Evidence-based treatments for PTSD symptoms resulting from military sexual trauma in women Veterans: A systematic review

Abstract: Introduction: Military sexual trauma (MST) can encompass sexual assault and harassment and has been shown to be pervasive across militaries, disproportionately affecting women. The most common psychological consequence is posttraumatic stress disorder (PTSD). This study sought to synthesize the treatments that demonstrate effectiveness in treating PTSD symptoms resulting from MST in women Veterans. Methods: A systematic review explored research into interventions that included measured outcomes of PTSD symptoms resulting from MST. An electronic search for studies published between 1992 and 2022 was conducted. Effect sizes were calculated for all interventions. Results: A total of 998 papers were initially identified, of which 12 met inclusion criteria. Seven interventions were studied, and all reported meaningful impact on PTSD symptoms. Studies with follow-up measurements post-treatment were limited in number (n = 5). Heterogeneity in study design and populations, and definition of MST were observed. Trauma-focused interventions — particularly cognitive processing therapy (CPT) — had the strongest evidence for reducing PTSD symptoms beyond treatment completion. One non-trauma-focused intervention — Trauma Center Trauma-Sensitive Yoga (TCTSY) — similarly demonstrated longitudinal PTSD symptom reductions. Higher dropout rates were reported for trauma-focused therapies compared to non-trauma-focused interventions. Discussion: CPT demonstrated the strongest published evidence base, with emerging evidence for TCTSY. Future attempts should be made to facilitate international comparisons, with a need for a consistent operationalization of MST. A focus on the sequalae resulting from MST beyond PTSD may also allow for developing targeted adjuvant interventions that may improve overall treatment response.

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