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Military sexual trauma (MST) (sexual harassment or sexual assault experienced during military service) is associated with adverse mental health outcomes. This systematic review assessed international, published, peer-reviewed academic literature and aimed to (1) identify the mental health outcomes of MST for serving and ex-servicewomen, (2) understand whether sexual harassment and sexual assault impact mental health differently, and (3) identify individual differences that may influence mental health outcomes. Included sources were peer reviewed, primary research, which investigated MST as a predictor of mental health outcome(s) in women. Database searches (June 2023, May 2024, and March 2025) yielded 63 studies, most of which (n = 58) were conducted in the United States and used quantitative methods (n = 60). A narrative synthesis approach facilitated data synthesis. Quantitative studies identified associations between MST and adverse mental health outcomes, with qualitative studies providing further context to these associations. Military sexual assault appeared to have a stronger relationship with adverse mental health than other MST experiences. Posttraumatic stress disorder and depression symptoms were associated with further outcomes, such as suicidality, disordered eating, and substance use. Some additional trauma exposures exacerbated the impacts of MST on mental health, whilst social support mitigated negative mental health outcomes. This review identifies significant mental health impacts of MST and highlights the importance of formal and informal support for serving and ex-servicewomen with MST experiences.

Sexual trauma, particularly childhood sexual trauma, is a potent risk factor for sexual health difficulties among civilian women. Women veterans report elevated rates of sexual trauma compared to their civilian peers, including sexual trauma during military service, perhaps making women veterans even more vulnerable to sexual health difficulties. A comprehensive review of the peer-reviewed literature on the relationship between sexual trauma and sexual health in women veterans was conducted. Inclusion criteria were measurement of sexual trauma and sexual health (i.e., sexual function or sexual satisfaction), a U.S. veteran sample including women veterans, and written in English. This process identified 18 articles. Results indicated that similar to the pattern observed among civilian women, sexual trauma was associated with an increased risk of sexual dysfunction and low sexual satisfaction among women veterans. Sexual pain was the most common sexual dysfunction among women veterans. Comorbid post-traumatic stress disorder and depression were identified as correlates of sexual dysfunction. Gaps in the literature included limited use of validated measures of sexual health and inconsistencies in the assessment of sexual trauma history. Future research is needed on the interrelationships between sexual trauma, sexual health, and mental health to inform treatment recommendations for improving sexual health among women veterans.

Study Objectives: This study evaluated the prevalence and correlates of insomnia in male veterans with military sexual trauma (MST) who currently receive care within a VA medical center. Methods: We evaluated cross-sectional data from a VA medical center (n = 138) using the following instruments: Insomnia Severity Index, Posttraumatic Stress Disorder Checklist, Quick Inventory of Depressive Symptomatology-Self Report, Alcohol Use Disorders Identification Test for Consumption, and a nightmare question for insomnia, posttraumatic stress disorder, depression, and drinking, respectively. Bivariate and multivariable analyses assessed the relationship between Insomnia Severity Index and other clinical variables. Results: About 31.9% screened positive for MST. When compared to those without MST (MST−), those with MST (MST+) had a higher prevalence of insomnia (95.5% vs 81.9%) and higher Insomnia Severity Index (20 ± 5.1 vs 16.7 ± 7.2, P = .003) and Posttraumatic Stress Disorder Checklist (48.5 ± 14.4 vs 38.2 ± 19.8, P = .0008) total scores. In the multivariable models, the Insomnia Severity Index total score was associated with the Posttraumatic Stress Disorder Checklist total score ( P = .015) in MST+ individuals and with Quick Inventory of Depressive Symptomatology-Self Report ( P < .001) in MST− individuals. Conclusions: Most veterans with MST within the Veterans Health Administration had insomnia, which was associated with their underlying psychiatric comorbidity. Citation: Makar K, Mills A, Rivera LA, Aguiar TL, He S, Subhajit C. Insomnia in male veterans with and without military sexual trauma receiving care within a VA medical center. J Clin Sleep Med . 2024;20(6):991–994.

