This article reviews the literature documenting the prevalence of military sexual trauma (MST) and its associated mental and physical health consequences. Existing research indicates that prevalence rates of MST vary depending on method of assessment, definition of MST used, and type of sample. Risk factors for MST have been identified as including age, enlisted rank, negative home life, and previous assault history. MST has been associated with increased screening rates of depression and alcohol abuse, in addition to significantly increased odds of meeting criteria for post-traumatic stress disorder. In addition, MST has been associated with reporting increased number of current physical symptoms, impaired health status, and more chronic health problems in veterans. Available research on health care utilization and MST is also discussed. Researchers are encouraged to utilize standardized definitions of MST, employ standardized assessment methodology, and utilize more male veterans in future research. Policy and practice implications are discussed.
Barrett, D.H., Doebbeling, C.C., Schwartz, D.A., Voelker, M.D., Falter, K.H., Woolson, R.F., et al. (2002). Posttraumatic stress disorder and self-reported physical health status among U.S. military personnel serving during the Gulf War period. Psychosomatics, 43(3), 195-205.
2.
Benda, B. (2006). Survival analyses and social support and trauma among homeless male and female veterans who abuse substances. American Journal of Orthopsychiatry, 76, 70-79.
3.
Bownes, I.T., O'Gorman, E.C., & Sayers, A. (1991). Assault characteristics and posttraumatic stress disorder in rape victims. Acta Psychiatrica Scandinavica, 83, 27.
4.
Burnam, M., Stein, J., Golding, J., Siegel, J., Sorenson, S., Forsythe, A., & Telles, C. (1988). Sexual assault and mental disorders in a community population. Journal of Consulting and Clinical Psychology , 56, 843-850
5.
Butterfield, M.I., Forneris, C.A., Feldman, M.E., & Beckham, J.C. (2000). Hostility and functional health status in women veterans with and without posttraumatic stress disorder: A preliminary study . Journal of Traumatic Stress, 13(4), 735-741.
6.
Butterfield, M., McIntyre, L., Stechuchak, K., Nanda, K., & Bastian, L. (1998). Mental disorder symptoms in veteran women: Impact of physical and sexual assault. Journal of the American Medical Women's Association, 53, 198-200.
7.
Campbell, R., & Raja, S. (2005). The sexual assault and secondary victimization of female veterans: Help-seeking experiences with military and civilian social systems. Psychology of Women Quarterly, 29, 97-106.
8.
Carney, C., Sampson, T., Voelker, M., Woolson, R., Thorne, P., & Doebbeling, B. (2003). Women in the Gulf War: Combat experience, exposures, and subsequent health care use. Military Medicine, 168, 654-661.
9.
Chang, B., Skinner, K., & Boehmer, U. (2001). Religion and mental health among women veterans with sexual assault experience. International Journal of Psychiatry in Medicine, 31, 77-95.
10.
Clum, G.A., Calhoun, K.S., & Kimerling, R. (2000). Associations among symptoms of depression and posttraumatic stress disorder and self-reported health in sexually assaulted women. The Journal of Nervous and Mental Disease, 188(10), 671-678.
11.
Coxell, A., King, M., Mezey, G., & Gordon, D. (1999). Lifetime prevalence, characteristics, and associated problems of non-consensual sex in men: Cross sectional survey. British Medicine Journal, 318, 846-850.
12.
Coyle, B.S., Wolan, D.L., & Van Horn, A.S. (1996). The prevalence of physical and sexual abuse in women veterans seeking care at a Veterans Affairs Medical Center. Military Medicine, 161, 588-593.
13.
Davis, T., & Wood, P. (1999). Substance abuse and sexual trauma in a female veteran population. Journal of Substance Abuse Treatment, 16(2), 123-127.
14.
Department of Veterans Affairs. (2004). Military sexual trauma (Independent study course). Retrieved from http://www.1.va.gov/vhi/docs/MST_www.pdf.
15.
Department of Veterans Affairs. (2005). The Center for Women Veterans. Counseling & medical treatment for the aftereffects of sexual trauma. Retrieved February 17, 2005, from http://www.1.va.gov/womenvet/page.
16.
DeRoma, V., Root L., & Smith, B. (2003). Socio-environmental context of sexual trauma and well-being of women veterans. Military Medicine, 168, 399-403.
17.
Fontana, A., & Rosenheck, R. (1998). Duty-related and sexual stress in the etiology of PTSD among women veterans who seek treatment. Psychiatric Services, 49, 658-662.
18.
Fontana, A., Schwartz, L., & Rosenheck, R. (1997). Posttraumatic stress disorder among female Vietnam veterans: A causal model of etiology. American Journal of Public Health, 87, 169-175.
19.
Frayne, S., Skinner, K., Sullivan, L., & Freund, K. (2003). Sexual assault while in the military: Violence as a predictor of cardiac risk? Violence and Victims, 18, 219-225.
20.
