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

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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.

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Acknowledgements

Drs. Lehavot and Katon were supported by VA Clinical Science Research and Development (CSR&D, CX000867) and Health Services Research and Development (HSR&D CDA 13–266) Career Development Awards (CDAs), respectively. Drs. Goldberg and Chen were supported by a VA Office of Academic Affiliations’ Advanced Fellowship in Health Services Research and Development (TPH 61-000-24 and TPH 61-000-14, respectively). Dr. Glass was supported by the National Institutes of Health Extramural Loan Repayment Program for Health Disparities Research (L60 MD009373) and a Mentored Research Scientist Development Award (K01 AA023859). The views expressed in this article are solely those of the authors and do not reflect an endorsement or the official policy or position of the Department of Veterans Affairs.

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Authors and Affiliations

  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, Simon B. Goldberg, Jessica A. Chen, Jodie G. Katon & John C. Fortney

  2. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA

    Keren Lehavot, Joseph E. Glass, John C. Fortney & Tracy L. Simpson

  3. Department of Health Services, University of Washington, Seattle, Washington, USA

    Keren Lehavot, Simon B. Goldberg, Jessica A. Chen, Jodie G. Katon & John C. Fortney

  4. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA

    Joseph E. Glass

  5. Center of Excellence in Substance Abuse and Treatment (CESATE), VA Puget Sound Health Care System, Seattle, WA, USA

    Tracy L. Simpson

  6. National Center for PTSD, White River Junction, VT, USA

    Paula P. Schnurr

  7. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Paula P. Schnurr

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  1. Keren Lehavot
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  2. Simon B. Goldberg
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  3. Jessica A. Chen
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  4. Jodie G. Katon
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  5. Joseph E. Glass
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  6. John C. Fortney
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  7. Tracy L. Simpson
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  8. Paula P. Schnurr
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Correspondence to Keren Lehavot.

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Data based on the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) conducted by the Laboratory of Epidemiology and Biometry (LEB), Division of Clinical and Biological Research and sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is available from NIAAA (http://www.niaaa.nih.gov). The Institutional Review Board at VA Puget Sound Health Care System approved this study.

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Lehavot, K., Goldberg, S.B., Chen, J.A. et al. Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?. Soc Psychiatry Psychiatr Epidemiol 53, 943–953 (2018). https://doi.org/10.1007/s00127-018-1550-x

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  • DOI: https://doi.org/10.1007/s00127-018-1550-x

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