The Impact of Sexual Functioning Problems on Mental Well-Being In U.S. Veterans from the Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Conflicts

ABSTRACT

Substantial literature currently exists linking medically-related sexual problems and Health Related Quality of Life (HRQoL). This study explores the impact of global/non-medically linked sexual functioning problems and HRQoL in United States (U.S.) Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. A total of 415 veterans newly registered to the Veterans Health Administration (VA) completed measures of demographic, mental health and physical health-related diagnoses and symptoms, including questions specific to sexual functioning. A multiple linear regression analysis was performed to examine associations between mental and physical component scores and sexual functioning problems. Age, hypertension, pain, depression, anxiety disorder, post-traumatic stress disorder, and substance abuse were included as covariates. Findings indicated that sexual dysfunction had a strong negative effect on the SF-36 Mental Component Summary (MCS) scale after adjusting for multiple physical and mental health characteristics. Although a number of covariates were significantly related to the MCS scale, sexual functioning problems exhibited a unique contribution to mental wellbeing. This study highlights the presence of sexual dysfunction in this rather young veteran cohort and its significant negative overall impact on wellbeing. Consequently, provider screening of sexual health needs within the VA system as part of holistic and veteran-centric healthcare model should be considered.

KEYWORDS:

• Sexual functioning
• U.S. veterans
• quality of life
• health-related quality of life
• HRQoL
• mental well-being
• emotional well-being
• OEF
• OIF

Acknowledgments

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Notes

*Positive response to either of two criteria: impotence or other sexual problems (yes); diminished sexual function or desire (yes).

^†Depression screen was positive if affirmative response to either: (1) During the past month have you often been bothered by feeling down, depressed, or hopeless? (2) During the past month have you often been bothered by little interest or pleasure in doing things?

^‡Positive PTSD screen with DTS score ≥40

^§Positive substance abuse screen if either AUDIT score ≥5 or DAST score ≥2.

^†Ware, Kosinski, & Keller, 1994.