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Trauma Experience Among Homeless Female Veterans: Correlates and Impact on Housing, Clinical, and Psychosocial Outcomes

Authors

  • Jack Tsai,

    Corresponding author
    1. Department of Psychiatry, Yale University, New Haven, Connecticut, USA
    • Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut, USA
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  • Robert A. Rosenheck,

    1. Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut, USA
    2. Department of Psychiatry, Yale University, New Haven, Connecticut, USA
    3. School of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA
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  • Suzanne E. Decker,

    1. Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut, USA
    2. Department of Psychiatry, Yale University, New Haven, Connecticut, USA
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  • Rani A. Desai,

    1. Department of Psychiatry, Yale University, New Haven, Connecticut, USA
    2. School of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA
    3. Northeast Program Evaluation Center, Department of Veterans Affairs, West Haven, Connecticut, USA
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  • Ilan Harpaz-Rotem

    1. Veterans Affairs New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut, USA
    2. Department of Psychiatry, Yale University, New Haven, Connecticut, USA
    3. Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA
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  • None of the authors report any conflicts of interest. This work was supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development. The views presented here are those of the authors alone, and do not represent the position of any federal agency or of the United States Government.

Correspondence concerning this article should be addressed to Jack Tsai, VACT, 950 Campbell Ave., 151D, West Haven, CT 06516. E-mail: Jack.Tsai@yale.edu

Abstract

This study examined lifetime exposure to traumatic events as reported by 581 homeless female veterans enrolled in a Homeless Women Veterans Program across 11 sites to characterize the types of trauma they experienced; their correlation with baseline characteristics; and their association with housing, clinical outcomes, and psychosocial functioning over a 1-year treatment period. Almost all participants endorsed multiple types and episodes of traumatic events. Among the most common were having someone close experience a serious or life-threatening illness (82%) and rape (67%). Exploratory factor analysis revealed 6 potential trauma categories: being robbed, experiencing accident or disasters, illness or death of others, combat, sexual assault, and physical assault. At baseline, trauma from sexual assault was associated with more days homeless (β = .18, p < .001), trauma from accidents or disasters was associated with poorer physical health (β = −.23, p < .001), and trauma from being robbed was related to greater use of drugs (β = .22, p < .001). Trauma reported at baseline, however, was not predictive of 1-year outcomes, suggesting type and frequency of trauma does not negatively affect the housing gains homeless women veterans can achieve through homeless services.

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