nd edn. Government Printing Office, Washington, DC

    Google Scholar 

  • United States Government Accountability Office (2015) GAO-15-284: military personnel: actions needed to address sexual assaults of male service members. http://www.gao.gov/assets/670/669096.pdf. Accessed 6 Sep 2016

  • United States Senate (2015) National Defense Authorizations Act. https://www.congress.gov/113/bills/hr4435/BILLS-113hr4435pcs.pdf. Accessed on 3 Aug 2016

  • Web of Science (2016) Thomson Reuters, New York. https://apps.webofknowledge.com. Accessed 1 Apr 2016

  • White AM (2003) What happened? Alcohol, memory blackouts, and the brain. Alcohol Res Health 27(2):186–196

    PubMed  Google Scholar 

  • Yaeger D, Himmelfarb N, Cammack A et al (2006) Posttraumatic stress disorder in female veterans with military and civilian sexual trauma. J Trauma Stress 19(6):837–846

    Article  PubMed  Google Scholar 

  • Yaffe K, Vittinghoff E, Lindquist K et al (2010) Posttraumatic stress disorder and risk of dementia among US veterans. Arch Gen Psychiatry 67:608–613

    Article  PubMed  PubMed Central  Google Scholar 

  • Zimmerman M (2015) Rudderless: 15 years and still little direction on the boundaries of military rule of evidence 513. Mil L Rev 223:312

    Google Scholar 

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Authors and Affiliations

  1. Center for Forensic Behavioral Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA

    David E. Johnson

  2. Benesh & Yeaw Consulting LLC, Upper Marlboro, MD, USA

    Jennifer Yeaw

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  1. David E. Johnson
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  2. Jennifer Yeaw
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Correspondence to David E. Johnson .

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Editors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA

    Laura Weiss Roberts

  2. US Army Medical Department Active Duty, Fort Stewart, Georgia, USA

    Christopher H. Warner

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Johnson, D.E., Yeaw, J. (2018). Military Sexual Assault. In: Roberts, L., Warner, C. (eds) Military and Veteran Mental Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7438-2_17

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  • DOI: https://doi.org/10.1007/978-1-4939-7438-2_17

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