(PS4-C61) Long-term Treatment Outcomes Among Survivors of Military Sexual Trauma in a Short-term Intensive Outpatient Program

Military sexual trauma (MST) is highly prevalent among military service members. According to a 2018 meta-analysis, the rate of MST was reported at 15.7%, with 38.4% of women and 3.9% of men disclosing. Experiencing MST has shown to be associated with a high prevalence of post-traumatic stress disorder as well as other comorbid psychopathologies.

Studies show that intensive outpatient programs offering evidence-based trauma treatment are effective in reducing symptoms of PTSD among service members. However, the efficacy of such programs for survivors of MST is not clearly defined in the literature. For instance, a recent meta-analysis indicated that treatment response among those with assault and combat-related trauma did not differ. In contrast, survivors of MST who received cognitive processing therapy (CPT) in a 3-week intensive treatment program for veterans with PTSD reported significantly less improvement in PTSD symptoms than those without a history of MST.

The current study seeks to examine the outcomes of a 2-week intensive clinical program (ICP) designed to treat symptoms of PTSD for service members based on patients’ history of MST. We hypothesized that based on patients’ history of MST, a) symptom reduction patterns in PTSD and depression will differ upon completion of the program and b) this trend will persist at 3-month follow-up.

Participants were 436 service members enrolled in the ICP between July 2020 and January 2022 during the COVID-19 pandemic. Nineteen percent of patients identified as female, 80.6% as male, and 0.40% as transgender. Patients who endorsed sexual assault or sexual harassment in the military were included in the MST group. MST rates within the sample were far greater than previously reported statistics, with 85.9% of females and 14.5% of males reporting a history of MST. The PTSD Checklist for DSM-5 (PCL5) and the Patient Health Questionnaire (PHQ9) evaluated PTSD and depression symptoms respectively. The ICP included daily individual therapy, group therapy and holistic interventions such as expressive art and mindful movement. Visits occurred in-person and virtually.

A mixed-model regression was used to assess treatment outcomes and to accommodate missing data. We used Akaike’s Information Criterion (AIC) model to identify the best fitting model. Both groups reported statistically significant symptom reductions in PHQ9 and PCL5 scores at post-treatment. At 3-month follow-up, however, only the MST group maintained improvements relative to post-completion for the PHQ9 (post M = 11.6 vs. 3m M = 13.7) and PCL5 (post M = 41.7 vs. 3m M = 44.0). For the non-MST group, decreased symptom levels were maintained relative to baseline; however, both PHQ9 (post M = 10.1 vs. 3m M = 12.6) and PCL5 (post M = 35.2 vs. 3m M = 42.5) scores were significantly elevated compared to post-treatment.

Results indicate that a 2-week intensive outpatient program is effective at reducing PTSD and depression symptoms in service members regardless of MST history. The finding that only the MST group maintained improvements at 3-month follow-up relative to post-completion differs from previous literature. Thus, future research should aim to investigate factors that contribute to either sustained or declined improvement after treatment.