Do adverse childhood experiences increase the risk of postdeployment posttraumatic stress disorder in US Marines?

Cynthia A Leardmann,Besa Smith,Margaret Ak Ryan

doi:10.1186/1471-2458-10-437

Abstract

BackgroundPosttraumatic stress disorder (PTSD) has been associated with combat intensity, lack of social support, and adverse childhood factors among military personnel in previous studies. It has not been well established if adverse childhood experiences reported predeployment are independently associated with postdeployment PTSD.MethodsData were evaluated from 8,391 male responders of the Recruit Assessment Program survey at Marine Corps Recruit Depot in San Diego who were deployed in support of military conflicts between September 2001 and June 2004. Using patient medical records to determine PTSD diagnoses, Cox proportional hazard modeling was performed to examine if adverse childhood experiences were independently associated with postdeployment PTSD.ResultsAfter adjustment, those who reported adverse childhood experiences in more than one category were significantly more likely to be diagnosed with postdeployment PTSD. Specifically, childhood physical neglect was mostly strongly associated with postdeployment PTSD.ConclusionsFindings suggest that Marines who experience multiple types of adverse childhood experiences may be at increased risk for postdeployment PTSD. It is possible, however, that these results indicate that men willing to report childhood adverse experiences are also more willing to seek care for PTSD.

Highlights

Posttraumatic stress disorder (PTSD) has been associated with combat intensity, lack of social support, and adverse childhood factors among military personnel in previous studies
A greater proportion of responders diagnosed with PTSD scored in the lowest quartile for Armed Forces Qualification Test (AFQT), reported having 1 or fewer close friends, and reported poor mental health some, most, or all of the time at the beginning of military training
A greater proportion of those diagnosed with PTSD reported childhood physical neglect, emotional neglect, emotional abuse, and domestic violence

Summary

Introduction

Posttraumatic stress disorder (PTSD) has been associated with combat intensity, lack of social support, and adverse childhood factors among military personnel in previous studies. It has been suggested that the psychological process that occurs during and immediately following a traumatic event affects an individual’s post-event mental health status [2] Those who respond to a traumatic event with intensely negative emotions, have dissociative experiences, and lack coping skills are at increased risk for PTSD. Factors, such as family history of mental illness and prior traumatic events, may lead to psychological difficulties, emotional dysregulation, and self-destructive behaviors [2,3]. Individuals who have experienced childhood trauma may be more vulnerable to develop PTSD, as they have less ability to positively respond and cope with new traumatic events

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