Tim Hoyt

Military Sexual Trauma in Men: A Review of Reported Rates

Military sexual trauma (MST) has historically been associated with female service members, but it is also experienced by male service members. This article reviews reported prevalence and incidence rates of mens MST in 29 studies. Sources for these studies included the Department of Defense, the U.S. military service academies, and the Department of Veterans Affairs. There is significant variability in reported rates of mens MST. Averaging across studies covering the past 30 years, we found that MST is reported by approximately 0.09% of male service members each year, with a range of 0.02% to 6%. MST is reported by 1.1% of male service members over the course of their military careers, with a range of 0.03% to 12.4%. Determining prevalence and incidence rates for both mens and womens MST is fraught with limitations, including (a) cross-study variations in sample, method, definitions, and assessment and (b) barriers to reporting MST. Each of these limitations is reviewed with an eye toward identifying male-specific issues.

Perceived barriers to care and provider gender preferences among veteran men who have experienced military sexual trauma: a qualitative analysis.

Research suggests that there may be unique barriers to accessing care among men who have experienced sexual trauma. The primary goal of the current research was to elucidate potential barriers to accessing military sexual trauma (MST)-related care for male veterans. A secondary goal was to explore whether veterans have preferences regarding the gender of clinicians providing MST-related care. Qualitative analyses were used to examine data collected from semistructured interviews conducted with 20 male veterans enrolled in Veterans Health Administration care who reported MST but who had not received any MST-related mental health care. Veterans identified a number of potential barriers, with the majority of reported barriers relating to issues of stigma and gender. Regarding provider gender preferences, veterans were mixed, with 50% preferring a female provider, 25% a male provider, and 25% reporting no gender preference. These preliminary data suggest that stigma, gender, and knowledge-related barriers may exist for men regarding seeking MST-related care. Interventions to address potential barriers, such as outreach interventions and providing gender-specific psychoeducation, may increase access to care for male veterans who report MST.

Silence and the shaping of memory: How distracted listeners affect speakers' subsequent recall of a computer game experience

The present study focused on how distracted listening affects subsequent memory for narrated events. Undergraduate students experienced a computer game in the lab and talked about it with either a responsive or distracted friend. One month later, those who initially spoke with distracted listeners showed lower retention of information about the computer game, and their subsequent memories were also less consistent with their initial conversational recall. Differences in subsequent memory across initial listener condition appeared likely to be mediated by differences in the initial conversations elicited by responsive and unresponsive listeners. Results are discussed in terms of their implications for the social shaping of memory and identity.

Internalizing and externalizing personality styles and psychopathology in OEF-OIF veterans.

Previous research with other trauma populations demonstrated that internalizing and externalizing personality styles are associated with different PTSD comorbidities. The present study tested this association in two distinct Operation Enduring Freedom-Operation Iraqi Freedom (OEF/OIF) combat samples. Cluster analysis was used to categorize subtypes, which were compared on measures of PTSD, depression, anxiety, and substance use. Internalizers showed the highest rates of PTSD and depression. Externalizers had higher rates of alcohol problems in one sample only, whereas the other sample showed more substance misuse. In general, these findings suggest that this method of classifying trauma survivors is useful in OEF/OIF populations. Results suggest some differences across this population in terms of how substance use issues are expressed in externalizers.

Preliminary examination of a mutual intimate partner violence intervention among treatment-mandated couples

Intimate partner violence (IPV) is a widespread global health problem. Despite growing evidence indicating that men and women commit IPV, most traditional interventions focus on male-to-female violence and do not address mutual violence. This circumscribed focus represents one potential reason traditional treatments have had only a modest effect on recidivism. The current study investigated a pilot intervention for mutually violent couples with ethnically diverse, treatment-mandated men and women. Using a longitudinal design, 121 couples were assessed (semistructured clinical interview, Conflict Tactics Scale-Revised [CTS-2]) and mandated to either the pilot intervention or another community agency. Of the 92 couples referred for the 12-week, pilot group intervention (plus 1-2 preparatory, individual sessions), 89% of couples had one or both partners complete. Posttreatment assessments were conducted (CTS-2, satisfaction ratings), anticipating reductions in perpetrated and received IPV among treatment completers. Using 1-year conviction data to assess recidivism (IPV and general violence convictions), it was hypothesized that the lowest recidivism rates would be found when both partners completed, intermediate rates when one partner completed, and the highest rates when neither completed. Consistent with hypotheses, men who completed treatment reported reduced perpetration of physical assault and received less injury, and women who completed reported receiving less physical assault and injury. At 1-year follow-up, couples who completed had lower recidivism rates, with couples in which both partners completed evidencing the best outcomes. Results provide preliminary support for the proposed mutual violence intervention. Clinical implications, including the effect of a thorough assessment and tailored treatment recommendations, are discussed.

