Treatment of military sexual trauma in male survivors of sexual abuse

¶ … Treatment of Sexual Dysfunction in Military Men who are Survivors of Sexual Abuse

The therapeutic definition of sexual abuse is based on varied parameters. For a therapist, the perception of a patient that they were abused sexually is the basis of the definition. The person has to recognize the act as an abusive act and so give it that label. The definition is relationship- specific (Binik & Hall, 2014). Women that endorse this label tend to have been through more invasive and chronic sexual behaviors and tend to function less sexually than other people who approve of definitions that are activity-specific (Rellini & Meston, 2007).

MST -- Military Sexual Trauma -- may be a sexual violence act against one military member by another or the response of a survivor psychologically to sexual violence. The United States U.S.) Department of Defense (DOD) does not officially recognize the term MST. However, the U.S. Department of Veteran Affairs notes that MST is sexual assault or sexual harassment repeatedly meted on the veteran during his or her time as a military officer (Sexual Violence in the Military, 2013). MST encompasses any instance where a person was involved in a sexual activity against their will. This can happen when one is pressured into such activities, or one is not capable of consenting to them, or is physically forced to take part. Other acts that can be included here include sexual grabbing or touching, making remarks about another person's body that are offensive, or making unwelcome sexual advances (Sexual Violence in the Military, 2013).

Provide a thorough account of etiology of the disorder

An understanding of the number of people affected by MST can guide decision making on the best way of designing and implementing policies, programs and interventions. Good resource allocation is largely dependent on the information gained through research on sexual assault epidemiology. Nonetheless, the counts of sexual assault are probably going to be inaccurate for several reasons, including: lack of clear definition of sexual assault, criteria and methodology for screening, and the reluctance to make reports on the populations affected (Farris, Schell & Tanielian, 2013). While there are social norms in normal society, such norms may be magnified in the military. Behavioral definitions such as selfless duty, loyalty, courage, teamwork, discipline, integrity, and honor are paid more attention to in the military than they are paid attention to in the outside world (DTFSAMS 2009, p.6). Sticking to these standards may assist to alleviate sexual violence. However, unclear messages in the areas of sexual violence during the training of the military officers lower the ability of the service to promote a culture that does not condone inappropriate sexual behavior or sexual violence (DTFSAMS, 2009, P.7). The military emphasis on unit cohesion as well as hierarchical structure may be a deterrent to the abused seeking assistance (DTFSAMS, 2009).

Because MST is not a diagnosis, but represents a stressor, VHA treatment efforts are focused on detection as well as access to care. Veterans reporting MST are treated based on their individual diagnosis or symptoms. Just as is the case with other traumatic stressors, MST could contribute to mental disorders or PTSD. Because of self blame and social stigma, individuals, whether inside or outside the military, seldom disclose that they have been sexually abused unless they have been expressly asked to do so.

Provide a thorough explanation

Studies doing investigations on sexual assault prevalence in the military using samples of veterans have consistently found high rates among men and women. There are variations to the statistics, however, this is because of different samples, characteristics of the samples, mode of selection, and also variations in questions asked. The prevalence rates of harassment experiences and sexual assault are part of the questions asked. Sexual Experiences Questionnaire -- Department of Defense (SEQ-DOD) is one survey that is reliable and can help in such a study. Suris and Lind (2008) give an extensive review of the different survey instruments made use of in MST and Veteran studies. Prevalence of mental health issues and MST tend to be higher among the sample seeking treatment than in the epidemiological samples (Hyun, Pavao & Kimerling, 2009).

Veterans that have experienced MST have a higher risk for certain mental and medical conditions. The link between PTSD and MST in both women and men is consistently covered in literature. There is need though for more research in the areas of possible gender differences, particularly those on treatment needs and comorbidity. Finally, having a better understanding of the synergistic effects of the traumatic experiences before the military service, combat trauma and military sexual trauma will give more insights on the Veterans' mental health comorbidities and military stressors (Hyun, Pavao & Kimerling, 2009). While there are effective therapies for several mental health conditions that are associated with MST, we can get to know more about how effective these treatments are from clinical studies reporting in detail the stressor exposure. Approaches in public health, like VHA's universal screening program, give good secondary prevention models. Evidence that the screening for sexual harassment and assault helps in detection as well as mental healthcare access give pointers that MST should be considered when carrying out studies on systems of care for mental health conditions and PTSD.