DUTY-RELATED AND SEXUAL STRESS IN THE ETIOLOGY OF PTSD AMONG WOMEN VETERANS WHO SEEK TREATMENT

Objective: The stressful experiences of women serving in the military have been a focus of increasing concern. A model of the impact of stre ss related to military duty and stress related to sexual abuse and har assment on the development of posttraumatic stress disorder (PTSD) amo ng female veterans was evaluated. Methods: Structural equation modelin g was applied to data from 327 women treated in a VA clinical program for women with stress disorders. The model was a chronological one and included variables related to the women's premilitary experience, the ir military service, and their postmilitary experience. Results: Altog ether 48 percent of the sample served overseas, and 12 percent were ex posed to enemy fire. A total of 63 percent reported experiences of phy sical sexual harassment during military service, and 43 percent report ed rape or attempted rape. Both duty-related and sexual stress were fo und to contribute separately and significantly to the development of P TSD. Sexual stress was found to be almost four times as influential in the development of PTSD as duty-related stress. Postmilitary social s upport played a highly significant mediational role between sexual str ess during military service and development of PTSD. Conclusions: Wome n's exposure to sexual stress in the military is much more prevalent t han previously believed. It is particularly toxic for the development of PTSD. Correct assessment is essential to effective treatment.