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Soc Psychiatry Psychiatr Epidemiol. 2018 Jun 23. doi: 10.1007/s00127-018-1550-x. [Epub ahead of print]

Do trauma type, stressful life events, and social support explain women veterans' high prevalence of PTSD?

Author information

1
Health Services Research and Development (HSR&D) Center of Innovation (COIN), VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA. keren.lehavot@va.gov.
2
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. keren.lehavot@va.gov.
3
Department of Health Services, University of Washington, Seattle, Washington, USA. keren.lehavot@va.gov.
4
Health Services Research and Development (HSR&D) Center of Innovation (COIN), VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
5
Department of Health Services, University of Washington, Seattle, Washington, USA.
6
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
7
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
8
Center of Excellence in Substance Abuse and Treatment (CESATE), VA Puget Sound Health Care System, Seattle, WA, USA.
9
National Center for PTSD, White River Junction, VT, USA.
10
Geisel School of Medicine at Dartmouth, Hanover, NH, USA.

Abstract

OBJECTIVES:

To examine factors that account for women veterans' higher prevalence of past-year DSM-5 posttraumatic stress disorder (PTSD) compared to women civilians and men veterans.

METHODS:

Cross-sectional analyses of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Face-to-face interviews with 379 women veterans, 20,007 women civilians, and 2740 men veterans were conducted. Trauma type (child abuse, interpersonal violence, combat or war zone, and other), number of trauma types, past-year stressful life events, current social support, and DSM-5 PTSD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Generalized linear models were used that accounted for the complex survey design.

RESULTS:

Women veterans had a higher unadjusted prevalence of past-year PTSD (11.40%) compared to their civilian (5.96%) and male (5.19%) counterparts. Individual predictor models indicated that the difference between women veterans' and civilians' prevalence of PTSD was attenuated when adjusting for number of trauma types, whereas the difference between men and women veterans was attenuated when adjusting for child abuse, interpersonal violence, and stressful life events. Nonetheless, while full adjustment in a multiple predictor model accounted for the difference in PTSD between women veterans and civilians, gender differences between men and women veterans remained.

CONCLUSIONS:

Number of trauma types, type of trauma, and social factors may together help explain women veterans' higher PTSD prevalence compared to women civilians, but do not fully account for differences between men and women veterans. Results highlight a need to explore additional explanatory factors and evaluate associations with longitudinal data.

KEYWORDS:

Gender differences; Posttraumatic stress disorder; Trauma; Veterans; Women veterans

PMID:
29936598
DOI:
10.1007/s00127-018-1550-x

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