Skip to main content
Top
Published in: The Journal of Behavioral Health Services & Research 3/2012

01-07-2012

Utilization and Intensity of Outpatient Care Related to Military Sexual Trauma for Veterans from Afghanistan and Iraq

Authors: Jessica A. Turchik, PhD, Joanne Pavao, MPH, Jenny Hyun, MPH, PhD, Hanna Mark, BA, Rachel Kimerling, PhD

Published in: The Journal of Behavioral Health Services & Research | Issue 3/2012

Login to get access

Abstract

Little research has examined factors associated with the utilization of outpatient health care services related to sexual assault experiences. The Veterans Health Administration provides free outpatient treatment services to veterans who report military sexual trauma (MST); this system provides a unique opportunity to examine factors related to the utilization of mental health and non-mental health outpatient services by patients with sexual trauma. The current study examined sociodemographic, military service factors, and primary diagnoses related to utilization and utilization intensity of MST-related care among 4,458 Operation Enduring Freedom/Operation Iraqi Freedom Veterans in a 1-year period after reporting an experience of MST. Of the veterans who reported MST, 75.9% received MST-related care. The most notable factor that influenced receipt and intensity of MST-related care was gender, where male veterans used less care than female veterans. These results have important treatment implications for both veteran and civilian sexual trauma survivors.
Literature
1.
go back to reference Kimerling R, Street AE, Pavao J, et al. Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq. American Journal of Public Health 2010;100(8):1409-1412.PubMedCrossRef Kimerling R, Street AE, Pavao J, et al. Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq. American Journal of Public Health 2010;100(8):1409-1412.PubMedCrossRef
2.
go back to reference Frayne SM, Skinner KM, Sullivan LM, et al. 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 1999;8(6):835-845.CrossRef Frayne SM, Skinner KM, Sullivan LM, et al. 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 1999;8(6):835-845.CrossRef
3.
go back to reference Kimerling R, Gima K, Smith MW, et al. The Veterans Health Administration and military sexual trauma. American Journal of Public Health 2007;97(12):2160-2166.PubMedCrossRef Kimerling R, Gima K, Smith MW, et al. The Veterans Health Administration and military sexual trauma. American Journal of Public Health 2007;97(12):2160-2166.PubMedCrossRef
4.
go back to reference Kessler RC, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 1995;52(12):1048-1060.PubMedCrossRef Kessler RC, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 1995;52(12):1048-1060.PubMedCrossRef
5.
go back to reference Yaeger D, Himmelfarb N, Cammack A, et al. DSM-IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma. Journal of General Internal Medicine 2006;21 Suppl 3:S65-S69.PubMedCrossRef Yaeger D, Himmelfarb N, Cammack A, et al. DSM-IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma. Journal of General Internal Medicine 2006;21 Suppl 3:S65-S69.PubMedCrossRef
6.
go back to reference Himmelfarb N, Yaeger D, Mintz J. Posttraumatic stress disorder in female veterans with military and civilian sexual trauma. Journal of Traumatic Stress 2006;19(6):837-846.PubMedCrossRef Himmelfarb N, Yaeger D, Mintz J. Posttraumatic stress disorder in female veterans with military and civilian sexual trauma. Journal of Traumatic Stress 2006;19(6):837-846.PubMedCrossRef
7.
go back to reference Suris AM, Lind L, Kashner TM, et al. Sexual assault in women veterans: an examination of PTSD risk, health care utilization, and cost of care. Psychosomatic Medicine 2004;66(5):749-756.PubMedCrossRef Suris AM, Lind L, Kashner TM, et al. Sexual assault in women veterans: an examination of PTSD risk, health care utilization, and cost of care. Psychosomatic Medicine 2004;66(5):749-756.PubMedCrossRef
8.
go back to reference Agar K, Read J, Bush J-M. Identification of abuse histories in a community mental health centre. Journal of Mental Health 2002;11:533-543.CrossRef Agar K, Read J, Bush J-M. Identification of abuse histories in a community mental health centre. Journal of Mental Health 2002;11:533-543.CrossRef
