Self- and Other-Directed Violence as Outcomes of Deployment-Based Military Sexual Assault

ABSTRACT

Although military sexual assault (MSA) has been well established as a risk factor for psychopathology (e.g., PTSD, depression), little research has examined the association between MSA and self- and other-directed violence. Furthermore, there has been a growing empirical focus on potential gender differences in the effects of MSA, but few of these studies have examined gender differences in self- and other-directed violence. In a sample of 1571 Iraq/Afghanistan-era veterans (21.0% women), we examined the effect of MSA on difficulty controlling violent behavior and attempting suicide among veteran men and women, above and beyond the influence of childhood sexual abuse, combat trauma, PTSD, and major depressive disorder. Results of a logistic regression revealed that MSA increased risk of attempting suicide and difficulty controlling violence among women but not men. Thus, the results suggest that MSA may be a risk factor for both types of violence in women. Furthermore, because PTSD was associated with both types of violence in both men and women, MSA may also confer risk of violence via PTSD.

KEYWORDS:

• Military sexual trauma
• functional correlates
• suicidal ideation
• suicide attempt
• aggression

Acknowledgments

The VA Mid-Atlantic MIRECC Workgroup contributors for this paper include: Mira Brancu, PhD, John A. Fairbank, PhD, Robin A. Hurley, MD, Jason D. Kilts, PhD, Angela Kirby, MS, Christine E. Marx, MD, MS, Scott D. McDonald, PhD, Scott D. Moore, MD, PhD, Rajendra A. Morey, MD, MS, Jennifer C. Naylor, PhD, Jared Rowland, PhD, Cindy Swinkels, PhD, Steven T. Szabo, MD, PhD, Katherine H. Taber, PhD., Larry A. Tupler, PhD, Elizabeth E. Van Voorhees, PhD, H. Ryan Wagner, PhD., Ruth E. Yoash-Gantz, PsyD. Dr. Van Voorhees is funded by VA Rehabilitation Research and Development Career Development Award #1K2RX001298. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Disclosure of Interest

None of the authors have any conflicts of interest to report.

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants included in the study.

Additional information

Funding

This work was supported, in part, by a Merit Award (#I01 CX001486) to Dr. Kimbrel from the Clinical Science Research and Development Service (CSR&D) of the Department of Veterans Affairs (VA) Office of Research and Development (ORD), a Research Career Scientist Award (#11S-RCS-009) to Dr. Beckham from CSR&D, and a Career Development Award (#IK2 HX002398) to Dr. Sarah Wilson from VA Health Services and Research Development (HSR&D), and Merit Review Award Number (#I01 CX001757-01) to Dr. Dedert from the United States (U.S.) Department of Veterans Affairs Clinical Sciences R&D (CSRD) Service. This work was also supported by the VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC) and the Durham Veterans Affairs Medical Center.