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Childhood trauma and the impact of deployment on the development of mental disorder in military males

Published online by Cambridge University Press:  05 April 2019

Rebecca Syed Sheriff Open the ORCID record for Rebecca Syed Sheriff [Opens in a new window] ,
Miranda Van Hooff ,
Gin Malhi Open the ORCID record for Gin Malhi [Opens in a new window] ,
Blair Grace  and
Alexander McFarlane
Rebecca Syed Sheriff*
Affiliation:
Centre for Traumatic Stress Studies (CTSS), University of Adelaide, Level 1, Helen Mayo North, 30 Frome Road, SA 5000, Australia Child and Adolescent Psychiatric Unit, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Institute of Mental Health, University of Nottingham, Nottingham, UK
Miranda Van Hooff
Affiliation:
Centre for Traumatic Stress Studies (CTSS), University of Adelaide, Level 1, Helen Mayo North, 30 Frome Road, SA 5000, Australia
Gin Malhi
Affiliation:
Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia Sydney Medical School Northern, University of Sydney, NSW, Australia CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
Blair Grace
Affiliation:
Department of Education and Child Development, 31 Flinders St, Adelaide, Australia
Alexander McFarlane
Affiliation:
Centre for Traumatic Stress Studies (CTSS), University of Adelaide, Level 1, Helen Mayo North, 30 Frome Road, SA 5000, Australia
*
Author for correspondence: Rebecca Syed Sheriff, E-mail: rebecca_syed@hotmail.com
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Abstract

Background

Childhood adversity is associated with mental disorder following military deployment. However, it is unclear how different childhood trauma profiles relate to developing a post-deployment disorder. We investigated childhood trauma prospectively in determining new post-deployment probable disorder.

Methods

In total, 1009 Regular male ADF personnel from the Australian Defence Force (ADF) Middle East Area of Operations (MEAO) Prospective Study provided pre- and post-deployment self-report data. Logistic regression and generalised structural equation modelling were utilised to examine associations between childhood trauma and new post-deployment probable disorder and possible mediator pathways through pre-deployment symptoms.

Results

There were low rates of pre-deployment probable disorder. New post-deployment probable disorder was associated with childhood trauma, index deployment factors (combat role and deployment trauma) and pre-deployment symptoms but not with demographic, service or adult factors prior to the index deployment (including trauma, combat or previous deployment). Even after controlling for demographic, service and adult factors prior to the index deployment as well as index deployment trauma, childhood trauma was still a significant determinant of new post-deployment probable disorder. GSEM demonstrated that the association between interpersonal childhood trauma and new post-deployment probable disorder was fully mediated by pre-deployment symptoms. This was not the case for those who experienced childhood trauma that was not interpersonal in nature.

Conclusions

To determine the risk of developing a post-deployment disorder an understanding of the types of childhood trauma encountered is essential, and pre-deployment symptom screening alone is insufficient

Keywords

Epidemiologymilitarychildhood traumamental disorderdeployment
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 5 , April 2020 , pp. 818 - 826
Copyright
Copyright © Cambridge University Press 2019