9.
go back to reference Campbell R, Raja S. The sexual assault and secondary victimization of female veterans: help-seeking experiences with military and civilian social systems. Psychology of Women Quarterly 2005;29(1):97-106.CrossRef Campbell R, Raja S. The sexual assault and secondary victimization of female veterans: help-seeking experiences with military and civilian social systems. Psychology of Women Quarterly 2005;29(1):97-106.CrossRef
10.
go back to reference Friedman LS, Samet JH, Roberts MS, et al. Inquiry about victimization experiences. A survey of patient preferences and physician practices. Archives of Internal Medicine 1992;152(6):1186-1190.PubMedCrossRef Friedman LS, Samet JH, Roberts MS, et al. Inquiry about victimization experiences. A survey of patient preferences and physician practices. Archives of Internal Medicine 1992;152(6):1186-1190.PubMedCrossRef
11.
go back to reference McCauley J, Yurk RA, Jenckes MW, et al. Inside “Pandora's box”: abused women's experiences with clinicians and health services. Journal of General Internal Medicine 1998;13(8):549-55.PubMedCrossRef McCauley J, Yurk RA, Jenckes MW, et al. Inside “Pandora's box”: abused women's experiences with clinicians and health services. Journal of General Internal Medicine 1998;13(8):549-55.PubMedCrossRef
12.
go back to reference Hurst C, MacDonald J, Say J, et al. Routine questioning about non-consenting sex: a survey of practice in Australian sexual health clinics. International Journal of STD and AIDS 2003;14(5):329-333.PubMedCrossRef Hurst C, MacDonald J, Say J, et al. Routine questioning about non-consenting sex: a survey of practice in Australian sexual health clinics. International Journal of STD and AIDS 2003;14(5):329-333.PubMedCrossRef
13.
go back to reference Pruitt J, Kappius R. Routine inquiry into sexual victimization: a survey of therapists' practices. Professional Psychology: Research and Practice 1992;23:474-479.CrossRef Pruitt J, Kappius R. Routine inquiry into sexual victimization: a survey of therapists' practices. Professional Psychology: Research and Practice 1992;23:474-479.CrossRef
14.
go back to reference Military Sexual Trauma Support Team. Military Sexual Trauma (MST) Screening Report, Fiscal Year 2009. Washington: Department of Veterans Affairs, Office of Mental Health Services; 2010. Military Sexual Trauma Support Team. Military Sexual Trauma (MST) Screening Report, Fiscal Year 2009. Washington: Department of Veterans Affairs, Office of Mental Health Services; 2010.
15.
go back to reference Golding JM, Stein JA, Siegel JM, et al. Sexual assault history and use of health and mental health services. American Journal of Community Psychology 1988;16(5):625-644.PubMedCrossRef Golding JM, Stein JA, Siegel JM, et al. Sexual assault history and use of health and mental health services. American Journal of Community Psychology 1988;16(5):625-644.PubMedCrossRef
16.
go back to reference Koss MP, Koss PG, Woodruff WJ. Deleterious effects of criminal victimization on women's health and medical utilization. Archives of Internal Medicine 1991;151(2):342-347.PubMedCrossRef Koss MP, Koss PG, Woodruff WJ. Deleterious effects of criminal victimization on women's health and medical utilization. Archives of Internal Medicine 1991;151(2):342-347.PubMedCrossRef
17.
go back to reference New M, Berliner L. Mental health service utilization by victims of crime. Journal of Traumatic Stress 2000;13(4):693-707.PubMedCrossRef New M, Berliner L. Mental health service utilization by victims of crime. Journal of Traumatic Stress 2000;13(4):693-707.PubMedCrossRef
18.
go back to reference Waigandt A, Wallace DL, Phelps L, et al. The impact of sexual assault on physical health status. Journal of Traumatic Stress 1990;3(1):93-102.CrossRef Waigandt A, Wallace DL, Phelps L, et al. The impact of sexual assault on physical health status. Journal of Traumatic Stress 1990;3(1):93-102.CrossRef
19.
go back to reference Kimerling R, Street AE, Gima K, et al. Evaluation of universal screening for military-related sexual trauma. Psychiatric Services 2008;59(6):635-640.PubMedCrossRef Kimerling R, Street AE, Gima K, et al. Evaluation of universal screening for military-related sexual trauma. Psychiatric Services 2008;59(6):635-640.PubMedCrossRef
