Mahoney Colin T, Shayani Danielle R, Iverson Katherine M
National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, USA, 02130.
Boston University School of Medicine, Department of Psychiatry, 72 E. Concord Street, Boston, MA, USA, 02118.
Traumatology (Tallahass Fla). 2024 Mar;30(1):17-26. doi: 10.1037/trm0000242. Epub 2020 Feb 27.
Women who serve in the military are at high risk for experiencing military sexual trauma (MST) and intimate partner violence (IPV), both of which are associated with symptoms of posttraumatic stress disorder (PTSD). To improve understanding of the psychological effects of experiencing multiple forms of interpersonal violence, it is important to identify the ways in which recent IPV experiences differentially increase the risk of specific PTSD symptom clusters for women with a history of MST. We aimed to identify if past-year IPV experiences mediate the relation between MST experiences and PTSD symptom clusters (i.e., intrusions, avoidance, negative alterations in cognitions/mood, hyperarousal) using structural equation modeling. A mail survey was administered to a sample of US female veterans at two time points 12 months apart. Among 198 participants, 108 women (54.5%) reported MST at Time 1, and 73 women (36.9%) reported IPV experiences in the past year at Time 2. PTSD symptom severity ranged from asymptomatic to beyond the diagnostic cutoff for a probable PTSD diagnosis. Past-year IPV experiences significantly mediated the association between MST history and PTSD avoidance symptoms, and MST history and PTSD negative alterations in cognitive/mood symptoms. No significant mediating effect was found for intrusion symptoms or hyperarousal symptoms. These findings can inform evidence-based practices for appropriate screening, assessment, detection, and intervention, including primary and secondary prevention efforts to instrumentally reduce future experiences of violence for female survivors of interpersonal violence.
在军队服役的女性遭受军事性创伤（MST）和亲密伴侣暴力（IPV）的风险很高，而这两者都与创伤后应激障碍（PTSD）的症状相关。为了更好地理解经历多种形式人际暴力的心理影响，识别近期IPV经历以何种方式差异化地增加有MST病史女性出现特定PTSD症状群的风险很重要。我们旨在使用结构方程模型确定过去一年的IPV经历是否介导MST经历与PTSD症状群（即侵入性症状、回避症状、认知/情绪的消极改变、过度警觉）之间的关系。对美国女性退伍军人样本在相隔12个月的两个时间点进行了邮件调查。在198名参与者中，108名女性（54.5%）在时间1报告有MST，73名女性（36.9%）在时间2报告在过去一年有IPV经历。PTSD症状严重程度从无症状到超过可能的PTSD诊断的诊断临界值不等。过去一年的IPV经历显著介导了MST病史与PTSD回避症状之间以及MST病史与PTSD认知/情绪消极改变症状之间的关联。未发现对侵入性症状或过度警觉症状有显著的中介作用。这些发现可为基于证据的适当筛查、评估、检测和干预措施提供参考，包括为减少人际暴力女性幸存者未来暴力经历而进行的一级和二级预防努力。
