Exploration of the Influence of Childhood Trauma, Combat Exposure, and the Resilience Construct on Depression and Suicidal Ideation Among U.S. Iraq/Afghanistan Era Military Personnel and Veterans

Abstract

OBJECTIVES This study evaluated the effect of childhood trauma exposure and the role of resilience on both depressive symptoms and suicidal ideation. METHODS 1488 military personnel and veterans, who served after September 2001, were evaluated for depressive, suicidal, and PTSD symptoms, combat exposure, childhood trauma exposure, and resiliency. Participants were enrolled as part of an ongoing multicenter study. Outcome measures were depressive symptoms and suicidal ideation. RESULTS After controlling for the effects of combat exposure and PTSD, results revealed that childhood trauma exposures were significantly associated with depressive symptoms and suicidal ideation. In addition, resilience was negatively associated with depressive symptoms and suicidal ideation, suggesting a potential protective effect. CONCLUSION These findings suggest that evaluation of childhood trauma is important in the clinical assessment and treatment of depressive symptoms and suicidal ideation among military personnel and veterans.

Longitudinal suicidal ideation across 18-months postpartum in mothers with childhood maltreatment histories

“…By contrast, resilience was significantly associated with 4-months and 15-months SI. These findings are consistent with non-postpartum research demonstrating negative associations between resilience and contemplation of suicide (Izadinia et al, 2010; Mansfield et al, 2011; Pietrzak et al, 2010; Pietrzak et al, 2011; Yousef et al 2013). Women with higher resilience likely have more adaptive strategies that allow them to cope with past experiences of maltreatment and parenting demands.…”

Racial/ethnic differences in the association of childhood adversities with depression and the role of resilience

“…We found that exposure to ACEs was significantly associated with severity of depression in a dose-response fashion. Along the same lines, given similar levels of childhood trauma exposure, young adults with high and medium levels of resilience showed less depressive symptoms compared to those with low resilience, as previously reported in both active duty service members and veterans (Youssef et al, 2013b). Our results replicated and generalized previous findings to the civilian young adult population.…”

“…(Felitti et al, 1998) Trauma exposure during early life has also been related to mental health issues later in life, including depression (Schulz et al, 2014; Wingo et al, 2010; Youssef et al, 2013b) and suicidality (Youssef et al, 2013a). For example, Youssef et al found that childhood trauma exposures were significantly associated with both depressive symptoms and suicidal ideation in 1488 military personnel and veterans while controlling for the effects of combat exposure and posttraumatic stress disorder (PTSD) (Youssef et al, 2013b).…”

“…For example, Youssef et al found that childhood trauma exposures were significantly associated with both depressive symptoms and suicidal ideation in 1488 military personnel and veterans while controlling for the effects of combat exposure and posttraumatic stress disorder (PTSD) (Youssef et al, 2013b). Resilience, defined as qualities that enable one to thrive in the face of adversity, (Connor and Davidson, 2003) has been negatively associated with depressive symptoms and suicidal ideation, suggesting a protective effect (Youssef et al, 2013a; Youssef et al, 2013b). However, the role of resilience and how it interacts with both ACEs and the potential development of depressive symptoms, including how race and ethnicity moderate these effects, are much less studied.…”

The independent effects of child sexual abuse and impulsivity on lifetime suicide attempts among female patients

“…This strong association is also true for a variety of diverse samples (Afifi et al, 2016;Fergusson, McLeod, & Horwood, 2013;Lopez-Castroman et al, 2013;Rabinovitch, Kerr, Leve, & Chamberlain, 2015). For example, childhood trauma exposure, including CSA, significantly predicted suicidal ideation above and beyond the effects of combat exposure among United States military personnel and Veterans (Youssef et al, 2013). Longitudinal studies demonstrate how the effects of CSA are long lasting and increase risk for suicidal behavior (Trickett, Noll, & Putnam, 2011).…”