Evaluation of universal screening for military-related sexual trauma
Evaluation of universal screening for military-related sexual trauma
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DOI：
10.1176/appi.ps.59.6.635
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发表时间：
2008-06-01
影响因子：
3.8
通讯作者：
Smith, Mark W.
中科院分区：
文献类型：
--
作者：
Kimerling, Rachel;Street, Amy E.;Smith, Mark W.
目的：为了回应人们对性暴力作为一种未被认识到的服兵役创伤后果的日益关注，退伍军人健康管理局的政策要求对服兵役期间遭受的性创伤进行普遍筛查。这项前瞻性研究首次评估了各国筛查军人性创伤的努力，调查了性创伤筛查是否与精神卫生服务的利用率增加有关。方法：这项研究调查了2005年所有对军队性创伤筛查有有效反应的男性(N=540,381)和女性(N=33,259)退伍军人的数据。对军性创伤筛查阳性者和筛查阴性者在筛查后三个月内使用精神卫生服务的情况进行了检查。调查结果根据筛查前六个月精神健康服务的使用情况进行了分层。结果：与阴性筛查相比，阳性筛查可显著提高筛查后心理健康治疗率。没有使用过精神卫生治疗的患者增加了两倍多(女性：相对风险[RR]=2.52，95%可信区间[CI]=2.38-2.66；男性：RR=2.47，95%CI=2.34-2.61)。在这一组中，增加一名患者获得治疗所需的阳性筛查次数女性为5.5，男性为7.2。结论：我们的研究结果表明，通过筛查进行检测与提高精神卫生治疗率有关。一个有效的筛查计划，促进性创伤的发现和获得精神卫生保健，可以帮助那些经历过军中性创伤的人减轻精神疾病的负担。
Objectives: In response to growing concerns about sexual violence as an underrecognized traumatic consequence of military service, Veterans Health Administration policy requires universal screening for sexual trauma sustained during military service. This prospective study, the first to evaluate national efforts to screen for military sexual trauma, investigated whether sexual trauma screening is associated with increased utilization of mental health services. Methods: This study examined data for all male (N=540,381) and female (N=33,259) veterans who had valid responses to screens for military sexual trauma in 2005. The use of mental health services during the three months after screening was examined for persons who screened positive for military sexual trauma and for those who screened negative. Findings were stratified by use of mental health services in the six months before the screening. Results: Compared with negative screens, positive screens were associated with significantly increased rates of postscreen mental health treatment. A more than twofold increase was observed for patients without previous use of mental health treatment ( women: relative risk [RR]=2.52, 95% confidence interval [CI]=2.38-2.66; men: RR= 2.47, 95% CI=2.34-2.61). In this group, the number of positive screens needed for one additional patient to access treatment was 5.5 for women and 7.2 for men. Conclusions: Our findings suggest that detection via screening is associated with increased rates of mental health treatment. An effective screening program that promotes detection of sexual trauma and access to mental health care can help to reduce the burden of psychiatric illness for those who have experienced military sexual trauma.