20.
go back to reference Sadler AG, Booth BM, Mengeling MA, et al. Life span and repeated violence against women during military service: Effects on health status and outpatient utilization. Journal of Women's Health 2004;13(7):799-811.PubMedCrossRef Sadler AG, Booth BM, Mengeling MA, et al. Life span and repeated violence against women during military service: Effects on health status and outpatient utilization. Journal of Women's Health 2004;13(7):799-811.PubMedCrossRef
21.
go back to reference Valdez C, Kimerling R, Mark HF, et al. VHA mental health treatment settings of patients who report military sexual trauma. Journal of Trauma and Dissociation 2011;12(3):232–243.PubMedCrossRef Valdez C, Kimerling R, Mark HF, et al. VHA mental health treatment settings of patients who report military sexual trauma. Journal of Trauma and Dissociation 2011;12(3):232–243.PubMedCrossRef
22.
go back to reference Zinzow HM, Grubaugh AL, Frueh BC, et al. Sexual assault, mental health, and service use among male and female veterans seen in Veterans Affairs primary care clinics: a multi-site study. Psychiatry Research 2008;159(1-2):226-236.PubMedCrossRef Zinzow HM, Grubaugh AL, Frueh BC, et al. Sexual assault, mental health, and service use among male and female veterans seen in Veterans Affairs primary care clinics: a multi-site study. Psychiatry Research 2008;159(1-2):226-236.PubMedCrossRef
23.
go back to reference Agency for Healthcare Research and Quality. Medical examination and treatment for victims of sexual assault: evidence-based clinical practice and provider training. Rockville: AHRQ; 2003. Report to Congress: No. 03-R210. Agency for Healthcare Research and Quality. Medical examination and treatment for victims of sexual assault: evidence-based clinical practice and provider training. Rockville: AHRQ; 2003. Report to Congress: No. 03-R210.
24.
go back to reference Liang K, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika 1986;73(1):13-22.CrossRef Liang K, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika 1986;73(1):13-22.CrossRef
25.
go back to reference Hall JA, Dornan MC. Patient sociodemographic characteristics as predictors of satisfaction with medical care: A meta-analysis. Social Science and Medicine 1990;30(7):811-818.PubMedCrossRef Hall JA, Dornan MC. Patient sociodemographic characteristics as predictors of satisfaction with medical care: A meta-analysis. Social Science and Medicine 1990;30(7):811-818.PubMedCrossRef
26.
go back to reference Pierce PF, Antonakos C, Deroba BA. Health care utilization and satisfaction concerning gender-specific health problems among military women. Military Medicine 1999;164(2):98-102.PubMed Pierce PF, Antonakos C, Deroba BA. Health care utilization and satisfaction concerning gender-specific health problems among military women. Military Medicine 1999;164(2):98-102.PubMed
27.
go back to reference Hoge CW, Castro CA, Messer SC, et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. The New England Journal of Medicine 2004;351(1):13-22.PubMedCrossRef Hoge CW, Castro CA, Messer SC, et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. The New England Journal of Medicine 2004;351(1):13-22.PubMedCrossRef
28.
go back to reference Banyard V, Ward S, Cohn E, et al. Unwanted sexual contact on campus: A comparison of women's and men's experiences. Violence & Victims 2007;22(1):52-70. Banyard V, Ward S, Cohn E, et al. Unwanted sexual contact on campus: A comparison of women's and men's experiences. Violence & Victims 2007;22(1):52-70.
29.
go back to reference Street AE, Gradus JL, Stafford J, et al. Gender differences in experiences of sexual harassment: data from a male-dominated environment. Journal of Consulting and Clinical Psychology 2007;75(3):464-474.PubMedCrossRef Street AE, Gradus JL, Stafford J, et al. Gender differences in experiences of sexual harassment: data from a male-dominated environment. Journal of Consulting and Clinical Psychology 2007;75(3):464-474.PubMedCrossRef
30.
go back to reference Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin 2006;132(6):959-92.PubMedCrossRef Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin 2006;132(6):959-92.PubMedCrossRef
31.
