Trauma In Men Research Articles

Features of treatment of posterior urethral injuries in the acute period of traumatic disease

BACKGROUND: Combined pelvic trauma in men in 10%–24% of cases is accompanied by damage to the posterior urethra, and no consensus on the treatment tactics has been established for such patients. AIM: This study aimed to evaluate the results of treatment of patients with closed injury of the posterior urethra and traumatic shock. MATERIALS AND METHODS: A retrospective analysis of the results of treatment of 46 patients with closed injury of the posterior urethra caused by a fracture of the pelvic bones and traumatic shock was performed. The average age of patients was 42.1 ± 9.9 years. The severity of urethral injuries was assessed according to the American Association for the Surgery of Trauma (AAST) classification. RESULTS: The choice of treatment techniques depended on the degree of damage to the urethra and severity of traumatic shock. Upon hospital admission, 15 (32.6%) patients were diagnosed with grade I, 21 (45.6%) with grade II, and 10 (21.7%) with grade III traumatic shock. In grade I–II traumatic shock patients with incomplete urethral rupture, a urethral catheter was inserted, followed by conservative therapy. If a catheter insertion was possible, a retropubic revision of the urethra was performed. Patients with grade III–V urethral injury according to AAST and grade I–II traumatic shock underwent primary or delayed urethroplasty, such as urethral suturing and urethra-urethral anastomosis. Patients with grade III traumatic shock had a urethral catheter or cystostomy. In the long-term, 6 of 17 (36.9%) patients who underwent primary or delayed urethroplasty had short-term (up to 5 mm) urethral strictures, for which optical urethrotomy was performed. All patients with complete urethral avulsion who did not undergo early urethroplasty developed 10–20 mm strictures, requiring reconstructive surgery. CONCLUSIONS: The choice of treatment techniques for patients with concomitant damage to the posterior urethra depends on the degree of damage to the urethra and severity of traumatic shock. The scope of treatment in the acute period may include urethral or suprapubic drainage of the bladder or reconstructive surgery.

The association of childhood trauma with depressive and negative symptoms in recent onset psychosis: a sex-specific analysis.

Childhood trauma may impact the course of schizophrenia spectrum disorders (SSD), specifically in relation to the increased severity of depressive or negative symptoms. The type and impact of trauma may differ between sexes. In a large sample of recent-onset patients, we investigated the associations of depressive and negative symptoms with childhood trauma and whether these are sex-specific. A total of 187 first-episode psychosis patients in remission (Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment study) and 115 recent-onset SSD patients (Simvastatin study) were included in this cross-sectional study (men: n = 218; women: n = 84). Total trauma score and trauma subtypes were assessed using the Childhood Trauma Questionnaire Short Form; depressive and negative symptoms were rated using the Positive And Negative Symptoms Scale. Sex-specific regression analyses were performed. Women reported higher rates of sexual abuse than men (23.5% v. 7.8%). Depressive symptoms were associated with total trauma scores and emotional abuse ratings in men (β: 0.219-0.295; p ≤ 0.001). In women, depressive symptoms were associated with sexual abuse ratings (β: 0.271; p = 0.011). Negative symptoms were associated with total trauma score and emotional neglect ratings in men (β: 0.166-0.232; p ≤ 0.001). Negative symptoms in women were not linked to childhood trauma, potentially due to lack of statistical power. Depressive symptom severity was associated with different types of trauma in men and women with recent-onset SSD. Specifically, in women, depressive symptom severity was associated with childhood sexual abuse, which was reported three times as often as in men. Our results emphasize the importance of sex-specific analyses in SSD research.

