ADAORA UDOJI:
For a more sobering story, a study release this week by the Department of Veteran Affairs reports fifteen percent of women in the military deployed to Iraq and Afghanistan experienced sexual trauma while in service. It also found that nearly one percent of men reported similar experiences.
On the line now is Dr. Rachel Kimerling, a clinical psychologist at the National Center for Post-Traumatic Stress Disorder at the V.A. Palo Alto Health Care System. Dr. Kimerling, good morning.
DR. RACHEL KIMERLING:
Hi, good morning.
ADAORA UDOJI:
I should also add you were one of the principal investigators of this study. The numbers are disturbing. Can you explain what you found?
DR. RACHEL KIMERLING:
Well, we looked at — specifically at veterans who served in Iraq and Afghanistan who sought V.A. health care services. V.A. has a universal screening policy for military sexual trauma.
So we examined the health care records of the, those veterans that had been screened, and looked at their experiences of sexual trauma and diagnoses of mental health conditions in those that reported military sexual trauma.
ADAORA UDOJI:
How do you define sexual trauma?
DR. RACHEL KIMERLING:
Well in, in V.A., sexual trauma is really a health care term that's used to refer to a psychological trauma which, in the judgment of a V.A. health care professional, resulted from sexual assault, physical assault of a sexual nature or re — sexual harassment. But the focus is repeated, unsolicited verbal or physical contact of a sexual nature that's threatening in character —
ADAORA UDOJI:
Could you just —
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DR. RACHEL KIMERLING:
— with a set of experiences that, that can occur during active military duty that, that can be associated with significant mental health consequences.
ADAORA UDOJI:
So give us an example of what one of those surveyed, described.
DR. RACHEL KIMERLING:
Well, there is — there's been some research on, on the kinds of sexual assault or, or sexual harassment experiences that these men and women report. And there's sexual coercion, which refers to being treated badly if men and women don't cooperate with requests for sexual favors or a sexual relationship, implied promotions or threats of hazardous duty or other kinds of retaliation.
Or another set of experiences that is referred to as unwanted sexual attention, which is kind of repeated unwanted touching, attempts to establish a sexual relationship. And you can imagine that during services, these kind of ongoing experiences can be quite psychologically traumatic.
ADAORA UDOJI:
I think what was — p — particularly stood out was this notion of quid pro quo that you've just described, particularly as in, "If you will not engage in some sexual act with me, I'm going to send you out on the frontlines."
DR. RACHEL KIMERLING:
Yes.
JOHN HOCKENBERRY:
I mean, is that part of a —
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DR. RACHEL KIMERLING:
And again, our — our data didn't, didn't specifically capture these kinds of experiences. But — but there is a considerable field of research on, on sexual harassment and, and the consequences of those kinds of experiences, in particular.
JOHN HOCKENBERRY:
Well, Dr., since we're, we're new in the experience of having women, you know, close to the frontline like this, I mean is this behavior something that comes directly out of the culture in the military, that, you know, they're not really fundamentally in control of? Or, or is this something fundamentally new?
DR. RACHEL KIMERLING:
Well, you know, and unfortunately, sexual harassment is, is not unique in the military. Again, other research does find rates of sexual harassment tend to be higher in largely male environments. And — and the military is a very male-dominated environment.
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But — oh, excuse me.
ADAORA UDOJI:
No, no, go ahead, I apologize.
DR. RACHEL KIMERLING:
No, go ahead.
ADAORA UDOJI:
I was just going to say I read some reports that commanders were reluctant to address the issue out on the battlefield. Is that a component?
DR. RACHEL KIMERLING:
Can you — can you say a little bit more about that, please?
ADAORA UDOJI:
Well, just that it — commanders were reluctant to confront issues of sexual harassment, that they were reluctant to engage in some preventative measures that might be undertaken to minimize those kinds of incidences?
DR. RACHEL KIMERLING:
Well, you know, as — as V.A. health care providers, our focus is on veterans. And, and this means they're already discharged from military service by the time they enter our care. So our data really can't focus on the primary prevention there.
But I think we can focus on the secondary prevention of intervening in a timely and effective manner to kind of prevent the secondary mental health consequences of these experiences.
ADAORA UDOJI:
So what do you do now with this information that you've gathered?
DR. RACHEL KIMERLING:
Well, I think this information shows — I think the V.A.'s universal screening policy for sexual trauma is quite remarkable. I think many of us, when we think about post-traumatic stress disorder or psychological trauma among veterans, think first of combat trauma.
And so, I think these data really raise awareness that the mental health issues of veterans really extend beyond that and includes these traumatic sexual experiences, as well.
And I think our data show that asking about these experiences is feasible. Providers are asking these questions, our patients are willing to respond with these experiences, which can be very difficult and, and stigmatizing to talk about.
And I think what's — what's notable to us in health care is that those returning from Iraq and Afghanistan are really the, the first generation coming back from a large-scale conflict —
ADAORA UDOJI:
Right.
DR. RACHEL KIMERLING:
— with such a comprehensive set of services in place. So the — the possibilities for prevention are really excellent.
ADAORA UDOJI:
Dr. Rachel Kimerling, thank you for joining us this morning.
DR. RACHEL KIMERLING:
Yeah, thank you very much.
ADAORA UDOJI:
Dr. Rachel Kimerling is a clinical psychologist at the National Center for PTSD at the V.A. Palo Alto Health Care System.
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