Search Results (8)

Disempowering experiences of military service and transition for women veterans exist within an established, dominant, masculinised culture, in which their presence is highly visible, challenged, and often subject to institutional prejudice. Sexual abuse of women in the military, in particular, is a persistent finding in contemporary international research and national inquiries into military culture in countries such as Australia, the United Kingdom (UK), the United States (US), and Canada. This study sought to understand military service, transition to civilian life, and post-military experiences of Australian women veterans, specifically their experiences of discrimination, military sexual harassment and assault, and consequent military sexual trauma (MST). In-depth qualitative interviews were undertaken with 22 Australian women veterans that examined how women veterans manage their identity as women in the military. Issues included gender-based challenges in conforming to a masculinised culture, experiences of misogyny, sexual harassment and assault, systemic failures to recognize women’s specific health needs, and experiences of separation from the military and transition, including help-seeking and engagement with services to address their experiences of MST. Women veterans’ adverse experiences largely stemmed from an entrenched masculinised military culture, in which military sexual assault was enabled, ignored, and condoned. Military and veteran support services have been slow to recognize, acknowledge, and address this significant issue. Full article

Background/Objectives: Like in the general population, the prevalences of eating- and weight-related health issues in the armed forces are increasing. Relevant medical conditions include the eating disorders (EDs) anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder (ARFID), as well as body dysmorphic disorder, muscle dysmorphia, and the relative energy deficiency in sport (RED-S) syndrome. Methods: We performed a narrative literature review on eating- and weight-related disorders in the armed forces. Results: Entry standards might exclude people with obesity, with EDs, or at high risk for EDs from entering the armed forces for military reasons and to protect the individual’s health. Relevant potential risk factors of eating- and weight-related disorders in the military are the emphasis on appearance and fitness in the military, high levels of stress, military sexual trauma, post-traumatic stress disorder, deployment, relocation, long commutes, consumption of ultra-processed foods and beverages, limitations on food selection and physical exercise, and intensive combat training and field exercises. Eating- and weight-related disorders negatively impact professional military appearance and lead to problems with cardiorespiratory and neuromuscular fitness; daytime sleepiness; and a higher risk of musculoskeletal injuries, and other physical and mental health problems. Current and potential future therapeutic options include occupational health measures, psychosocial therapies, neuromodulation, and drug treatments. Conclusions: Even though randomized controlled trials (RCTs) have been performed to test treatments for obesity in the armed forces, RCTs for the treatment of EDs, body dysmorphic disorder, muscle dysmorphia, and RED-S syndrome are lacking in the military context. Full article

Military sexual trauma-related post-traumatic stress disorder (PTSD) is highly prevalent and costly among women veterans, making the need for effective and accessible treatment of critical importance. Access to care is a key mechanism of mental health disparities and might affect differential response to treatment. The goal of this study was to estimate an individualized treatment rule based on readily available individual characteristics related to access to care to optimize allocation to in-person vs. telehealth delivery of prolonged exposure for PTSD in military sexual trauma survivors. The following variables were used as prescriptive factors: age, race, disability status, socioeconomic status, rural vs. urban status, and baseline PTSD level. The rule was estimated using a machine-learning approach, Outcome Weighted Learning. The estimated optimal rule outperformed a one-size-fits-all rule where everyone is universally assigned to telehealth; it led to markedly lower mean PTSD levels following 6 months from treatment ($V$d_opt − $V$_Telehealth = −14.55, 95% CI: −27.24, −1.86). However, the rule did not significantly discriminate for in-person therapy ($V$d_opt − $V$_In-person = −11.86, 95% CI: −25.83, 2.12). Upon further validation with larger and more diverse samples, such a rule may be applied in practice settings to aid clinical decision-making and personalization of treatment assignment. Full article

Women’s experiences of military service and transition occur within a highly dominant masculinized culture. The vast majority of research on military veterans reflects men’s experiences and needs. Women veterans’ experiences, and therefore their transition support needs, are largely invisible. This study sought to understand the role and impact of gender in the context of the dominant masculinized culture on women veterans’ experiences of military service and transition to civilian life. In-depth qualitative interviews with 22 Australian women veterans elicited four themes: (1) Fitting in a managing identity with the military; (2) Gender-based challenges in conforming to a masculinized culture—proving worthiness, assimilation, and survival strategies within that culture; (3) Women are valued less than men—consequences for women veterans, including misogyny, sexual harassment and assault, and system failures to recognize women’s specific health needs and role as mothers; and (4) Separation and transition: being invisible as a woman veteran in the civilian world. Gendered military experiences can have long-term negative impacts on women veterans’ mental and physical health, relationships, and identity due to a pervasive masculinized culture in which they remain largely invisible. This can create significant gender-based barriers to services and support for women veterans during their service, and it can also impede their transition support needs. Full article

