Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel

Sareen, Jitender; Henriksen, Christine; Bolton, Shay-Lee; Afifi, Tracie O.; Stein, Murray B.; Asmundson, Gordon J.G.

doi:10.1017/s003329171200102x

Cited by 139 publications

(116 citation statements)

References 34 publications

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“…Second, we could not control for some potential confounders or effect modifiers, such as past mental health [11], childhood adversity [52], other lifetime trauma, unit cohesion, deployment length, leadership, and homecoming experiences. Third, we used cross-sectional data, which has clear limitations when it comes to establishing causality; this approach has however been used in other similar research [17,18].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Contribution of traumatic deployment experiences to the burden of mental health problems in Canadian Armed Forces personnel: exploration of population attributable fractions

Born

Zamorski

2018

Soc Psychiatry Psychiatr Epidemiol

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Purpose Mental health problems are prevalent after combat; they are also common in its absence. Estimates of deploymentattributability vary. This paper quantifies the contribution of different subtypes of occupational trauma to post-deployment mental health problems. Methods Participants were a cohort of 16,193 Canadian personnel undergoing post-deployment mental health screening after return from the mission in Afghanistan. The screening questionnaire assessed post-traumatic stress disorder, depression, panic disorder, generalized anxiety disorder, and exposure to 30 potentially traumatic deployment experiences. Logistic regression estimated adjusted population attributable fractions (PAFs) for deployment-related trauma, which was treated as count variables divided into several subtypes of experiences based on earlier factor analytic work. Results The overall PAF for overall deployment-related trauma exposure was 57.5% (95% confidence interval 44

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Section: Strengths and Limitationsmentioning

confidence: 99%

Contribution of traumatic deployment experiences to the burden of mental health problems in Canadian Armed Forces personnel: exploration of population attributable fractions

Born

Zamorski

2018

Soc Psychiatry Psychiatr Epidemiol

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“…A no, compared with any, variable of deployment-related traumatic events was also created. This variable was previously conceptualized in another study 52 in the CCHS-CFS and consisted of combining 4 items:…”

Section: Sociodemographic and Military-related Covariatesmentioning

confidence: 99%

Protective Factors for Mental Disorders and Psychological Distress in Female, Compared with Male, Service Members in a Representative Sample

et al. 2013

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Objective: Although military interest in promoting psychological resilience is growing, resources protective against psychopathology have been understudied in female service members. Using a representative sample of Canadian Forces personnel, we investigated whether religious attendance, spirituality, coping, and social support were related to mental disorders and psychological distress in female service members, and whether sex differences occurred in these associations.Method: Religious attendance and spirituality were self-reported. Coping items were taken from 3 scales and produced 3 factors (active, avoidance, and self-medication). Social support was assessed with the Medical Outcomes Study Social Support Survey. Past-year mental disorders were diagnosed with the World Mental Health Composite International Diagnostic Interview. The Kessler Psychological Distress Scale assessed distress. Multivariate regression models investigated links between correlates and psychological outcomes within each sex. For associations that were statistically significant in only one sex, sex by correlate interactions were computed. Results:In female service members, inverse relations were found between social support and MDD, any MDD or anxiety disorder, suicidal ideation, and distress. No associations were found between religious attendance and outcomes, and spirituality was associated with an increased likelihood of some outcomes. Active coping was related to less psychological distress, while avoidance coping and self-medication were linked to a higher likelihood of most outcomes. Although several statistically significant associations were found in only one sex, only one sex by correlate interaction was statistically significant. Conclusions:Social support was found to be inversely related to several negative mental health outcomes in female service members. Few differences between men and women reached statistical significance. Future research should identify additional helpful resources for female service members. W W W Facteurs de protection contre les troubles mentaux et la détresse psychologique chez les membres féminins, comparés aux membres masculins des forces armées dans un échantillon représentatifObjectif : Quoique l'intérêt militaire pour la promotion de la résilience psychologique va en grandissant, les ressources protectrices contre la psychopathologie ont été sous-étudiées chez les membres féminins des forces armées. À l'aide d'un échantillon représentatif du personnel des Forces canadiennes, nous avons recherché si la pratique religieuse, la spiritualité, l'adaptation, et le soutien social étaient liés aux troubles mentaux et à la détresse psychologique chez le personnel féminin des Forces, et si des différences selon le sexe survenaient dans ces associations.

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“…Subsequent studies of other populations have shown that chronic exposure to ACEs, as defined by Felitti et al, affect health outcomes and health care utilization by the time of young adulthood. [5][6][7] While ACEs have been widely promoted 4,8,9 and examined in practice, 10 community 11,12 and state-wide surveys, 13 as well as retrospective chart reviews, 13 there have, to our knowledge, been no other peer-reviewed publications where ACE questionnaires have been used by clinicians for screening in primary care.…”

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confidence: 99%

Screening for Adverse Childhood Experiences in a Family Medicine Setting: A Feasibility Study

Glowa

Olson

Johnson

2016

The Journal of the American Board of Family Medicine

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Introduction:The role of adverse childhood experiences (ACEs) in predicting later adverse adult health outcomes is being widely recognized by makers of public policy. ACE questionnaires have the potential to identify in clinical practice unaddressed key social issues that can influence current health risks, morbidity, and early mortality. This study seeks to explore the feasibility of implementing the ACE screening of adults during routine family medicine office visits.Methods: At 3 rural clinical practices, the 10-question ACE screen was used before visits with 111 consecutive patients of 7 clinicians. Clinician surveys about the use of the results and the effect on the visits were completed immediately after the visits. The presence of any ACE risk and "high-risk" ACE scores (>4) were compared with clinician survey responses.Results: A risk of ACEs was present in 62% of patients; 22% had scores >4. Clinicians were more likely to have discussed ACE issues for high-risk patients (score 0 -3, 36.8%; score >4, 83.3%; P ‫.؍‬ 00). Clinicians also perceived that they gained new information (score 0 -3, 35.6%; score >4, 83.3%; P ‫؍‬ .00). Clinical care changed for a small proportion of high-risk patients, with no change in immediate referrals or plan for follow-up. In 91% of visits where a risk of ACEs was present, visit length increased by <5 minutes.

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Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel

Abstract: ACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.

Cited by 139 publications

References 34 publications

Contribution of traumatic deployment experiences to the burden of mental health problems in Canadian Armed Forces personnel: exploration of population attributable fractions

Contribution of traumatic deployment experiences to the burden of mental health problems in Canadian Armed Forces personnel: exploration of population attributable fractions

Protective Factors for Mental Disorders and Psychological Distress in Female, Compared with Male, Service Members in a Representative Sample

Screening for Adverse Childhood Experiences in a Family Medicine Setting: A Feasibility Study

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