Journal of General Internal Medicine

, Volume 21, Supplement 3, pp S65–S69

DSM-IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma

  • Deborah Yaeger
  • Naomi Himmelfarb
  • Alison Cammack
  • Jim Mintz
Original Articles


BACKGROUND: This study compares rates of post-traumatic stress disorder (PTSD) in female veterans who had military sexual trauma (MST) with rates of PTSD in women veterans with all other types of trauma.

METHODS: Subjects were recruited at the Women’s Comprehensive Healthcare Center when attending medical or psychiatric appointments or through a mailing; 230 women agreed and 196 completed the study. They completed questionnaires on health and military history, along with the Stressful Life Events Questionnaire (SLEQ). Those who met DSM-IV PTSD Criterion A completed the PTSD Symptom Scale-Interview (PSS-I) on which PTSD diagnoses were based.

RESULTS: Ninety-two percent reported at least 1 trauma. Forty-one percent had MST, alone or with other trauma, and 90% had other trauma, with or without MST. Overall, 43% of subjects with trauma had PTSD. Those with MST had higher rates of PTSD than those with other trauma. Sixty percent of those with MST had PTSD; 43% of subjects with other traumas (with or without MST) had PTSD. Military sexual trauma and other trauma both significantly predicted PTSD in regression analyses (P=.0001 and .02, respectively) but MST predicted it more strongly. Prior trauma did not contribute to the relationship between MST and PTSD.

DISCUSSION: Findings suggest that MST is common and that it is a trauma especially associated with PTSD.

