Relationships among adverse childhood experiences, posttraumatic stress disorder symptom clusters, and health in women veterans

Abstract

Adverse childhood experiences (ACEs) increase risk for negative health outcomes. The goal of this study was to examine the relationships among cumulative ACEs, ACEs type, posttraumatic stress disorder (PTSD) symptoms, PTSD symptom clusters, and physical health symptoms in a sample of women veterans (N = 76). Bivariate correlations were used to determine which ACE domains were associated with PTSD and physical health symptoms. Follow-up linear regressions indicated cumulative ACEs were significantly associated with total PTSD symptoms. Cumulative ACEs were also significantly associated with the avoidance and hyperarousal symptom clusters, but not the re-experiencing symptom cluster. Total PTSD symptoms were significantly related to physical health symptoms. Of the three symptom clusters, only hyperarousal was significantly associated with physical health symptoms. Cross-sectional mediation analyses indicated the total and direct effects of ACEs on physical health were not significant. However, the indirect effect through PTSD was significant (b = 0.46, [95% CI: 0.02, 0.91]), as well as through the avoidance (b = 0.47, [95% CI: 0.06, 0.90]), and hyperarousal symptom clusters (b = 0.56, [95% CI: 0.11, 1.04]). This study highlights the potential impact of ACEs on PTSD symptoms and physical health and suggests that hyperarousal symptoms of PTSD, may play a potential role in the development of physical health problems.

Sexual and physical revictimization in U.S. military veterans

“…First, it could highlight a difference in the childhood environment of many individuals who volunteer to join the military. Previous research with volunteer-era veterans has found elevated risks of childhood adversity (Blosnich et al, 2014) and high ACE exposure in this population (Lamson et al, 2020;Wooldridge et al, 2020). Second, it could be related to differences in the way childhood physical abuse is defined and measured across studies.…”

“…A recent systematic review concluded that MST survivors are at increased risk for further victimization after military service (Tirone et al, 2020). In the study by Wooldridge et al (2020), 77% of the sample reported MST, and 44% of the sample reported experiencing postdeployment assault. Within and outside of the military, women have a higher risk of experiencing sexual victimization than their male counterparts (Russo & Pirlott, 2006;Schry et al, 2016).…”

“…In the study by Wooldridge et al. (2020), 77% of the sample reported MST, and 44% of the sample reported experiencing postdeployment assault. Within and outside of the military, women have a higher risk of experiencing sexual victimization than their male counterparts (Russo & Pirlott, 2006; Schry et al., 2016).…”

“…Instead, volunteer‐era veterans chose to enlist and serve in the military and were given financial incentives (e.g., signing bonuses, college tuition) for their participation. Veteran men experience significantly higher numbers of adverse childhood experiences (ACEs) compared to civilian men (Carroll et al., 2017); high numbers of ACEs have also been reported among women veterans and associated with posttraumatic stress disorder in this population (PTSD; Wooldridge et al., 2020). Research in U.S. military samples focused on revictimization is limited, but because the rates of childhood victimization are elevated in samples of military personnel who served following the September 11, 2001, terrorist attacks (post‐9/11), the risk of revictimization in adulthood may be high.…”

The mediating role of anxiety/depression symptoms between adverse childhood experiences (ACEs) and somatic symptoms in adolescents

“…Increasing evidence suggests that anxiety/depression symptoms may mediate the relationship between ACEs and somatic symptoms (Bonvanie et al, 2017;Bugge et al, 2017;Hammond et al, 2019;Kugler et al, 2012;McCall-Hosenfeld et al, 2014;Wooldridge et al, 2020). For example, Kugler et al (2012) conducted a cross-sectional study on children (ages 8-17 years) residing in foster homes and have found that anxiety symptoms mediated the relationship between sexual abuse and somatic symptoms (Kugler et al, 2012).…”