: Research has demonstrated that the verbal disclosure for adult victims of childhood sexual trauma (CST) presents significant challenges and seldom provides comprehensive trauma integration. Limited psychosocial support and specialist trauma care particularly in marginalised communities, can further exacerbate the non-disclosure of CST. Although various intervention models for adult victims of CST exist, the potential of facilitating integrative silence as part of community centred integrative trauma informed care (ITIC), remains under-explored. : The objective of this article, is to document how facilitating spaces of integrative silence in a therapeutic context, shifts embodied trauma awareness, comprehensive trauma realisation and trauma integration for adult victims of CST from intergenerational marginalised contexts. : Through participatory action research (PAR), framed in de-colonial feminist community praxis with 13 women aged 21-62, the first author as therapist-researcher facilitated audio-visual recorded semi-structured interviews (  = 13) and integrative trauma informed care (ITIC) follow-up sessions (  = 60) to assess the value of the spoken, unspoken and silence in trauma care. Inductive reflexive thematic analysis and a multistage recursive coding process of verbatim transcriptions, were used to identify embodied trauma awareness before, during, and after periods of silence. : The de-colonial, feminist framing for community centred ITIC enhanced participant-specific embodied awareness, establishing a safe space for self-reflection. Contextual sensitivity and careful attention to the therapeutic environment were paramount. The facilitation of non-verbal expression empowered participants to explore alternatives to normative, essentialist and religious narratives that often stigmatise trauma responses. This approach enabled participants to reclaim a sense of agency, improving self-regulation and self-care. : This study highlights the potential of integrative silence in community based therapeutic contexts. Future research could explore the role of integrative silence in treating various forms of trauma in different cultural and geographic settings and its integration with other therapeutic modalities to enhance culturally sensitive mental health care.

IntroductionThis study investigates the rates of military sexual trauma (MST) and its associations with adverse mental health among a sample of UK female ex-service personnel who served during the Iraq/Afghanistan eras.Methods and analysisFemale ex-service personnel, who participated in the fourth phase (Phase 4) of the King’s Centre for Military Health Research (KCMHR) Health and Well-being Cohort Study (2022–2023) and consented to be recontacted for follow-up studies (n=295), are being invited to participate in an online questionnaire between July 2024 and February 2025. The questionnaire contains surveys and questions related to experiences of sexual harassment and sexual assault during and outside of military service, disordered eating and broader female health issues. While the questionnaire relates to several female health topics, this study focuses on the surveys related to experiences of sexual trauma and eating disorders. Sociodemographic variables and some health variables, including post-traumatic stress disorder (PTSD), complex PTSD, common mental disorders, alcohol misuse, physical somatisation and social support, will be extracted from participants’ pre-existing data collected in Phase 4 of the KCMHR Cohort Study. Analyses will assess rates of MST, and hierarchical multiple logistic regressions will investigate associated health impacts. Rates and ORs, employing 95% CIs, will be reported.Ethics and disseminationThis study has been granted full ethical approval by the King’s College London Research Ethics Committee (Ref: HR/DP-23/24–39040). Participants provide informed consent before participating and have access to a signposting booklet containing contact details for a range of support services. A risk protocol is in place, which outlines the procedure to be undertaken if a participant contacts the research team in distress. Findings will form part of a PhD thesis and will be further disseminated through peer-reviewed publication and dissemination with veteran mental health services and charities, and relevant government departments.

Black women disproportionately experience sexual health-related trauma, yet their mental health needs are often inadequately addressed due to systemic barriers and stigma. This literature review examines trauma-informed care (TIC) frameworks tailored to Black women, emphasizing culturally responsive practices in addressing sexual health-related trauma. By synthesizing findings from existing research, including the importance of intersectionality, culturally specific interventions, and community-centered approaches, this review highlights effective strategies for mental health providers. The review concludes with implications for enhancing TIC training and implementation in clinical settings which contributes to the advancement of equitable mental health services for Black women.

Introduction: Military sexual trauma (MST) is a serious and pervasive problem among military men and women. Recent findings have linked MST with various negative outcomes including risky, self-destructive, and health-compromising behaviors. Objective: The current review summarizes the existing literature on the association between MST and risky behaviors among military men and women who have served in the U.S. Armed Forces. Method: We systematically searched five electronic databases (PubMed, EMBASE, PSYCINFO, PILOTS, and CINAHL Plus) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Of the initial 2,021 articles, 47 met the inclusion criteria. Reviewed studies revealed three patterns of findings: (1) largely studied and consistent (i.e., suicidal behaviors, disordered eating), (2) mixed and in need of future research (i.e., alcohol and drug use, smoking), and (3) underexamined (i.e., sexual behaviors, illegal/aggressive behaviors) or completely neglected (e.g., problematic technology use, gambling). Discussion: The current systematic review advances literature by providing strong support for an association between MST and a wide range of risky behaviors. Moreover, it highlights important areas for future research.

