Association of Child Maltreatment and Deployment-related Traumatic Experiences with Mental Disorders in Active Duty Service Members and Veterans of the Canadian Armed Forces: Association de la Maltraitance des Enfants et des Expériences Traumatisantes Liées au Déploiement Avec les Troubles Mentaux Chez les Membres du Service Actif et Les Anciens Combattants des Forces Armées Canadiennes

Tracie O Afifi, Jitender Sareen, Tamara Taillieu, Ashley Stewart-Tufescu, Natalie Mota, Shay-Lee Bolton, Gordon J G Asmundson, Murray W Enns, Katie A Ports, Rakesh Jetly, Tracie O Afifi, Jitender Sareen, Tamara Taillieu, Ashley Stewart-Tufescu, Natalie Mota, Shay-Lee Bolton, Gordon J G Asmundson, Murray W Enns, Katie A Ports, Rakesh Jetly

Abstract

Objective: Mental health among military personnel is an important public health priority. It is known that military personnel experience a high prevalence of child maltreatment and deployment-related traumatic events (DRTEs) and both are related to mental health outcomes. However, few, if any, studies have examined the cumulative and interactive effects of child maltreatment and DRTEs on mental health disorders in a sample of active duty service members and military veterans.

Methods: Data were from the Canadian Armed Forces (CAF) Members and Veterans Mental Health Follow-up Survey collected in 2018 (N = 2,941, response rate = 68.7%), a 16-year follow-up survey of CAF Regular Force members interviewed in 2002. Five types of child maltreatment and 10 types of DTREs were assessed for impact on mental health. Mental disorders included past 12-month generalized anxiety disorder (GAD), panic disorder, social phobia, and major depressive episode (MDE). Past 12-month symptoms of posttraumatic stress disorder (PTSD) were also examined.

Results: The prevalence of any exposure to child maltreatment and DRTEs was 62.5% and 68.6%, respectively. All types of child maltreatment were associated with increased odds of past 12-month PTSD symptoms and mental disorders with the exception of physical abuse and GAD as well as childhood exposure to intimate partner violence and panic disorder. Cumulative effects of having experienced both child maltreatment and DRTEs increased the odds of past 12-month PTSD symptoms, GAD, social phobia, and MDE. No interaction effects were significant.

Conclusions: The prevalence of a child maltreatment history is high among active Canadian military and veterans. As well, child maltreatment may increase the likelihood of mental disorders across the life span. This may be especially true for individuals who also experience DRTEs. Understanding these relationships may provide insight into developing effective interventions for military personnel and veteran mental health outcomes.

