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Military Sexual Trauma MST

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Title: Assessing for Sexual Trauma Author: Dianne Castillo Last modified by: Hoyt Roberson Created Date: 9/25/2000 2:40:58 PM Document presentation format – PowerPoint PPT presentation

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Title: Military Sexual Trauma MST


1
Military Sexual TraumaMST
  • Wounds of War Conference
  • Diane T. Castillo, Ph.D.
  • Coordinator, WSDTT
  • February 6, 2008

2
Overview
  • Definitions
  • Diagnoses and Statistics
  • Effective Treatments

3
MST Mandate in VA System
  • Public Law 102-585 Mandated outreach and
    counseling
  • Public Law 103-452 MST counseling to men as
    well as women
  • Public Law 106-177 Veterans Millennium Health
    Care Act
  • Above laws require assessing and treating all
    veterans with MST

4
Definitions by VA
  • When you were in the military, did you ever
    receive uninvited or unwanted sexual attention
    (i.e., touching, cornering, etc.)?
  • or
  • When you were in the military did anyone use
    force or the threat of force to have sex against
    your will?

5
Standard Definitions
  • Sexual Harassment-Repeated, unsolicited, verbal
    or physical contact of a sexual nature
  • Sexual Assault-Actual sexual contact through the
    use of threat, non-consensual
  • Rape-Non-consensual sexual penetration through
    use of force
  • Abuse-Intentionally caused or attempted bodily
    injury or apprehension of injury

6
Common Signs of Sexual Abuse
  • Depression
  • Anxiety
  • Sleep Difficulties
  • Alcohol/SA
  • Somatic Complaints

7
Most Common Diagnosis Post traumatic Stress
Disorder--PTSD
  • Trauma
  • 3 Categories of Symptoms
  • Reexperiencing
  • Avoidance/Numbing
  • Hyperarousal
  • Symptoms last more than 1 month

8
Trauma
  • The person has been exposed to a traumatic event
    in which both of the following were present
  • The person experienced, witnessed, or was
    confronted with an event or events that involved
    actual or threatened death or serious injury, or
    a threat to the physical integrity of self or
    others
  • The persons response involved intense fear,
    helplessness, or horror.

9
PTSD Symptom Categories
  • Reexperiencing (min. of 1)
  • Intrusive recollections
  • Nightmares
  • Flashbacks
  • Psychological distress with reminders
  • Physiological reaction to reminders
  • Avoidance/Numbing (min. of 3)
  • Avoidance of thoughts, feelings
  • Avoidance of reminders
  • Social isolation
  • Feelings of detachment from others
  • Reduction of emotions (positive)
  • Sense of foreshortened future

10
PTSD Symptom Categories (cont.)
  • Hyperarousal (min. of 2)
  • Sleep difficulties
  • Irritability and/or anger outbursts
  • Poor concentration
  • Exaggerated startle response
  • Hypervigilence

11
Demographics (N236)
  • Mean Age49.9, SD10.4
  • 77 Veteran, 20 ChampVA, 3 AF
  • 43 Army, 29 AF, 22 Navy, 3 Marine Corps
  • 14 OIF/OEF veterans
  • 60 white, 26 Hispanic 9 African American, 3
    Native American, 2 other
  • 42 married, 29 divorced, 26 never married

12
Demographics (cont.)
  • 72 sexual trauma, 8 other, 20 combo
  • 28 childhood trauma, 31 adult, 41 both
  • 69 diagnosed with PTSD another diagnosis (31
    PTSD only)
  • 84 more than one trauma

13
Percentages of MST in VA System
Males Females Total
YesReports MST 2,718 (1.2) 2,952 (23.2) 5,670 (2.3)
NoDoes Not Report MST 232,907 12,724 245,631
ScreenedDeclined to Answer 1,764 269 2,033
14
Treatment for PTSD at Alb. VA
  • Trauma clinic for mennot just for combat-related
    trauma
  • Womens Stress Disorder Treatment Teammilitary/
    childhood/other adult rape other traumas
  • Both programs offer individual and group
    counseling as well as medication
    evaluation/management

15
Womens Stress Disorder Treatment Team (WSDTT)
  • Staff
  • Two f/t psychologists
  • One f/t social worker
  • One h/t psychiatrist
  • One h/t nurse clinical specialist

16
WSDTT Program Components
  • Assessment
  • Initial Interview
  • Psychological Testing (MMPI, MCMI, BDI, BUSS)
  • CAPSClinician Administered PTSD Scale

17
  • Treatments Groups, Individual, Medication
  • Core Groups
  • PsychEd (intro)
  • Cognitive Processing
  • Skills
  • Sexual Intimacy
  • Focus (exposure therapy)
  • Most effective for PTSD

18
Assessment Data
  • CAPS
  • Current M73.8, SD27.7
  • Lifetime M104.9, SD24.7
  • MMPI2
  • Peaks on F(86.8), 2(78.5), 8(82.5), PK(79.2),
    and PS(79.3)
  • MCMI2
  • Peaks on Schizoid and Avoidant scales (BRgt80).
  • BDI M24.7, SD11.9

19
Outcome Data with PCL
  • Focus--Sig. improvement on
  • Overall PTSD
  • Avoidance/ Numbing
  • Cognitive--Sig. improvement on
  • Overall PTSD
  • Avoidance/Numbing
  • Hyperarousal
  • Skills--Sig. improvement on
  • Avoidance/ Numbing
  • Sexual Intimacy No sig. improvement in PTSD

20
Conclusion
  • MST is priority for VA in assessing for and
    treating male and female veterans
  • MST can result in variety of symptoms,
    particularly PTSD
  • Effective treatments are available for treating
    PTSD and are available at VA
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