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A study published in the medical journal JAMA Psychiatry found that as many as one in five women who served in Vietnam during the 1960s and 1970s experienced post-traumatic stress disorder at some point in their lives. The study, led by Kathryn Magruder and published on Oct. 7, also found that some still suffer from the condition.

Roughly 20% of the women who served in Vietnam met the criteria for post-traumatic stress at some point in their lives, compared to 12% for those who served nearby, and 14% for those who served in the U.S.

According to the findings, the main cause for post-traumatic stress among subjects was sexual harassment, said Magruder in an email to Reuters.

“It was these experiences — especially sexual harassment and performance pressures — that explained their higher levels of PTSD,” wrote Magruder of the higher rates of post-traumatic stress among women who served in Vietnam, compared to women who served in the theater or at home. “We need to work hard to change military culture so that . . . military sexual harassment is not a PTSD risk factor for future generations.”

Between 5,000 and 7,500 American servicewomen served with the U.S. military during Vietnam, and at least 2,000 served aboard bases in the region, with 250,000 stationed in the U.S. The researchers collected data from 1,956 women who served in Vietnam, 657 who served near Vietnam, and 1,606 who served stateside between 1965 and 1973.