A Quest on the Development of Feminism in America in Riding Freedom and Fingersmith

The feminist movement in America is experiencing rapid development. The early feminist idea about woman's right to vote has developed on other issues, including sexuality and reproductive rights, ideas about universal femininity, the body, gender, and heteronormativity. In its development, feminism is sometimes associated with lesbianism. This linkage occurs because lesbian and feminist criticism grow in response to patriarchal oppression. Raised as an orphan, the two main female characters in Riding Freedom struggle to survive and achieve their freedom and happiness. Charlotte in Riding Freedom obscures her feminist identity to get equal opportunities with men. Susan in Fingersmith fights for her rights, even though she engages in lesbianism. By using these two novels as primary data, and data on the development of feminism in America as secondary data, this study aims to show the evolution of feminism in America, starting from the issue of voting described in The Riding Freedom, to the issue of lesbianism in Fingersmith's novel as the effect of disappointment from man's oppression. Feminist criticism and lesbian criticism are the two theories used in this research. This study finds that American women's struggle to gain equality with men requires a long process. The trauma of men's oppression supports the practice of lesbianism in America.

Interaction between COMT Val158 Met polymorphism and childhood trauma predicts risk for depression in men.

Depression is a disabling illness with complex etiology. While the catechol-O-methyltransferase (COMT) gene, in particular the functional Val158 Met polymorphism, has been related to depression, the mechanisms underlying this gene-disease association are not completely understood. Therefore, we explore the association of COMT Val158 Met polymorphism with depression as well as its interaction with childhood trauma in 1136 young adults from a population-based study carried out in the city of Pelotas, Brazil. The diagnosis was performed through the Mini International Neuropsychiatric Interview 5.0 (MINI 5.0), and trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Total DNA was extracted and genotyped by real-time PCR, and the QTLbase dataset was queried to perform large-scale quantitative trait locus (QTL) analysis. Our research showed no direct association between the Val158 Met polymorphism and the diagnosis of depression (women: χ2 =0.10, d= 1, p= 0.751; men: χ2 =0.003, df =1, p= 0.956). However, the Met-allele of the Val158 Met polymorphism modified the effect of childhood trauma in men (OR =2.58 [95% CI: 1.05-6.29]; p= 0.038) conferring risk for depression only on those who suffer from trauma. The conditional effect from moderation analysis showed that trauma impacts the risk of depression only in men carrying the Met-allele (effect: 0.9490, standard error [SE]: 0.2570; p= 0.0002). QTLbase and dataset for Val158 Met polymorphism were consistent for markers that influence chromatin accessibility transcription capacity including histone methylation and acetylation. The changes caused in gene regulation by childhood trauma exposure and polymorphism may serve as evidence of the mechanism whereby the interaction increases susceptibility to this disorder in men.

Changes in Injury Patterns Associated With Elevated Blood Alcohol Level.

This study aims to improve public health outreach in a high-risk population. This is a single center study of Trauma Registry data, inclusive years January 1, 2016 to March 30, 2021. The study population was stratified into two groups: ETOH ≥ 80 mg/dL and ETOH <80 mg/dL. A total of 1141 were included. Those above the legal drinking limit had a significantly higher mean ETOH (231 mg/dL; P <.01) and were typically younger men that arrived by ground ambulance. The significant injury patterns of those above the legal limit included full activation and consults who fell from stairs and fell from other or unknown. A higher proportion of intoxicated fall trauma patients above the legal limit were diagnosed with a concussion. Excess alcohol consumption, particularly during a pandemic year, may lead to a higher incidence of fall from stairs trauma in men who are more likely to be diagnosed with a concussion.

Gender Differences in the Correlations between Childhood Trauma, Schizotypy and Negative Emotions in Non-Clinical Individuals.

Early life trauma has a negative impact on the developing brain, and this can lead to a wide range of mental illnesses later in life. Childhood trauma is associated with increased psychotic symptoms and negative emotions such as depressive, anxiety, and stress symptoms in adulthood. Childhood trauma has also been shown to influence sub-clinical ‘schizotypy’ characteristics of psychosis in the general population. As it has been reported that mental health outcomes after early life trauma exposure are influenced by gender, the current study aimed to investigate the gender differences in the relationship between childhood trauma, schizotypy and negative emotions. Sixty-one non-clinical participants (33 men and 28 women) aged between 18 and 45 completed self-report questionnaires to measure early life trauma, schizotypy and negative emotions. Despite similar levels of childhood trauma in men and women, early life trauma in women was associated with increased schizotypy personality characteristics (Cognitive Disorganisation) and increased depression, anxiety and stress later in life, but no correlations were observed in men. Our findings suggest that the sociocultural and biological processes affected by early life adversities may differ between the genders. Women may be more vulnerable to the influence of childhood trauma, which may be associated with increased psychopathology later in life.

