mchsrosМедико-биологические и социально-психологические проблемы безопасности в чрезвычайных ситуацияхMedicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations1995-44412541-7487«The Nikiforov Russian Center of Emergency and Radiation Medicine»10.25016/2541-7487-2014-0-3-84-93mchsros-151Research ArticleСоциально-психологические проблемыSocial and Psychological Issues«СЕКСУАЛЬНАЯ ТРАВМА В АРМИИ» КАК ФАКТОР РИСКА ПОСТТРАВМАТИЧЕСКОГО СТРЕССОВОГО РАССТРОЙСТВА У ЖЕНЩИНВЕТЕРАНОВ В США (ОБЗОР ЛИТЕРАТУРЫ)Military sexual trauma as a risk factor for posttraumatic stress disorder in US women veterans (literature review)МухинаН. А.MukhinaN. A.

канд. мед. наук, ст. науч. сотр.

PhD Med. Sci., Senior Researcher

nata26@inbox.ruЕвдокимовВ. И.EvdokimovV. I.

др мед. наук проф.

Dr. Med. Sci. Prof., Dept. of Life Safety, Extreme and Radiation Medicine

9334616@mail.ruВсероссийский центр экстренной и радиационной медицины им. А.М. Никифорова МЧС РоссииРоссияThe Nikiforov Russian Center of Emergrency and Radiation Medicine, EMERCOM of RussiaRussian Federation201423042016038493Copyright © Мухина Н.А., Евдокимов В.И., 20162016Мухина Н.А., Евдокимов В.И.Mukhina N.A., Evdokimov V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mchsros.elpub.ru/jour/article/view/151

Изучены научные публикации по проблемам сексуальной травмы в армии (СТА) (Military sexual trauma), проиндексированные в реферативно-библиографической базе данных Scopus в 1994-2012 гг, зарубежные диссертации, представленные в базе данных ProQuest Digital Dissertations and Theses, и официальные электронные ресурсы Управления по делам ветеранов США (Department of Veterans Affairs, DVA). Под СТА понимается психическая травма, причиной которой послужили физическое насилие сексуального характера, побои сексуального характера или сексуальное домогательство, имевшие место в период прохождения военной службы или нахождения отставного военнослужащего на военно-тренировочных сборах. Сотрудники DVA США проводят национальную программу скрининга, в рамках которой каждого отставного военнослужащего, обратившегося за медицинской помощью, расспрашивают о СТА. Оказалось, что каждая 4-я женщина и 100-й мужчина дают утвердительный ответ на вопрос о пережитой ими СТА. Как правило, это касается только ветеранов, обратившихся за медицинской помощью, поэтому трудно оценить фактическое число сексуальных правонарушений в вооруженных силах. По данным DVA США, распространенность сексуальных домогательств и насилия у женщин-военнослужащих во время военной службы больше, чем в общей популяции женщин за всю жизнь. СТА - это стрессовое событие, а не диагноз, и реакции на это событие у женщин-военнослужащих (ветеранов вооруженных сил), как и потребности, могут быть разными. Представлены распространенность, факторы риска и связь СТА с развитием нарушений состояния здоровья. Установлено, что у женщин-ветеранов с СТА риск развития посттравматического стрессового расстройства в 9 раз больше по сравнению с женщинами-ветеранами без СТА.

Research publications on military sexual trauma (MST), indexed in the reference-bibliographic database Scopus in 1994-2012 were reviewed along with foreign dissertations submitted to ProQuest Dissertations and Theses database, and official electronic resources of the US Department of Veterans Affairs. MST is determined as a psychological trauma resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the veteran was serving on active duty or active duty for training. US DVA runs a national screening program, in which every veteran seen for health care is asked about MST. As it turned out, every 4th woman and 100th man respond «yes», that they experienced MST. Usually, this only applies to veterans who sought medical help, so it is difficult to estimate the actual prevalence of sexual abuse in the military. According to the US DVA, prevalence of sexual harassment and assault is higher among women soldiers throughout their military service than among general population of women across the lifespan. MST is a stressful event, not a diagnosis, and there are a variety of reactions that women veterans can have in response to MST, as well as their needs. MST prevalence, risk factors and possible health consequences are described. PTSD risk was found to be 9-fold higher in women veterans with MST history as compared to women veterans without MST.

