Gibson Carolyn J, Gray Kristen E, Katon Jodie G, Simpson Tracy L, Lehavot Keren
Medical Service Line, San Francisco VA Medical Center, San Francisco, California.
Health Services Research & Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington.
Womens Health Issues. 2016 Mar-Apr;26(2):225-31. doi: 10.1016/j.whi.2015.09.013. Epub 2015 Nov 26.
Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts.
Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined.
The sample included 781 women veterans. Compared with the oldest age group (≥ 65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77-6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25-7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32-9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64.
Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care.
服役期间遭受性创伤和身体创伤与不良的身心健康结果相关。对于不同年龄组的女性退伍军人中这些创伤的患病率及其影响知之甚少。
利用2013年一项针对女性退伍军人的全国性在线调查数据，研究服役期间年龄与创伤（包括性侵犯、性骚扰和身体侵害）之间的关联。采用逻辑回归进行分析，并对服役时长和人口统计学因素进行了调整。在二次分析中，考察了年龄在创伤与自我报告健康之间关系中的调节作用。
样本包括781名女性退伍军人。与最年长年龄组（≥65岁）相比，除最年轻年龄组外，其他所有年龄组在服役期间报告创伤的几率一直更高。这些差异在45至54岁的女性中最为明显（性侵犯优势比[OR]为3.81[95%CI，2.77 - 6.71]；性骚扰OR为3.99[95%CI，2.25 - 7.08]；身体侵害OR为5.72[95%CI，3.32 - 9.85]）。服役期间的创伤与自我报告的健康状况之间的关联也因年龄组而异，在45至54岁和55至64岁的女性中观察到的负面影响最强。
与其他年龄组相比，中年女性在服役期间最有可能报告创伤，并且这些经历对她们自我报告的健康有更大的负面影响。医疗服务提供者应意识到，服役期间的创伤对于目前处于中年的女性群体可能尤其成问题，她们占使用退伍军人事务部医疗保健服务的女性的最大比例。