Association of Concussion Symptoms With Testosterone Levels and Erectile Dysfunction in Former Professional US-Style Football Players

Small studies suggest that head trauma in men may be associated with low testosterone levels and sexual dysfunction through mechanisms that likely include hypopituitarism secondary to ischemic injury and pituitary axonal tract damage. Athletes in contact sports may be at risk for pituitary insufficiencies or erectile dysfunction (ED) because of the high number of head traumas experienced during their careers. Whether multiple symptomatic concussive events are associated with later indicators of low testosterone levels and ED is unknown. To explore the associations between concussion symptom history and participant-reported indicators of low testosterone levels and ED. This cross-sectional study of former professional US-style football players was conducted in Boston, Massachusetts, from January 2015 to March 2017. Surveys on past football exposures, demographic factors, and current health conditions were sent via electronic and postal mail to participants within and outside of the United States. Analyses were conducted in Boston, Massachusetts; the data analysis began in March 2018 and additional analyses were performed through June 2019. Of the 13 720 male former players eligible to enroll who were contacted, 3506 (25.6%) responded. Concussion symptom score was calculated by summing the frequency with which participants reported 10 symptoms, such as loss of consciousness, disorientation, nausea, memory problems, and dizziness, at the time of football-related head injury. Self-reported recommendations or prescriptions for low testosterone or ED medication served as indicators for testosterone insufficiency and ED. In 3409 former players (mean [SD] age, 52.5 [14.1] years), the prevalence of indicators of low testosterone levels and ED was 18.3% and 22.7%, respectively. The odds of reporting low testosterone levels or ED indicators were elevated for previously established risk factors (eg, diabetes, sleep apnea, and mood disorders). Models adjusted for demographic characteristics, football exposures, and current health factors showed a significant monotonically increasing association of concussion symptom score with the odds of reporting the low testosterone indicator (highest vs lowest quartile, odds ratio, 2.39; 95% CI, 1.79-3.19; P < .001). The ED indicator showed a similar association (highest quartile vs lowest, odds ratio, 1.72; 95% CI, 1.30-2.27; P < .001). Concussion symptoms at the time of injury among former football players were associated with current participant-reported low testosterone levels and ED indicators. These findings suggest that men with a history of head injury may benefit from discussions with their health care clinicians regarding testosterone deficiency and sexual dysfunction.

Stress resilience in young men mediates the effect of childhood trauma on their offspring's birth weight - An analysis of 250,000 families.

Experiencing the death of a parent during childhood is a severe trauma that seems to affect the next generation's birth weight. We studied the consequences of parental loss during childhood for men's psychological and physiological characteristics at age 18, and whether these were important for their first-born offspring's birth outcomes. We used a structured life-course approach and four-way decomposition analysis to analyse data for 250,427 three-generation families retrieved from nationwide Swedish registers and found that psychological resilience was impaired and body mass index was higher in men who had experienced parental death. Both characteristics were linked to offspring birth weight. This was lower by 18.0 g (95% confidence interval: 5.7, 30.3) for men who lost a parent at ages 8–17 compared to other ages. Resilience mediated 40% of this influence. Mediation by body mass index, systolic and diastolic blood pressure was negligible, as was the effect of parental loss on length of gestation. There was no mediation by the education of the men's future spouse.Previous literature has indicated that the period before puberty, the “slow growth period”, is sensitive. Our evidence suggests that this may be too narrow a restriction: boys aged 8–17 appear to be particularly likely to respond to parental loss in a way which affects their future offspring's birth weight. We conclude that the observed transgenerational influence on birth weight is mediated by the father's psychological resilience but not by his body mass index or blood pressure.

