3064 — The Effect on Women's Health Outcomes by Type of Trauma Exposure

Mengeling MA (Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Iowa City VA Medical Center and University of Iowa), Sadler AG (CRIISP, Iowa City VAMC), Torner JC (Iowa City VAMC and Univeristy of Iowa), Booth BM (Center for Mental Healthcare Outcomes and Research, Central Arkansas Veterans Healthcare System, University of Arkansas)

Objectives:
To determine if there are differences in women’s health outcomes by type of trauma exposures. Traumatic events are grouped by military trauma, lifespan trauma, and sexual assault.

Methods:
1004 women ( < 52 years of age) participated in a retrospective study of current health, health risk behaviors, and care utilization of veterans. Consenting women seeking care from two Midwestern VAMCs and outlying clinics within the preceding five years completed a computer assisted telephone interview. Depression was measured by the Composite International Diagnostic Interview (CIDI-SF) and PTSD symptoms with the PTSD Symptom Scale (PSS-I).

Results:
Mean age of participants was 38 (8.8 sd). Fifty-one percent of participants reported one or more lifetime rapes with 32% (321) experiencing MST. Repeated occurrence of rape during military was reported by 37%. Women experiencing MST were significantly more likely to report childhood rape (41% vs 26%) and rape following military service (18% vs 8%) (p < .0001). Women were asked about traumatic events from the Diagnostic Interview Schedule for DSM-IV augmented with detailed combat events. The most commonly experienced trauma was having a close friend or relative die suddenly (75%). Of those serving in combat (n = 296), 67% had experienced incoming artillery, mortar or scud missiles. Sexual assault was the event most often identified as the greatest traumatic event. There was no significant difference in physical or mental health scores as measured using the SF12 for those who had experienced a military trauma or life span trauma, but there was a significant difference in mental health scores for those who had experienced a sexual trauma (p < .05). Women experiencing a sexual trauma were more likely to be depressed (39% vs 16%, p < .0001) or to have a PTSD diagnosis (35% vs 11%) compared to their non-assaulted peers; 22% of those experiencing a sexual trauma were diagnosed with both PTSD and depression.

Implications:
Women appear to be resilient to military and lifespan traumas. However, sexual assault has long lasting effects on women’s health, most notably mental health, whenever it occurs in a women’s life.

Impacts:
Screening for sexual assault exposures throughout life is vital in order to address veteran’s health care needs.