Publication year
2012
Citation Title
Childhood trauma exposure in Iraq and Afghanistan war era veterans: Implications for posttraumatic stress disorder symptoms and adult functional social support.
Journal Name
Child Abuse & Neglect
Journal Volume
36
Issue Number
5
Page Numbers
423-432
DOI
10.1016/j.chiabu.2012.03.004
Summary
Survey data from Veterans who served post 9-11 were utilized to examine the relationships among childhood trauma, posttraumatic stress disorder (PTSD) symptoms, and adult social support. Childhood trauma exposure (both abuse related and other non-abuse related trauma) was associated with adult PTSD symptoms. Certain childhood trauma-based PTSD symptoms negatively influenced the relationship between childhood trauma and social support in adulthood.
Key Findings
After accounting for combat exposure, childhood abuse as well as other childhood trauma (e.g., exposure to accidents, natural disasters, and severe illness) was significantly associated with adult PTSD symptom severity.
Although data did not suggest that childhood abuse interacted with combat exposure to increase the risk of PTSD symptoms, childhood trauma and adult combat exposure both contributed independently to adult PTSD symptomatology.
While all three PTSD symptom clusters related to adult functional social support, the avoidance and numbing symptom cluster carried the most powerful indirect effect on the relationship between childhood trauma and adult functional social support.
Implications for Program Leaders
Provide education to Service members and their families regarding how adverse childhood experiences (including abuse) can impair functioning and elevate the risks for certain mental health issues
Offer additional innovative and evidence-based workshops that prove useful in addressing PTSD symptoms among Service members experiencing deployment, particularly those groups at high risk of experiencing PTSD symptoms (e.g., those with childhood trauma)
Educate family and friends of Service members about the symptoms service members may experience after deployments, particularly the symptoms associated with avoidance and numbing
Implications for Policy Makers
Continue to support programs that promote access to treatment for PTSD and other mental health concerns among military service members and their families
Recommend professional development opportunities for those working with Service members might highlight the evidence related to deployment, combat experiences, and childhood trauma
Encourage collaboration among DoD and community-based programs and services to provide Service members coping with childhood and military trauma streamlined care
Methods
Veterans and Active Duty personnel who had deployed post 9-11 were recruited through letters, fliers, clinical providers, and word of mouth and invited to participate in a study.
Participants completed self-report surveys regarding mood, trauma exposure, mental health, and physical health; a subset of 482 participants completed the measure of functional social support.
Data were collected between June 2005 and February 2010.
Participants
The sample included 1,301 Veterans; 62% to Iraq with Operation Iraqi Freedom (OIF), 34% to Kuwait for OIF, 13% to Afghanistan in service of Operation Enduring Freedom, 18% in the Persian Gulf War.
The majority of participants were male (81%), and were on average 36.8 years old.
The ethnic composition of the sample was: 44% White, 46% Black, and 10% other.
Service branch data were not provided.
Limitations
This sample, drawn from Veterans registered for services with the VA who volunteered and were compensated for their time, may be different from the broader population of Veterans in the general population.
The PTSD symptoms were measured using self-report surveys; participants may be reporting in ways that are socially desirable.
The Combat Exposure Scale does not account for overall war zone stress that may contribute to predictions of adult PTSD symptoms; therefore, results may be biased.
Avenues for Future Research
Utilize a longitudinal design that follows children with and without trauma histories into adulthood and through exposure to subsequent traumas are needed to determine the directionality between avoidance symptoms and diminished social support
Investigate to what extent childhood-based PTSD symptoms and combat exposure influence post-deployment adjustment
Examine the effects of resilience training programs on Service members mental health outcomes
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: This study examined the relationship among childhood trauma, posttraumatic stress disorder (PTSD) symptoms, and adult social support in a large sample of veterans who served in the military after 09/11/2001, with a specific focus on the potential role of the PTSD avoidance and numbing cluster as intervening in the association between childhood abuse and adult functional social support. Method: Participants were 1,301 veterans and active duty soldiers who have served in the military since 09/11/2001; a subsample of these participants (n=482) completed an inventory of current functional social support. Analyses included linear regression and nonparametric bootstrapping procedures. Results: After controlling for combat exposure, exposure to childhood trauma was associated with PTSD symptoms in adulthood. Further, PTSD symptoms, and particularly PTSD avoidance/numbing cluster symptoms, intervened in the relationship between childhood trauma and adult functional social support. Conclusions: Findings support the association of childhood trauma (both abuse related and other, non-abuse related trauma) with PTSD symptoms in military personnel and veterans, even after accounting for combat exposure. Additionally, the avoidance and numbing symptom cluster of childhood trauma-based PTSD may be particularly salient in compromising one's subsequent ability to garner functional social support in adulthood.
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