The impact of childhood abuse and combat‐related trauma on postdeployment adjustment

Abstract

This retrospective study examined the effects of childhood physical abuse (CPA) and combat-related trauma on postdeployment psychiatric symptoms in an outpatient clinical sample of 1,045 U.S. service members. The authors conducted hierarchical multiple regression analyses to examine the impact of CPA and combat-related trauma on alcohol use, anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms. Analyses revealed significant main effects for CPA and combat-related trauma on anxiety, depression, and PTSD. In contrast, no interactive effects were observed. Findings support and expand current knowledge about the roles that CPA and combat trauma play in the development of psychiatric symptoms and suggest a more complex etiology for postdeployment symptomatology. Clinical implications and future research opportunities are discussed.

Distress and drinking: Cross-cultural connections and contexts

“…Several studies have found no increase in drinking related to stressful life events (Droomers, Schrijvers, Stronks, Van De Mheen, & Mackenbach, 1999;Robertson, Xu, & Stripling, 2010;Welte & Mirand, 1995), social anxiety (Eggleson, Woolaway-Bickel, & Schmidt, 2004;Ham & Hope, 2006;Tran, Haaga, & Chambless, 1997) and posttraumatic stress disorder (Boscarino et al, 2006;Breslau, Davis, & Schultz, 2003;Najdowski & Ullman, 2009), and there are also studies reporting no drinking increase in people who have suffered pain (Yokoyama et al, 2009), sexual victimization (Testa, Livingston, & Hoffman, 2007) and effects of military combat (Fritch, Mishkind, Reger, & Gahm, 2010). Workrelated stress has a particularly uncertain relationship with drinking; sometimes distressed employees drink more (Ahola et al, 2006;Bobak et al, 2005;Richman, Shinsako, Rospenda, Flaherty, & Freels, 2002) and sometimes they do not (Hodgins, Williams, & Munro, 2009;Kouvonen et al, 2005;Ng & Jeffery, 2003).…”

Cumulative trauma and midlife well-being in American women who served in Vietnam: effects of combat exposure and postdeployment social support

“…Relatively little work examining cumulative trauma and the military has focused on the experiences of women, who tend to have more extensive histories of childhood trauma and higher rates of PTSD (see Sareen et al, 2013), and who are increasingly exposed to combat-related stressors in their formal work capacity as soldiers or other workers in war zones. For example, most of the studies cited above comprise samples of entirely or primarily men; the abovementioned sample of post-9/11 military was 78% male (Dedert et al, 2009) and the abovementioned study of OEF/OIF veterans was 86% male (Fritch et al, 2010).…”

“…For example, the mean age of the participants in the abovementioned OEF/OIF sample was 30.5 years (Fritch et al, 2010). We anticipated that combat exposure would account for unique variance above and beyond that of childhood and adulthood traumas.…”

“…The majority of these studies have found direct, main effects of childhood abuse on posttraumatic stress symptoms (e.g., Sareen et al, 2013), suggesting that childhood abuse and combat exposure independently contribute to PTSD symptomatology. For example, in veterans from Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF), childhood physical abuse predicted combat-related PTSD above and beyond combat exposure (e.g., Fritch, Mishkind, Reger, & Gahm, 2010). Trauma experienced as a child appears to have a particularly strong impact on subsequent physical and psychological well-being and to sensitize people to more severe reactions to future traumatic encounters (Cloitre et al, 2009).…”

“…Most of this work has specifically focused on psychiatric disorders, particularly diagnosed PTSD (e.g., Dedert et al, 2009), and much of it has been conducted in samples currently in treatment (Fritch et al, 2010). Although less well-established, adulthood trauma exposure also appears to serve as a risk factor for combat-related PTSD (e.g., Dedert et al, 2009); some studies have suggested that effects of childhood exposure may be partly mediated by adulthood trauma exposure (e.g., Clancy et al, 2006).…”