Physical and sexual assault among women veterans: Effects on physical and mental health

Armand C, Simon B, Lanto AB, Bradley A, Rubenstein LV. Physical and sexual assault among women veterans: Effects on physical and mental health. Paper presented at: VA HSR&D National Meeting; 2001 Feb 14; Washington, DC.

Objectives: Physical and sexual trauma among women veterans is emerging as a major health care issue in the provision of VA care for women. Before effective treatment to address the adverse health effects of such trauma can be determined, VA needs a better understanding of physical and sexual trauma prevalence among women veterans and its associated physical and mental health effects. We performed an analysis of the results of a pilot study with women veterans to determinelifetime prevalence and its associated physical and mental health symptoms.Methods: We conducted an analysis of pilot data on lifetime physical and sexual abuse reported by a convenience sample of 53 woman visiting primary care outpatient clinics at two VA medical centers, one rural, one urban. These respondents answered an interviewer-administered survey assessing their trauma experiences, health and health care utilization, including use of counseling services. The survey used previously validated measures of sexual and physical abuse over the life course, the MHI-5 measure of emotional well-being, and basic and intermediate activities of daily living (FSQ). We used multivariable regression to assess impact on use of counseling services of years since the assault and age at first assault.Results: Preliminary analysis indicates that of 51 respondents, 59% (32) reported physical assault during their lifetime. Of these 32 women, 34% experienced assault during their military service. Of 52 respondents, 46% (25) reported sexual assault, and 28% (7) of the 25 reported military sexual assault. Women reporting either physical or sexual trauma had significantly lower scores on the MHI-5 than women reporting no trauma (p = 0.01, p = 0.002, respectively). Women who experienced assault, either physical or sexual, also scored lower on basic activities of daily living (p = 0.019). 39% of assaulted women veterans used counseling services as opposed to no counseling use by those who were not assaulted. There was no effect on counseling use in relation to years since the assault or to age at first assault.Conclusions: Of our sample of women veterans seeking treatment at a VA center, a high proportion reported physical and sexual assault and those that reported assault demonstrated poorer mental health. One third of the women experienced assault during their military service. Women veterans with a history of assault had greater difficulty than those without assault in performing basic activities of daily living. Although rates of counseling use among assaulted women were high compared to women who were not assaulted, the majority of those assaulted were never counseled.Impacts: 1. Those caring for women veterans should have a high index of suspicion for a history of physical or sexual assault, either before or after military service. 2. Assaulted women should be monitored closely for mental and emotional distress, as well as for impaired daily functioning. 3. More information is needed about how best to improve outcomes among assaulted women veterans.