ptsd Functional Status, Rates Of Trauma, And Personal Hardships Of Women And Men Who Applied For Va Posttraumatic Stress Disorder (ptsd) Disability Benefi

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86. Functional Status, Rates of Trauma, and Personal Hardships of Women and Men who applied for VA Posttraumatic Stress Disorder (PTSD) Disability Benefits, 1994 to 1998

M Murdoch, Minneapolis VAMC Center for Chronic Disease Outcomes Research; K Halek, Minneapolis VAMC Center for Chronic Disease Outcomes Research; L Fortier, Minneapolis VAMC Center for Chronic Disease Outcomes Research

Objectives: The poor overall functioning and high rates of trauma and personal hardships in men who seek service connection (SC) for PTSD has been well described, but little comparable data is known about women who seek SC for PTSD. Our goals were to describe and contrast these parameters in a large, nationally representative group of men and women who applied for VA PTSD disability benefits between 1994 and 1998.

Methods: Cross sectional, mailed survey of 4,819 randomly selected men and women. The sample represented 3% of all men and 57% of all women in the parent population. The survey questionnaire was composed of well-validated measures.

Results: 3337 veterans returned surveys (69%). Most men (76%) served during Vietnam; most women, in the post-Vietnam era (41%). Men's mean age was 55 (SD = 11); women's, 41 (SD = 10). Forty-four percent of men and women reported annual incomes of $20,000, but men were 1.37 times more likely to be SC for PTSD. Women were 1.5 times more likely than men to be employed.

Medical comorbidities were low for both genders (mean Charlson Comorbidity Index scores: men: 0.31, SD = 0.76; women: 0.20, SD = 0.52), but PTSD symptomatology, as measured by the Penn Inventory, was high. 72% of men and 68% of women had Penn Inventory scores > 35, denoting PTSD. Mean physical functioning scores for men were 17.2 (SD = 5) and 16.2 (SD = 4.5) for women, compared to a national norm of 29.5 (SD = 2.1). Overall role functioning, as measured by the Social Adjustment Scale, was 2.8 (SD = 0.8) for both men and women. These scores were almost twice as poor as that estimated for community norms and 1.4 times worse than norms for persons with schizophrenia.

Combat exposure rates were 29% in women and 94% in men. Rates of in-service sexual assault were 71% in women and 4% in men. Of a checklist of 11 post-service stressors, on average, women endorsed 5 (SD = 3) and men, 4 (SD = 2). More than half the women and men reported serious economic hardships or traumatic, personal losses. Thirty-eight percent of women and 29% of men, said they had been the victim of a serious crime; 40% of women and 17% of men said they had been seriously hurt by someone they knew. Additionally, 66% of women reported emotional abuse and neglect; 54% said they had been sexually assaulted after leaving the military.

Conclusions: Despite younger age, slightly fewer medical comorbidities, and higher employment rates, women and men reported similar levels of PTSD symptomatology, physical functioning, and overall role functioning. Both groups were severely impaired in terms of physical and role functioning, and both reported high rates of trauma and personal hardships. However, post-service trauma and personal hardship rates for women were substantially higher.

Impact: Our data show that women seeking SC for PTSD are as severely impaired functionally as men. As with men, clinicians should be aware of the high rates of trauma and personal hardships in these women's backgrounds.

Source: http://www.hsrd.research.va.gov/meetings/2001/HSRD2001AMab86.htm