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Sexual Harassment and Assault Experienced by Reservists During Military Service: Prevalence and Health Correlates

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Sexual Harassment and Assault Experienced by Reservists During Military Service: Prevalence and Health Correlates Volume 45, Number 3, 2008 JRRDJRRD Pages 409–420 Journal of Rehabilitation Research & Development Sexual harassment and assault experienced by reservists during military service: Prevalence and health correlates Amy E. Street, PhD;1–2* Jane Stafford, PhD;3 Clare M. Mahan, PhD;4 Ann Hendricks, PhD5–6 1National Center for Posttraumatic Stress Disorder, Department of Veterans Affairs (VA) Boston Healthcare System, Boston, MA; 2Department of Psychiatry, Boston University School of Medicine, Boston, MA; 3Department of Psychol- ogy, University of South Carolina Aiken, Aiken, South Carolina; 4VA Environmental Epidemiology Service, Washing- ton, DC; 5VA Boston Healthcare System, Boston, MA; 6Department of Health Policy and Management, Boston University School of Public Health, Boston, MA Abstract—The current investigation identified the gender- INTRODUCTION specific prevalence of sexual harassment and assault experi- enced during U.S. military service and the negative mental and In recent years, concerns about the high rates of sexual physical health correlates of these experiences in a sample of harassment and sexual assault experienced by members of former reservists. We surveyed a stratified random sample of the U.S. military during their national service have caused 3,946 former reservists about their experiences during military researchers, policymakers, and the press to pay consider- service and their current health, including depression, posttrau- able attention to this issue [1–3]. Sexual harassment, long matic stress disorder, somatic symptoms, and medical condi- tions. Prevalence estimates and confidence intervals of sexual identified as a significant occupational health concern harassment and assault were calculated. A series of logistic in the civilian sector [4], is defined by the Equal Employ- regressions identified associations with health symptoms and ment Opportunity Commission as “unwelcome sexual conditions. Both men and women had a substantial prevalence advances, requests for sexual favors, and other verbal or of military sexual harassment and assault. As expected, higher physical conduct of a sexual nature” that occur in a work proportions of female reservists reported sexual harassment setting [5]. The term sexual harassment encompasses (60.0% vs 27.2% for males) and sexual assault (13.1% vs 1.6% for males). For both men and women, these experiences were associated with deleterious mental and physical health condi- tions, with sexual assault demonstrating stronger associations than other types of sexual harassment in most cases. This inves- Abbreviations: AOR = adjusted odds ratio, CES-D = Center tigation is the first to document high instances of these experi- for Epidemiologic Studies Depression Scale, CI = confidence ences among reservists. These data provide further evidence that interval, DMDC = Defense Manpower Data Center, DSM-IV- experiences of sexual harassment and assault during military TR = Diagnostic and Statistical Manual of Mental Disorders- service have significant implications for the healthcare needs of Fourth Edition-Text Revision, PCL = PTSD Checklist, PTSD = military veterans. posttraumatic stress disorder, SEQ-DOD = Sexual Experiences Questionnaire (military version), VA = Department of Veterans Affairs. *Address all correspondence to Amy E. Street, PhD; Key words: mental health, military service, military sexual National Center for PTSD (116B-3), VA Boston Healthcare trauma, physical health, posttraumatic stress disorder, rehabili- System, 150 South Huntington Avenue, Boston, MA 02130; tation, reservists, sexual assault, Sexual Experiences Question- 857-364-5998; fax: 857-364-4515. Email: [email protected] naire, sexual harassment. DOI: 10.1682/JRRD.2007.06.0088 409 410 JRRD, Volume 45, Number 3, 2008 a continuum of behaviors including, at the severe end, (1) estimated the gender-specific prevalence of experi- those that constitute workplace-based sexual assault. ences of military sexual harassment and sexual assault The Department of Defense’s Sexual Harassment and (2) identified the negative mental and physical health Survey (1995), a large-scale investigation of unwanted correlates of these experiences in a sample of former sexual experiences across all branches of the active duty reservists. military, identified high annual occurrences of military sexual harassment and assault. Specifically, 78 percent of women and 38 percent of men reported at least one expe- METHODS rience of unwanted sexual behavior generally defined as sexual harassment and 6 percent of women and 1 percent Study Population of men reported at least one sexual assault experience The Defense Manpower Data Center (DMDC) pro- during the past year [6]. Lifetime prevalence of military vided the names and Social Security numbers of former sexual harassment and assault are also high among reservists who, to the best of their knowledge, had not female veterans who use Department of Veterans Affairs also