Female Service Members Research Articles

The Willingness of Military Members to Seek Help: The Role of Social Involvement and Social Responsibility.

Anchored in the social organization theory of action and change, we use data from a large sample of active-duty Air Force members to examine the direct and indirect influence of social involvement and social responsibility on willingness to seek help in times of need via trust in formal systems and informal supports. Group comparisons are conducted between junior male, junior female, senior male, and senior female service members. The key mediational path in the model for all groups is the connection between social involvement and willingness to seek help via trust in formal systems. These results can inform both unit- and community-level interventions intended to increase the likelihood that active-duty AF members will seek help in times of need.

Women service members, veterans, and their families: What we know now

The purpose of this paper is to highlight what we know now about female service members, veterans, and their families. The experiences of U.S. female service members and veterans are more complex than previous eras and significant demographic changes have taken place. U.S. female veterans are more likely to be younger, come from ethnic and racial minority groups, have children, and combat exposure. U.S. female service members report high rates of sexual violence and they are more vulnerable to homelessness and unemployment when compared to previous female military cohorts. U.S. female service members and veterans are also at higher risk for significant mental and health issues. Children and adolescents of women service members and veterans may also carry a heavy burden as a result of lengthy deployments. A majority of female service members and veterans will utilize community based healthcare and social services, therefore, it is essential that all healthcare providers understand the unique needs of this cohort of women. Practice implications at the micro, mezzo, and macro levels are discussed. Qualitative and quantitative studies that expand our understanding of women's experience in the military and as veterans are encouraged.

The Many Faces of Military Families: Unique Features of the Lives of Female Service Members.

Female service members' family structures differ from the traditional male service member-female spouse composition of military families. Consequently, this mixed-methods study reviewed demographic data, empirical evidence, and presented findings from secondary analyses of the 2010 wave of the Military Family Life Project regarding structural differences in male and female service members' families and perceptions and experiences of military spouses. In addition, to gain an understanding of the influence of women's service on their family functioning, we conducted in-depth telephone interviews with 20 civilian husbands residing in 11 states around the United States. Empirical evidence suggests service women had higher rates or remarriage and divorce than service men. Women were also more likely than men to be part of nontraditional family forms. Civilian husbands of female service members, however, reported lower marital satisfaction, less support from the community, and less satisfaction with the military lifestyle than military wives. Husbands' accounts indicated that their families experienced both benefits and challenges from wives' service. Integration in the military community and separation presented major challenges for women's families. Implications of benefits and challenges of women's service for their families are discussed.

Women in Combat: Summary of Findings and a Way Ahead.

The Women in Combat Symposium was held at the Defense Health Headquarters April 29 to May 1, 2014, cohosted by the Office of the Assistant Secretary of Defense for Health Affairs and the Consortium for Health and Military Performance. The conference was a call to renew and extend research investment and policy commitment to recognize operational scenarios, requirements, health priorities, and combat-related injury exposures uniquely relevant to the performance and well-being of female Service members. Symposium participants worked in groups to identify knowledge and capability gaps critical to the successful integration, health, and performance of female Service members in combat roles and to develop recommendations for researchers and policy makers to address gaps in three specific areas of concern: Leadership and Peer Behavior, Operational Performance, and Health and Well-Being. Consensus findings are summarized as 20 research gaps and accompanying recommendations. Each represents an opportunity to advance health and performance outcomes and to leverage female Service members' strengths and capacities to the general benefit of all Service members and their families.

Military/Civilian Risk Markers for Physical Intimate Partner Violence: A Meta-Analysis.

This meta-analysis compared risk markers for perpetration of physical intimate partner violence (IPV) among military and civilian males. We also examined strength of risk markers among male and female service members. In total, 36 military studies and 334 civilian studies, which reported 883 effect sizes, were included in the analyses. Results revealed more similarities than differences in risk markers for IPV among military and civilian males and among military males and females. Of the risk markers examined, relationship satisfaction and alcohol problems were significantly stronger risk markers for IPV among civilian males compared to military males. Perpetrating emotional abuse was a significantly stronger risk marker for IPV perpetration among military females compared to military males. Recommendations for IPV prevention and intervention are discussed.