экстремальная психологиябоевой стрессженщинывоеннослужащиевоенные ветеранывооруженные силысексуальные правонарушенияпосттравматическое стрессовое расстрой ствоextreme psychologycombat stressservicewomenwar veteransarmed forcessexual assaultspost traumatic stress disorderReferencesАлексеев Т. В американской армии растет количество преступлений на сексуальной почве. – URL:http://www.peacekeeper.ru/ru/?module=news&action=view&id=17552Alekseev T. V amerikanskoj armii rastet kolichestvo prestuplenij na seksual'noj pochve [In the American army, the number of sexual offenses increases]. – URL: http://www.peacekeeper.ru/ru/?module=news&action= view&id=17552. (In Russ.)Пешков В.В., Деренчук В.В. Гендерные тенденции в процессе завершения формирования нового облика Вооруженных сил Российской Федерации // Мед._биол. и соц._психол. пробл. безопасности в чрезв. ситуациях. – 2014. – № 2. – С. 84–89.Peshkov V.V., Derenchuk V.V. Gendernye tendentsii v protsesse zaversheniya formirovaniya novogo oblika Vooruzhennykh sil Rossiyskoy Federatsii [Gender trends in the process of completing the formation of a new image of the Armed Forces of the Russian Federation]. Mediko:biologicheskie i sotsial'no:psikhologicheskie problemy bezopasnosti v chrezvychaynykh situatsiyakh [Medical_Biological and Socio_Psychological Problems of Safety in Emergency Situations]. 2014. N 2. P. 84– 89. (In Russ.)Bobek R.S. Betrayal Trauma in the Military: A Phenomenological Study Exploring Betrayal with Veterans Returning from Iraq and Afghanistan : in Partial Fulfillment Requirements for the Degree Doctor of Psychology from Massachusetts School of Professional Psychology (Massachusetts, USA). – Ann Arbor, 2011. – 128 p. – (ProQuest, UMI Dissertations Publishing N 3509726).Bobek R.S. Betrayal Trauma in the Military: A Phenomenological Study Exploring Betrayal with Veterans Returning from Iraq and Afghanistan : in Partial Fulfillment Requirements for the Degree Doctor of Psychology from Massachusetts School of Professional Psychology (Massachusetts, USA). Ann Arbor, 2011. 128 p. (ProQuest, UMI Dissertations Publishing N 3509726).Department of Veterans Affairs [DVA]. – URL:http://www.mentalhealth.va.gov/docs/mst_ general_factsheet.pdf.Department of Veterans Affairs [DVA]. – URL:http://www.mentalhealth.va.gov/docs/mst_ general_factsheet.pdf.Fontana A., Rosenheck R. Duty_related and sexual stress in the etiology of PTSD among women veterans who seek treatment // Psychiatric Services. – 1998. – Vol. 49, N 5. – P. 658–662.Fontana A., Rosenheck R. Duty_related and sexual stress in the etiology of PTSD among women veterans who seek treatment // Psychiatric Services. – 1998. – Vol. 49, N 5. – P. 658–662.Fontana A., Schwartz L., Rosenheck R. Posttraumatic stress disorder among female Vietnam veterans: A causal model of etiology // American Journal of Public Health. – 1997. – Vol. 87, N 7. – P. 169–175.Fontana A., Schwartz L., Rosenheck R. Posttraumatic stress disorder among female Vietnam veterans: A causal model of etiology // American Journal of Public Health. – 1997. – Vol. 87, N 7. – P. 169–175.Frayne S., Skinner K., Sullivan L., Freund K. Sexual assault while in the military: Violence as a predictor of cardiac risk? // Violence and Victims. – 2003. – Vol. 18, N 2. – P. 219–225.Frayne S., Skinner K., Sullivan L., Freund K. Sexual assault while in the military: Violence as a predictor of cardiac risk? // Violence and Victims. – 2003. – Vol. 18, N 2. – P. 219–225.Kang H., Dalager N., Mahan C., Ishii E. The role of sexual assault on risk of PTSD among Gulf War veterans // Annals of Epidemiology. – 2005. – Vol. 15, N 3. – P. 191–195.Kang H., Dalager N., Mahan C., Ishii E. The role of sexual assault on risk of PTSD among Gulf War veterans // Annals of Epidemiology. – 2005. – Vol. 15, N 3. – P. 191–195.Katz L.S., Cojucar G., Beheshti S. [et al.]