When solidarity hurts: (Intra)cultural trust, cultural betrayal sexual trauma, and PTSD in culturally diverse minoritized youth transitioning to adulthood

Sexual trauma is associated with PTSD, with perpetrators putting women and girls more at risk than men and boys. Young adulthood is a time where risk of victimization and susceptibility to mental health problems increase. Certain contributors of costly trauma outcomes may be affected by the larger context of societal inequality. Cultural betrayal trauma theory (CBTT) highlights cultural betrayal in within-group trauma in minoritized populations as a dimension of harm that affects outcomes. In CBTT, within-group trauma violates the (intra)cultural trust—solidarity, love, loyalty, connection, responsibility—that is developed between group members to buffer against societal inequality. This violation, termed a cultural betrayal, can contribute to poorer mental health. The purpose of the current study is to address a gap in the CBTT literature by examining the role of (intra)cultural trust on the association between cultural betrayal sexual trauma and symptoms of PTSD among diverse minoritized youth transitioning to adulthood. Participants ( N = 173) were diverse minoritized college students, who completed a 30-min online questionnaire at a location of their own choosing. Participants received course credit and could decline to answer any question without penalty. The results reveal that the interaction between cultural betrayal sexual trauma and (intra)cultural trust predicted clinically significant symptoms of PTSD. These findings have implications for increased cultural and contextual specificity in trauma research in minoritized populations, which can aid in the development and implementation of culturally competent interventions for diverse minoritized youth survivors of sexual trauma.

Linking gene expression patterns and brain morphometry to trauma and symptom severity in patients with functional seizures

ObjectiveAdverse life experiences (ALEs) increase the susceptibility to functional (somatoform/dissociative) symptoms, likely through neurodevelopmental effects. This analysis aimed to illuminate potential genetic influences in neuroanatomical variation related to functional symptoms and ALEs in patients with functional seizures.MethodsQuestionnaires, structural brain MRIs and Allen Human Brain Atlas gene expression information were used to probe the intersection of functional symptom severity (Somatoform Dissociation Questionnaire, SDQ-20), ALE burden, and gray matter volumes in 20 patients with functional seizures.ResultsFunctional symptom severity positively correlated with the extent of sexual trauma, emotional neglect, and threat to life experiences. In voxel-based morphometry analyses, increased SDQ-20 scores related to decreased bilateral insula, left orbitofrontal, right amygdala, and perigenual and posterior cingulate gray matter volumes. Left insula findings held adjusted for psychiatric comorbidities. Increased sexual trauma burden correlated with decreased right posterior insula and putamen volumes; increased emotional neglect related to decreased bilateral insula and right amygdala volumes. The sexual trauma–right insula/putamen and emotional neglect– right amygdala relationships held adjusting for individual differences in psychiatric comorbidities. When probing the intersection of symptom severity and sexual trauma volumetric findings, genes overrepresented in adrenergic, serotonergic, oxytocin, opioid, and GABA receptor signaling pathways were spatially correlated. This set of genes was over-expressed in cortical and amygdala development.ConclusionALEs and functional symptom severity were associated with gray matter alterations in cingulo-insular and amygdala areas. Transcriptomic analysis of this anatomical variation revealed a potential involvement of several receptor signaling pathways.

From sexual harassment to sexual assault: Prevalence and correlates of sexual trauma in the French military

Background Sexual harassment (SH) is prevalent in military settings and dependent on the workplace environment. Few studies have investigated this issue in non-US military settings nor have examined how contextual and individual factors related to Military Sexual Trauma (MST) vary by gender. Methods This study draws on a national sexual survey in the French military including 1268 servicemen and 232 servicewomen. We examined four sexual stressors (repeated sexual comments, sexual coercion, repeated unwanted verbal sexual attention and sexual assault (SA)) and two combined measures of verbal SH (comments, unwanted attention) and MST (all forms). We conducted multivariate logistic regressions to identify contextual and individual factors related to these outcomes. Results 36.7% of women and 17.5% of men experienced MST in the last year and 12.6% and 3.5% reported SA. Factors associated with verbal SH differed from those related to SA. The odds of verbal SH were elevated among men who had sex with men (OR = 3.5) and among women officers (OR = 4.6) while the odds of SA were elevated among men less than 25 years (OR = 3.5) and women with less than a high school diploma (OR = 10.9). The odds of SH increased by 20% to 80% when men worked in units with higher female representation, higher prevalence of MST (sexual comments, or sexual assault, coercion, repeated unwanted attention) and lower acceptance of women in the miliatry. The odds of SA also increased by 70% among men working in units with higher female representation and higher prevalence of sexual oppression. The odds of SA against women were particular high (OR = 5.7) in units with a high prevalence of sexual assault, coercion, or repeated unwanted attention. Conclusion MST is common in the French military, with women experiencing more severe forms than men. Our resuls call for programmatic action to reduce workplace factors related to verbal SH and SA in the French military.

