Association Between Adverse Childhood Experiences and Military Sexual Trauma

The role adverse childhood experiences (ACE) play on one's physical and mental health has become more understood over the past several years. A strong and graded relationship has been identified between the level of traumatic stress in childhood and poor physical and mental health in adulthood. Military sexual trauma (MST) is defined as "sexual assault or repeated, threatening sexual harassment that happened while the veteran was in the military". Previous history of trauma such as ACE may increase the risk of experiencing MST. This project utilized an ACE questionnaire to study the association between the level of traumatic stress in childhood and MST. The goal was to disseminate the importance of this topic, help healthcare providers identify some of the underlying causes of emotional and physical disturbance, and help healthcare providers to provide effective MST care. Four primary objectives were designed to meet this goal: a) increase knowledge regarding tools to assess ACE and MST, b) conduct a case-control study between those who experienced MST and those who did not experience MST, c) disseminate information regarding relationship between ACE and MST to a group of Veterans Administration (VA) healthcare providers in Utah, and d) disseminate information to a wider audience through submission of an abstract to a conference. The experience of ACE increases life time risk of substance abuse, depression, cardiovascular disease, diabetes, cancer and premature mortality. MST is a strong predictor for physical and mental illness such as post-traumatic stress disorder, anxiety, depression, liver disease, ischemic heart disease, cancer, skeletal fractures, and weight conditions. Both the mental and physical illnesses that are associated with MST and ACE can significantly impair quality of life. To implement this project, a literature review was done on the prevalence of ACE and MST and tools that assess them. Content experts from the psychology department at the VA and applied statistics department at the University Of Utah College Of Nursing were contacted. One validated tool for assessing ACE was selected for use for this project and approval was obtained from content experts and chair. An IRB application for the project was submitted and approved. The ACE questionnaire was used to gather information on ACE from a group of veterans with MST and a group of veterans without MST during Post-Traumatic Stress Disorder (PTSD) evaluations and psychotherapy groups. A 30- minute presentation on the relationship between ACE and MST was developed and delivered to a group of VA healthcare providers during a Salt Lake VA PTSD team meeting. An abstract of the project was written, submitted, and accepted by the Western Institute of Nursing (WIN) conference. In order to live fully in the present and plan adequately for the future, we need to learn from our past. The ACE questionnaire utilizes validated questions from published surveys to gain information on 7 categories of childhood exposure. This project helps providers gain knowledge on the relationship between ACE and MST and build on this foundation of knowledge to provide better MST care and prevention.