Perceptions of Institutional Betrayal Predict Suicidal Self-Directed Violence among Veterans Exposed to Military Sexual Trauma

OBJECTIVES:

We examined perceptions of institutional betrayal among Veterans exposed to military sexual trauma (MST) and whether perceptions of institutional betrayal are associated with symptoms of posttraumatic stress disorder (PTSD), depression, and suicidal ideation and attempt after MST.

METHOD:

A total of 49 Veterans with MST completed self-report measures and interviews in a Veterans Health Administration setting.

RESULTS:

Many participants reported perceptions that a military institution created an environment in which MST seemed common, likely to occur, and did not proactively prevent such experiences. Many participants expressed difficulty reporting MST and indicated that the institutional response to reporting was inadequate. Over two-thirds perceived that the institution had created an environment in which they no longer felt valued or in which continued membership was difficult. Perceptions of institutional betrayal were associated with PTSD symptoms, depressive symptoms, and increased odds of attempting suicide after MST. In contrast, perceptions of institutional betrayal were not associated with post-MST suicidal ideation. Among the subsample of Veterans exposed to military sexual assault, the association between institutional betrayal and PTSD symptoms approached significance.

CONCLUSIONS:

Perceptions regarding institutional betrayal appear to be highly relevant to MST and its sequelae. These findings underscore the importance of Veterans' perceptions of the military institution's efforts to prevent and respond to MST to individual recovery from sexual trauma. Additional research regarding the association between institutional betrayal and health-related outcomes is needed.

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By:  Monteith LL1,2, Bahraini NH1,2, Matarazzo BB1,2, Soberay KA1, Smith CP3.

• 1Rocky Mountain Mental Illness Research, Education and Clinical Center.
• 2University of Colorado Anschutz Medical Campus.
• 3University of Oregon. 
• J Clin Psychol. 2016 Mar 23. doi: 10.1002/jclp.22292.

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Infected Lives: Lived Experiences of Young African American HIV-Positive Women

This hermeneutic phenomenological study explored the lived experiences of young African American HIV-infected women. Eleven women between the ages of 21 and 35 participated. 

One pattern, Infected Lives, and three themes-Living Alone With HIV, Living With Unresolved Conflicts, and Living With Multiple Layers of Betrayal-emerged. The pattern and themes portray the very complex and challenging experiences faced by these young women living with HIV infection. 

They have experienced isolation, abandonment, betrayal, and discrimination in their interpersonal and social systems. They often dealt with conflicts of hope and anguish in the relationships with their children, and portraying strength, while feeling fragile. These complexities negatively influence the ability to fully engage in self-care activities. 

Implications for future research include further investigation about the experiences of psychological distress experienced post-diagnosis, development and evaluation of holistic nursing interventions, and evaluative research on mass media educational campaigns to reduce HIV-related stigma.

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By:   Peltzer JN1, Domian EW2, Teel CS2.

• 1University of Kansas School of Nursing, Kansas City, USA jpeltzer2@kumc.edu.
• 2University of Kansas School of Nursing, Kansas City, USA.
• West J Nurs Res. 2016 Feb;38(2):216-30. doi: 10.1177/0193945914552167. Epub 2014 Sep 18. 

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