Military sexual trauma (MST) can have significant adverse effects on mental health and well-being, often leading to posttraumatic stress disorder (PTSD) symptoms and maladaptive beliefs. Although effective psychotherapies exist, stigma, confidentiality concerns, and systemic barriers often hinder help-seeking among service members and veterans. Mobile mental health apps offer an accessible and anonymous support alternative, potentially addressing such barriers. However, app effectiveness depends on user engagement and emerging evidence suggests that engagement may be shaped by symptom severity. This retrospective observational study aimed to explore the relationship between posttraumatic symptom severity and user engagement with Beyond MST (US Department of Veterans Affairs [VA] National Center for PTSD), an app for individuals who experienced MST. Specific aims included (1) characterizing trauma-related symptom levels and app engagement among users who completed in-app assessments, and (2) evaluating how PTSD symptom severity, negative posttraumatic cognitions, and mental well-being relate to objective measures of engagement. Anonymous usage data from 27,517 users collected between March 11, 2021 and July 29, 2024, were analyzed. Three subsamples were identified: those who completed the in-app PTSD checklist for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]; PCL-5, n=3689), the Posttraumatic Maladaptive Beliefs Scale (PMBS; n=2197), and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS; n=2160). Engagement metrics included duration of use (ie, days of use and minutes of use), frequency of feature access (ie, coping tool and psychoeducation access), and frequency of feature use (ie, total assessment completions). Regression analyses, including quadratic terms, were conducted to evaluate how symptom severity and well-being levels influenced engagement and identify possible curvilinear trends. Median engagement levels ranged across subsamples as follows: 3-4 days of use (IQR 5-6), 22-30 minutes of use (IQR 33.7-42.9), 1-5 feature accesses (IQR 6-9), and 2-3 assessment completions (IQR 2). Subsamples were highly symptomatic. Analyses revealed that moderate PTSD symptom and negative posttraumatic cognition severity were associated with higher engagement relative to users with very low and very high symptom levels, particularly for days of use and frequency of coping tool access. Conversely, higher mental well-being scores were generally linked to increased app engagement with linear effects. Effect sizes were small, suggesting limited clinical impact. This study highlights the possible challenges in engaging highly symptomatic individuals with digital mental health interventions. Although Beyond MST successfully reaches its targeted population, very low or high symptom levels and lower well-being may hinder sustained engagement. These findings suggest that symptom levels should be considered in app development (ie, personalization) and when integrating apps into professional care. Interpretation is limited by the anonymous nature of the data, which prevented characterization of users and their trauma histories. Further research is needed to clarify how symptom patterns influence engagement, especially in trauma contexts. RR2-10.31979/etd.882a-5fcx.

Previous research has documented the utility of synchronous neural interactions (SNI) in classifying women veterans with and without posttraumatic stress disorder (PTSD) and other trauma-related outcomes based on functional connectivity using magnetoencephalography (MEG). Here, we extend that line of research to evaluate trauma-specific PTSD neural signatures with MEG in women veterans. Participants completed diagnostic interviews and underwent a task-free MEG scan from which SNI was computed. Thirty-five women veterans were diagnosed with PTSD due to sexual trauma and sixteen with PTSD due to non-sexual trauma. Strength of SNI was compared in women with and without sexual trauma, and linear discriminant analysis was used to classify the brain patterns of women with PTSD due to sexual trauma and non-sexual trauma. Comparison of SNI strength between the two groups revealed widespread hypercorrelation in women with sexual trauma relative to those without sexual trauma. Furthermore, using SNI, the brains of participants were classified as sexual trauma or non-sexual trauma with 100% accuracy. These findings bolster evidence supporting the utility of task-free SNI and suggest that neural signatures of PTSD are trauma-specific.

Up to 70% of women service members in the United States report military sexual trauma (MST); many develop post-traumatic stress disorder (PTSD) and co-occurring disorders. Trauma-informed yoga (TIY) is suggested to improve psychiatric symptoms and shown feasible and acceptable in emerging research, yet no work has evaluated TIY in MST survivors. The current quality improvement project aimed to examine TIY’s feasibility, acceptability, and perceived effects in the context of MST. Collective case series (N = 7). New England Vet Center. Extant TIY program (Mindful Yoga Therapy) adapted for Veteran women with MST in concurrent psychotherapy. Attrition and attendance; qualitative exit interview; validated self-report measure of negative affect pre/post each yoga class, and symptom severity assessments and surveys before (T1; Time 1) and after the yoga program (T2; Time 2). Feasibility was demonstrated and women reported TIY was acceptable. In qualitative interviews, women reported improved symptom severity, diet, exercise, alcohol use, sleep, and pain; reduced medication use; and themes related to stress reduction, mindfulness, and self-compassion. Regarding quantitative change, results suggest acute reductions in negative affect following yoga sessions across participants, as well as improved affect dysregulation, shame, and mindfulness T1 to T2. TIY is both feasible and acceptable to Veteran women MST survivors in one specific Vet Center, with perceived behavioral health benefits. Results suggest TIY may target psychosocial mechanisms implicated in health behavior change (stress reduction, mindfulness, affect regulation, shame). Formal research should be conducted to confirm these QI project results.