Health and occupational consequences of spouse abuse victimization among male U.S. Army soldiers

Little is known about the health and occupational outcomes of male victims of spouse abuse. 87,426 male Army soldiers: 11,294 spouse abuse victims with record of prior spouse abuse perpetration; 3,277 spouse abuse victims with no record of prior perpetration, and 72,855 non-victims who were never perpetrators were followed for up to twelve years to assess risk for hospitalization and attrition from the Army. In multivariate Cox proportional hazards models controlling for age, race, education, rank, time in service, and number of dependents, victims of spouse abuse were at significantly greater risk for hospitalization and early discharge from the Army than non-victims. In particular, victims were more likely than non-victims to experience a hospitalization for depression, alcohol dependence syndrome or other mental health disorders, even when the hospitalization occurred many years after the initial spouse abuse event. Spouse abuse victims with prior history of spouse abuse perpetration were at greatest risk for both hospitalizations (HR Victim/Perpetrator = 1.45, 95% CI =1.38-1.52, HR Victim/Non-Perpetrator = 1.38, 95% CI = 1.27-1.49) and attrition (HR Victim/Perpetrator = 1.13, 95% CI = 1.08-1.18; HR Victim/Non-perpetrator = 1.05, 95% CI = 1.02-1.08.). However, drinking by the female perpetrator or mutual drinking during the abuse event mediated the association between prior perpetrator status and hospitalization and reversed the effect on attrition such that male victims who were prior perpetrators were at lower risk than victim-non-perpetrators for early discharge from the Army. Male victims of spouse abuse need greater support to reduce their risk for adverse outcomes.