. Military sexual trauma during deployment to Iraq and Afghanistan: Prevalence, readjustment, and gender differences // Violence and Victims. – 2012. – Vol. 27, N 4. – P. 487–499.Katz L.S., Cojucar G., Beheshti S. [et al.]. Military sexual trauma during deployment to Iraq and Afghanistan: Prevalence, readjustment, and gender differences // Violence and Victims. – 2012. – Vol. 27, N 4. – P. 487–499.Kessler R.C., Sonnega A., Bromet E. [et al.]. Posttraumatic stress disorder in the national comorbidity survey // Archives of General Psychiatry. – 1995. – Vol. 52, N 12. – P. 1048–1060.Kessler R.C., Sonnega A., Bromet E. [et al.]. Posttraumatic stress disorder in the national comorbidity survey // Archives of General Psychiatry. – 1995. – Vol. 52, N 12. – P. 1048–1060.Kimerling R., Gima K., Smith M. [et al.]. The Veterans Health Administration and military sexual trauma // American Journal of Public Health. – 2007. – Vol. 97, N 12. – P. 2160–2166.Kimerling R., Gima K., Smith M. [et al.]. The Veterans Health Administration and military sexual trauma // American Journal of Public Health. – 2007. – Vol. 97, N 12. – P. 2160–2166.King D.W., Vogt D.S., King L.A. Risk and resilience factors in the etiology of chronic PTSD // Early interventions for trauma and traumatic loss in children and adults: Evidence_based directions / Ed. B.T. Litz. – New York : Guilford Press, 2004. – P. 34– 64.King D.W., Vogt D.S., King L.A. Risk and resilience factors in the etiology of chronic PTSD // Early interventions for trauma and traumatic loss in children and adults: Evidence_based directions / Ed. B.T. Litz. – New York : Guilford Press, 2004. – P. 34– 64.Lee E.A.D. Military sexual trauma exposure and heart rate variability outcomes in female veterans : in Partial Fulfillment Requirements for the Degree Doctor of Philosophy from The University of Tennessee Health Science Center (Tennessee, USA). – Ann Arbor, 2011. – 103 p. – (ProQuest, UMI Dissertations Publishing N 3482438).Lee E.A.D. Military sexual trauma exposure and heart rate variability outcomes in female veterans : in Partial Fulfillment Requirements for the Degree Doctor of Philosophy from The University of Tennessee Health Science Center (Tennessee, USA). – Ann Arbor, 2011. – 103 p. – (ProQuest, UMI Dissertations Publishing N 3482438).Lee E.A.D., Bissett J.K., Carter M.A. [et aj.]. Preliminary Findings of the Relationship of Lower Heart Rate Variability with Military Sexual Trauma and Presumed Posttraumatic Stress Disorder // Journal of Traumatic Stress. – 2013. – Vol. 26, N 2. – P. 249–256.Lee E.A.D., Bissett J.K., Carter M.A. [et aj.]. Preliminary Findings of the Relationship of Lower Heart Rate Variability with Military Sexual Trauma and Presumed Posttraumatic Stress Disorder // Journal of Traumatic Stress. – 2013. – Vol. 26, N 2. – P. 249–256.Long N., Chamberlain K., Vincent C. Effect of the Gulf War on reactivation of adverse combat_related memories in Vietnam veterans // Journal of Clinical Psychology. – 1994. – Vol. 50, N 2. – P. 138–144.Long N., Chamberlain K., Vincent C. Effect of the Gulf War on reactivation of adverse combat_related memories in Vietnam veterans // Journal of Clinical Psychology. – 1994. – Vol. 50, N 2. – P. 138–144.Maguen S., Cohen B., Ren L. [et aj.]. Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder // Women's Health Issues. – 2012. – Vol. 22, N 1. – P. e61–e66.Maguen S., Cohen B., Ren L. [et aj.]. Gender differences in military sexual trauma and mental health diagnoses among Iraq and Afghanistan veterans with posttraumatic stress disorder // Women's Health Issues. – 2012. – Vol. 22, N 1. – P. e61–e66.Martin L., Rosen L., Durand D. [et al.]. Psychological and physical health effects of sexual assaults and nonsexual trauma among male and female United States army soldiers // Behavioral Medicine. – 2000. – Vol. 26, N 1. – P. 23–34.Martin L., Rosen L., Durand D. [et al.]. Psychological and physical health effects of sexual assaults and nonsexual trauma among male and female United States army soldiers // Behavioral Medicine. – 2000. – Vol. 26, N 1. – P. 23–34.National Center for Veterans Analysis and Statistics [NCVAS]. America's women veterans: Military service history and VA benefit utilization statistics. Washington, DC; Department of Veterans Affairs. – URL: http://www.va.gov/ vetdata/Report.asp.National Center for Veterans Analysis and Statistics [NCVAS]. America's women veterans: Military service history and VA benefit utilization statistics. Washington, DC; Department of Veterans Affairs. – URL: http://www.va.gov/ vetdata/Report.asp.O'Brien B.S., Sher L. Military sexual trauma as a determinant in the development of mental and physical illness in male and female veterans // International Journal of Adolescent Medicine and Health. – 2013. – Vol. 25, N 3. – P. 269–274.O'Brien B.S., Sher L. Military sexual trauma as a determinant in the development of mental and physical illness in male and female veterans // International Journal of Adolescent Medicine and Health. – 2013. – Vol. 25, N 3. – P. 269–274.Park S.E. Relationships between posttraumatic stress disorder, attachment, self_blame, and social support among women veterans with a history of childhood and/or military sexual trauma in Partial Fulfillment Requirements for the Degree Doctor of Philosophy from the Biola University (California, USA). – Ann Arbor, 2013. – 194 p. – (ProQuest, UMI Dissertations Publishing N 3599501).Park S.E. Relationships between posttraumatic stress disorder, attachment, self_blame, and social support among women veterans with a history of childhood and/or military sexual trauma in Partial Fulfillment Requirements for the Degree Doctor of Philosophy from the Biola University (California, USA). – Ann Arbor, 2013. – 194 p. – (ProQuest, UMI Dissertations Publishing N 3599501).Pavao J., Turchik J.A., Hyun J.K. [et aj.]. Military sexual trauma among homeless veterans // Journal of General Internal Medicine. – 2013. – Vol. 28, N 2. – P. S536–S541.Pavao J., Turchik J.A., Hyun J.K. [et aj.]. Military sexual trauma among homeless veterans // Journal of General Internal Medicine. – 2013. – Vol. 28, N 2. – P. S536–S541.Sadler A., Booth B., Mengeling M., Doebbeling B. Life span and repeated violence against women during military service: Effects on health status and outpatient utilization // Journal of Women's Health. – 2004. – Vol. 13, N 7. – P. 799–811.Sadler A., Booth B., Mengeling M., Doebbeling B. Life span and repeated violence against women during military service: Effects on health status and outpatient utilization // Journal of Women's Health. – 2004. – Vol. 13, N 7. – P. 799–811.Sadler A.G., Booth B.M., Cook B.L., Doebbeling