Life Course Epidemiology of Trauma and Related Psychopathology in Civilian Populations

Fink, David S.; Galea, Sandro

doi:10.1007/s11920-015-0566-0

Cited by 51 publications

(33 citation statements)

References 112 publications

(109 reference statements)

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“…Moreover, PTSD and depression risk is the consequence of pre-deployment experiences and combat exposures, such that those with early life sexual and violent assault are documented to be at an increased risk of post-deployment PTSD symptoms compared to those without prior assaults (28). Insofar as recent military personnel are more likely to experience early life traumatic experiences than civilians (8), the study of the consequences of military trauma should focus on predeterminants of those consequences over the life course (29). …”

Section: Discussionmentioning

confidence: 99%

Incidence of and risk for post-traumatic stress disorder and depression in a representative sample of US Reserve and National Guard

Fink

Cohen

Sampson

et al. 2016

Annals of Epidemiology

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Purpose We aim to determine the incidence rates (IR) of first ever PTSD and depression in a population-based cohort of US Reserve and National Guard service members. Methods We used data from the US Reserve and National Guard Study (N = 2003) to annually investigate incident and recurrent PTSD and depression symptoms from 2010 to 2013. We estimated the IR and recurrence rate over 4 years and according to several sociodemographic and military characteristics. Results From 2010 to 2013, incidence rates were 4.7 per 100 person-years for both PTSD and depression symptoms using the sensitive criteria, 2.9 per 100 person-years using the more specific criteria, recurrence rates for both PTSD and depression were more than 4 times as high as IRs, and IRs were higher among those with past-year civilian trauma, but not past-year deployment. Conclusions The finding that civilian trauma, but not past-year military deployment, is associated with an increased risk of PTSD and depression incidence suggest that RNG psychopathology could be driven by other, non-military, traumatic experiences.

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Section: Discussionmentioning

confidence: 99%

Incidence of and risk for post-traumatic stress disorder and depression in a representative sample of US Reserve and National Guard

Fink

Cohen

Sampson

et al. 2016

Annals of Epidemiology

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“…For example, it has been shown that exposure to repeated severe (e.g., abuse) and chronic (e.g., conflict between parents) stressful events in early life can result in abnormal behaviors in children and adolescents, who may try to reduce tension or stress through avoidant, self-medicating (e.g., smoking or alcohol abuse), compulsive (e.g., overeating), and/or self-injurious behaviors [13–15]. Traumatic experiences in childhood can also affect emotional and psychological development, increasing vulnerability to mental health problems such as major depression and posttraumatic stress disorder (PTSD) [16]. Moreover, emerging data suggest that adversity in early life is able to alter biological functioning in stress regulatory pathways, leading to long-lasting altered stress responsivity in adulthood [17].…”

Section: Introductionmentioning

confidence: 99%

The Role of Adverse Childhood Experiences in Cardiovascular Disease Risk: a Review with Emphasis on Plausible Mechanisms

et al. 2015

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Childhood adversity, characterized by abuse, neglect, and household dysfunction, is a problem that exerts a significant impact on individuals, families, and society. Growing evidence suggests that adverse childhood experiences (ACEs) are associated with health decline in adulthood, including cardiovascular disease (CVD). In the current review, we first provide an overview of the association between ACEs and CVD risk, with updates on the latest epidemiological evidence. Second, we briefly review plausible pathways by which ACEs could influence CVD risk, including traditional risk factors and novel mechanisms. Finally, we highlight the potential implications of ACEs in clinical and public health. Information gleaned from this review should help physicians and researchers in better understanding potential long-term consequences of ACEs and considering adapting current strategies in treatment or intervention for patients with ACEs.

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“…The comparisons of PTSS trajectories that arise from deployment versus civilian traumatic events are well suited for this analysis. Indeed, the characteristics of traumatic events vary greatly across several dimensions that have been associated with PTSS outcomes, including: type, chronicity, and severity (Fink & Galea, 2015). First, rare exposures during civilian life are ubiquitous exposures during deployment, such as receiving incoming fire and being attacked or ambushed (Gallaway et al, 2014; Hoge et al, 2004).…”

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confidence: 99%

Trajectories of posttraumatic stress symptoms after civilian or deployment traumatic event experiences.

Fink¹,

Lowe

Cohen

et al. 2017

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective Growth mixture model studies have observed substantial differences in the longitudinal patterns of posttraumatic stress symptom (PTSS) trajectories. This variability could represent chance iterations of some prototypical trajectories or measurable variability induced by some aspect of the source population or traumatic event experience. Testing the latter, we analyzed a nationally representative sample of U.S. Reserve and National Guard members to identify the influence of civilian versus deployment trauma on the number of PTSS trajectories, the nature of these trajectories, and proportion of respondents in each trajectory. Method Data were collected from 2010 to 2013 and latent class growth analysis was used to identify different patterns of PTSS in persons exposed to both a civilian and a deployment trauma and to test whether respondents’ exposure to civilian trauma developed similar or distinct patterns of response compared to respondents exposed to deployment trauma. Results PTSS were found to follow three trajectories, with respondents predominantly clustered in the lowest symptom trajectory for both trauma types. Covariates associated with each trajectory were similar between the two traumas, except number of civilian-related traumatic events; specifically, a higher number of civilian traumatic events was associated with membership in the ‘borderline-stable,’ compared to ‘low-consistent,’ trajectory, for civilian traumas and associated with the ‘pre-existing chronic’ trajectory for military traumas. Conclusions Holding the source population constant, PTSS trajectory models were similar for civilian and deployment-related trauma, suggesting that irrespective of traumatic event experienced there might be some universal trajectory patterns. Thus, the differences in source populations may have induced the heterogeneity observed among prior PTSS trajectory studies.

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Life Course Epidemiology of Trauma and Related Psychopathology in Civilian Populations

Cited by 51 publications

References 112 publications

Incidence of and risk for post-traumatic stress disorder and depression in a representative sample of US Reserve and National Guard

Incidence of and risk for post-traumatic stress disorder and depression in a representative sample of US Reserve and National Guard

The Role of Adverse Childhood Experiences in Cardiovascular Disease Risk: a Review with Emphasis on Plausible Mechanisms

Trajectories of posttraumatic stress symptoms after civilian or deployment traumatic event experiences.

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