Providing Treatment Services for PTSD at an Army FORSCOM Installation

This article provides an overview of treatment services for posttraumatic stress disorder (PTSD) at a major U.S. Army medical center, including lessons learned that can be applied to a variety of military and civilian treatment settings. The processes of postdeployment and subsequent behavioral health screenings are detailed. Treatment options for active duty, National Guard, and reserve military personnel returning from deployment in Afghanistan and Iraq are discussed. Case vignettes on the utilization of treatment options by servicemembers are considered. Recommendations for providers regarding the facilitation of group and individual treatment for PTSD in servicemembers are provided.

Military Sexual Trauma in Men: Exploring Treatment Principles

Military sexual trauma (MST) is reported in approximately 20%-43% of female service members and veterans, and 1%-3% of male service members and veterans. These rates reflect thousands of individual cases. However, there is limited research on treatment interventions for posttraumatic stress disorder (PTSD) associated with mens MST. The authors illustrate a model for integrating empirically based treatment protocols into an outpatient treatment program for PTSD related to mens MST. This model is based on Hermans trauma recovery model of safety, mourning, and reconnection. This proposed series of interventions integrates components of several empirically supported treatments into this model, including dialectical behavior therapy, seeking safety, and cognitive processing therapy. The aim of this approach is to first increase trust and knowledge about PTSD and MST, then increase distress tolerance and emotional regulation skills. This lays the groundwork for further trauma-focused treatment. The authors discuss lessons learned for facilitating treatment. Language: en

Limits to Confidentiality in U.S. Army Treatment Settings

A number of reports detail ethical concerns of behavioral health providers in the U.S. Military regarding limited confidentiality. This article provides a review of limits to confidentiality in behavioral health settings as outlined by U.S. Army regulations and Department of Defense directives. Specific limits are discussed under seven categories, including: medical treatment and oversight, command notification, threats to safety, public health purposes, judicial or administrative proceedings, law enforcement investigation, and specialized personnel programs. Specific attention is given to war crimes reporting, special duty, and command involvement. Lessons learned for best practice across service branches are provided as a collaborative model for resolving perceived conflict between the APA Ethics Code and military regulations.

Factors Affecting Women's Verbal Immediacy to Sexually Risky Situations

The current study used a word count measure of verbal immediacy to analyze undergraduate womens responses to a set of written vignettes describing hypothetical situations involving sexual risk. Several influences on verbal immediacy were examined, including severity of previous victimization, sexual-risk proximity, relationship intimacy, and response effectiveness. Results revealed that women with a more severe history of victimization evidenced less immediacy in their responses than both women with a less severe or no history of victimization. Responses higher in immediacy were rated as more effective by a group of undergraduate peers. The interaction of risk proximity and relationship intimacy also predicted verbal immediacy. Women responded with greater immediacy to distal risk situations involving nonintimates, and less immediacy to proximal risk situations as well as distal risk situations involving intimates.

Individual and Situational Influences on Men’s Responses to Dating and Social Situations

This study employed multilevel modeling to evaluate individual and situational influences on men’s responses to hypothetical dating and social situations. Three hundred and fifty college men completed measures assessing their propensity for sexual aggression and provided written responses to 10 written vignettes, each of which was followed by four statements provided by women that varied in their degree of effectiveness in decreasing victimization risk. Rape-supportive attitudes, poor heterosocial perception, earlier age of first sexual experience, and number of lifetime sexual partners were significant predictors of sexually aggressive responses. The presence of alcohol use, social isolation, relationship intimacy, and less effective responses from the woman involved also were significant predictors of sexually aggressive responses. Certain individual risk factors (i.e., poor heterosocial perception, rape-supportive attitudes) showed a stronger relationship to sexually aggressive responses in the context of situational risk factors (i.e., alcohol use, isolation). These findings indicate the importance of assessing both individual and situational influences on men’s risk for engaging in sexually aggressive behavior.