Eating disorder symptoms in female veterans: The role of childhood, adult, and military trauma exposure
Objective: Eating disorders are understudied among female U.S. military veterans, who may be at increased risk due to their high rates of trauma exposure and trauma-related sequelae. The current study sought to examine whether different types of trauma in childhood and adulthood confer differential risk for eating disorder symptoms (EDSs) in this population. Method: We analyzed survey data from a sample of female Veterans Health Administration patients (N = 186) to examine the association between 5 trauma types (i.e., childhood physical abuse, adult physical assault, childhood sexual abuse, adult sexual assault, and military-related trauma) and EDS severity. Results: Approximately 14% of the sample reported clinical levels (i.e., standardized Eating Disorder Diagnostic Scale score ≥16.5) of EDSs. Multiple traumatization was associated with increased EDSs. Adult physical assault, adult sexual assault, and military-related trauma were individually associated with more severe eating disorder symptomatology, though only military-related trauma was uniquely associated with disordered eating in the full model. Discussion: EDSs are common among female veterans, and trauma exposures are differentially associated with symptom severity. It is critical to assess for EDSs in female veterans, particularly those with a history of military-related trauma, to facilitate detection and appropriate treatment.
Abstract: Objectives: Increasing numbers of older adults are reentering community following incarceration (i.e., reentry), yet risk of incident neurodegenerative disorders associated with reentry is unknown. Our objective was to determine association between reentry status (reentry vs never-incarcerated) and mild cognitive impairment (MCI) and/or dementia. Methods: This nationwide, longitudinal cohort study used linked Centers for Medicare & Medicaid Services and Veterans Health Administration data. Participants were aged 65 years or older who experienced reentry between October 1, 2012, and December 31, 2018, with no preincarceration MCI/dementia, compared with age-matched/sex-matched never-incarcerated veterans. MCI/dementia was defined by diagnostic codes. Fine-Gray proportional hazards models were used to examine association. Results: This study included 35,520 veterans, mean age of 70 years, and approximately 1% women. The reentry group (N = 5,920) had higher incidence of MCI/dementia compared with the never-incarcerated group (N = 29,600; 10.2% vs 7.2%; fully adjusted hazard ratio [aHR] 1.12; 95% CI 1.00-1.25). On further investigation, reentry was associated with increased risk of dementia with or without prior MCI diagnosis (aHR 1.21; 95% CI 1.06-1.39) but not MCI only. Discussion: Transition from incarceration to community increased risk of neurocognitive diagnosis. Findings indicate health/social services to identify and address significant cognitive deficits on late-life reentry. Limitations include generalizability to nonveterans.