served in the active duty forces. In the stratified ran- (VA) health services. In one large survey, 55 percent dom sampling design, the target population was stratified reported that they were sexually harassed and 23 percent by gender (oversampling females) and by the seven spe- reported they were sexually assaulted during military ser- cific Reserve components (i.e., Army Reserve, Army vice [2]. Unfortunately, surveys of wartime military sam- National Guard, Naval Reserve, Marine Corps Reserve, ples suggest a similarly high prevalence of military Air Force Reserve, Air National Guard, and Coast Guard sexual harassment and assault. Among a sample of Army Reserve). A total of 2,338 female reservists participated women who served in the 1991 gulf war, 69 percent out of a target of 2,500 (93.5%), and a total of 1,684 male reported experiencing sexual harassment and 7 percent reservists participated out of a target of 2,000 (84.2%). reported experiencing sexual assault during their war After we deleted data from 76 reservists from whom only zone service [3]. partial data were available, the final study group con- The high prevalence of sexual harassment and assault sisted of 3,946 former reservists (2,318 females and reported by active duty military is particularly troubling 1,628 males). All participants had completed military given the significant negative health consequences often service by December 31, 2000. On average, participants associated with these experiences. In a sample of more had completed service 9.12 years before data collection. than 28,000 active duty men and women, military sexual Selected characteristics of survey participants, stratified harassment was associated with poorer psychological by sexual harassment/sexual assault status, are presented well-being and health satisfaction [1]. Among female vet- in Table 1 (females) and Table 2 (males). erans using VA services, a self-reported history of military sexual harassment or assault was associated with more Data Collection readjustment problems after discharge (e.g., difficulties VA Boston Healthcare System’s committee on the use finding work, higher rates of substance abuse disorders, of human subjects in research approved the data collec- poorer general psychological and physical health) [2]. tion. Location efforts used several address and telephone Despite the wealth of evidence demonstrating the search services (National Institute for Occupational high prevalence of sexual harassment and assault and Safety and Health/Internal Revenue Service, Telematch, associated negative health consequences among active Experian Credit Bureau, directory assistance) to identify duty and veteran populations, no previous large-scale accurate contact information, resulting in a final sample investigation has examined these issues among members of 13,032 former reservists, not all of whom were guaran- of the Reserve components of the Armed Forces. This teed to meet study eligibility requirements (i.e., served in fact represents a significant gap in the knowledge base, the Reserves but did not serve in active duty). Accurate because reservists, who serve a minimum of 39 days a contact information was unavailable on the remainder of year, comprise a significant proportion of U.S. military the target sample, primarily because of errors in the personnel. Currently, the Reserve forces have approxi- DMDC database. mately 1.1 million members, representing 45 percent of Participants were interviewed with a computer-assisted total U.S. military forces [7]. The current investigation telephone interview protocol during a 7-month period 411 STREET et al. Harassment, assault, and health correlates Table 1. Female participants: Demographic and military characteristics strati- fied by military sexual harassment (SH)/sexual assault (SA) status. SH/SA No SH/SA SH/SA No SH/SA Characteristic Characteristic (%) (%) (%) (%) Demographic (Continued) Age at Interview* Discharged from Reserves/Guard 20–29 9.0 15.0 Honorable 87.0 86.7 30–39 51.7 46.0 General 11.3 10.7 40–49 26.1 21.5 Other than Honorable 1.7 2.6 50–59 10.3 13.2 Service-Connected Disability Status* 60+ 2.9 4.3 Yes 5.8 3.6 * Race/Ethnicity No 94.2 96.4 White 67.9 63.7 *p < 0.05, p significance probability by chi-square test of independence Black/African American 22.5 26.7 between SH/SA assault status. Rows of some characteristics were collapsed to Hispanic/Latino 5.4 4.3 meet minimum expected cell size required for approximation of chi-square dis- Other 4.2 5.3 tribution (i.e., year first served, years served). † Marital Status If participant served in more than one Reserve component, this information Married/Live as Couple 57.0 56.8 refers to component described as primary. Separated/Divorced 17.8 17.4 Widowed 1.6 1.7 Never Married 23.6 24.1 between August 2002 and March 2003. Advance letters, Income ($) including prepaid return letters as a mechanism to with- <15,000 7.0 6.8 draw, were mailed in waves 2 weeks before initial contact 15,000–34,999 23.0 24.5 attempts by telephone. Female interviewers made 25 call- 35,000–54,999 28.2 32.0 back attempts to each respondent on different days and at 55,000–74,999 19.3 16.5 75,000–94,999 10.5 8.2 different times over a period of at least 3 months.
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