B.N. Factors associated with women's risk of rape in the military environment // American Journal of Industrial Medicine. – 2003. – Vol. 43, N 3. – P. 262– 273.Sadler A.G., Booth B.M., Cook B.L., Doebbeling B.N. Factors associated with women's risk of rape in the military environment // American Journal of Industrial Medicine. – 2003. – Vol. 43, N 3. – P. 262– 273.Schnurr P.P., Lunney C.A., Sengupta A., Spiro A. A longitudinal study of retirement in older male veterans // Journal of Consulting and Clinical Psychology. – 2005. – Vol. 73, N 3. – P. 561–566.Schnurr P.P., Lunney C.A., Sengupta A., Spiro A. A longitudinal study of retirement in older male veterans // Journal of Consulting and Clinical Psychology. – 2005. – Vol. 73, N 3. – P. 561–566.Sledjeski E.M., Speisman B., Dierker L.B. Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey Replication (NCS_R) // Journal of Behavioral Medicine. – 2008. – Vol. 31, N 4. – P. 341–349.Sledjeski E.M., Speisman B., Dierker L.B. Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey Replication (NCS_R) // Journal of Behavioral Medicine. – 2008. – Vol. 31, N 4. – P. 341–349.Street A.E., Stafford J., Mahan C.M., Hendricks A. Sexual harassment and assault experienced by reservists during military service: Prevalence and health correlates // Journal of Rehabilitation Research and Development. – 2008. – Vol. 45, N 3. – P. 409–419.Street A.E., Stafford J., Mahan C.M., Hendricks A. Sexual harassment and assault experienced by reservists during military service: Prevalence and health correlates // Journal of Rehabilitation Research and Development. – 2008. – Vol. 45, N 3. – P. 409–419.Suris A., Lind L., Kashner T.M. [et al.]. Sexual assault in women veterans: An examination of PTSD risk, health care utilization // Psychosomatic Medicine. – 2004. – Vol. 66, N 5. – P. 749–756.Suris A., Lind L., Kashner T.M. [et al.]. Sexual assault in women veterans: An examination of PTSD risk, health care utilization // Psychosomatic Medicine. – 2004. – Vol. 66, N 5. – P. 749–756.Suris A., Lind L.. Military Sexual Trauma: A Review of Prevalence and Associated Health Consequences in Veterans // Trauma Violence Abuse. – 2008. – Vol. 9, N 4. – P. 250–269.Suris A., Lind L.. Military Sexual Trauma: A Review of Prevalence and Associated Health Consequences in Veterans // Trauma Violence Abuse. – 2008. – Vol. 9, N 4. – P. 250–269.Tolin D.F., Foa E.B. Gender and PTSD: A cognitive model // Gender and PTSD / Eds.: R. Kimerling, P. Ouimette, J. Wolfe. – New York : Guilford Press, 2002. – P. 76–97.Tolin D.F., Foa E.B. Gender and PTSD: A cognitive model // Gender and PTSD / Eds.: R. Kimerling, P. Ouimette, J. Wolfe. – New York : Guilford Press, 2002. – P. 76–97.Wolfe J., Brown P.J., Bucsela M.L. Symptom responses of female Vietnam veterans to Operation Desert Storm // American Journal of Psychiatry. – 1992. – Vol. 149, N 5. – P. 676–679.Wolfe J., Brown P.J., Bucsela M.L. Symptom responses of female Vietnam veterans to Operation Desert Storm // American Journal of Psychiatry. – 1992. – Vol. 149, N 5. – P. 676–679.Yaeger D., Himmelfarb N., Cammack A., Mintz J. DSM_IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma // Journal of General Internal Medicine. – 2006. – Vol. 21, N 3. – P. S65–S69.Yaeger D., Himmelfarb N., Cammack A., Mintz J. DSM_IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma // Journal of General Internal Medicine. – 2006. – Vol. 21, N 3. – P. S65–S69.

The authors declare that there are no conflicts of interest present.