Frayne, S., Skinner, K., Sullivan, L., Tripp, T., Hankin, C., Kressin, N., et al. (1999). Medical profile of women Veterans Administration outpatients who report a history of sexual assault occurring while in the military. Journal of Women's Health & Gender-Based Medicine , 8, 835-845.
21.
Golding, J.M. (1999). Sexual assault history and long-term physical health: Evidence from clinical and population epidemiology. Current Directions in Psychological Science, 8, 191-194.
22.
Golding, J.M., Cooper, M.L., & George, L.K. (1997). Sexual assault history and health perceptions: Seven general population studies. Health Psychology, 16, 417-425.
23.
Hall, M.E., Sedlacek, A.R., Berenbach, J.A., & Dieckmann, N.F. (2007). Military sexual trauma services for women veterans in the Veterans Health Administration: The patient-care practice environment and perceived organizational support. Psychological Services, 4(4), 229-238.
24.
Hankin, C., Skinner, K., Sullivan, L., Miller, D., Frayne, S., & Tripp, T. (1999). Prevalence of depressive and alcohol abuse symptoms among women VA outpatients who report experiencing sexual assault while in the military. Journal of Traumatic Stress, 12, 601-612.
25.
Kang, H., Dalager, N., Mahan, C., & Ishii, E. (2005). The role of sexual assault on risk of PTSD among Gulf War veterans. AEP, 15, 191-195.
26.
Kessler, R., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060.
27.
Kimerling, R., Clum, G.A., & Wolfe, J. (2000). Relationships among trauma exposure, chronic posttraumatic stress disorder symptoms and self-reported health in women: Replication and extension. Journal of Traumatic Stress, 13(1), 115-128.
28.
Kimerling, R., Gima, K., Smith, M., Street, A., & Frayne, S. (2007). The Veterans Health Administration and military sexual trauma. American Journal of Public Health, 97(12), 2160-2166.
29.
Kimerling, R., Rellini, A., Kelly, V., Judson, L., & Learman, L. (2002). Gender differences in victim and crime characteristics of sexual assaults. Journal of Interpersonal Violence, 17, 526-532.
30.
Martin, L., Rosen, L., Durand, D., Knudson, K., & Stretch, R. (2000). Psychological and physical health effects of sexual assaults and nonsexual trauma among male and female United States army soldiers . Behavioral Medicine, 26, 23-34.
31.
Martin, L., Rosen, L., Durand, D., Stretch, R., & Knudson, K. (1998). Prevalence and timing of sexual assaults in a sample of male and female U.S. army soldiers. Military Medicine , 163(4), 213-216.
32.
Merrill, L., Newell, C., Thomsen, C., Gold, S., Milner, J., Koss, M., et al. (1999). Childhood abuse and sexual revictimization in a female Navy recruit sample. Journal of Traumatic Stress , 12(2), 211-225.
33.
Murdoch, M., Polusny, M., Hodges, J., & Cowper, D. (2006). The association between in-service sexual harassment and post-traumatic stress disorder among department of Veterans Affairs disability applicants. Military Medicine, 171, 166-173.
34.
Murdoch, M., Polusny, M., Hodges, J., & O'Brien, N. (2004). Prevalence of in-service and post-service sexual assault among combat and noncombat veterans applying for department of veterans affairs posttraumatic stress disorder disability benefits. Military Medicine, 169, 392-395.
35.
National Institute of Justice Centers for Disease Control and Prevention. (1998). Prevalence, incidence, and consequences of violence against women: Findings from the National Violence Against Women Survey (Research in Brief). Washington, DC : U.S. Department of Justice.
36.
Norris, F. (1992). Epidemiology of trauma: Frequency and impact of different potentially traumatic events on different demographic groups. Journal of Consulting and Clinical Psychology, 60, 409-418.
37.
Norwood, A.E., Ursano, R.J., & Gabbay, F.H. (1997). Health effects of the stressors of extreme environments on military women. Military Medicine, 162, 643-648.
38.
Ratner, P.A., Johnson, J.L., Shoveller, J.A., Chan, K., Martindale, S.L.,; Schilder, A.J., et al. (2003). Non-consensual sex experienced by men who have sex with men: Prevalence and association with mental health. Patient Education & Counseling, 49(1), 67-74.
39.
Rosen, L., & Martin, L. (1996). The measurement of childhood trauma among male and female soldiers in the U.S. army. Military Medicine, 161, 342-345.
40.
Sadler, A.G., Booth, B.M., Cook, B.L., & Doebbeling, B.N. (2003). Factors associated with women's risk of rape in the military environment. American Journal of Industrial Medicine, 43, 262-273.
41.
Sadler A.G., Booth, B.M., Cook, B.L., Torner, J.C., & Doebbeling, B.N. (2001). The military environment: Risk factors for women's non-fatal assaults. Journal of Occupational and Environmental Medicine, 43(4), 325-334.
42.