Sexually transmitted infections and sexual behaviour of deploying shipboard US military personnel: a cross-sectional analysis

ObjectivesSexually transmitted infection (STI) prevalence and risk behaviour may differ at different phases of deployment. We examined STI prevalence and sexual behaviour in the predeployment time period (12 months prior)...

Why Women Join the Military: Enlistment Decisions and Postdeployment Experiences of Service Members and Veterans

Over the past three decades women's enlistment has continued to increase. In an effort to help social workers better meet the needs of female veterans, this study sought to learn women's enlistment motivations and postdeployment experiences. This qualitative study was nested within the Women Veterans Cohort Study. Using a semistructured interview guide, authors interviewed 18 enlisted female service members and veterans. The themes that emerged, based on grounded theory, included not only opportunity and calling, but also outcomes. Unexpectedly, enlistment resulted in a professional military career, with over half of the participants making the military their life's work. Further study on the motivation, retention, and the reintegration needs of women postmilitary is necessary, particularly with military recruitment targets of 20 percent women by the year 2020 and the increased awareness of the military as a potentially hostile work environment for women.

Outcomes of Open Dorsal Wrist Ganglion Excision in Active-Duty Military Personnel

To examine the most common presenting complaints of active-duty service members with isolated dorsal wrist ganglions and to determine the rate of return to unrestricted duty after open excision. Surgical records at 2 military facilities were screened to identify male and female active duty service members undergoing isolated open excision of dorsal wrist ganglions from January 1, 2006 to January 1, 2014. Electronic medical records and service disability databases were searched to identify the most common presenting symptoms and to determine whether patients returned to unrestricted active duty after surgery. Postoperative outcomes examined were pain persisting greater than 4 weeks after surgery, stiffness requiring formal occupational therapy treatment, surgical wound complications, and recurrence. A total of 125 active duty military personnel (Army, 54; Navy, 43; and Marine Corps, 28) met criteria for inclusion. Mean follow-up was 45 months. Fifteen percent (8 of 54) of the Army personnel were given permanent waivers from performing push-ups owing to persistent pain and stiffness. Pain persisting greater than 4 weeks after surgery was an independent predictor of eventual need for a permanent push-up waiver. The overall recurrence incidence was 9%. No demographic or perioperative factors were associated with recurrence. Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations that may occur after open dorsal wrist ganglion excision. Therapeutic IV.

Supplemental Material for The Influence of the Dissociative Subtype of Posttraumatic Stress Disorder on Treatment Efficacy in Female Veterans and Active Duty Service Members

Supplemental Material for The Influence of the Dissociative Subtype of Posttraumatic Stress Disorder on Treatment Efficacy in Female Veterans and Active Duty Service Members

The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel.

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.

Longitudinal assessment of gender differences in the development of PTSD among US military personnel deployed in support of the operations in Iraq and Afghanistan

Divergent findings from previous research examining gender differences in the development of posttraumatic stress disorder (PTSD) among US military members deployed to the operations in Iraq or Afghanistan (recent operations) prompted this study utilizing a matching approach to examine whether risk for new-onset PTSD and PTSD severity scores differed by gender. US military members from the Millennium Cohort Study deployed in support of the recent operations were followed for approximately 7 years from baseline through 2 follow-up periods between 2001 and 2008. Propensity score matching was used to match 1 male to each female using demographic, military, and behavioral factors including baseline sexual assault. Analyses were stratified by combat experience defined as reporting at least one of five exposures during follow-up. Outcome measures included a positive screen for PTSD and severity scores measured by the PTSD Patient Checklist–Civilian Version. Discrete-time survival analysis quantified the association between gender and incident PTSD. Among 4684 matched subjects (2342 women and men), 6.7% of women and 6.1% of men developed PTSD during follow-up. Results showed no significant gender differences for the likelihood of developing PTSD or for PTSD severity scores among women and men who reported combat experience and among those who did not. This study is the first of its kind to match a large population of male and female service members on important baseline characteristics including sexual assault. Findings suggest that while combat deployed personnel develop PTSD, women do not have a significantly different risk for developing PTSD than men after experiencing combat.

