Depression and PTSD-related anhedonia mediate the association of military sexual trauma and suicidal ideation in female service members/veterans

Previous research shows a direct link between military sexual trauma and suicide risk. Little is known about mediators of this association, including posttraumatic stress disorder (PTSD) or depression severity, mental health conditions that are correlated with both suicide risk and military sexual trauma. Moreover, existing studies of military sexual trauma do not distinguish between harassment and assault, resulting in a gap in our knowledge regarding suicide risk as a function of sexual trauma type. We explored whether PTSD symptom clusters and depression mediated the association of military sexual trauma type (none, harassment-only, assault) and suicidal ideation (SI). Female service members/Veterans (n = 1190) completed a demographic inventory, military sexual trauma history and type screening, and PTSD symptom cluster severity, depression severity, and SI measures. Structural equation modeling revealed that the association of military sexual trauma, particularly assault, with SI was mediated by depression severity and PTSD-related anhedonia. Screening for SI among those endorsing a history of military sexual trauma, PTSD-related anhedonia, and depression may help identify those at risk for SI. Therapeutic interventions aimed at reducing PTSD-related anhedonia and depression symptoms may be the most efficient way to mitigate suicide risk in those with histories of assault military sexual trauma.