Risk Factors for Veteran Food Insecurity: Findings from a National US Department of Veterans Affairs Food Insecurity Screener

Objective: Food insecurity is associated with numerous adverse health outcomes. The US Veterans Health Administration (VHA) began universal food insecurity screening in 2017. This study examined prevalence and correlates of food insecurity among Veterans screened. Design: Retrospective cross-sectional study using VHA administrative data. Multivariable logistic regression models were estimated to identify sociodemographic and medical characteristics associated with a positive food insecurity screen. Setting: All US VA medical centers (n=161). Participants: All Veterans screened for food insecurity since screening initiation (July 2017-December 2018). Results: Of 3,304,702 Veterans screened for food insecurity, 44,298 were positive on their initial screen (1.3% of men; 2.0% of women). Food insecurity was associated with identifying as non-Hispanic Black or Hispanic. Veterans who were non-married/partnered, low-income Veterans without VA disability-related compensation, and those with housing instability had higher odds of food insecurity, as did Veterans with a BMI<18.5, diabetes, depression, and post-traumatic stress disorder. Prior military sexual trauma was associated with food insecurity among both men and women. Women screening positive, however, were eight times more likely than men to have experienced military sexual trauma (48.9% vs 5.9%). Conclusions: Food insecurity was associated with medical and trauma-related comorbidities as well as unmet social needs including housing instability. Additionally, Veterans of color and women were at higher risk for food insecurity. Findings can inform development of tailored interventions to address food insecurity such as more frequent screening among high-risk populations, onsite support applying for federal food assistance programs, and formal partnerships with community-based resources.

1353. Gonorrhea and Chlamydia Testing and Case Rates Among Women Veterans in the Veterans Health Administration

Background United States (US) rates of sexually transmitted infection (STI) in women, especially gonorrhea and chlamydia, have increased over the past decade. Women Veterans have many risk factors associated with STIs, including high rates of childhood sexual assault, military sexual trauma and intimate partner violence. Despite the availability of effective diagnostic tests and evidence-based guidelines for annual screening among sexually active women under age 25, screening rates for gonorrhea and chlamydia remain low in the US and among Veterans. Methods We performed a retrospective cohort study of all women Veterans in Veterans Health Administration (VHA) care between January 1, 2018 and December 31, 2019 to examine patient characteristics and health system factors associated with gonorrhea and chlamydia testing and case rates among women Veterans in the VHA in 2019. Results Among women under age 25, 21.3% were tested for gonorrhea or chlamydia in 2019. After adjusting for demographic and other health factors, predictors of testing in women under age 25 included Black race (aOR: 2.11 CI: 1.89, 2.36), rural residence (aOR: 0.84, CI: 0.74, 0.95), and cervical cancer screening (aOR: 5.05 CI: 4.59, 5.56). Women under age 25 had the highest infection rates, with an incidence of chlamydia and gonorrhea of 1,950 and 267 cases/100,000, respectively. Incidence of gonorrhea and chlamydia was higher for women with a history of military sexual trauma (MST) (Chlamydia case rate: 265, Gonorrhea case rate: 97/100,000) and those with mental health diagnoses (Chlamydia case rate: 263, Gonorrhea case rate: 72/100,000.) Over a third of chlamydia cases (35.2%) and gonorrhea cases (35.5%) occurred in women who resided in the South Atlantic census division. Chlamydia cases per 100,000 women Veterans seen in VHA (2019) Gonorrhea cases per 100,000 women Veterans seen in VHA (2019) Conclusion Gonorrhea and chlamydia testing remains underutilized among women in the VHA and infection rates are high among younger women. Patient-centered, system-level interventions are urgently needed to address low testing rates. Disclosures All Authors: No reported disclosures

Role of mentoring for women in the Canadian Armed Forces

LAY SUMMARY In Canada, mentoring has been used in the armed forces to support women’s careers and personal development, but there is little evidence that the unique experiences of being a woman in the military have been considered in mentoring efforts. The current study aims to find reasons why servicewomen are using mentorship in the Canadian Armed Forces and to identify the gender and cultural factors that may play a role in those mentoring experiences. This article presents some of the findings from 28 interviews that explored the experiences of mentorship for women in the military. For women, career development advice includes learning how to manage personal responsibilities along with career objectives. Women are also looking for support to address issues related to gender and military culture, kinship and visibility, and surviving sexual trauma in the workplace. The current study provides a foundation for ongoing research and forms a basis on which future mentorship work can be built.

Working with sex offenders with a history of sexual trauma: An Interpretative Phenomenological Analysis

Gender differences impact the work that professionals engage in with sexual offenders and victims of sexual trauma (with females often perceived as more likely to experience sexual trauma, and males as more likely to commit a sexual offence). However, there is no evidence looking at these factors in combination. This study aimed to address this gap, asking: “Are experiences of nursing staff working with sex offenders with a history of sexual trauma affected by gender differences, that is, in terms of gender of the staff member, and gender of the client they are working with?” Eight participants, (four male, four female) working within a Forensic Mental Health Service took part in semi-structured interviews. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis. Five superordinate themes emerged from the data, along with a number of subordinate themes. Superordinate themes included: ‘Gender has a role’, ‘The trauma response’, ‘How we cope’, and ‘What we need’. Nursing staff working with sexual offenders with historic sexual trauma found work to be challenging both emotionally and socially. Such challenges were complicated by the gender interaction between them as professionals, and the patients who have experience of being both victims and perpetrators of sexual abuse.