go back to reference Hosoda M, Stone DL. Current gender stereotypes and their evaluative content. Perceptual and Motor Skills 2000;90(3):1283-1294.PubMedCrossRef Hosoda M, Stone DL. Current gender stereotypes and their evaluative content. Perceptual and Motor Skills 2000;90(3):1283-1294.PubMedCrossRef
32.
go back to reference Kassing L, Beesley D, Frey L. Gender role conflict, homophobia, age, and education as predictors of male rape myth acceptance. Journal of Mental Health Counseling 2005;27:311-328. Kassing L, Beesley D, Frey L. Gender role conflict, homophobia, age, and education as predictors of male rape myth acceptance. Journal of Mental Health Counseling 2005;27:311-328.
33.
go back to reference Lisak D. Men as victims: challenging cultural myths. Journal of Traumatic Stress 1993;6:577-580.CrossRef Lisak D. Men as victims: challenging cultural myths. Journal of Traumatic Stress 1993;6:577-580.CrossRef
34.
go back to reference Struckman-Johnson C, Struckman-Johnson D. Acceptance of male rape myths among college men and women. Sex Roles 1992;27:85-100.CrossRef Struckman-Johnson C, Struckman-Johnson D. Acceptance of male rape myths among college men and women. Sex Roles 1992;27:85-100.CrossRef
35.
go back to reference Turchik JA, Edwards KM. Myths about male rape: a literature review. Psychology of Men & Masculinity 2012; doi: 10.1037/a0023207 Turchik JA, Edwards KM. Myths about male rape: a literature review. Psychology of Men & Masculinity 2012; doi: 10.1037/a0023207
36.
go back to reference Anderson I, Quinn A. Gender differences in medical students' attitudes toward male and female rape victims. Psychology, Health & Medicine 2009;14:105-110.CrossRef Anderson I, Quinn A. Gender differences in medical students' attitudes toward male and female rape victims. Psychology, Health & Medicine 2009;14:105-110.CrossRef
37.
go back to reference Long JA, Bamba MI, Ling B, et al. Missing race/ethnicity data in Veterans Health Administration based disparities research: a systematic review. Journal of Health Care for the Poor and Underserved 2006;17:128-140.PubMedCrossRef Long JA, Bamba MI, Ling B, et al. Missing race/ethnicity data in Veterans Health Administration based disparities research: a systematic review. Journal of Health Care for the Poor and Underserved 2006;17:128-140.PubMedCrossRef
38.
go back to reference Jia H, Zheng YE, Cowper DC, et al. Race/ethnicity: who is counting what?. Journal of Rehabilitation Research and Development 2006;43(4):475-484.PubMedCrossRef Jia H, Zheng YE, Cowper DC, et al. Race/ethnicity: who is counting what?. Journal of Rehabilitation Research and Development 2006;43(4):475-484.PubMedCrossRef
39.
go back to reference Cohen B, Gima K, Bertenthal D, et al. Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. Journal of General Internal Medicine 2009;25(1):18-24.PubMedCrossRef Cohen B, Gima K, Bertenthal D, et al. Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. Journal of General Internal Medicine 2009;25(1):18-24.PubMedCrossRef
40.
go back to reference Turchik JA, Wilson SM. Sexual assault in the US military: a review of the literature and recommendations for the future. Aggression and violent behavior 2010;15:267-277.CrossRef Turchik JA, Wilson SM. Sexual assault in the US military: a review of the literature and recommendations for the future. Aggression and violent behavior 2010;15:267-277.CrossRef
41.
go back to reference Smith MW, Chow A, Kimerling R. Estimating lost revenue from a free-care mandate in the U.S. Department of Veterans Affairs. Psychiatric Services 2010;61(11):1150-1152.PubMedCrossRef Smith MW, Chow A, Kimerling R. Estimating lost revenue from a free-care mandate in the U.S. Department of Veterans Affairs. Psychiatric Services 2010;61(11):1150-1152.PubMedCrossRef
Metadata
Title
Utilization and Intensity of Outpatient Care Related to Military Sexual Trauma for Veterans from Afghanistan and Iraq
Authors
Jessica A. Turchik, PhD
Joanne Pavao, MPH
Jenny Hyun, MPH, PhD
Hanna Mark, BA
Rachel Kimerling, PhD
Publication date
01-07-2012
Publisher
Springer US
Published in
The Journal of Behavioral Health Services & Research / Issue 3/2012
Print ISSN: 1094-3412
Electronic ISSN: 2168-6793
DOI
https://doi.org/10.1007/s11414-012-9272-4

Other articles of this Issue 3/2012

The Journal of Behavioral Health Services & Research 3/2012 Go to the issue