Laparoscopic entry techniques: What is the controversy?

To review reported complications related to the different laparoscopic entry techniques in the human and veterinary literature and describe the benefits and limitations of each technique. Literature review of 57 peer-reviewed articles. An electronic database search identified human and veterinary literature describing complications related to entry technique during laparoscopy. Open- and closed-entry techniques may result in trauma of abdominal organs or vasculature. During laparoscopy in man, injury to bowel and major vasculature is reported in 0.02% and 0.04% of procedures with open- or closed-entry techniques, respectively. Designs of Veress needles and trocar cannula assemblies have been developed to improve ease and safety. Early complications, defined as those observed at the time of port entry into the abdominal cavity, result from the puncture of a blood vessel leading to substantial visible hemorrhage. Late complications are detected 24 or 48 hours after surgery and result from the puncture of a loop of intestine that was not detected at the time of initial surgery. The major reasons for iatrogenic trauma in man are related to anatomical factors and the presence of adhesions. No explanation for cause of complications was identified for animals. There is no consensus in the human or veterinary literature about the best entry technique for laparoscopy. The rate of complications related to entry technique in small animals is not known because the data are underreported. Complications related to entry techniques are expected in both man and animals. Improvements in techniques and equipment design are being developed to minimize risk.

Trauma exposure and aggression toward partners and children: Contextual influences of fear and anger.

Trauma exposure is a consistent correlate of intimate partner aggression (IPA) and parent-to-child aggression (PCA) perpetration, and difficulties with emotions (particularly fear and anger) are hypothesized to underlie these relations. However, the absence of knowledge of the immediate, contextual influence of emotions on aggression renders existing conclusions tenuous. This study illustrates a new method for studying contextual influences on aggressive behavior. Quarterly for 1 year, 94 men and 109 women with children age 2.5 years at study commencement were interviewed to measure the sequence of behaviors during aggressive incidents as well as the intensity of their emotions immediately prior to initiation of aggression. Within aggressive incidents, the number of acts of men's PCA was predicted by men's greater fear, anger, and trauma exposure, and the positive association between men's trauma exposure and PCA perpetration was especially strong under conditions of high fear and anger. In contrast, men's IPA was predicted by greater fear and anger, but not trauma exposure. Men with low trauma exposure engaged in more IPA under conditions of high fear; among men with high trauma exposure, fear inhibited their IPA persistence. Trauma exposure and fear interacted in the same manner to predict women's IPA, but many other findings among men did not generalize to women's aggression. This study illuminates the utility of simultaneously examining aggression across genders and family dyads, and serves as a foundation for refining theories of trauma and family aggression to account for emotion as a factor that can both motivate and inhibit aggression. (PsycINFO Database Record

Oral and maxillofacial trauma in motorcyclists in an Iranian subpopulation.

Road traffic accidents are considered a major cause of oral and maxillofacial trauma. Given that many traumatic injuries and deaths involve motorcyclists, the aim of this study was to investigate this vulnerable group in terms of oral and maxillofacial injuries following accidents. This cross-sectional study was conducted on 330 patients with oral and maxillofacial injuries at Shahid Rajaee Hospital in Shiraz, Iran, from April to September 2017. A questionnaire with questions regarding age, gender, helmet use, and driver's license was completed for all the patients and their injury type (including dental injuries). Data were analyzed using descriptive statistics and the chi-squared test with a significance level of 95%. Of the 330 patients, 291 (88.2%) were male and 39 (11.8%) were female. There were 283 (85.75%) patients aged 21-30years, and their mean age was 27.2±6.5. Most of them (287, 87%) had not been wearing helmets at the time of the accident. Dental injuries were observed in 168 (50.9%) of the patients. Uncomplicated crown fractures were diagnosed in 25.4% of the patients, luxation injuries in 23.2%, and avulsion in 18.9%. Only 19.9% of the patients under the age of 25 had suffered facial injuries. Most injuries in motorcycle accidents were dental trauma in men due to not wearing a helmet. Dental injuries had the highest frequency of damage.

