VA Connecticut Healthcare System, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
VA Connecticut Healthcare System, West Haven, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Womens Health Issues. 2020 May-Jun;30(3):214-220. doi: 10.1016/j.whi.2020.03.001. Epub 2020 Apr 19.
Rates of smoking and related health consequences are higher for women veterans as compared with their civilian counterparts, and trauma is a known risk factor associated with smoking. Military sexual trauma is prevalent among women veterans and associated with deleterious health outcomes, including tobacco use. However, research has not examined variables that may explain this association. The purpose of the present study was to examine the association between deployment sexual trauma (DST; military sexual trauma that occurs during deployment) and nicotine dependence, and whether perceived stress is a potential explanatory variable (i.e., mediator) in this relationship.
Cross-sectional associations and Hayes mediation models were examined using baseline interview data from the Survey of Experiences of Returning Veterans sample (352 recently returned women veterans).
DST was associated with postdeployment nicotine dependence and greater perceived stress. Further, perceived stress was a significant mediator between DST and binary nicotine dependence (indirect effect [standard error] of DST on nicotine dependence through perceived stress, 0.04 [0.01]; 95% confidence interval, 0.01-0.07; odds ratio, 1.04; p < .01) when controlling for education.
Findings suggest that perceived stress may be a clinical target for decreasing nicotine dependence among women veterans who have experienced DST.
与女性平民相比，女性退伍军人的吸烟率和相关健康后果更高，而创伤是与吸烟相关的已知风险因素。性创伤是女性退伍军人中普遍存在的问题，与包括烟草使用在内的不良健康后果有关。然而，研究尚未探讨可能解释这种关联的变量。本研究的目的是调查部署性创伤（DST；发生在部署期间的军事性创伤）与尼古丁依赖之间的关联，以及感知压力是否是这种关系的潜在解释变量（即中介变量）。
使用最近返回的退伍军人调查经验样本（352 名女性退伍军人）的基线访谈数据，检验了横断面关联和海斯中介模型。
DST 与部署后尼古丁依赖和更高的感知压力有关。此外，当控制教育程度时，感知压力在 DST 和二元尼古丁依赖之间是一个显著的中介变量（DST 通过感知压力对尼古丁依赖的间接效应[标准误差]，0.04[0.01]；95%置信区间，0.01-0.07；优势比，1.04；p<.01）。
研究结果表明，对于经历过 DST 的女性退伍军人来说，感知压力可能是减少尼古丁依赖的临床目标。
