Fontana A, Rosenheck R
Northeast Program Evaluation Center, Veterans Affairs Connecticut Healthcare System, West Haven 06516, USA.
Psychiatr Serv. 1998 May;49(5):658-62. doi: 10.1176/ps.49.5.658.
The stressful experiences of women serving in the military have been a focus of increasing concern. A model of the impact of stress related to military duty and stress related to sexual abuse and harassment on the development of posttraumatic stress disorder (PTSD) among female veterans was evaluated.
Structural equation modeling was applied to data from 327 women treated in a VA clinical program for women with stress disorders. The model was a chronological one and included variables related to the women's premilitary experience, their military service, and their postmilitary experience.
Altogether 48 percent of the sample served overseas, and 12 percent were exposed to enemy fire. A total of 63 percent reported experiences of physical sexual harassment during military service, and 43 percent reported rape or attempted rape. Both duty-related and sexual stress were found to contribute separately and significantly to the development of PTSD. Sexual stress was found to be almost four times as influential in the development of PTSD as duty-related stress. Postmilitary social support played a highly significant mediational role between sexual stress during military service and development of PTSD.
Women's exposure to sexual stress in the military is much more prevalent than previously believed. It is particularly toxic for the development of PTSD. Correct assessment is essential to effective treatment.
女性军人的应激经历一直是日益受到关注的焦点。对一个关于军事任务相关应激以及性虐待和性骚扰相关应激对女性退伍军人创伤后应激障碍（PTSD）发展影响的模型进行了评估。
对在退伍军人事务部（VA）针对患有应激障碍的女性开展的临床项目中接受治疗的327名女性的数据应用结构方程模型。该模型是按时间顺序构建的，包括与女性入伍前经历、军事服役经历以及退伍后经历相关的变量。
样本中共有48%的人曾在海外服役，12%的人曾遭遇敌方火力攻击。共有63%的人报告在军事服役期间有身体性骚扰经历，43%的人报告曾遭受强奸或强奸未遂。研究发现，与任务相关的应激和性应激均分别对PTSD的发展有显著影响。性应激在PTSD发展过程中的影响力几乎是与任务相关应激的四倍。退伍后的社会支持在军事服役期间的性应激与PTSD发展之间起到了非常显著的中介作用。
女性在军事服役期间遭受性应激的情况比之前认为的更为普遍。这对PTSD的发展尤其有害。正确评估对于有效治疗至关重要。
