a Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, USA.
b Department of Psychiatry, University of Colorado Anschutz Medical Campus, USA.
J Trauma Dissociation. 2019 May-Jun;20(3):340-356. doi: 10.1080/15299732.2019.1571888. Epub 2019 Feb 4.
Although rates vary, approximately 38.4% of women and 3.9% of men report experiencing military sexual trauma (MST). MST is associated with numerous psychosocial consequences, increased propensity for physical and mental health diagnoses, suicide, and an elevated likelihood of revictimization. Consequently, medical and mental health care for MST-related health sequelae is often warranted for individuals who have experienced MST; however, many MST survivors forgo or delay MST-related care, despite the fact that the Veterans Health Administration (VHA) provides free healthcare for MST-related health conditions. One potential explanation for this phenomenon is that survivors of MST feel betrayed by the military institution that they served when the MST occurred due to the institutional response to MST or perceptions that the institution failed to prevent MST from occurring. Perceptions of institutional betrayal may, in turn, decrease survivors' likelihood of disclosing MST and utilizing necessary treatment through VHA or affiliated institutions. A theoretical model of the role of institutional betrayal on help-seeking is proposed in which institutional betrayal serves as a potential barrier to utilizing MST-related healthcare. Potential mediators of this association (e.g., distrust, beliefs about safety) are also posited. This model offers utility in conceptualizing institutional factors that may influence helping-seeking following MST. By testing and refining such models, institutions and providers may be better-equipped to support MST survivors in obtaining necessary healthcare.
尽管发生率有所不同，但约有 38.4%的女性和 3.9%的男性报告曾经历过军事性创伤（MST）。MST 与许多心理社会后果相关，增加了身体和心理健康诊断、自杀的倾向，并增加了再次受害的可能性。因此，对于经历过 MST 的人来说，通常需要对与 MST 相关的健康后果进行医疗和心理健康护理；然而，许多 MST 幸存者会放弃或延迟与 MST 相关的护理，尽管退伍军人健康管理局（VHA）为与 MST 相关的健康状况提供免费医疗。这种现象的一个潜在解释是，当 MST 发生时，由于对 MST 的机构反应或机构未能防止 MST 发生的看法，MST 的幸存者感到被他们所服务的军事机构背叛了。对机构背叛的看法可能反过来降低幸存者通过 VHA 或附属机构披露 MST 并利用必要治疗的可能性。提出了一个关于机构背叛对寻求帮助的作用的理论模型，其中机构背叛是利用与 MST 相关的医疗保健的潜在障碍。还假设了这种关联的潜在中介因素（例如，不信任、对安全的信念）。该模型有助于理解可能影响 MST 后寻求帮助的机构因素。通过测试和完善这些模型，机构和提供者可能能够更好地支持 MST 幸存者获得必要的医疗保健。
