An Etiological Model of Posttraumatic Stress Disorder in Female OEF/OIF/OND Veterans: Adding Military Sexual Trauma as a Risk Factor

AN ETIOLOGICAL MODEL OF POSTTRAUMATIC STRESS DISORDER IN FEMALE OEF/OIF/OND VETERANS: ADDING MILITARY SEXUAL TRAUMA AS A RISK FACTOR Erin Doty Kurtz Virginia Consortium Program in Clinical Psychology, 2016 Director: Dr. Michelle L. Kelley Studies on posttraumatic stress disorder (PTSD) in returning Iraq and Afghanistan veterans have involved limited focus on the specific risk and protective factors for female veterans and how these may differ from factors identified for male veterans. Additionally, models incorporating risk and protective factors for PTSD in female veterans have yet to include military sexual trauma (MST) as a risk factor. Given the prevalence of MST among female service members, this study examined whether MST predicts PTSD diagnosis in addition to other frequently examined variables (premilitary trauma exposure, combat exposure, postmilitary trauma, and perceived social support). In addition, the degree to which social support mediated any identified relationship between MST and PTSD diagnosis was explored, as well as whether MST moderated the relationship between combat exposure and PTSD diagnosis. An etiological model for PTSD was proposed and was explored for model fit with female veterans to determine pathways among risk and protective factors for women. Data were examined from 202 female veterans and active duty service members who took part in a multi-site research study conducted through the Department of Veterans Affairs (VA) VISN 6 Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC). Results indicate that MST is a key risk factor to include in models of PTSD in female veterans returning from Iraq and Afghanistan. It was found that social support mediated the relationship between MST and PTSD symptoms, and partially mediated the relationship between aftermath of battle and PTSD symptoms, but did not mediate the relationship between combat trauma and PTSD symptoms; rather, combat experiences had a direct effect on PTSD symptoms. Additionally, results suggest that experiences of premilitary trauma may increase female service members’ vulnerability to MST and that social support mediated the relationship between premilitary trauma and PTSD symptoms, but only through an increased vulnerability to MST. Postmilitary trauma was also found to mediate the relationship between premilitary trauma and PTSD symptoms. Results may provide key information for developing training programs and therapeutic interventions to reduce both MST and PTSD in female veterans.