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References

Acock, AC (2006) A Gentle Introduction to STATA. College Station, TX: STATA Press.Google Scholar
Andrews, G and Slade, T (2001) Interpreting scores on the Kessler Psychological Distress Scale (K10). Australian and New Zealand Journal of Public Health 25, 494–497.CrossRefGoogle Scholar
Arrighi, HM and Hertz-Picciotto, I (1994) The evolving concept of the healthy worker survivor effect. Epidemiology 5, 189–196.CrossRefGoogle ScholarPubMed
Berntsen, D, Johannessen, KB, Thomsen, YD, Bertelsen, M, Hoyle, RH and Rubin, DC (2012) Peace and war: trajectories of posttraumatic stress disorder symptoms before, during, and after military deployment in Afghanistan. Psychological Science 23, 1557–1565.CrossRefGoogle ScholarPubMed
Cabrera, OA, Hoge, CW, Bliese, PD, Castro, CA and Messer, SC (2007) Childhood adversity and combat as predictors of depression and post-traumatic stress in deployed troops. American Journal of Preventive Medicine 33, 77–82.CrossRefGoogle ScholarPubMed
Davy, C, Dobson, A, Lawrence-Wood, E, Lorimer, M, Moores, K, Lawrence, A, Horsley, K, Crockett, A and McFarlane, A (2012) The Middle East Area of Operations (MEAO) Health Study: Prospective Study Summary Report. Adelaide, Australia: The University of Adelaide, Centre for Military and Veterans Health.Google Scholar
Dobson, A, Treloar, S, Zheng, W, Anderson, R, Bredhauer, K, Kanesarajah, J, Loos, C, Pasmore, K and Waller, M (2012) The Middle East Area of Operations (MEAO) Health Study: Census Study Summary Report. Brisbane, Australia: The University of Queensland, Centre for Military and Veterans Health.Google Scholar
Fear, NT, Jones, M, Murphy, D, Hull, L, Iversen, AC, Coker, B, Machell, L, Sundin, J, Woodhead, C, Jones, N, Greenberg, N, Landau, S, Dandeker, C, Rona, RJ, Hotopf, M and Wessely, S (2010) What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. Lancet 375, 1783–1797. Epub 2010 May 12.CrossRefGoogle ScholarPubMed
Finkelhor, D, Ormrod, RK and Turner, HA (2007) Polyvictimization and trauma in a national longitudinal cohort. Development and Psychopathology 19, 149–166.CrossRefGoogle Scholar
Forbes, D, Lockwood, E, Phelps, A, Wade, D, Creamer, M, Bryant, RA, McFarlane, A, Silove, D, Rees, S, Chapman, C, Slade, T, Mills, K, Teesson, M and O'Donnell, M (2014) Trauma at the hands of another. The Journal of Clinical Psychiatry 75, 147–153.CrossRefGoogle Scholar
Fritch, AM, Mishkind, M, Reger, MA and Gahm, GA (2010) The impact of childhood abuse and combat-related trauma on postdeployment adjustment. Journal of Traumatic Stress 23, 248–254.Google ScholarPubMed
Goldney, RD, Wilson, D, Dal Grande, E, Fisher, LJ and McFarlane, AC (2000) Suicidal ideation in a random community sample: attributable risk due to depression and psychosocial and traumatic events. Australian and New Zealand Journal of Psychiatry 34, 98–106.CrossRefGoogle Scholar
Hotopf, M, Hull, L, Fear, NT, Browne, T, Horn, O, Iversen, A, Jones, M, Murphy, D, Bland, D, Earnshaw, M, Greenberg, N, Hughes, JH, Tate, AR, Dandeker, C, Rona, R and Wessely, S (2006) The health of UK military personnel who deployed to the 2003 Iraq war: a cohort study. Lancet 367, 1731–1741.CrossRefGoogle ScholarPubMed
Iversen, AC, Fear, NT, Simonoff, E, Hull, L, Horn, O, Greenberg, N, Hotopf, M, Rona, R and Wessely, S (2007) Influence of childhood adversity on health among male UK military personnel. British Journal of Psychiatry 191, 506–511.CrossRefGoogle ScholarPubMed
Kessler, RC and Ustun, TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.CrossRefGoogle Scholar
Kessler, RC, Andrews, G, Colpe, LJ, Hiripi, E, Mroczek, DK, Normand, SL, Walters, EE and Zaslavsky, AM (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine 32, 959–976.CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL and Williams, JB (2002) The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine 64, 258–266.CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JB and Lowe, B (2010) The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. General Hospital Psychiatry 32, 345–359. doi: Epub 2010 May 7.CrossRefGoogle ScholarPubMed
