Publication year
2007
Citation Title
Childhood adversity and combat as predictors of depression and post-traumatic stress in deployed troops.
Journal Name
American Journal of Preventive Medicine
Journal Volume
33
Issue Number
2
Page Numbers
77-82
DOI
10.1016/j.amepre.2007.03.019
Summary
Soldiers prior to an OIF deployment and Soldiers after an OIF deployment completed a survey to assess the mental health impact of childhood adverse events (e.g., psychological abuse, mental illness in the home) on combat troops. Adverse childhood events significantly predicted mental health symptoms beyond combat exposure after deployment.
Key Findings
Soldiers who reported two or more traumatic childhood experiences were at increased risk of meeting criteria for depression and PTSD (in both the pre- and post-Iraq deployment samples).
In the post-deployment sample, adverse childhood experiences were a significant predictor of depression and PTSD symptoms (above and beyond combat exposure in Iraq).
When examining all Soldiers who had combat exposure, those with a history of adverse childhood experiences displayed lower levels of PTSD and depression compared to those without adverse childhood experiences. Researchers speculate that these Soldiers may be displaying lower reactivity to combat or their previous trauma may have created a ceiling effect for mental health functioning.
Implications for Program Leaders
Offer supportive classes that address the impact of childhood adverse events on Service members, and teach strategies for managing the aftermath of such experiences
Offer courses for family members, such as training on understanding and supporting the Service member who is facing mental health concerns after deployment
Disseminate information regarding possible symptoms of mental health problems Service members may face after deployment and where individuals and families can find help for those problems
Implications for Policy Makers
Recommend that Service members be assessed for childhood adverse events and any associated mental health difficulties prior to deployment
Continue to support programs dedicated to the provision of mental health interventions that address the impact of childhood adverse events on Service member functioning
Recommend integrating education on trauma and coping into existing service delivery systems for military families
Methods
Soldiers were surveyed prior to deployment to Iraq and approximately three months after returning from deployment.
Participants completed scales of childhood adverse events, depression, PTSD symptoms, combat exposure, demographic, and military questions.
Statistical analyses were used to predict depression and PTSD symptoms based on childhood adverse experiences.
Participants
Four thousand five hundred tweny nine Soldiers participated prior to deployment to Iraq and 2,392 Soldiers participated after deployment to Iraq; both samples were 100% male.
Participants' pre-Iraq deployment sample characteristics: 65% were 18-24 years old, 70% were White, 13% were Latino, 9% were African American, and 40% were married.
Participants' post-Iraq deployment sample characteristics: 57% were 18-24 years old, 69% were White, 11% were Latino, 13% were African American, and 48% were married.
All participants were Active Duty Soldiers serving in infantry and support units; no other military or demographic variables were presented.
Limitations
All data were retrospective and self-report which may introduce biases (particularly in the recall for childhood events).
Only male Active Duty Soldiers were used; it is unknown how these results might generalize to female, Reserve, or Guard Service members and those in other branches of the military.
The data were cross-sectional which means no conclusions based on causation can be determined.
Avenues for Future Research
Utilize a longitudinal design to measure and control for pre-deployment mental health
Investigate women exposed to combat to see if these patterns are similar for both genders
Gather data about current traumatic or adverse experiences to explore the extent to which past and current experiences are related among Service members
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Background: Previous studies have shown a relationship between childhood adversity and health outcomes in adulthood. The military represents a segment of the young working population that faces unique hazards that may be worsened by previous adverse life experiences. To date, no comprehensive studies of childhood adversity have been conducted with military samples that have included combat troops before and after a combat deployment. Methods: Surveys were administered in 2003 to 4,529 male soldiers who had not deployed to Iraq, and in 2004 to a separate group of 2,392 male soldiers 3 months after returning from Iraq. The main predictor was adverse childhood experiences, an aggregated construct representing incremental exposure to six types of traumatic childhood experiences. This construct correlated with depression and post-traumatic stress disorder rates, as well as symptom scores. For the post-Iraq sample, analyses were conducted to assess whether individuals with childhood trauma were affected differently by exposure to combat. Results: The likelihood of screening positive for depression and post-traumatic stress disorder was significantly higher for individuals reporting exposure to two or more categories of childhood adversity. Core analyses showed that adverse childhood experiences were a significant predictor of mental health symptoms, beyond the expected contribution of combat. Conclusions: This study confirms the high prevalence of adverse childhood experiences and the association of these experiences with key mental health outcomes. In addition, the results highlight the importance of considering pre-enlistment childhood traumatic experiences as well as the level of combat exposure in the treatment of military personnel returning from combat operations.
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