New study explores the link between depression symptoms, disordered eating, and sexual dysfunction in military women

A survey of women who served in the U.S. military found evidence that depressive symptoms form a link between highly disordered eating and lower sexual function. Findings indicate that it would be valuable to integrate treatments for sexual dysfunction into treatments for women with disordered eating and depression symptoms. The study was published in Military Psychology.

The proportion of women serving in militaries across the world has increased rapidly in recent decades. In the United States, women are the fastest growing subpopulation within the veteran community. Due to this, they are an important subpopulation for research into the mental health of military personnel.

Previous studies suggest that it is critical for understanding the mental health issues of women in the military to include the assessment of sexual function. Research has shown that women in the military report higher numbers of sexual partners relative to non-veterans and a high rate of exposure to events that can trigger sexual dysfunction, such as sexual trauma. Studies also found that higher sexual dysfunction is associated with higher suicide risks in these individuals.

Although the sexual function of women in the military is generally an understudied topic, available findings indicate that sexual dysfunction is associated with disordered eating behaviors and depressive symptoms.

Whitney S. Livingston from the Utah State University and her colleagues wanted to examine the nature of the association between depression, disordered eating, and sexual dysfunction in military women. With this goal, they analyzed survey responses of 494 women with a history of military service. These data were taken from a larger dataset that collected data to “examine the association between relationship satisfaction, sexual function, and military sexual trauma in women service members and veterans.” Participants each received $15 for their participation.

The participants completed a demographic inventory asking about their race, ethnicity, age, marital status, military discharge status, history of military sexual trauma, and probable exposure to a Criterion A event. As defined in DSM-IV-TR, a Criterion A event means: A1) experiencing, witnessing, or being confronted with an event that involves actual or threatened death or serious injury, or a threat to the physical integrity of self or others; and A2) experiencing intense fear, helplessness, or horror.

The women also completed assessments of sexual function (Female Sexual Function Index), disordered eating (Eating Disorder Examination – Questionnaire, EDE-Q) and depressive symptoms (Patient Health Questionnaire-9, PHQ-9).

“Based on self-report measures, probable sexual dysfunction, eating disorder, and depressive disorders were found among 58.70%, 38.5%, and 44.13% of participants, respectively,” the researchers wrote. The association between disordered eating, depressive symptoms and sexual dysfunction was confirmed. However, “the relationship of higher disordered eating symptoms and lower sexual function was indirect, through higher depressive symptoms.”

Additionally, better sexual function was quite strongly associated with better relationship satisfaction and sexual function tended to be somewhat better in younger women. Depressive symptoms were more common in women of races other than white, those with experience of military sexual trauma, and trauma exposure in general, as well as in veterans compared to active-duty personnel.

Sexual functioning was somewhat poorer in participants who experienced trauma or military sexual trauma, in veterans (compared to active-duty personnel), and in married women (compared to unmarried women).

The study adds new insights into the knowledge on the relationships between depression, eating disorders and sexual functioning. However, it should be taken into account that observed differences between compared groups can be due to factors not included in the study. The study was based on self-reports. Finally, study participants were women with military service history and results for women who have not served in the military might not be the same.

The study, “Depression symptoms as a potential mediator of the association between disordered eating symptoms and sexual function in women service members and veterans“, was authored by Whitney S. Livingston, Jamison D. Fargo, and Rebecca K. Blais.

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