Main and interaction effects of childhood trauma and the MAOA uVNTR polymorphism on psychopathy

Psychopathy is characterized by callous affect, interpersonal manipulation, a deviant lifestyle, and antisocial behavior. Previous research has linked psychopathic traits to childhood trauma, but also to the upstream variable number tandem repeat (uVNTR) polymorphism of the monoamine oxidase A (MAOA) gene. An interaction between childhood trauma and MAOA genotype has been associated with antisocial behavior, but so far little is known about interaction effects of childhood trauma and the MAOA uVNTR on psychopathy. In order to bridge this gap, we used data of 1531 male and 1265 female twins and their siblings from a Finnish community sample to estimate structural equation models. The psychopathy and childhood trauma constructs were conceptualized as bifactor models with one general and two orthogonal group factors. Data comprised self-reports on childhood trauma and psychopathic traits as well as MAOA uVNTR genotype. In both genders, childhood trauma was associated with the general factor that represents the overarching psychopathy construct, and with the group factor that captures social deviance, but not with the group factor capturing psychopathic core personality traits. Women with a low activity variant of the MAOA uVNTR reported slightly higher levels of psychopathy than those with a high activity allele, but only with respect to the general psychopathy factor. There was no evidence for an interaction effect between MAOA uVNTR genotype and childhood trauma on psychopathy in either gender. Our results suggest that psychopathy in general and social deviance in particular are associated with childhood trauma in men and women, and that psychopathic traits are subject to variation in the MAOA uVNTR genotype in women.

Analysis of regeneration- and myelination-associated proteins in human neuroma in continuity and discontinuity.

Neuromas are pathologic nerve distensions caused by a nerve's response to trauma, resulting in a dysfunctional to non-functional nerve. Depending on the severance of the affected nerve, the resulting neuroma can be differentiated into continuous and stump neuroma. While neuroma formation has been investigated in animal models with enormous regenerative capacity, the search for differences in human response to nerve trauma on a molecular level ultimately seeks to identify reasons for functionally successful versus unsuccessful regeneration after peripheral nerve trauma in man. In the present study, the regenerative potential of axons and the capability of Schwann cells (SC) to remyelinate regenerating axons was quantitatively and segmentally analyzed and compared within human neuroma in-continuity and discontinuity. For the stump neuroma and the neuroma in-continuity, there was a significant reduction of the total number of axons (86% stump neuroma and 91% neuroma in-continuity) from the proximal to the distal part of the neuroma, while the amount of fibrotic tissue increased, respectively. Labeling the myelin sheath of regenerating axons revealed a remyelination of regenerating axons by SCs in both neuroma types. The segmented analysis showed no distinct alterations in the number and spatial distribution of regenerating, mature, and myelinated axons between continuous and discontinuous neuroma. The quantitative and segmented analysis showed no distinct alterations in the number and spatial distribution of regenerating, mature, and myelinated axons between continuous and discontinuous neuroma, while the extensive expression of Gap43 in up to 55% of the human neuroma axons underlines their regenerative capacity independent of whether the neuroma is in continuity or discontinuity. Remyelination of Gap43-positive axons suggests that the capability of SCs to remyelinate regenerating axons is preserved in neuroma tissue.

