Higher depression severity mediates the association of assault military sexual trauma and sexual function in partnered female service members/veterans

2020 ◽  
Vol 261 ◽  
pp. 238-244 ◽  
Author(s):  
Rebecca K. Blais ◽  
Whitney S. Livingston ◽  
Jamison D. Fargo
2020 ◽  
pp. 088626052095769
Author(s):  
Rebecca K. Blais ◽  
Alyson K. Zalta ◽  
Whitney S. Livingston

Healthy sexual function among women service members/veterans (SM/Vs) is associated with higher quality of life, lower incidence and severity of mental health diagnoses, higher relationship satisfaction, and less frequent suicidal ideation. Although trauma exposure has been established as a predictor of poor sexual function and satisfaction in women SM/Vs, no study to date has examined whether specific trauma types, such as military sexual trauma (MST), increase risk for sexual issues. Moreover, the possible mechanisms of this association have not been explored. The current study examined whether posttraumatic stress disorder (PTSD) and depression symptom clusters mediated the association of trauma type and sexual function and satisfaction in 426 trauma-exposed women SM/Vs. Two hundred seventy participants (63.4%) identified MST as their index trauma. Path analyses demonstrated that MST was related to poorer sexual function and lower satisfaction relative to the other traumas ( χ2[28, N = 426] = 43.3, p = 0.03, CFI = 1.00, TLI = 0.99, and RMSEA = 0.04), and this association was mediated by higher non-somatic depressive symptoms and PTSD symptom clusters of anhedonia and negative alterations in cognition and mood (NACM). Causality cannot be inferred due to the cross-sectional nature of the data. However, our findings suggest that interventions aimed at decreasing sexual issues among female SM/Vs with MST should target depressogenic symptoms, whether the origin is depression or PTSD. Longitudinal research exploring the etiological processes that contribute to sexual dysfunction among those with MST is needed.


2020 ◽  
Author(s):  
Rebecca K Blais

Abstract Introduction Compulsive sexual behavior (CSB) is understudied in military service members/veterans despite elevated risk for psychological disorders that are associated with CSB, including posttraumatic stress disorder (PTSD), depression, and alcohol misuse. Civilian research shows that sexual trauma is associated with higher CSB. Among military service members/veterans, sexual trauma that occurred before military service is identified as a risk factor for CSB, but the impact of screening positive for sexual trauma that occurred during military service (military sexual harassment[MSH]/military sexual assault[MSA]) on CSB is unknown. Moreover, screening positive for MSH/A confers a higher risk for distress relative to sexual trauma that occurred before or after military service, suggesting that MSH/A may be a robust predictor of CSB. The current study examined whether screening positive for MSH/A was associated with higher CSB after accounting for mental health and demographic characteristics. The current study specifically focused on men service members/veterans given that men show higher engagement and distress associated with CSB relative to women. Materials and Method Male service member/veterans (n = 508) completed self-report measures of CSB, MSH/A, PTSD and depression severity, hazardous drinking, and age. CSB was regressed on MSH/A, PTSD and depression severity, hazardous drinking, and age to determine if MSH/A was uniquely associated with CSB after accounting for other risk factors. Results A total of 9.25% to 12.01% of the sample reported scores suggestive of high levels of CSB. The regression of CSB on MSH/A screen status, PTSD, depression, alcohol use, and age explained 22.3% of the variance. Screening positive for MSH/A, higher PTSD symptoms, and higher depression symptoms were associated with higher CSB, but age or alcohol use were not. Conclusion Screening positive for MSH/A appears to be a unique risk factor for higher CSB above and beyond the effects of depression and PTSD. Since screening for CSB is not part of routine mental health care, clinicians may consider a positive screen for MSH/A as a possible indicator that CSB may be of clinical concern. Previous research on MSH/A and individual and sexual health outcomes suggest that distinguishing between MSH/A severities (harassment only vs. assault) is critical as the most dysfunction is observed with sexual trauma that involves assault. Owing to low endorsement of MSA, this study did not examine differences between MSA and MSH. Future research in this area would be strengthened by exploring MSH/A severities as a correlate of CSB.


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