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Background: This workshop will review the demographics of military sexual trauma and illustrate the consequences of this trauma, including co-occurring substance abuse and eating disorders. The unique challenges associated with being a woman in the military will be discussed and trauma-aware recovery focused therapy for military women will be shared.
1) Military Culture
a) Environment, chain of command
b) Who, why?
c) Current struggle between CMW paradigm and evolving model
d) Face of the military is changing
i) About 11% of the U.S. forces currently serving in Iraq and Afghanistan are women
ii) Longer tours of duty adds to PTSD risk for soldiers
iii) Multiple tours of duty puts strain on soldiers and their families
2) Eating Disorders in the Military
a) Prevalence, study
i) AN, BN, ED-NOS: rates for Marine Corps highest
ii) 60% of respondents had some type of ED, and nearly every Marine Corps respondent (97.5%) met criteria for an ED
b) Diagnosis in the military
c) Weight standards
i) Army
ii) Navy
iii) Air Force
iv) Marines
d) Obesity, veterans
3) Substance Abuse in the Military
a) Increase of prescription drugs
i) Military today regularly prescribes medication for soldiers:
(1) to help ease their stress and anxiety
(2) to help with physical pain
(3) to keep them alert when they need to be
(4) to help with insomnia
ii) Some of these prescription drugs are highly addictive. When soldier returns to normal life, can’t do without them.
b) Alcohol and stress
c) Alcohol, gender study
i) Study of 685 men and 325 women in US Army
4) Trauma
a) Aftermath
b) Combat-related vs military sexual trauma (MST)
c) Types of MST
d) Underreporting of MST
e) MST and Personality Disorder (PD)
f) Prevalence, sexual harassment
g) Trauma and PTSD
5) Research Regarding Pre-Disposition to PTSD as a Response to Trauma
a) Exposure to chronic stress, the hippocampal formation
b) Controversy
c) Twins study
d) Outcomes
e) Risk factors across genders
f) Trauma, PTSD and physical health
6) Unified Treatment for Co-Occurring PTSD, Eating Disorders, and Substance Abuse
a) Trauma aware
b) Trauma screening
c) Culture of support
d) 12-step recovery
e) Dialectical Behavior Therapy
f) Somatic Experiencing
g) EMDR
h) Medical
i) Psychotropic medications
7) Case Study
a) Overview
b) Symptoms
i) PTSD
ii) Mood
iii) ED
iv) Substances
v) Self-injury
c) Treatment history, suicidal attempts, meds
d) Developmental history
e) Social history
f) Treatment
This workshop will review the demographics of military sexual trauma (MST) and illustrate the consequences of this trauma, including co-occurring substance abuse and eating disorders. The unique challenges associated with being a woman in the military will be discussed and trauma-aware recovery focused therapy for military women will be shared. In order to effectively treat EDs, substance abuse and trauma in female soldiers, treatment providers need to have an understanding of the basics of military culture (i.e. importance of branch of military, chain of command, types of reporting of MST, treatment options within the military, military life stressors including deployment, etc). When identifying and treating eating disorders in the military, clinicians must have knowledge of the physical demands on the soldier, weight requirements of each branch of service, and risk category depending on branch of military. Clinical decision making upon return to military necessitates communication with military case worker and/or chain of command, especially when recommending a patient return with exercise limitations and clear guidelines about protected meal times. As a treatment specialist, we also need to make recommendation on whether or not to return at all, or whether to return to a different position. Military sexual trauma is a growing problem among military women, and many times it is associated with eating disorders, substance use disorders and/or history of early life trauma. The types of MST and challenges to reporting it will be highlighted. Barriers to seeking treatment for MST will also be outlined. Research examining predisposition to developing PTSD after trauma will be discussed in light of identifying higher versus lower risk populations of soldiers.
Finally, a unified treatment approach for achieving healing in women with co-occurring MST and ED or substance abuse will be reviewed. This approach uses a holistic treatment frame, combining experiential therapies with 12 step facilitation therapy and DBT to treat the co-occurring disorders. A case study will be used throughout to tie the conceptual material to a real life clinical scenario.
Dr. Kim Dennis is a board-certified psychiatrist who specializes in eating disorder treatment, addictions recovery, trauma/PTSD and co-occurring disorders. As Medical Director at Timberline Knolls, she supervises the medical staff and sets the overall vision and direction for the treatment program. Dr. Dennis received her undergraduate degree from the University of Chicago. She obtained her medical degree from the University Of Chicago Pritzker School Of Medicine and completed her psychiatry residency training at the University of Chicago Hospitals, where she served as chief resident. She is a member of several professional organizations, including the International Association of Eating Disorder Professionals.