Similar mechanisms of traumatic rectal injuries in patients who had anal sex with animals to those who were butt-fisted by human sexual partner

Sexual pleasure comes in various forms of physical play, for many it involves stimulation of the vagina, while the anus for others; some enjoy both. A recent report by Cappelletti etal.1 shows a meta-analysis of cases describing anal trauma due to sexual fisting in human partners. This clinical article reports four cases of males diagnosed with zoophilia, and who received anal sex from animals, resulting in injuries. Surgical and psychiatric evaluations are summarized. Unusual etiology of sexual activity with animals caused peri-anal trauma in men who engaged in anal sex with dogs and farm animals. Injuries to patients who receive anal sex from animals are mechanistically similar to fisting-induced rectal damage. Among zoophiles, the mode of harm occurs through blood-engorged, interlocked penis that causes tissue lacerations upon retraction from an anus. In people experimenting with fisting, repetitive stretching within anal canal and of external sphincter causes the internal injuries. The mode of physical stimulation explains the extent of injuries in fisters vs. zoophiles: in fisting, the pressure applied by hand is controllable proximally around and within anal sphincter, while penetration by the animal penis is unpredictable and occurs within the proximal anal canal. Forensically, the findings presented in this article describe a significant mechanism of injury in fisters versus passive zoophiles. These descriptions may aid in clinically differentiating pleasurable and pathological rectal stimulation.

Il trattamento con placche e viti delle fratture del terzo distale di femore

Distal femur fractures can result from high-energy trauma in men under 30 years of age or from low-energy trauma in women over 75. Surgical fixation of distal femoral fractures has evolved to the point that non-operative treatment entails a higher risk of complications, which makes surgical intervention the treatment of choice in most of these fractures. The lateral approach to the distal femur allows for visualization, reduction and fixation of simple articular fractures. More complex fractures are better exposed with a lateral parapatellar approach (Krettek’s approach). Plate osteosynthesis is indicated in fractures of the distal femur Type 33-A, in particular in high comminution subgroups, and in case of Type 33-C according to the AO classification system. Evolving materials and design have enhanced plates reliability. Nevertheless, the surgical technique is extremely demanding, and even a mild inaccuracy may lead to an high rate of complications, down to complete synthesis failure. If articular involvement is identified at imaging, adequate surgical exposure and accurate reconstruction of the articular surface must be performed. Mininvasive techniques with biological saving of periosteal vascularization and lower soft tissue damage may promote bone consolidation and must be considered by the surgeon.

The Association between Compassionate Love and Spiritual Coping with Trauma in Men and Women Living with HIV

Our ten-year study examined the association between compassionate love (CL)—other-centered love, as well as compassionate self-love, and spiritual coping (SC)—the use of spirituality (connection to a Higher Presence or God) as a means to cope with trauma, and gender differences in 177 people living with HIV (PLWH). In a secondary data analysis of six-monthly interviews/essays, we coded five criteria of CL and rated the benefit of CL giving, receiving and self for the recipient. Synergistically, we rated longitudinal SC based on coding of 18 coping strategies. Overall, mean CL towards self was very high, followed by CL receiving and giving, while mean SC was moderately high. Women, in comparison to men, perceived higher benefit from SC and giving CL to others. Overall, CL towards self had the strongest association with SC, more pronounced in women than in men. Beyond gender, only CL for the self was a significant predictor of SC. Although there was a moderate association between SC and the perceived benefit from giving CL, after controlling for gender, this association was present in men only. Conversely, receiving CL from others yields a stronger association with SC in women than in men. Women perceived to benefit significantly more from SC and giving CL to others compared to men, whereas no gender differences were found on perceiving benefit from receiving CL from others or oneself. In conclusion, although women perceive more benefit from giving CL to others than men, this does not explain the higher benefit from SC among women. Ultimately, both men and women perceive to benefit more from SC the more they exhibit CL towards self and thus spiritual counseling should keep the importance of the balance between CL towards self and others in mind.

The Lens of Masculinity: Trauma in Men and the Landscapes of Sexual Abuse Survivors

The aim of this study was to identify the implications of masculinity for male sexual abuse survivors. To address the lack of research on male sexual abuse survivors, this study focuses on the trauma sustained by male survivors and the interplay of the cultural concept of masculinity. Given the sensitive nature of this topic and to protect the respondents, a three-phase methodological design was used. Initial observation of the participants in the treatment groups was followed by fieldwork involving focus groups and, eventually, in-depth individual interviews. This study’s implications for social workers helping male sexual abuse survivors are discussed through the lens of masculinity.

