Military sexual violence and cannabis use disorder among OEF/OIF veterans

Abstract

Sexual violence experienced during military service can have lasting negative psychosocial effects on veterans long after service ends. Current research reports veterans who have experienced military sexual violence are more likely to develop mental health and substance use disorders. Little is known, though, about the relationship between military sexual violence and subsequent cannabis use disorder (CUD). The current study investigated prevalence of military sexual violence among a large sample of OEF/OIF veterans (N = 1,005), its effect on later CUD, and the potential moderating role of resilience. First, t-tests examined differences in experience of military sexual violence between LGBQ vs. heterosexual and female vs. male veterans. Then, using logistic regressions controlling for sex, sexual orientation, and race/ethnicity, we assessed the effects of sexual violence on CUD (Cannabis Use Disorder Identification Test score of 12 or higher), followed by adding resilience into the model to examine independent and moderation effects. T-test results indicated that female (t(99) = -7.46, p < 0.001) and LGBQ veterans (t(38) = -3.85, p < 0.001) were significantly more likely to experience military sexual violence. Veterans who experienced military sexual violence had higher odds of screening for CUD (OR = 3.37; 95% CI = [1.76, 6.45]). Greater resilience was associated with lower odds of CUD (OR = 0.40; 95% CI = [0.23, 0.70]), but it did not moderate the relationship between sexual violence and CUD. Our findings are in line with prior work that female and LGBQ veterans may experience sexual violence during military service at higher rates. We also showed that veterans who experience military sexual violence are at increased risk for subsequent CUD. This suggests the importance of screening for military sexual violence among veterans, including among those seeking care for CUD, as well as screening for CUD symptoms among those who have experienced military sexual violence. Since we found that greater levels of resilience were associated with lower odds of CUD, programs and treatments aimed at building resilience to adverse events may have independent protective effects on CUD.