Posttraumatic Stress Symptomatology as a Mediator of the Association Between Military Sexual Trauma and Post-Deployment Physical Health in Women

Abstract

This study examined posttraumatic stress symptomatology (PSS) as a mediator of the association between military sexual trauma and post-deployment physical health. Relationships were examined in a sample of 83 female veterans of the first Gulf War (1990–1991) approximately 10 years post-deployment. Participants reported on the frequency of sexual harassment and sexual assault experienced during deployment. Physical health was measured using participants' self-reports of pre-deployment and post-deployment symptoms within 7 body systems. Sexual harassment exposure was not found to be associated with PSS-mediated associations with physical health symptoms. However, sexual assault during deployment was found to be associated with PSS and 4 of the 7 health symptom clusters assessed: gastrointestinal, genitourinary, musculoskeletal, and neurological symptoms. Furthermore, PSS was found to be a significant mediator of the sexual assault–physical health relationship in each of these domains, with the indirect path accounting for 74% to 100% of the relationship. The findings from the current study indicate that sexual assault has detrimental associations with physical health and that PSS plays a primary role in that relationship.

Keywords:

• posttraumatic stress symptomatology
• posttraumatic stress disorder
• physical health
• women's health
• military sexual trauma
• Gulf War
• sexual assault
• sexual harassment

Acknowledgments

This study was supported by a Department of Defense/Department of Veterans Affairs grant (“Measurement and Validation of Psychosocial Risk and Resilience Factors Associated With Physical and Mental Health-Related Quality of Life in Persian Gulf War Veterans,” PG Project DoD-87, Daniel W. King and Lynda A. King, co-principal investigators). The authors also thank the National Center for PTSD for ongoing support.

Notes

1. Approximately half of the participants from the current sample also responded to items assessing alcohol use and depression. Additional mediational analyses were tested for this subgroup controlling for depression and alcohol use, and the results, although only based on a subsample, did mirror the findings of the larger study, such that including these additional variables as covariates yielded the same pattern of significant findings observed in the primary analyses on sexual assault. However, in the interest of preserving statistical power, the study sample was not limited to just those individuals who completed these additional measures.