What Is War? Female Veterans’ Experiences of Combat in Iraq and Afghanistan

Many female service members deployed to Iraq and Afghanistan report experiencing some level of combat. However, female veterans may perceive combat and threat differently than their male counterparts. A feminist analysis of semistructured interviews was used to examine female veterans’ ( N = 12) definitions of and experiences with combat. Participants described combat in three themes—experiencing combat-related events, witnessing combat-related events, and feeling threatened. Veterans also described a flexible definition of “combat veteran,” comparing their experiences to others’ to determine their status. This study has implications for practice, research, and policy on veterans, including broadening the assessment of combat.

The Impact of Maternal and Paternal Deployment on Depressive Symptoms and Well-Being Among Military-Connected Youth

Objective: This study examines how military parents' gender moderates the association between deployments and well-being and depression among military-connected youth. Methods: Secondary analyses were run on 2011 California Healthy Kids Survey data from 1,370 military-connected adolescents. Results: For depression, we found a significant interaction between deployments and parents' gender (β = .10, p = 0.0208). The relationship between deployment and depression is stronger for children of female service members. We also found a significant association between two or more deployments and well-being (β = 0.24, p = 0.0049). Discussion: Children of female service members may be at greater risk of psychosocial morbidity. Further, youth well-being may increase during/following deployments, perhaps suggesting resilience.

Don't tell: Military culture and male rape.

The issue of sexual assault that occurs during military service has been a focus of attention over the past several years. Although approximately 50% of survivors of military sexual assault are men, virtually all of the literature focuses on the assault of female service members. Research has demonstrated that cultural variables are robust correlates of the sexual assault of women. This paper proposes that cultural variables are equally important when examining the rape of men, especially when this assault occurs in military contexts. We discuss male rape myths and related constructs as they are expressed within military culture. The results of data analysis from a treatment sample of veterans with military sexual trauma (MST)-related posttraumatic stress disorder (PTSD) and clinical case examples are presented to further explore the concepts. We conclude that male rape myths and related beliefs that arise from cultural norms and are further amplified and modified by military culture impact male MST survivors and delay or obstruct their recovery. Suggestions for clinical application and future research are offered to encourage further efforts in this important area of practice.

Woman, Civilian, Veteran, Student: The Multifaceted Identity of Female Service Members

Woman, Civilian, Veteran, Student: The Multifaceted Identity of Female Service Members

Alice in Wonderland: Exploring the Experiences of Female Service Members With a Pregnancy Resulting From Rape

Currently, no clinical research has ever been conducted to examine what, if any, traumatic effects take place when pregnancy results from a sexual assault during military service. The present study investigated the emotional experience and impact of rape and pregnancy on women serving in the military. A qualitative, grounded theory research methodology analyzed single-session interview data with seven self-selected participants. Five major themes emerged from the data. The authors discuss the implications of pregnancy from a sexual assault in military service and suggest future research regarding how social workers can begin to address the traumatic impact of this silent epidemic of pregnancy resulting from rape.

Intimate Partner Violence Among Female Service Members and Veterans: Information and Resources Available Through Military and Non-Military Websites

With the expansion of women’s roles in the military, the number of female service members and veterans has increased. Considerable knowledge about intimate partner violence (IPV) in civilian couples exists but little is known about IPV among female service members and veterans. Prevalence rates of IPV range from 17% to 39% for female service members, and 21.9% to 74% for veterans. Most service members and veterans indicated using the Internet at least occasionally and expressed willingness to seek information about services via the Internet. Informed by data, we conducted a systematic review of military (Army, Navy, Air Force, and Marine Corps) and non-military (Veterans Affairs and Google) websites to explore the availability and presentation of information and resources related to IPV. The websites search revealed a variety of resources and information available, and important differences between sites with regard to what and how information is presented. Implications for practice and further research are discussed.

Military accession and disordered eating among women: clinical and policy recommendations.

