Skip to main content

Polytrauma with Sexual Dysfunction in a Female Soldier Following IED Blast Exposure

  • Chapter
  • First Online:
Posttraumatic Stress Disorder and Related Diseases in Combat Veterans

Abstract

Women represent a significant proportion of the military forces and female veterans of the OIF/OEF conflicts have extensive combat experiences. Exposure to combat and improvised explosive devices during the recent conflicts has led to a frequent pattern of polytraumatic injuries, both somatic and psychological. Factors relevant to women living with these injuries are reviewed and comparisons with men sustaining similar injuries are made. We refer to the literature to discuss each of these aspects. We discuss a case exemplifying these topics from initial consultation through management techniques used during the initial stages of rehabilitation. The case is formulated using the Biocognitive Model and its implications for treatment are discussed. We provide clinical pearls and pitfalls that relate to the unique challenges and management of women facing rehabilitation from war wounds.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sternke LM. Measurement of military combat exposure among women: analysis and implications. Women’s Health Issues. 2011;21(4 Suppl):S160–8.

    Article  PubMed  Google Scholar 

  2. Boyd MA, Bradshaw W, Robinson M. Mental health issues of women deployed to Iraq and Afghanistan. Arch Psychiatr Nurs. 2013;27(1):10–22.

    Article  PubMed  Google Scholar 

  3. Vogt D, Vaughn R, Glickman ME, Shultz M, Drainoni M, Elwy R, Eisen S. Gender differences in combat-related stressors and their association with postdeployment mental health in a nationally representative sample of U.S. OEF/OIF Veterans. J Abnorm Psychol. 2011;120(4):797–806.

    Article  PubMed  Google Scholar 

  4. U.S. military casualty conflicts reports: Defense Casualty Analysis System Web site. https://www.dmdc.osd.mil/dcas/pages/main.xhtml Accessed: 19 Feb 2015.

  5. Mossadegh S, Tai N, Midwinter M, Parker P. Improvised explosive device related pelvi-perineal trauma: anatomic injuries and surgical management. J Trauma Acute Care Surg. 2012;73(2 Suppl 1):S24–S31.

    Article  PubMed  Google Scholar 

  6. Sharma DM, Webster CE, Kirman-Brown J, Mossadegh S, Whitbread T. Blast injury to the perineum. J Royal Army Med Corps. 2013;159(Issue Suppl 1):i1–3.

    Article  Google Scholar 

  7. Cater JK. Traumatic amputation: psychosocial adjustment of six Army women to loss of one or more limbs. J Rehabil Res Dev. 2012;49(10):1443–56.

    Article  PubMed  Google Scholar 

  8. Julia PE, Othman AS. Barriers to sexual activity: counselling spinal cord injured women in Malaysia. Spinal Cord. 2011;49:791–4.

    Article  CAS  PubMed  Google Scholar 

  9. Belmont PJ Jr, McCriskin BJ, Hsiao MS, Burks R, Nelson KJ, Schoenfeld AJ. The nature and incidence of musculoskeletal combat wounds in Iraq and Afghanistan (2005–2009). J Orthop Trauma. 2013;27(5):e107–13. doi:10.1097?BOT.0b013e3182703188.

    Article  PubMed  Google Scholar 

  10. Ghetti C, Lowder JL, Ellison R, Krohn MA, Moalli P. Depressive symptoms in women seeking surgery for pelvic organ prolapse. Int Urogynecol J. 2010;21(7):855–60.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006;194(5):1455–61.

    Article  PubMed  Google Scholar 

  12. Zeleke BN, Ayele TA, Woldetsadik MA, Bisetegn TA, Adane AA. Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia. BMC Psychiatry. 2013;13:236.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Khan ZA, Whittal C, Mansol S, Osborne LA, Reed P, Emery S. Effect of depression and anxiety on the success of pelvic floor muscle training for pelvic floor dysfunction. J Obstet Gynaecol. 2013;33(7):710–4.

    Article  CAS  PubMed  Google Scholar 

  14. Lucas PA, Page PRJ, Phillip RD, Bennett AN. The impact of genital trauma on wounded servicemen: qualitative study. Injury (Int J Care Injured). 2014;45(5):825–9.