Sadler, A., Booth, B., Mengeling, M., & Doebbeling, B. (2004). Life span and repeated violence against women during military service: Effects on health status and outpatient utilization. Journal of Women's Health, 13, 799-811.
43.
Sadler, A., Booth, B., Nielson, D., & Doebbeling, B. (2000). Health-related consequences of physical and sexual violence: Women in the military. Obstetrics & Gynecology, 96, 473-480.
44.
Schnurr, P.P., & Jankowski, M.K. (1999). Physical health and post-traumatic stress disorder: Review and synthesis. Seminars in Clinical Neuropsychiatry, 4(4), 295-304.
45.
Schultz, J., Bell, K., Naugle, A., & Polusny, M. (2006). Child sexual abuse and adulthood sexual assault among military veteran and civilian women. Military Medicine , 171(8), 723-728.
46.
Seedat, A., & Stein, D.J. (2000). Trauma and post-traumatic stress disorder in women: A review. International Clinical Psychopharmacology, 15, S25-S33.
47.
Resick, P.A. (1993). The psychological impact of rape. Journal of Interpersonal Violence, 8, 223-255.
48.
Skinner, K.M. (2000). Quality of life in women veterans using VA ambulatory health care: Final report. Bedford, MA: Health Services Research and Development Service, Center for Health Quality, Outcomes, and Economic Research.
49.
Skinner, K., Kressin, N., Frayne, S., Tripp, T., Hankin, C., Miller, D., et al. (2000). The prevalence of military sexual assault among female Veterans' Administration outpatients. Journal of Interpersonal Violence, 15(3), 291-310.
50.
Smith, D., Frueh, B., Sawchuk, C., & Johnson, M. (1999). Relationship between symptom over-reporting and pre- and post-combat trauma history in veterans evaluated for PTSD. Depression and Anxiety, 10, 119-124.
51.
Stern, A., Wolfe, J., Daley, J., Zaslavsky, A., Roper, S., & Wilson, K. (2000). Changing demographic characteristics of women veterans: Results from a national sample. Military Medicine , 165(10), 773-780.
52.
Suris, A., Lind, L., Kashner, T.M., Borman, P., & Petty, F. (2004). Sexual assault in women veterans: An examination of PTSD risk, health care utilization, and cost of care. Psychosomatic Medicine, 66, 749-756.
53.
Tjaden, P., & Thoennes, N. (2000). Full report of the prevalence, incidence, and consequences of violence against women: Findings from the National Violence Against Women Survey (Rep. NCJ 183781). Washington, DC : National Institute of Justice.
54.
Turner, C., & Frayne, S. (Eds.). (2004). Veterans health initiative: Military sexual trauma. Birmingham, AL: Department of Veterans Affairs, Employee Education System. Available from www.va.gov/vhi
55.
U.S. Government Accountability Office. (2005 , February). Report to the ranking Democratic member, Committee of Veterans Affairs, House of Representatives. VA health care: VA should expedite the implementation of recommendations needed to improve post-traumatic stress disorder services. Retrieved from http://www.gao.gov/docsearch/abstract.php?rptno=GAO-05-287.
56.
Veterans Health Administration Office of Public Health and Environmental Hazards. (2004, May 3). Women veterans of Operations Iraqi Freedom and Enduring Freedom: Analysis of VA health care utilization-Report 1. Retrieved from http://dva.state.wi.us/News_Releases/OEF_first_roster_analysis.pdf.
57.
Wagner, A.W., Wolfe, J., Rotnitsky, A., Proctor, S.P., & Erickson, D.J. (2000). An investigation of the impact of posttraumatic stress disorder on physical health. Journal of Traumatic Stress, 13(1), 41-55.
58.
Walker, E., Katon, W., Hansom, J., Griffiths, J., Holm, L., Jones, M., et al. (1992). Medical and psychiatric symptoms in women with childhood sexual abuse. Psychosomatic Medicine, 54, 658-664.
59.
Walker, E., Torkelson, N., Katon, W.J., & Koss, M.P. (1993). The prevalence rate of sexual trauma in a primary care clinic. Journal of the American Board of Family Practice , 6(5), 465-471.
60.
Whealin, J.M. (2005). Men and sexual trauma: A National Center for PTSD fact sheet. Retrieved February 17, 2005, from http://www.ncptsd.org/facts/specific/fs_male_sexual_assault.html
61.
Yaeger, D., Himmelfarb, N., Cammack, A., & Mintz, J. (2006). DSM-IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma. Journal of General Internal Medicine, 21, S65-S69.
62.
Zinzow, H., Grubaugh, A., Monnier, J., Suffoletta-Malerie, S., & Freuh, B. (2007). Trauma among female veterans: A critical review . Trauma, Violence, & Abuse, 8, 384-400.
63.
Zoellner, L.A., Goodwin, M.L., & Foa, E.B. (2000). PTSD severity and health perceptions in female victims of sexual assault. Journal of Traumatic Stress, 13, 635-649.