Eating disorder prevalence has steadily increased in the U.S. population. Between 1996 and 2006, there was a significant increase in rates of both diagnosis and hospitalization for adolescents and young adults—primarily women—with eating disorders. Health care professionals in the military have long been aware that new active duty accessions are at risk for problems related to eating, including serious medical disorders such as anorexia nervosa and bulimia nervosa, and that eating disorders in the military are consistently higher than in the civilian population. This article summarizes the literature bearing on the prevalence, risk factors, and context-specific triggers for eating disordered behavior among female service members. We suggest that stressors specific to military accession—when coupled with existing risk factors related to age, gender, family, and life experience—often exacerbate disordered eating. In essence, military induction itself may create the conditions for situation-induced eating impairment. We are concerned that the military could be far more effective in screening for and responding to disordered eating among new military personnel. In this commentary, we endeavor to bring fresh attention to the problem of disordered eating among new service members and offer a way forward for health care professionals and policy-makers with responsibility for military accessions. We begin by reviewing the revised diagnostic categories for eating disorders in the Diagnostic and Statistical Manual of Mental Disorders (5th edition: DSM-V), and provide a selective review of literature relevant to eating disorder risk factors and eating disorder risk during the military accession and indoctrination process. We conclude with numerous recommendations for military health care providers and policy-makers. Although men certainly struggle with eating disorders—particularly men engaged in certain sports associated with cutting weight—this article focuses exclusively on women. The new DSM-V—the definitive source for prevalence rates of mental disorders—states that for both anorexia nervosa and bulimia nervosa, women are diagnosed far more frequently than men—at a 10:1 female to male ratio. Because persons with eating disorders are far more likely to suffer comorbid mood and anxiety disorders, personality psychopathology, and higher risk for suicidal behavior, it is essential that military providers be vigilant for eating disorder symptoms among women in the accession phase of military service.

Attention and visual tracking degradation during acute sleep deprivation in a military sample.

Fatigue due to sleep restriction places individuals at elevated risk for accidents, degraded health, and impaired physical and mental performance. Early detection of fatigue-related performance decrements is an important component of injury prevention and can help to ensure optimal performance and mission readiness. This study used a predictive visual tracking task and a computer-based measure of attention to characterize fatigue-related attention decrements in healthy Army personnel during acute sleep deprivation. Serving as subjects in this laboratory-based study were 87 male and female service members between the ages of 18 and 50 with no history of brain injury with loss of consciousness, substance abuse, or significant psychiatric or neurologic diagnoses. Subjects underwent 26 h of sleep deprivation, during which eye movement measures from a continuous circular visual tracking task and attention measures (reaction time, accuracy) from the Attention Network Test (ANT) were collected at baseline, 20 h awake, and between 24 to 26 h awake. Increases in the variability of gaze positional errors (46-47%), as well as reaction time-based ANT measures (9-65%), were observed across 26 h of sleep deprivation. Accuracy of ANT responses declined across this same period (11%). Performance measures of predictive visual tracking accurately reflect impaired attention due to acute sleep deprivation and provide a promising approach for assessing readiness in personnel serving in diverse occupational areas, including flight and ground support crews.

Anger problems and posttraumatic stress disorder in male and female National Guard and Reserve Service members

Anger is a common problem among veterans and has been associated with posttraumatic stress disorder (PTSD). This study aimed to improve understanding of how anger and PTSD co-occur by examining gender differences and differences by whether the triggering traumatic event is deployment-related vs. civilian-related in current service members. A representative cohort of Reserve and National Guard service personnel (n = 1293) were interviewed to assess for deployment- or civilian-related traumas, PTSD, and anger. The prevalence of self-reported anger problems was estimated among male (n = 1036) and female (n = 257) service members. Log Poisson regression models with robust standard errors were used to estimate the associations of problems with anger with PTSD and PTSD symptom severity for men and women. Self-reported anger problems were common among male (53.0%) and female (51.3%) service members. Adjusted prevalence ratios (PR) showed associations between anger and PTSD connected to both civilian- and deployment-related traumas (PR were 1.77 (95% CI 1.52–2.05) and 1.85 (95% CI 1.62–2.12), respectively). PTSD symptom severity was also associated with anger. This study was cross-sectional and so a causal relationship between PTSD and anger cannot be established. Problems with anger are common among male and female current Guard and Reserve members. These findings suggest that anger treatment should be made available to current service members and that clinicians should assess anger problems irrespective of gender. Future research should examine the effectiveness of anger treatment protocols by gender.