EFFECTS OF MILITARY SEXUAL TRAUMA ON TREATMENT OUTCOMES AND PATTERNS OF ATTRITION IN COGNITIVE PROCESSING THERAPY

Abstract

Military sexual trauma, or MST, is the term used by the Department of Veterans Affairs (VA) to refer to experiences of sexual assault or repeated, threatening sexual harassment that a veteran experienced during his or her military service. The estimated annual number of sexual assaults in the military continues to increase, despite Department of Defense (DoD) prevention measures and VA treatment efforts. The prevalence rates of sexual trauma along with the devastating psychological and medical sequelae for victimized military personnel are well documented. This at-risk population merits further research to explore the effects of MST in conditions representative of clinical practice to verify and inform effective prevention and treatment efforts. The present study examined how MST-related posttraumatic stress disorder (PTSD) impacts treatment outcomes and patterns of attrition and completion in outpatient individual cognitive processing therapy (CPT). A retrospective chart review of 350 patients was conducted. Eighty veterans from 19 states who received individual outpatient CPT from the VA were included in the study (n = 38 participants with a history of MST; n = 42 participants without a documented history of MST). Independent samples t-tests were performed to evaluate mean differences in PCL scores and number of CPT sessions between MST positive and MST negative conditions. A dependent samples t-test was conducted to evaluate whether combined cohorts realized a reduction in PCL scores from pre- to post- treatment. Results revealed non-significant findings in differential rate of response to CPT for individuals with a history of MST as compared to those without a documented history of MST. However, the results of the combined cohorts revealed that there was a significant change on test scores t(47) = 5.96, p < .001. This suggests that treatment completers show improvement from pre- to post- treatment PCL scores. No significant differences in attrition were found for these two groups (i.e., MST positive and MST negative conditions). Furthermore, the current study could not disaggregate sex differences to reach significant power in the MST positive conditions due to limited male representation. The study discusses the significance of these findings in light of prior research, future directions for research, and implications for practice.