Owens, GP, Dashevsky, B, Chard, KM, Mohamed, S, Haji, U, Heppner, PS and Baker, DG (2009) The relationship between childhood trauma, combat exposure, and posttraumatic stress disorder in male veterans. Military Psychology 21, 114–125.CrossRefGoogle Scholar
Reinert, DF and Allen, JP (2002) The Alcohol Use Disorders Identification Test (AUDIT): a review of recent research. Alcoholism, Clinical and Experimental Research 26, 272–279.CrossRefGoogle ScholarPubMed
Rona, RJ, Fear, NT, Hull, L and Wessely, S (2007) Women in novel occupational roles: mental health trends in the UK Armed Forces. International Journal of Epidemiology 36, 319–326.CrossRefGoogle ScholarPubMed
Rona, RJ, Hooper, R, Jones, M, Iversen, AC, Hull, L, Murphy, D, Hotopf, M and Wessely, S (2009) The contribution of prior psychological symptoms and combat exposure to post Iraq deployment mental health in the UK military. Journal of Traumatic Stress 22, 11–19.CrossRefGoogle ScholarPubMed
Sareen, J, Henriksen, CA, Bolton, SL, Afifi, TO, Stein, MB and Asmundson, GJ (2013) Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel. Psychological Medicine 43, 73–84.CrossRefGoogle Scholar
Sartory, G, Cwik, J, Knuppertz, H, Schurholt, B, Lebens, M, Seitz, RJ and Schulze, R (2013) In search of the trauma memory: a meta-analysis of functional neuroimaging studies of symptom provocation in posttraumatic stress disorder (PTSD). PLoS ONE 8, e58150. Epub 2013 Mar 25.CrossRefGoogle Scholar
Searle, AK, Van Hooff, M, McFarlane, AC, Davies, CE, Fairweather-Schmidt, AK, Hodson, SE, Benassi, H and Steele, N (2015) The validity of military screening for mental health problems: diagnostic accuracy of the PCL, K10 and AUDIT scales in an entire military population. International Journal of Methods in Psychiatric Research 24, 32–45.CrossRefGoogle Scholar
Searle, AK, Van Hooff, M, Lawrence-Wood, ER, Grace, BS, Saccone, EJ, Davy, CP, Lorimer, M and McFarlane, AC (2017) The impact of antecedent trauma exposure and mental health symptoms on the post-deployment mental health of Afghanistan-deployed Australian troops. Journal of Affective Disorders 220, 62–71.CrossRefGoogle ScholarPubMed
Solomon, Z and Flum, H (1988) Life events, combat stress reaction and post-traumatic stress disorder. Social Science and Medicine 26, 319–325.CrossRefGoogle ScholarPubMed
Syed Sheriff, R, Van Hooff, M, Malhi, G, Grace, B and McFarlane, A (2018) Childhood determinants of suicidality: comparing males in military and civilian employed populations. Psychological Medicine 13, 1–11.Google Scholar
Teicher, MH, Anderson, CM, Ohashi, K and Polcari, A (2014) Childhood maltreatment: altered network centrality of cingulate, precuneus, temporal pole and insula. Biological Psychiatry 76, 297–305.CrossRefGoogle ScholarPubMed
Unwin, C, Blatchley, N, Coker, W, Ferry, S, Hotopf, M, Hull, L, Ismail, K, Palmer, I, David, A and Wessely, S (1999) Health of UK servicemen who served in Persian Gulf War. Lancet 353, 169–178.CrossRefGoogle ScholarPubMed
Van Hooff, M, Lawrence-Wood, E, Hodson, S, Sadler, N, Benassi, H, Hansen, C, Grace, B, Avery, J, Searle, A, Iannos, M, Abraham, M, Baur, J and McFarlane, A (2018) Mental Health Prevalence, Mental Health and Wellbeing Transition Study. Canberra: the Department of Defence and the Department of Veterans' Affairs.Google Scholar
Van Voorhees, EE, Dennis, MF, Calhoun, PS and Beckham, JC (2014) Association of DHEA, DHEAS, and cortisol with childhood trauma exposure and post-traumatic stress disorder. International Clinical Psychopharmacology 29, 56–62.CrossRefGoogle ScholarPubMed
Vogt, DS, Proctor, SP, King, DW, King, LA and Vasterling, JJ (2008) Validation of scales from the Deployment Risk and Resilience Inventory in a sample of Operation Iraqi Freedom veterans. Assessment 15, 391–403.doi: 10.1177/1073191108316030. Epub 2008 Apr 24.CrossRefGoogle Scholar
Weathers, FW, Litz, BT, Herman, DS, Huska, JA and Keane, TM (1993) The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper Presented at the Annual Convention of the International Society for Traumatic Stress Studies.Google Scholar
Wilk, JE, Bliese, PD, Kim, PY, Thomas, JL, McGurk, D and Hoge, CW (2010) Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war. Drug and Alcohol Dependence 108, 115–121. Epub 2010 Jan 8.CrossRefGoogle ScholarPubMed