    Article  CAS  Google Scholar 

  15. Fisher H. A guide to U.S. military casualty statistics: Operation Inherent Resolve, Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom. Congressional Research Service. https://www.fas.org/sgp/crs/natsec/RS22452.pdf Published November 20, 2014. Accessed: 16 Feb 2014.

  16. Benetato BB. Posttraumatic growth among operation enduring freedom and operation Iraqi freedom amputees. J Nurs Scholarsh. 2011;43(3):412–20.

    Article  PubMed  Google Scholar 

  17. Belon HP, Vigoda DF. Emotional adaptation to limb loss. Phys Med Rehabil Clin N Am. 2014;25:53–74.

    Article  PubMed  Google Scholar 

  18. Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder. Arlington, VA: American Psychiatric Association Practice Guidelines; 2004.

    Google Scholar 

  19. de Roos C, Veenstra AC, de Jongh A, den Hollander-Gijsman ME, van der Wee NJA, Zitman FG, van Rood YR. Treatment of chronic phantom limb pain using a trauma-focused psychological approach. Pain Res Manag. 2010;15(2):65–71.

    PubMed Central  PubMed  Google Scholar 

  20. Schneider J, Hofmann A, Rost C, Shapiro F. EMDR in the treatment of chronic phantom limb pain. Pain Med. 2008;9(1):76–82.

    Article  PubMed  Google Scholar 

  21. Kimerling R, Gima K, Smith MW, Street A, Frayne S. The Veterans Health Administration and military sexual trauma. Am J Public Health. 2007;97:2160–6.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Maguen S, Luxton DD, Skopp NA, Madden E. Gender differences in traumatic experiences and mental health in active duty soldiers redeployed from Iraq and Afghanistan. J Psychiatr Res. 2012;46:311–6.

    Article  PubMed  Google Scholar 

  23. Hourani L, Williams J, Brav R, Kandel D. Gender differences in the expression of PTSD symptoms among active duty military personnel. J Anxiety Disord. 2015;29:101–8.

    Article  PubMed  Google Scholar 

  24. King MW, Street AE, Gradus JL, Vogt DS, Resick PA. Gender differences in posttraumatic stress symptoms among OEF/OIF Veterans: an item response theory analysis. J Trauma Stress. 2013;26:175–83.

    Article  PubMed  Google Scholar 

  25. Nillni YI, Pineles SL, Patton SC, Rouse MH, Sawyer AT, Rasmusson AM. Menstrual cycle effects on psychological symptoms in women with PTSD. J Trauma Stress. 2015; epub ahead of print, published online January 22, 2015. doi:10.1002/jts.21984.

    Google Scholar 

  26. Resnick EM, Mallampalli M, Carter CL. Current challenges in female veteran’s health. J Women’s Health. 2012;21(9):895–900.

    Article  Google Scholar 

  27. McLaren N. The mind-body problem explained: the biocognitive model for psychiatry. Ann Arbor: Future Psychiatry Press; 2012.

    Google Scholar 

  28. Stahl SM. Stahl’s essential psychopharmacology: the prescriber’s guide. 3rd ed. New York: Cambridge University Press; 2009.

    Google Scholar 

  29. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000;38:319–45.

    Article  CAS  PubMed  Google Scholar 

  30. Westbrook D, Kennerley H, Kirk J. An introduction to cognitive behavioral therapy: skills and applications. 2nd ed. London: Sage; 2011.

    Google Scholar 

  31. Burns LH. Psychiatric aspects of infertility and infertility treatments. Psychiatr Clin North Am. 2007;30:689–716.

    Article  PubMed  Google Scholar 

  32. About Ground Combat Element Integrated Task Force. Marines.mil Web site. http://www.gceitf.marines.mil/About.aspx. Accessed: 16 Feb 2015.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathan R. Dettmer MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Dettmer, J., Ford, S., Gray, K. (2015). Polytrauma with Sexual Dysfunction in a Female Soldier Following IED Blast Exposure. In: Ritchie, E. (eds) Posttraumatic Stress Disorder and Related Diseases in Combat Veterans. Springer, Cham. https://doi.org/10.1007/978-3-319-22985-0_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22985-0_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22984-3

  • Online ISBN: 978-3-319-22985-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics