Abstract
OBJECTIVE: Although sexual minority women (SMW) veterans are disproportionately impacted by military sexual trauma and its negative consequences, little research has examined effective treatments in this population. This secondary analysis aims to address this gap by reporting outcomes of SMW veterans participating in a clinical trial of skills training in affective and interpersonal regulation (STAIR) compared with present-centered therapy (PCT) for the treatment of posttraumatic stress disorder. METHOD: Women veterans who experienced military sexual trauma (N = 161) were randomly assigned to individual STAIR or PCT. Forty-two participants were SMW (M(age) = 45.45, SD = 14.05; 69.0% White) and 119 were heterosexual (M(age) = 44.19, SD = 12.53; 54.6% White). Participants completed baseline, posttreatment, and follow-up assessments that included self-report measures of posttraumatic stress disorder symptoms (Posttraumatic Stress Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th edition), social support (Interpersonal Support Evaluation List), emotion regulation (Difficulties with Emotion Regulation Scale), posttraumatic maladaptive beliefs (Posttraumatic Maladaptive Beliefs Scale), depression symptoms (Beck Depression Inventory, Revised), and working alliance (Working Alliance Inventory-Patient Version). Independent samples t tests and piecewise mixed-effects regression models were conducted to evaluate SMW veterans' outcomes. RESULTS: Both groups (sexual minority and heterosexual women) improved on posttraumatic stress disorder symptoms. SMW started off with comparable symptoms to heterosexual women but improved more on emotion regulation (p = .002), maladaptive beliefs (p = .002), and depression symptoms (p = .002) than heterosexual participants. Regardless of sexual orientation, participants had greater benefits in STAIR. Therapeutic alliance and treatment satisfaction were high in both STAIR and PCT with no difference between groups. CONCLUSIONS: SMW veterans may particularly benefit from therapies that focus on emotion regulation, interpersonal skills, and/or provide strategies that address day-to-day stressors (e.g., STAIR, PCT). (PsycInfo Database Record (c) 2026 APA, all rights reserved).