Sexual trauma while serving in the U.S. military is high among female veterans with fibromyalgia, as is childhood trauma, and screening for such abuse may improve their care, a pilot study by VA Boston Healthcare System suggests.
Military sexual trauma includes harassment, the study noted, with almost 91% of participating veterans reporting such abuse and some 68% saying it included sexual assault.
Researchers suggest these findings support trauma therapy being part of fibromyalgia symptom management for female veterans, and the importance of applying a more holistic approach in managing this condition.
The study, ”Experience of Childhood Abuse and Military Sexual Trauma Among Women Veterans with Fibromyalgia,” was published in the Journal of General Internal Medicine.
Fibromyalgia, which mainly affects women, is already known to be linked with personal trauma, particularly childhood abuse. Trauma of this sort can lead to lasting physiologic adaptations that promote chronic pain.
The disease is also more common among women who served in the U.S. military than among those in the general population, the study said, with many female veterans reporting both chronic pain and trauma during and prior to military service.
An earlier study found that women who were veterans of the wars in Afghanistan and Iraq and under Veterans Health Administration (VA) care had a 4.2% prevalence of fibromyalgia, compared to 3.4% of women across the U.S.
Recognizing a possible link between childhood abuse, sexual trauma and fibromyalgia, researchers at the VA Boston Healthcare System examined 22 women with fibromyalgia (mean age, 51.3) referred to VA for care. Using specific questionnaires, they evaluated them for degrees of post-traumatic stress disorder (PTSD), child abuse, and military sexual trauma.
Nearly all, 90.9%, reported experiencing sexual trauma while in military service, with 68.2% saying it extended to sexual assault.
The average score on the Child Trauma Questionnaire (CTQ) also indicated moderate to high exposure to abuse in childhood, with many indicating sexual abuse and emotional neglect.
Veterans reporting high levels of sexual harassment while in the service also reported experiencing abuse as children and had more severe PTSD.
The researchers concluded that as military sexual trauma and PTSD inquiries are mandatory in the VA, screening for child abuse among women with fibromyalgia might also yield information important in treating them.
“This small study only evaluated women accessing VA services; these findings may not generalize to non-user women veterans. Finally, data are cross-sectional and do not allow evaluation of the temporal relationship of child abuse to fibromyalgia, or of fibromyalgia diagnosis to military service,” they wrote.
But it supports adopting a more interdisciplinary approach in such care, one addressing biological, psychological and social aspects of a patient.
“Our fibromyalgia patients have often told us that their disease feels ‘invisible’ at times. We believe these preliminary study results may help female Veterans with fibromyalgia seek treatment for both their physical symptoms and trauma histories,” Megan Gerber, medical director at VA Boston Healthcare System, associate professor of medicine at Boston University School of Medicine, and the study’s first author said in a press release.
“The VA is uniquely positioned to treat a complex condition like fibromyalgia and additional research is underway here to better understand interventions for this disabling chronic pain syndrome.”