User:Atcovi/Psychopathology/Paper2

Objective in a Gist: Purpose was to look at incidents of sexual assault in female veterans and the relationship to PTSD and mental health care utilization, pre and post 9/11. 325 female vets were identified for inclusion, 40% reported sexual assault and majority of them met diagnosis of PTSD. 2583 veterans were considered through online/in-person surveys.

Highlights the issue of sexual assault in the military and how it's gone up by 88% from 2007-2013. Few of them are reported out of fear of reprecussions. Because of the increase in assault and lack of adequate provisions to deal with it (mainly because a lack of reports), it is important for "care systems" to address the issue sufficiently.

Sexual Trauma in the Military and PTSD

 * Women who enlist have higher chances of having childhood trauma vs. women that did not enlist.
 * Women have harder time with PTSD from sexual trauma due to military culture ("shut up so you can focus on the task!").
 * Wide-range of physical/psychological effects from PTSD.

Health Care Utilization

 * Health cares are used for sexual assault victims, but not very well known for military populations.
 * Female vets who experience sexual assault in the military are less likely to use health care services + lower cost of health care vs. civilian sexual assault, even though PTSD is higher in female vets. Though MST-related care has increased, now present in 92% of VA health centers.
 * Issues still remain: females may feel that MST services are not adequate in a male dominated society (military), fear of focus on medication vs. focus on actually dealing with the trauma, stigma, no education, and lack of support in a male dominated culture.

Method

 * 2583 veterans in South CA, invitation to participate in study through recruitment strategy. 1st strat was a state agency of veterans' contact info, email was sent. 2nd strat was community call centers to find potential participants through initial screening processes. 3rd strat was using national veteran organization, which any vets in the desired zip codes were emailed. 4th strat was working with agencies that provides benefits to veterans. Methods of communication include agencies send an email inviting them to survey, while the other method was an on-ground survey. 5th strat was going to college veteran agencies and see who's willing and eligible. The last strat was TV/printed advertisements and just general advertising. A $15 gift card was rewarded.

Study Variables and Measures

 * Demographic variables: Included
 * PTSD checklist: Used to assess 17 symptoms of PTSD. Rate each item from 1-5. Scores range from 17-85, with a score of >50 significant PTSD.
 * Sexual trauma in military: Looks at sexual harassment and sexual assault. Second item looked at if there were unconsensual sexual incidents.
 * Utilization of mental health services: Did they seek help? Did they get mental health counseling?

Results

 * 327 vets = females. Divided between pre-9/11 and post-9/11. A bunch of demographics have been reported.

Sexual Trauma in the Military and PTSD

 * 40% sample reported sexual assault.
 * PCL scores had a mean of 42.
 * 35% of the sample met the clinical cutoff score of 50, 76% of these people reported experiencing sexual assault.
 * pre-9/11: 48%, 53% of these people met the cutoff score on PCL.
 * post-9/11: 30%, 65% met cutoff score of PTSD, 24% of these females who did not experience sexual assault still met PTSD diagnostic.

Service Utilization
Majority of both pre and post 9/11 vets did not seek help during military service, only 10% (pre 911) and 18% (post 9/11) - though 81% and 76% of pre and post have sought mental health services. 27% of pre09/11 and 32% of post09/11 vets who did not get sexually assaulted have recieved mental counseling within the last year.

Discussion

 * Reports of sexual assault incidents is consistent with what was posted among female vet samples (20% - 43%).
 * Scary increase in pre-9/11 female vets reporting sexual assault.
 * Consistent with post09/11 vets reporting of sexual assault incidents.
 * Highlights limitations of reported sexual assaults in military becuase... research methodology, sample selection, and what really constitutes as a sexual assault.

Scientists regard that sexual assault less to majority of PTSD symptoms. 1/3 of women reported significant PTSD symptoms.

Sexual assaults are lower in post-9/11 vets than pre-9/11 vets, why?


 * 1) SAPR program
 * 2) Increased awareness of MST
 * 3) More women in military, less male dominated.

Precieved "barriers" make it harder for those who experience MST to deal with their symptoms of depression/PTSD. Some may not even acknowledge it. Not sure how a "high use of VA mental health services" represent long-term psycho problems.

CONCLUDING STATEMENTS


 * Geographical location is very limited.
 * Though MST is still prominent in post 9/11 vets. Emphasis on preventing sexual assault and promoting a more open environment rather than "toughness".
 * Treatment should be open, address isues, be private and nonjudgmental.
 * Opens up with possible Internet-based technologies to treat sexual trauma.