Sexual Assault Victimization and Mental Health Treatment, Suicide Attempts, and Career Outcomes Among Women in the US Army

Objectives. To examine associations of administratively recorded sexual assault victimization during military service with subsequent mental health and negative career outcomes among US Army women controlling for nonrandom victimization exposure. Methods. We used data from the Army Study to Assess Risk and Resilience in Service-members to apply propensity score methods to match all 4238 female Regular Army soldiers with administratively recorded sexual assault victimization during 2004 to 2009 to 5 controls per case with similar composite victimization risk. We examined associations of this victimization measure with administratively recorded mental health treatment, suicide attempt, and Army career outcomes over the subsequent 12 months by using survival analysis for dichotomous outcomes and conditional generalized linear models for continuous outcomes. Results. Women with administratively recorded sexual assault had significantly elevated odds ratios (ORs) of subsequent mental health treatment (any, OR=2.5; 95% confidence interval [CI]=2.4,2.6; specialty, OR=3.1; 95% CI=2.9,3.3; inpatient, OR=2.8; 95% CI=2.5,3.1), posttraumatic stress disorder treatment (any, OR=6.3;95% CI=5.7, 6.9; specialty, OR=7.7; 95% CI=6.8, 8.6; inpatient, OR=6.8; 95% CI=5.4, 8.6), suicide attempt (OR=3.0; 95% CI=2.5, 3.6), demotion (OR=2.1; 95% CI=1.9, 2.3), and attrition (OR=1.2; 95% CI=1.1, 1.2). Conclusions. Sexual assault victimization is associated with considerable suffering and likely decreased force readiness.