StrongVeterans.com Blog The Burden of Military Sexual Trauma in US Veterans

Sexual harassment and sexual assaults occurring within the military have begun to receive increased public attention in the wake of recent reports of the
high prevalence of sexual traumas among returning veterans from Iraq and Afghanistan, as well as
the public testimony of survivors and their advocates. The term military sexual trauma (MST) was developed to aid in screening and
advocacy efforts within the Department of Veterans Affairs (VA). The VA defines MST as “sexual harassment that is threatening in character or physical
assault of a sexual nature that occurred while the victim was in the military regardless of geographic location of the trauma, gender of the victim or the
relationship to the perpetrator.” Previous studies have reported a range of estimates of the prevalence of MST, in part due to differences in the samples
studied or the definition of MST used.

In our study of a contemporary, nationally representative sample of
US veterans spanning World War II to more recent war eras, we found that a substantial portion of US veterans—7.6%—reported a history of MST, including
32.4% of female veterans and 4.8% of male veterans. Factors positively associated with MST in our study included female sex, younger age (the highest rate
of MST was in veterans aged 18–29 years), racial/ethnic minority status, enlisted status, and history of childhood sexual abuse.

Veterans with a history of MST in our study were 2–3 times more likely than those without a history of MST to screen positive for PTSD, depression,
generalized anxiety disorder, and social phobia and to report current thoughts of suicide, as well as a history of suicide attempt. They also reported
greater severity of somatic symptoms, as well as lower mental and cognitive functioning and quality of life. Notably, a history of MST was associated with
increased likelihood of engagement in mental health treatment, independent of PTSD and depression, suggesting that the experience of MST, in and of itself,
may motivate mental health treatment seeking in veterans. Taken together, these findings suggest that MST is associated with a broad range of negative
health effects and underscore the importance of integrated health care for veterans with a history of MST.

The VA has implemented universal screening initiatives and dedicated clinicians for coordination of care of veterans with a history of MST. However, underreporting of MST is thought
to be common, and the majority (69.4%) of veterans with a history of MST in our study reported that the VA is not their primary source of health care.
Thus, it may be helpful for health care providers in all sectors of the health care system to screen for MST in veterans and to be aware of the broad range
of negative health outcomes associated with MST in this population. Expanding such efforts beyond the VA health care system may further aid in reducing the
stigma faced by veterans with a history of MST and may be helpful in further reducing the culture of silence surrounding this issue.

Financial disclosure:Dr Klingensmith
had no relevant personal financial relationships to report. Dr Pietrzak is a consultant for Cogstate and has received grant/research
support from NIH and DoD.

For related material on mental health issues in the military, please visit StrongVeterans.com.