Hannan Susan M, Thomas Katie B, Allard Carolyn B
Veterans Affairs San Diego Healthcare System, CA, USA.
University of California, San Diego, USA.
J Interpers Violence. 2021 Sep;36(17-18):NP10035-NP10054. doi: 10.1177/0886260519864355. Epub 2019 Jul 17.
Numerous studies attest to the prevalence and complex negative consequences associated with military sexual trauma (MST). However, relatively less is known about male survivors and about the interaction of psychological problems such as posttraumatic stress disorder (PTSD) symptoms and emotion management difficulties following MST. The current study examined the path of psychological distress following MST in both male and female veterans. We predicted that (a) history of MST would predict more severe PTSD symptoms, which in turn would predict greater use of dysfunctional emotion management strategies (specifically, tension reduction behaviors) and that (b) PTSD symptoms would mediate the relationship between history of MST and tension reduction behaviors. Finally, we explored whether the indirect (i.e., mediating) effect was moderated by gender. Data were obtained from pretreatment paper and pencil assessments administered as part of standard clinical care from 338 veterans seeking treatment at a Veterans Affairs (VA) mental health specialty clinic. Veterans who endorsed MST experienced more severe PTSD symptoms and greater reported use of tension reduction behaviors. Bootstrapping testing the indirect effect revealed that PTSD symptoms mediated the relationship between history of MST and tension reduction behaviors. An exploratory moderated mediation analysis found that the indirect effect did not differ as a function of gender. PTSD symptoms appear to mediate the relationship between MST and tension reduction behaviors in veterans, regardless of gender. While previous research has suggested that civilian men report a greater number of tension reduction behaviors following a sexual assault compared to civilian women, we did not find the same gender differences among veterans. These results may provide support for using trauma-focused treatment even when MST survivors are reporting high-risk tension reduction behaviors.
众多研究证实了军事性创伤（MST）的普遍性及其带来的复杂负面后果。然而，对于男性幸存者以及MST后诸如创伤后应激障碍（PTSD）症状和情绪管理困难等心理问题之间的相互作用，我们了解得相对较少。当前的研究考察了男性和女性退伍军人在经历MST后的心理困扰路径。我们预测：（a）MST史会预示更严重的PTSD症状，而这反过来又会预示更多地使用功能失调的情绪管理策略（具体而言，减压行为）；（b）PTSD症状会在MST史和减压行为之间起中介作用。最后，我们探究了这种间接（即中介）效应是否受到性别的调节。数据来自于338名在退伍军人事务部（VA）心理健康专科诊所寻求治疗的退伍军人，这些数据是在标准临床护理过程中进行的治疗前纸笔评估中获得的。认可有MST经历的退伍军人表现出更严重的PTSD症状，且报告使用减压行为的频率更高。对间接效应进行的自助法检验表明，PTSD症状在MST史和减压行为之间起中介作用。一项探索性的调节中介分析发现，间接效应并不会因性别而有所不同。无论性别如何，PTSD症状似乎都在退伍军人的MST和减压行为之间起中介作用。虽然先前的研究表明，与平民女性相比，平民男性在遭受性侵犯后报告的减压行为更多，但我们在退伍军人中并未发现同样的性别差异。这些结果可能为即使MST幸存者报告有高风险的减压行为时仍采用以创伤为重点的治疗方法提供支持。
