Military Sexual Trauma in Older Women Veterans: Prevalence and Comorbidities
Recent attention has highlighted the common occurrence and health consequences of military sexual trauma (MST) in younger women veterans. However, almost nothing is known about MST in older veterans.
To describe MST among older women veterans, including prevalence and common comorbidities.
Cross-sectional observational study, using data from national Department of Veterans Affairs medical records.
Population-based sample of women Veterans aged 55+ with at least one documented MST screen response and at least one clinical encounter in fiscal years 2005–2015.
MST screen: medical diagnoses (diabetes, hypertension, hyperlipidemia, myocardial infarction, cerebrovascular disease, congestive heart failure, obesity, chronic pain conditions, back pain, dementia, insomnia, sleep apnea, menopause symptoms) and mental health diagnoses (anxiety, depression, posttraumatic stress disorder, tobacco use, alcohol use disorder, substance use disorder, opioid use disorder, suicidal ideation) from International Classification of Diseases, Ninth Revision Clinical Modification codes in the medical record.
In this cohort of older women veterans (n = 70,864, mean age 65.8 ± 10.4 years), 13% had a positive MST screen. In multivariable regression analyses adjusted for age, race/ethnicity, and marital status, MST was strongly associated with most mental health diagnoses, particularly posttraumatic stress disorder (OR 7.25, 95% CI 6.84–7.68), depression (OR 2.39, 95% CI 2.28–2.50), and suicidal ideation (OR 2.42, 95% CI 2.08–2.82). MST was also associated with multiple medical conditions, particularly sleep disorders (insomnia OR 1.61, 95% CI 1.43–1.82; sleep apnea OR 1.48, 95% CI 1.37–1.61) and pain (chronic pain OR 1.58, 95% CI 1.50–1.67; back pain OR 1.40, 95% CI 1.34–1.47).
A history of MST is common among older women veterans and associated with a range of medical and mental health diagnoses. These findings call attention to the need for additional research in this understudied population, and the importance of trauma-informed care approaches for women across the lifespan.
KEY WORDSwomen’s health veterans sexual assault mental health chronic disease
CJG, SM, and KY were responsible for the study concept and design. KY obtained funding and supervised the study. FX conducted the statistical analysis. All authors were involved in the interpretation of data. CJG drafted the manuscript, and all authors critically revised it for important intellectual content and approved the final version. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
This research was supported by the Department of Defense Grant W81XWH-16-0507 (PI: Yaffe) and in part by the VA Advanced Fellowship Program in Women’s Health at the San Francisco VA Health Care System and VA HSR&D Career Development Award (CDA IK2 HX002402; CJG).
Compliance with Ethical Standards
The study was approved by the institutional review boards of the University of California, San Francisco and the Research and Development Committee of the San Francisco VA Health Care System.
Conflict of Interest
Dr. Yaffe serves on DSMBs for Takeda Inc. and a National Institute on Aging–sponsored study, and is also member of the Beeson Scientific Advisory Board. All other authors report no disclosures.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs.
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