Childhood adversities and post-traumatic stress disorder: evidence for stress sensitisation in the World Mental Health Surveys

Abstract

Background Although childhood adversities are known to predict increased risk of post-traumatic stress disorder (PTSD) after traumatic experiences, it is unclear whether this association varies by childhood adversity or traumatic experience types or by age. Aims To examine variation in associations of childhood adversities with PTSD according to childhood adversity types, traumatic experience types and life-course stage. Method Epidemiological data were analysed from the World Mental Health Surveys (n = 27 017). Results Four childhood adversities (physical and sexual abuse, neglect, parent psychopathology) were associated with similarly increased odds of PTSD following traumatic experiences (odds ratio (OR) = 1.8), whereas the other eight childhood adversities assessed did not predict PTSD. Childhood adversity-PTSD associations did not vary across traumatic experience types, but were stronger in childhood-adolescence and early-middle adulthood than later adulthood. Conclusions Childhood adversities are differentially associated with PTSD, with the strongest associations in childhood–adolescence and early-middle adulthood. Consistency of associations across traumatic experience types suggests that childhood adversities are associated with generalised vulnerability to PTSD following traumatic experiences.

Inflammation and post‐traumatic stress disorder

“…Indeed, it is reported that more than half of patients with PTSD have comorbid depressive disorders . Moreover, early‐life adversities, such as childhood maltreatment, are known to increase risk of PTSD in later life . In particular, depression and history of childhood maltreatment have also been associated with increased inflammation; therefore, these conditions can confound the association between PTSD and inflammation.…”

The impact of patterns of trauma exposure among low income children with and without histories of child maltreatment

“…As a result, very little research has evaluated the interconnections between child maltreatment and other forms of trauma. In one example of research examining variation in the associations of various childhood adversities with PTSD, McLaughlin and colleagues (2017) analyzed data from a large, nationwide sample collected by World Mental Health Surveys. Results indicated that physical and sexual abuse, neglect, and parent psychopathology all predicted similar odds of developing PTSD, whereas interpersonal loss, parental maladjustment, serious physical illness, and economic adversity did not predict PTSD.…”

A Proof-of-Mechanism Study to Test Effects of the NMDA Receptor Antagonist Lanicemine on Behavioral Sensitization in Individuals With Symptoms of PTSD

“…Behavioral sensitization refers to a process whereby traumaassociated stress (but also repeated use of substances of abuse, mood or anxiety episodes, and suicide attempts) sensitize behavioral, motivational and stress systems, thereby increasing the behavioral and physiological reactivity to subsequent stressors or other sensitizing agents even after a prolonged absence of those agents (15)(16)(17)(18). Consistent with findings in animals, research in humans showed at least three different aspects of behavioral sensitization: induction, the development of behavioral sensitization to a sensitizing agent, including uncontrollable stressors (19), substances of abuse (18,20,21), and, in PTSD, repeated illness episodes (22); expression, exaggerated behavioral or physiological responses to a sensitizing agent even after prolonged absence of that agent (18,21,23); and cross-sensitization, the process by which sensitization to one agent results in sensitization to other agents (e.g., facilitation of behavioral sensitization to psychostimulants after exposure to uncontrollable stress) (24).…”