5 days after their return from deployment (time 1), 8% of the women and 3% of the men exceeded the cutoff point for PTSD on the Mississippi Scale for Combat-Related PTSD (OR 3.2, 95% CI 1.9-5.5). At 18-24 months after their return (time 2), however, this increased to 16% of the women and 7% of the men (OR 2.3, 95% CI 1.5-3.5) even after adjustment for combat exposure. Six percent of the women exceeded the cutoff point for PTSD at both time points, 2.2% exceeded it at time 1 only and 9% exceeded it at time 2 only, with 73% of the women who scored above the cutoff point at time 1 also scoring above the cutoff point at time 2.
Kang et al. (2005) used data collected in the National Health Survey of Gulf War Era Veterans and Their Families (Kang et al., 2000) to screen for PTSD among the respondents and to examine its association with sexual harassment and with sexual assault. Of the 11,441 Gulf War veterans surveyed 336 females (15.8%) and 1045 males (11.2%) met the screening criteria for PTSD. For women, sexual harassment while deployed was found to be associated with PTSD (OR 2.52, 95% CI 1.91-3.33), and sexual assault was even more strongly associated with PTSD (OR 5.41, 95% CI 3.19-9.17). When the intensity of combat was examined, a dose-response for the development of PTSD in women was found ranging from an OR of 1.47 from low combat to an OR of 4.03 (95% CI 1.97-8.23) for high combat exposure; men showed a similar trend.
In an assessment of deployment to the Gulf War as a risk factor for the development of mental disorders, Fielder et al. (2006) used a telephone interview with the Composite International Diagnostic Interview-Short Form/Diagnostic and Statistical Manual IV to diagnose any of 17 psychiatric disorders among deployed and nondeployed veterans. Compared with the 892 deployed male veterans, the 75 deployed female veterans had a higher 12-month prevalence of all disorders except for alcohol and drug dependence disorders. However, the 93 nondeployed female veterans also had a higher prevalence of the disorders than the 691 nondeployed male veterans, again with the exception of alcohol dependence.
Vogt et al. (2005) found that lack of social support in the Gulf War theater was a risk factor for the development of depression among women as were, to a lesser degree, concerns about family and relationship disruptions during deployment.
In a study of UK female veterans who had been deployed to the Gulf War, Rona et al. (2007) found that the 645 female veterans scored higher on the General Health Questionnaire-12 (GHQ-12; which measures psychological distress) (OR 1.49, 95% CI 1.02-2.17) and for fatigue (OR 1.48, 95% CI 1.03-2.31) than men. Differences in reports of PTSD, alcohol misuse, and general health perception were not significantly different between men and women. Comparing deployed female veterans with nondeployed female veterans, however, showed that the deployed female veterans had more symptoms of posttraumatic stress reaction (OR 13.80, 95% CI 3.13-60.78), higher scores on the GHQ-12 (OR 2.53, 95% CI 1.56-4.11), higher fatigue scores (OR 3.49, 95% CI 2.18-5.59), more physical symptoms (OR 21.70, 95% CI 5.05-93.19), and poorer general health perception (OR 2.57, 95% CI 1.23-5.40), only alcohol misuse was similar for the two groups.
Sexual assault and harassment6 are widely acknowledged stressors in the general population and are severe stressors when incurred in a war zone. In the military environment
The US Army defines sexual assault as “intentional sexual contact, characterized by use of force, physical threat or abuse of authority or when the victim does not or cannot consent. Sexual assault includes rape, nonconsensual sodomy, indecent assault (unwanted, inappropriate sexual contact or fondling), or attempts to commit these acts.”