Examining the Association between Trauma Exposure and Work-Related Outcomes in Women Veterans.

Megan E Sienkiewicz,Brian N Smith,Karen S Mitchell,Aneline Amalathas,Katherine M Iverson

doi:10.3390/ijerph17124585

Abstract

Women veterans have high rates of trauma exposure, including military sexual trauma (MST), which are associated with numerous health and psychosocial consequences. However, associations between trauma history and work-related outcomes are less well-characterized. We examined whether military-related and non-military trauma types were associated with work-related outcomes and whether posttraumatic stress disorder (PTSD) and depression symptoms mediated these associations. A total of 369 women veterans completed up to two mailed surveys, 12 months apart, assessing trauma exposure, depression and PTSD symptoms, occupational functioning, and employment status (unemployed, out of the workforce, employed). Participants reported high rates of trauma exposure. Nearly half (47.5%) were out of the workforce. Military-related trauma, military sexual assault, and adult sexual assault were associated with worse occupational functioning. Only PTSD symptoms mediated associations between trauma types and occupational functioning. No trauma types were significantly directly associated with employment status; however, PTSD and depression symptoms mediated associations between trauma types and being out of the workforce. Findings can inform screening for military trauma exposures, mental health, and work-related needs among women veterans.

Highlights

The majority (51–69%) of women in the U.S report trauma exposure at some point in their lives [1], including adult and childhood sexual assault and physical assault, and intimate partner violence (IPV)
We examined the potential mediating roles of depression and posttraumatic stress disorder (PTSD) symptoms, respectively, for all models as independent variables may be indirectly associated with outcomes, even in the absence of direct effects [38]
We found that PTSD symptom scores mediated the relationships between military sexual trauma (MST), military sexual assault (MSA), military sexual harassment (MSH), military-related trauma, adult physical assault, adult sexual assault, and childhood physical assault, respectively, and occupational functioning

Summary

Introduction

The majority (51–69%) of women in the U.S report trauma exposure at some point in their lives [1], including adult and childhood sexual assault and physical assault, and intimate partner violence (IPV). Women veterans experience high rates of lifetime trauma exposure (i.e., 81–93%) [2], including military sexual trauma (MST) [3], defined as sexual harassment and/or sexual assault experiences during military service. The latest Department of Defense (DoD) annual report on sexual assault in the military [4] reported that 24.2% of active duty females experienced sexual harassment during the 2018 fiscal year and 6.2% experienced sexual assault during the same period. Women veterans report high rates of interpersonal violence in general, e.g., 37% of a sample of women veterans reported past-year intimate partner violence (IPV) [5].

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Results

Discussion

Conclusion