Cumulative trauma and midlife well-being in American women who served in Vietnam: effects of combat exposure and postdeployment social support

Abstract

Background and Objectives: Research increasingly demonstrates that trauma exposure can have cumulative effects, yet much remains to be learned about effects of cumulative trauma, particularly regarding longer term adjustment. One such trauma, combat exposure, is insufficiently understood, especially for women, who are increasingly engaged in professional combat activities. Design: The study comprised a cross-sectional survey assessing multiple aspects of current well-being in women approximately 25 years after their service in Vietnam during the Vietnam War. Methods: Participants were 1374 women (78% military and 22% nonmilitary; mean age = 59.7). This study investigated the relations between three separate categories of trauma exposure (childhood, adulthood, and combat) and well-being and examined whether perceived social support at return from Vietnam moderated the association between combat exposure and well-being. Results: While both childhood and adulthood trauma exposure related to midlife well-being, combat exposure still uniquely predicted outcomes. Further, postdeployment perceived social support moderated the association of combat and well-being: recollected higher perceived social support at homecoming buffered participants from the links between combat exposure and well-being. Conclusions: These results may have important implications for interventions to reduce the impact of traumatic experiences, particularly in light of the increasing exposure of women to direct combat events.

Keywords:

• trauma
• women
• combat exposure
• perceived social support
• PTSD

Acknowledgement

The authors express their appreciation to the Women's Vietnam Memorial Project, Inc., for its collaboration and to their colleagues in the Stress, Health, and Aging Research Program (SHARP), VA Boston Healthcare System.

Additional information

Funding

Study design and data collection were supported by the National Academy of Sciences Subcontract [NAS-VA-5124-98-001]. Support for this study was also provided by the Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System.