Gender differences in traumatic experiences and mental health in active duty soldiers redeployed from Iraq and Afghanistan

doi:10.1016/j.jpsychires.2011.11.007

Journal of Psychiatric Research

Volume 46, Issue 3, March 2012, Pages 311-316

https://doi.org/10.1016/j.jpsychires.2011.11.007 Get rights and content

Abstract

The purpose of this study was to examine gender differences in combat exposure, military sexual trauma (MST), and their associations with mental health screen results among military personnel deployed in support of the wars in Afghanistan and Iraq. Data were collected as part of a pre- and post-deployment screening program at a large Army medical treatment facility. Cases included 7251 active duty soldiers (6697 men and 554 women) who presented for their pre- and post-deployment screening from March 2006 to July 2009. Pre-deployment mental health symptoms were statistically controlled for in our analyses. We found significant gender differences in demographic variables, exposure to combat, and MST. Women reported greater exposure to MST than did men. Although men reported greater exposure to high-intensity combat experiences than women, results indicate that women are experiencing combat at higher rates than observed in prior cohorts. Men were more likely to report problem drinking, and women were more likely to report depression symptoms. There were no gender differences with respect to PTSD symptoms. Although we found few differences between women and men in the impact of combat stressors on mental health, there was a stronger association between injury and PTSD symptoms for women than for men. Our findings indicate that it would be useful for clinicians to be aware of this difference and assess for exposure to a full range of traumatic combat experiences, particularly injury, as not all types of combat experiences may be equally experienced by men and women returning from military deployments.

Section snippets

Participants

There were 7869 active duty soldiers serving in support of OEF/OIF who presented for their pre- and post-deployment screening from March 2006 to July 2009. Of these, 7251 (6697 men and 554 women) had complete responses for all variables included in analysis. The proportion excluded did not differ by gender. Ages ranged from 17 to 52 years, with a mean of 25.7 years (SD = 6.1), with no significant differences between age for men (M = 25.7, SD = 6.08) vs. women (M = 25.6, SD = 6.23). The majority

Combat, MST and mental health comparisons

Although men had higher combat exposure than women as expected, 31% of women reported exposure to death, 9% reported witnessing killing, 7% reported injury in the war zone, and 4% reported killing in war (Table 2). Furthermore, women reported MST more frequently than men, with 12% of women reporting MST, as compared to less than 1% of men. Interestingly, while more men screened positive for hazardous alcohol consumption, there were no gender differences on dichotomous PTSD or depression screen

Discussion

Whereas men were more likely to report hazardous alcohol use, there were no gender differences with respect to PTSD symptoms. The relationship between gender and depression symptoms was more complex; at first there seemed to be no gender difference (Table 2), but in unadjusted and adjusted analyses, female gender was more likely to be associated with both mean levels of and increases in depression symptoms. The finding that depression symptoms are more frequently associated with female gender

Role of funding source

This study was funded by a VA Health Services Research and Development (HSR&D) Career Development Award (Maguen). VA HSR&D had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Contributors

Drs. Maguen, Luxton and Skopp designed the study; Dr. Maguen, Dr. Luxton, and Erin Madden analyzed the data; all authors interpreted the data; Dr. Maguen prepared the initial manuscript; all authors edited the manuscript; and all authors have approved the final manuscript.

Author disclosure statement

No competing financial interests exist for any of the authors.

Acknowledgments

The authors would like to thank Jeane Bosch, Dr. Mark Reger and Dr. Gregory Gahm for their assistance with this manuscript. The authors are also grateful to LTC Gary Southwell, PhD, and the Department of Psychology staff at Madigan.

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^☆: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or representing the views of the Department of the Army or the Department of Defense.

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Gender differences in traumatic experiences and mental health in active duty soldiers redeployed from Iraq and Afghanistan☆

Abstract

Section snippets

Participants

Combat, MST and mental health comparisons

Discussion

Role of funding source

Contributors

Author disclosure statement

Acknowledgments

Annals of Epidemiology

Journal of Clinical Epidemiology

Clinical Psychology Review

Validating the primary care posttraumatic stress disorder screen and the posttraumatic stress disorder checklist with soldiers returning from combat

Journal of Consulting and Clinical Psychology

Women in the Gulf War: combat experience, exposures, and subsequent health care use

Military Medicine

An introduction to the boostrap

Prevalence of depressive symptoms among women VA outpatients who report experiencing sexual assault while in the military

Journal of Traumatic Stress

Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care

New England Journal of Medicine

Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan

JAMA

The veterans health administration and military sexual trauma

American Journal of Public Health

Military-related sexual trauma among VHA patients returning from Afghanistan and Iraq

American Journal of Public Health

The PHQ-9: a new depression and diagnostic severity measure

Psychiatric Annals

The PHQ-9: validity of a brief depression severity measure

Journal of General Internal Medicine

Gender differences in depression and PTSD symptoms following combat exposure

Depression and Anxiety