(PS10-55) Diversity, Intersectionality, Contextual Factors and Cumulative Trauma Exposure in a Veteran Sample Seeking Military Sexual Trauma Treatment

Background: Military sexual trauma (MST) is a ubiquitous experience reported by Veterans and associated with multiple mental and physical health complaints. Cumulative trauma exposure in addition to MST has been associated with increased negative outcomes, though there is a dearth of investigation to clarify diversity-related and intersectional differences in exposure, particularly for clinical populations who may be experiencing significant distress. To meet community needs and better respond to the potential interplay between cultural identities and differential risk for particular forms of cumulative interpersonal trauma, peritraumatic contextual variables and diversity-centered factors (e.g. sex, age, sexual orientation, ethnoracial identity, and the intersectionality of these aspects of identity) must be examined.

Method: Participants (N = 640) presented to the VA for treatment related to their MST history. Veterans completed identity, military, and trauma history-related questionnaires and a semi-structured diagnostic interview. Regression analyses with interaction terms to capture intersectionality were conducted to examine the effect of diversity characteristics on exposure.

Results: In this treatment-seeking MST-exposed population, cumulative trauma exposure was ubiquitous (80% endorsed emotional abuse, 70% physical abuse, 70% recurrent sexual assault) and higher than the general population estimates (estimated 52.3%), highlighting that treatment-seeking Veteran populations have unique concerns and presentations. The diversity variables of sex and age, as well as the interaction between these two, demonstrated significant relationships with several forms of recurrent trauma. Women Veterans were more likely to report a range of interpersonal cumulative trauma experiences compared to their male counterparts, including higher endorsement of Childhood Sexual Assault (CSA), adult sexual assault, repeat MST experiences, adult IPV experiences, and lifetime exposure to emotional abuse. Identification as lesbian, gay, or bisexual was associated with less exposure to adult interpersonal violence, though this effect was null once considering sex in the model. Ethnoracial minority identification was not associated with any forms of recurrent interpersonal trauma, multiple perpetrator trauma, or relationship to perpetrators. Findings from this study support age or cohort effects may relate to differences in reporting around MST trauma exposure, with younger Veterans reporting greater levels of CSA and repeat MST experiences. Results demonstrated women Veterans, in general, report greater revictimization than men, but among Veteran men, younger age is related to greater frequency of repeat victimization. Regarding context, MST directed at men was more likely to involve multiple perpetrators. Significant effects ranged from small to medium in magnitude. The study advances the literature by extending beyond consideration of Veterans as a single monolith to explore the association of unique and intersectional identities on cumulative interpersonal trauma exposure to amplify our abilities to utilize culturally-informed recommendations for those serving MST-exposed Veterans.