Gender Differences in Combat Exposure, Military Sexual Trauma, and Mental Health among Active Duty Soldiers
BACKGROUND:
The number of women in the military has significantly increased in the last decade, with women currently representing 15% of active duty and 17% of National Guard/Reserve personnel. The number of female Veterans has grown in tandem, with a two-fold increase in female Veterans over the last 20 years. Further, in the OEF/OIF conflicts, women on operational deployments are performing an expanded scope of duties in combat environments. Overall, war zone exposures have increased for women serving in OEF/OIF, and there is growing literature on the rising prevalence and incidence of mental health disorders among OEF/OIF Veterans (male and female). This study examined gender differences in combat exposure, military sexual trauma (MST), and their associations with mental health outcomes among OEF/OIF active-duty personnel. From 3/06 through 7/09, data were collected for 7,251 active duty soldiers (6,697 men and 554 women) as part of a pre- and post-deployment screening program at one large Army facility. Investigators assessed demographic and military service variables (e.g., age, race/ethnicity, rank, number of deployments), in addition to combat exposure, MST, PTSD symptoms, depression symptoms, and alcohol use.
FINDINGS:
- Although men reported greater exposure to high-intensity combat experiences than women, results indicate that women are experiencing combat at higher rates than observed in prior cohorts. For example, 7% of women reported injury in the war zone, and 4% reported killing in war, compared to 2% and 1%, respectively, for a Gulf War cohort.
- MST was a significant predictor of both PTSD and depression symptoms: 12% of women and less than 1% of men reported MST in the war zone.
- There were no gender differences in PTSD symptoms; however, there was a stronger association between injury in combat and PTSD symptoms for women than for men.
- Men were more likely to report hazardous alcohol use, while female gender was more likely to be associated with depression symptoms.
LIMITATIONS:
- This study was conducted with active duy OEF/OIF soldiers at one Army installation, thus results may not be generalizable.
- Outcomes were based on self-report measures used for mental health screening rather than diagnostic instruments.
IMPLICATIONS:
Authors note that findings indicate it would be useful for clinicians to assess for exposure to a full range of traumatic combat experiences, as not all types of combat experiences may be equally experienced by men and women.
AUTHOR/FUNDING INFORMATION:
This study was partly funded by HSR&D. Dr. Maguen is part of HSR&D’s Program to Improve Care for Veterans with Complex Comorbid Conditions, San Francisco, CA.
Maguen S, Luxton D, Skopp N, and Madden E. Gender Differences in Traumatic Experiences and Mental Health in Active Duty Soldiers Redeployed from Iraq and Afghanistan. Journal of Psychiatric Research December 13, 2011;e-pub ahead of print.