Keywords: child maltreatment; mental health; trauma.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Richardson JD, Thompson A, King L, et al. Comorbidity patterns of psychiatric conditions in Canadian armed forces personnel. Can J Psychiatry. 2019;64(7):501–510.
    1. Afifi TO, MacMillan HL, Boyle M, Taillieu T, Cheung K, Sareen J. Child abuse and mental disorders in Canada. CMAJ. 2014;186(9):E324–E332.
    1. Afifi TO, Taillieu T, Zamorski MA, Turner S, Cheung K, Sareen J. Association of child abuse exposure with suicidal ideation, suicide plans, and suicide attempts in military personnel and the general population in Canada. JAMA Psychiatry. 2016;73(3):229–238.
    1. Bandoli G, Campbell-Sills L, Kessler RC, et al. Childhood adversity, adult stress, and the risk of major depression or generalized anxiety disorder in US soldiers: a test of the stress sensitization hypothesis. Psychol Med. 2017;47(13):2379–2392.
    1. Sareen J, Henriksen CA, Bolton SL, Afifi TO, Stein MB, Asmundson GJ. Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel. Psychol Med. 2013;43(1):73–84.
    1. Sareen J, Cox BJ, Afifi TO, et al. Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel. Arch Gen Psychiatry. 2007;64(7):843–852.
    1. Boulos D, Fikretoglu D. Influence of military component and deployment-related experiences on mental disorders among Canadian military personnel who deployed to Afghanistan: a cross-sectional survey. BMJ Open. 2018;8(3):e018735.
    1. Searle AK, Van Hooff M, Lawerence-Wood ER, et al. The impact of antecedent trauma exposure and mental health symptoms on the post-deployment mental health of Afghanistan-deployed Australian troops. J Affect Disord. 2017;220:62–71.
    1. Afifi TO, Ford D, Gershoff ET, et al. Spanking and adult mental health impairment: The case for the designation of spanking as an adverse childhood experience. Child Abus Negl. 2017;71:24–31.
    1. Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the adverse childhood experiences study. J Am Med Assoc. 2001;286(24):3089–3096.
    1. Felitti VJ, Anda RF, Nordenberd D, et al. Relationship of child abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med. 1998;14(4):245–258.
    1. Merrick MT, Ports KA, Ford DC, Afifi TO, Gershoff ET, Grogan-Kaylor A. Unpacking the impact of adverse childhood experiences on adult mental health. Child Abus Negl. 2017;69:10–19.
    1. Merrick MT, Ford DC, Ports KA, et al. Vital signs: estimated proportion of adult health problems attributable to adverse childhood experiences and implications for prevention - 25 states, 2015-2017. MMWR Morb Mortal Wkly Rep. 2019;68(44):999–1005.
    1. Laird CW, Alexander P. Prevalence of adverse childhood experiences among veterans. Clin Soc Work J. 2019;47(4):384–393.
    1. Carroll TD, Currier JM, McCormick WH, Drescher KD. . Adverse childhood experiences and risk for suicidal behavior in male Iraq and Afghanistan veterans seeking PTSD treatment. Psychol Trauma Theory, Res Pract Policy. 2017;9(5):583–586.
    1. Nichter B, Hill M, Norman S, Haller M, Pietrzak RH. Associations of childhood abuse and combat exposure with suicidal ideation and suicide attempt in U.S. military veterans: a nationally representative study. J of Affect Disord. 2020;276:1102–1108.
    1. Mclaughlin KA, Conron KJ, Koenen KC, Gilman SE. Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder: a test of the stress sensitization hypothesis in a population-based sample of adult. Psychol Med. 2010;40(10):1647–1658.
    1. Vest BM, Hoopsick RA, Homish DL, Daws RC, Homish GG. Childhood trauma, combat trauma, and substance use in national guard and reserve soldiers. Subst Abus. 2018;39(4):452–460.
    1. Turner S, Taillieu T, Carleton RN, Sareen J, Afifi TO. Association between a history of child abuse and suicidal ideation, plans and attempts among Canadian public safety personnel: a cross-sectional survey. CMAJ Open. 2018;6(4):E463–E470.
    1. Zheng WY, Kanesarajah J, Waller M, McGuire AC, Treloar SA, Dobson AJ. Childhood adversity and traumatic exposures during deployment as predictors of mental health in Australian military veterans. Aust NZJ Public Heal. 2016;40(1):10–15.
    1. Gaska KA, Kimerling R. Patterns of adverse experiences and health outcomes among women veterans. Am J Prev Med. 2018;55(6):803–811.
    1. Statistics Canada. Canadian community health survey cycle 1.2 - mental health and well-being - Canadian forces - master file documentation. 2004. Published 2004 [accessed 2020 Jan 31).
    1. Bolton SL, Afifi TO, Mota N, et al. Predictors of attrition in a 16-year longitudinal follow-up in the Canadian military. Can J Psychiatry. Forthcoming.
    1. Afifi TO, Bolton SL, Mota M, et al. Rationale and methodology of the 2018 Canadian armed forces and veterans mental health follow up survey (CAFVMHS): a 16-year follow up survey. Can J Psychiatry. 2020 Dec 2 [Epub ahead of print]. 10.1177/0706743720974837
    1. Statistics Canada. Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey 2018. Master File User Guide; Ottawa, ON. 2019.
    1. Walsh CA, MacMillan HL, Trocme N, Jamieson E, Boyle MH. Measurement of victimization in adolescence: development and validation of the childhood experiences of violence questionnaire. Child Abus Negl. 2008;32(11):1037–1057.
    1. Kessler RC, Ustun BB. The World Mental Health (WMH) survey initiative version of the world health organization (WHO) composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res. 2004;13(2):93–121.
    1. World Health Organization. Composite International Diagnostic Interview (CIDI) researcher’s manual (Version 1.1, 1994). World Health Organization American Psychiatric Association; 1994.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington, DC: American Psychiatric Association; 1994.
    1. Kessler RC, Abelson J, Demler O, et al. Clinical calibration of DSM-IV diagnoses in the World mental health (WMH) version of the world health organization (WHO) composite international diagnostic interview (WMH-CIDI). Int J Methods Psychiatr Res. 2004;13(2):122–139.
    1. Afifi TO, Mather A, Boman J, et al. Childhood adversity and personality disorders: results from a nationally representative population-based study. J Psychiatr Res. 2011;45(6):814–822.
    1. Scoglio AAJ, Shirk SD, Mazure C, et al. It all adds up: addressing the roles of cumulative traumatic experiences on military veterans. Child Abus Negl. 2019;98:104227.
    1. McLafferty M, Ross J, Bradley BW, Armour C. Childhood adversities and psychopathology among military veterans in the US: the mediating role of social networks. J Anxiety Disord. 2019;65:47–55.
    1. Hardt J, Rutter M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry. 2004;45(2):260–273.
    1. Hardt J, Sidor A, Bracko M, Egle UT. Reliability of retrospective assessments of childhood experiences in Germany. J Nerv Ment Dis. 2006;194(9):676–683.
    1. Hardt J, Vellaisamy P, Schoon I. Sequelae of prospective versus retrospective reports of adverse childhood experiences. Psychol Rep. 2010;107(2):425–440.

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