Trauma Exposure and Mental Health in Ex-Servicewomen Compared with Civilian Women in the UK

Trauma Exposure and Mental Health in Ex-Servicewomen Compared with Civilian Women in the UK | medRxiv Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Trauma Exposure and Mental Health in Ex-Servicewomen Compared with Civilian Women in the UK View ORCID Profile Alexandria Smith , View ORCID Profile Lynsay Ayer , View ORCID Profile Sharon A.M. Stevelink doi: https://doi.org/10.64898/2026.03.18.26348680 Alexandria Smith 1 King’s Centre for Military Health Research (KCMHR), Institute of Psychiatry, Psychology and Neuroscience, King’s College London Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Alexandria Smith For correspondence: Alexandria.smith{at}kcl.ac.uk layer{at}rand.org sharon.stevelink{at}kcl.ac.uk Lynsay Ayer 2 RAND Corporation , Arlington, Virginia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Lynsay Ayer For correspondence: Alexandria.smith{at}kcl.ac.uk layer{at}rand.org sharon.stevelink{at}kcl.ac.uk Sharon A.M. Stevelink 1 King’s Centre for Military Health Research (KCMHR), Institute of Psychiatry, Psychology and Neuroscience, King’s College London 3 Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Sharon A.M. Stevelink For correspondence: Alexandria.smith{at}kcl.ac.uk layer{at}rand.org sharon.stevelink{at}kcl.ac.uk Abstract Full Text Info/History Metrics Data/Code Preview PDF Abstract Background Exposure to trauma is associated with poor mental health, but little is known about how trauma profiles differ between ex-servicewomen and civilian women. Differences in trauma exposure may arise before, during, and after military service. Objective To characterise trauma profiles in ex-servicewomen and civilian women in the UK using separate latent class analyses, and to examine associations between trauma class membership and mental health outcomes within each group. Methods Data were drawn from the UK Biobank and stratified by serving status. Ex-servicewomen (n = 446) were compared with civilian women (n = 54,068). Within each group, sixteen lifetime traumatic experiences were assessed, and latent class analysis was applied to identify trauma profiles. Multinomial logistic regression examined associations between class membership and sociodemographic characteristics, and logistic regression assessed associations between trauma classes and mental health difficulties. Results Five trauma classes were identified for both ex-servicewomen and civilian women. Ex-servicewomen were less likely than civilians to belong to the low-trauma class (33.0% vs 62.8%) and reported higher exposure to childhood trauma and intimate partner violence. Among civilians, all trauma classes were associated with elevated odds of depression, anxiety, self-injurious thoughts and behaviours (SITB), as well as reduced meaning in life. Among ex-servicewomen, associations were less consistent; only severe cumulative trauma was linked to all adverse mental health outcomes, while other classes showed no differences in anxiety compared to ex-servicewomen with low trauma exposures. Conclusion Trauma profiles and their mental health correlates differ between ex-servicewomen and civilian women. These differences may reflect early life vulnerabilities, military experiences, and post-service exposures. Although ex-servicewomen reported higher levels of trauma, the associations between trauma classes and mental health were less pronounced than among civilians. Highlights Ex-servicewomen showed substantially higher prevalence of trauma exposure compared to civilian women, with the greatest differences in childhood adverse events and intimate partner violence Separate latent class analyses identified five distinct trauma profiles in both groups, with ex-servicewomen considerably less likely to belong to the low-trauma class than civilian women (33.0% vs 62.8%). The association between trauma exposure and mental health outcomes was less consistent among ex-servicewomen than civilian women, suggesting that military service may involve resilience factors that moderate the trauma–mental health relationship. Competing Interest Statement This research was partly supported by a grant from the Forces in Mind Trust (FiMT) FiMT/2202. No other potential conflicts of interest or financial disclosures were reported by the authors of this paper. SAMS is supported by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and funded by the National Institute for Health and Care Research, NIHR Advanced Fellowship, NIHR300592. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Funding Statement This research was partly supported by a grant from the Forces in Mind Trust (FiMT) FiMT/2202. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval for using UK Biobank was provided by the Northwest Multi-centre Research Ethics Committee (MREC) as a Research Tissue Bank (RTB). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability Statement The data used in this study are available from the UK Biobank ( https://www.ukbiobank.ac.uk ). Researchers can apply for access to UK Biobank data via the Access Management System at https://www.ukbiobank.ac.uk/enable-your-research/apply-for-access . Data cannot be made freely available due to participant confidentiality restrictions and data sharing agreements. This study used UK Biobank Application Number 213421. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Back to top Previous Next Posted March 19, 2026. Download PDF Data/Code Email Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. 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