Key words

military sexual trauma PTSD women’s health 


  1. 1.
    Sadler AG, Booth BM, Cook BL, Torner JC, Doebbeling BN. The military environment: risk factors for women’s non-fatal assaults. J Occup Environ Med. 2001;43:325–34.PubMedCrossRefGoogle Scholar
  2. 2.
    Sadler AG, Booth BM, Nielson D, Doebbeling BN. Health-related consequences of physical and sexual violence: women in the military. Obstet Gynecol. 2000;96:473–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Hankin CS, Skinner KM, Sullivan LM, Miller DR, Frayne S, Tripp TJ. Prevalence of depressive and alcohol abuse symptoms among women VA outpatients who report experiencing sexual assault while in the military. J Trauma Stress. 1999;12:601–12.PubMedCrossRefGoogle Scholar
  4. 4.
    Coyle BS, Wolan DL, Van Horn S. The prevalence of physical and sexual abuse in women veterans seeking care at a Veterans Affairs Medical Center. Mil Med. 1996;161:588–93.PubMedGoogle Scholar
  5. 5.
    Sadler AG, Booth BM, Cook BL, Doebbeling BN. Factors associated with women’s risk of rape in the military environment. Am J Ind Med. 2003;43:262–73.PubMedCrossRefGoogle Scholar
  6. 6.
    Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048–60.PubMedCrossRefGoogle Scholar
  7. 7.
    Kilpatrick DG, Saunders BE, Veronen LJ, Best CL, Von JM. Criminal victimization: lifetime prevalence, reporting to police, and psychological impact. Crime Delinquency. 1987;33:479–89.CrossRefGoogle Scholar
  8. 8.
    Dobie DJ, Kivlahan DR, Maynard C, Bush KR, Davis TM, Bradley KA. Posttraumatic stress disorder in female veterans: association with self reported health problems and functional impairment. Arch Intern Med. 2004;164:394–400.PubMedCrossRefGoogle Scholar
  9. 9.
    Wolfe J, Sharkansky EJ, Read JP, Dawson R, Martin JA, Ouimette PC. Sexual harassment and assault as predictors of PTSD symptomatology among US female Persian Gulf War military personnel. J Interpers Violence. 1998;13:40–57.CrossRefGoogle Scholar
  10. 10.
    Fontana A, Rosenheck R. Duty-related and sexual stress in the etiology of PTSD among women veterans who seek treatment. Psychiatric Serv. 1998;49:658–9.Google Scholar
  11. 11.
    Fontana A, Schwartz LA, Rosenheck R. Posttraumatic stress disorder among female Vietnam veterans: a causal model of etiology. Am J Public Health. 1997;87:169–75.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Suris A, Lind L, Kashner M, Borman PD, Petter F. Sexual assault in women veterans: an examination of PTSD risk, health care utilization, and cost of care. Psychosom Med. 2004;66:749–56.PubMedCrossRefGoogle Scholar
  13. 13.
    Skinner K, Sullivan L, Tripp T, et al. Comparing the health status of male and female veterans who use VA health care: results from the VA Women’s Health Project. Women Health. 1999;2:17–31.CrossRefGoogle Scholar
  14. 14.
    Goodman LA, Corcoran C, Turner K, Yuan N, Green BL. Assessing traumatic event exposure: general issues and preliminary findings for the Stressful Life Events Screening Questionnaire. J Trauma Stress. 1998;11:521–42.PubMedCrossRefGoogle Scholar
  15. 15.
    Resnick HS, Kilpatrick DG, Dansky BS, Saunders BE, Best CL. Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. J Consult Clin Psychol. 1993;61:984–91.PubMedCrossRefGoogle Scholar
  16. 16.
    Kilpatrick DG, Edmunds CN, Seymour AK. Rape in America: A REPORT to the Nation. Arlington, VA: National Victim Center and Medical University of South Carolina; 1992.Google Scholar
  17. 17.
    Foa E, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing posttraumatic stress disorder. J Trauma Stress. 1993;6:459–79.CrossRefGoogle Scholar
  18. 18.
    American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. 4th edn. Washington, DC: American Psychiatric Association; 1994.Google Scholar
  19. 19.
    SPSS. Version 13.0.1 for Windows. Chicago, IL: SPSS Inc.; 2004.Google Scholar
  20. 20.
    Washington DL, Yano EM, Simon B, Sun S. To use or not to use—what influences why women veterans choose VA healthcare? J Gen Intern Med. 2006;21(3):S11-S18.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Skinner KM, Christiansen CL, Frayne SM, et al. Status of VA women veterans health program perceptions of women veterans coordinators: Results of a national survey: final report. Bedford, MA: Center for Health Quality, Outcomes, and Economic Research, Health Services Research and Development Service; 2000. Project No.: XVA 65-003.Google Scholar
  22. 22.
    Martin L, Rosen LN, Durand DB, Stretch RH, Knudson KJ. Prevalence and timing of sexual assaults in a sample of male and female U.S. Army soldiers. Mil Med. 1998;163:213–6.PubMedGoogle Scholar
  23. 23.
    Skinner KM, Kressin N, Frayne S, et al. The prevalence of military and sexual assault among female Veterans Administration outpatients. J Interpers Violence. 2000;15:291–310.CrossRefGoogle Scholar
  24. 24.
    Moffeit M, Herdy A. Betrayal in the ranks. The Denver Post. 2003 November 15; Sect. 1:A (col. 1).Google Scholar
  25. 25.
    Calhoun PS, Bosworth HB, Grambow SC, et al. Medical service utilization by veterans seeking help for posttraumatic stress disorder. Am J Psychiatry. 2002;159:2081–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Zoellner LA, Goodwin ML, Foa EB. PTSD severity and health perceptions in the female victims of sexual assault. J Trauma Stress. 2000;13:635–49.PubMedCrossRefGoogle Scholar
  27. 27.
    Zatzick DF, Weiss DS, Marmar CR, et al. Post-traumatic stress disorder and functioning and quality of life outcomes in female Vietnam veterans. Mil Med. 1997;162:661–5.PubMedGoogle Scholar
  28. 28.
    Calhoun PS, Bosworth HB, Grambow SC, Dudley TK, Beckham JC. Medical service utilization by veterans seeking help for posttraumatic stress disorder. Am J Psychiatry. 2002;159:2081–6.PubMedCrossRefGoogle Scholar
  29. 29.
    Schnurr PP, Friedman MJ, Sengupta A, Jankowski MK, Holmes T. PTSD and utilization of medical treatment services among male Vietnam veterans. J Nerv Ment Dis. 2000;188:496–504.PubMedCrossRefGoogle Scholar
  30. 30.
    Hoge CW, Lesikar SE, Guevara R, et al. Mental disorder among U.S. military personnel in the 1990s: association with high levels of health care utilization and early military attrition. Am J Psychiatry. 2002;159:1576–83.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2006

Authors and Affiliations

  • Deborah Yaeger
    • 1
    • 2
  • Naomi Himmelfarb
    • 1
  • Alison Cammack
    • 3
  • Jim Mintz
    • 2
  1. 1.Women’s Comprehensive Healthcare CenterVA Greater Los Angeles Healthcare SystemLos AngelesUSA
  2. 2.Department of Psychiatry and Biobehavioral SciencesUCLA David Geffen School of MedicineLos AngelesUSA
  3. 3.Department of Psychiatry and Human BehaviorUniversity of California at IrvineIrvineUSA

Personalised recommendations