Equine-assisted services (EASs) are being increasingly used as complementary interventions for military veterans who have experienced trauma. However, there is limited evidence of benefit for this population and almost no literature describing the desired potential outcomes and possible mechanisms of action. The aim of this article is to address these gaps by reviewing the extant literature of animal-assisted interventions in general, and equine-assisted services in particular, with the goal of providing guidance for future investigations in the field. Currently, the field is in the early stage of scientific development, but published results are promising. Interventions that enhance treatment compliance and/or outcomes could benefit this population. Preliminary results, reviewed herein, indicate that EAS interventions might benefit the military veteran population by enhancing treatment engagement and therapeutic alliance, as well as by contributing to symptom reduction and resulting in various transdiagnostic benefits. It is recommended that future studies include exploration of potential beneficial outcomes discussed herein, as well as investigate suggested mechanisms of action. Full article

Russia’s military incursion into Ukraine triggered the mass displacement of two-thirds of Ukrainian children and adolescents, creating a cascade of population health consequences and producing extraordinary challenges for monitoring and controlling preventable pediatric infectious diseases. From the onset of the war, infectious disease surveillance and healthcare systems were severely disrupted. Prior to the reestablishment of dependable infectious disease surveillance systems, and during the early months of the conflict, our international team of pediatricians, infectious disease specialists, and population health scientists assessed the health implications for child and adolescent populations. The invasion occurred just as the COVID-19 Omicron surge was peaking throughout Europe and Ukrainian children had not received COVID-19 vaccines. In addition, vaccine coverage for multiple vaccine-preventable diseases, most notably measles, was alarmingly low as Ukrainian children and adolescents were forced to migrate from their home communities, living precariously as internally displaced persons inside Ukraine or streaming into European border nations as refugees. The incursion created immediate impediments in accessing HIV treatment services, aimed at preventing serial transmission from HIV-positive persons to adolescent sexual or drug-injection partners and to prevent vertical transmission from HIV-positive pregnant women to their newborns. The war also led to new-onset, conflict-associated, preventable infectious diseases in children and adolescents. First, children and adolescents were at risk of wound infections from medical trauma sustained during bombardment and other acts of war. Second, young people were at risk of sexually transmitted infections resulting from sexual assault perpetrated by invading Russian military personnel on youth trapped in occupied territories or from sexual assault perpetrated on vulnerable youth attempting to migrate to safety. Given the cascading risks that Ukrainian children and adolescents faced in the early months of the war—and will likely continue to face—infectious disease specialists and pediatricians are using their international networks to assist refugee-receiving host nations to improve infectious disease screening and interventions. Full article

Women veterans have high rates of trauma exposure, including military sexual trauma (MST), which are associated with numerous health and psychosocial consequences. However, associations between trauma history and work-related outcomes are less well-characterized. We examined whether military-related and non-military trauma types were associated with work-related outcomes and whether posttraumatic stress disorder (PTSD) and depression symptoms mediated these associations. A total of 369 women veterans completed up to two mailed surveys, 12 months apart, assessing trauma exposure, depression and PTSD symptoms, occupational functioning, and employment status (unemployed, out of the workforce, employed). Participants reported high rates of trauma exposure. Nearly half (47.5%) were out of the workforce. Military-related trauma, military sexual assault, and adult sexual assault were associated with worse occupational functioning. Only PTSD symptoms mediated associations between trauma types and occupational functioning. No trauma types were significantly directly associated with employment status; however, PTSD and depression symptoms mediated associations between trauma types and being out of the workforce. Findings can inform screening for military trauma exposures, mental health, and work-related needs among women veterans. Full article

Suicide attempts and psychiatric hospitalization represent the final outcomes of a complex dynamical system of interacting factors that influence a particular individual’s likelihood of engaging in suicidal behavior, as well as their ability to seek help prior to acting upon suicidal impulses. This study examined the association between different types of lifetime trauma exposure and the likelihood of psychiatric hospitalization following a suicide attempt (SA) rather than suicidal ideation (SI) alone. Electronic medical records for 1100 U.S. military service members and their dependents admitted to a military psychiatric inpatient setting for SA or SI were reviewed for documented lifetime trauma exposure history. Findings indicated that exposure to at least one childhood trauma of any type, and childhood neglect in particular, increased the likelihood that an individual would be hospitalized for SA rather than SI. Exploratory gender-stratified analyses demonstrated that childhood neglect, childhood sexual abuse, and adulthood traumatic loss may be linked with the likelihood of being hospitalized for SA. These findings demonstrate the importance of developing more detailed and nuanced conception of factors known to be associated with suicide as their effects may depend on details of their timing and nature, as well as their interactions with other systems. Full article