Comparing Holographic Reprocessing and Prolonged Exposure for Women Veterans with Sexual Trauma: A Pilot Randomized Trial

This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted.     

In Her Own Words: Semi-structured Interviews of Women Veterans Who Experienced Military Sexual Assault

Twenty-one female veterans volunteered to talk about 29 events of military sexual assault (MSA) via semi-structured interviews covering pre-military abuse, during and immediately after the assault and reactions post-assault. The 14 who reported on-going abuse in childhood, also experienced multiple events of MSA. Common themes revealed that most events happened at night (52% specifically referenced night, while 69% most likely occurred at night), 24% in a car, and 24% while the victim was on duty. MSA was associated with a low use of weapons (17% with knives or guns) but a high use (52%) of physical violence (e.g., hitting, choking) and intimidation (59%). 69% knew their perpetrator prior to the assault and 12 of them (60%) were superiors. 34.5% of the perpetrators and 24% of the victims were drinking alcohol prior to the assault. 27.5% reported the MSA; however, 52% had to continue to interact with the perpetrator as part of her job. 67% reported being pregnant or seriously injured as a result of the MSA; however, only 28% received help. 71% disclosed that they had suicidal ideation 14% made suicide attempts while on active duty, and 38% made a suicide attempt some time in their lifetime post-MSA. 52% said the MSA lead to an early discharge from the military. 76% stated MSA interfered with their ability to have an intimate relationship. All participants graduated Warrior Renew sexual trauma treatment and reported positive responses. Although this is a small sample, findings may help generate hypotheses for larger scale studies.     

War Experiences Inventory: Initial Psychometric and Structural Properties

We examined the structural and psychometric properties of the War Experiences Inventory (WEI) with data from 255 post deployed service members (224 men and 31 women). Results from principal components analyses yielded a five-factor solution assessing sexual trauma, combat exposure, interpersonal distress, circumstances of deployment, and personal injury. Psychometric analyses revealed scale scores were internally consistent; validity evidence showed WEI subscales were significantly correlated with measures of readjustment, PTSD, psychological distress, and alcohol abuse. Findings provide preliminary evidence of structural and psychometric properties of the WEI and its utility in assessing war-related experiences in operations in Afghanistan and Iraq.     

Renew: An Integrative Psychotherapy Program for Women Veterans with Sexual Trauma

Renew is an integrative treatment consisting of 210 hours of programming for women Veterans to address sexual trauma, including military sexual trauma. The curriculum consists of a holistic approach to healing and is based on the principles of Holographic Reprocessing. Of the 119 women Veterans enrolled in an uncontrolled outcome study (e.g., completed pre- and post-treatment questionnaires), 80 of the participants reported multiple traumas across their lifespan and 95 experienced military sexual trauma. Of the 112 who started treatment, 97 graduated (13 % dropout rate). Graduates showed a significant reduction in posttraumatic stress disorder (PTSD), psychiatric symptoms, and posttraumatic negative cognitions (up to 60 % had reliable clinical change at the 95 % confidence interval), and significant increases in self-esteem, optimism, and satisfaction with life with large to moderate effect sizes. These initial data are promising and further research is warranted to test if Renew is effective to treat women Veterans with complex issues including sexual trauma, PTSD, medical problems, chronic pain, and histories of homelessness and substance abuse.