Future-proofing our community for natural disaster requires more attention on men

To the EditorIn recent years, Australia and New Zealand have witnessed an increased prevalence in highly destructive natu-ral disasters. These events result in significant loss of life and reduced quality of life in their aftermath. Since the 2011 Brisbane floods, affected residents have experienced increased levels of common psychiatric disor-ders, sleeping difficulties, and Posttraumatic stress disorder (PTSD) (Turner et al., 2012). These effects are substantial and can be long-lasting (Raphael and Meldrum, 1993).A question arises: how do we ‘future-proof’ our community to be resilient following such devastation? To start, we need a clearer understanding of how different groups in the commu-nity experience and express different forms of psychiatric illness in the con-text of natural disaster.Turner et al. (2012) recently high-lighted the significant impact of the 2011 Brisbane floods on the physical and mental health of people living in affected areas. Controlling for prop-erty type and demographic variables including sex, made little difference to risk of self-reported distress and PTSD from experiencing the direct impact of the flooding. However, the paper did not report predictive effects of sex after control for exposure. Even if none were identified, differen-tial reactions by men may still require attention, if community-wide resil-ience is to be optimised. Other research suggests that women have a small but significantly increased risk of PTSD from similar trauma exposure (Lee and Young, 2001). However, such differences in self-reported dis-tress may reflect a differential emo-tional awareness or willingness to report distress, and men may also have increased risks of other trauma responses such as substance misuse (Danielson et al., 2009). Furthermore, men are less likely to seek help for psychiatric disorders, including PTSD (Mackenzie et al., 2012).An opportunity exists, particularly for primary care mental health clinicians. If men appear for medical consultations after disaster exposure, opportunistic screening for any behavioural or emo-tional changes may increase the chance of them receiving appropriate treat-ment. This requires disaster first aid and intervention programs to be informed by greater understanding of gender dif-ferences in mental health problems in post-disaster situations.We need to know more about how to prevent and treat psychiatric seque-lae to trauma in men. Improving what we know about men’s mental health in post-disaster situations, might also provide further clarification about why large proportions of Australian men with mental disorders do not access mental health services post-disaster.

Military sexual trauma in men: Exploring treatment principles.

Military sexual trauma (MST) is reported in approximately 20%-43% of female service members and veterans, and 1%-3% of male service members and veterans. These rates reflect thousands of individual cases. However, there is limited research on treatment interventions for posttraumatic stress disorder (PTSD) associated with men's MST. The authors illustrate a model for integrating empirically based treatment protocols into an outpatient treatment program for PTSD related to men's MST. This model is based on Herman's trauma recovery model of safety, mourning, and reconnection. This proposed series of interventions integrates components of several empirically supported treatments into this model, including dialectical behavior therapy, seeking safety, and cognitive processing therapy. The aim of this approach is to first increase trust and knowledge about PTSD and MST, then increase distress tolerance and emotional regulation skills. This lays the groundwork for further trauma-focused treatment. The authors discuss lessons learned for facilitating treatment. Language: en

Military Sexual Trauma in Men: A Review of Reported Rates

Military sexual trauma (MST) has historically been associated with female service members, but it is also experienced by male service members. This article reviews reported prevalence and incidence rates of men's MST in 29 studies. Sources for these studies included the Department of Defense, the U.S. military service academies, and the Department of Veterans Affairs. There is significant variability in reported rates of men's MST. Averaging across studies covering the past 30 years, we found that MST is reported by approximately 0.09% of male service members each year, with a range of 0.02% to 6%. MST is reported by 1.1% of male service members over the course of their military careers, with a range of 0.03% to 12.4%. Determining prevalence and incidence rates for both men's and women's MST is fraught with limitations, including (a) cross-study variations in sample, method, definitions, and assessment and (b) barriers to reporting MST. Each of these limitations is reviewed with an eye toward identifying male-specific issues.