PTSD, Depression, and Suicidality Among Survivors of Childhood Sexual Trauma (CST), Military Sexual Trauma (MST), and Sexual Revictimization (CST plus MST)

Objective: Research to date has not examined how childhood sexual trauma (CST) followed by sexual trauma during military service (MST) relates to posttraumatic stress disorder (PTSD), depression, and suicidality among women and men. Given the strong association between MST in particular, and these serious posttraumatic outcomes, the current study sought to address this gap. Method: The current study compared the mental health concerns of 268 treatment-seeking veterans who were survivors of CST, MST, or both (CST + MST). We hypothesized that MST would be associated with greater severity of symptoms compared with CST and that those who experienced sexual revictimization (CST + MST) would report more severe symptoms than veterans who experienced CST or MST alone. Results: Veteran men presented with significantly higher suicidality but not higher PTSD or depression scores than women. Controlling for gender, MST survivors had significantly higher PTSD and depression symptom severity scores, but not suicidality, than CST survivors. PTSD, depression, and suicidality scores were significantly higher for the CST + MST group than for CST only survivors, but did not significantly differ from survivors of MST alone. Conclusion: Findings support the more severe clinical impact of CST + MST-specific sexual revictimization compared with CST-only among military men and women, but also suggest that MST alone can have negative consequences similar to revictimization. While results point to the need to consider context and trauma history in future trauma research and clinical applications, they should be interpreted in light of our sample demographics, which were representative of the southwest U.S. veteran population. Clinical Impact Statement Our study found that male and female veteran survivors of both childhood sexual trauma (CST) and military sexual trauma (MST; i.e., sexual revictimization) experience more severe posttraumatic stress, depression, and suicidality than individuals who have experienced CST alone. Regardless of the type of sexual trauma, men reported more suicidality than women. Additionally, MST survivors who did not report CST reported mental health concerns similar to the revictimized group, suggesting the powerful impact of MST on mental health. The context of a veteran's trauma history should inform assessment of current mental health symptoms (i.e., suicidality) and treatment planning.