Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada.
Psychol Med. 2013 Jan;43(1):73-84. doi: 10.1017/S003329171200102X. Epub 2012 May 21.
Although it has been posited that exposure to adverse childhood experiences (ACEs) increases vulnerability to deployment stress, previous literature in this area has demonstrated conflicting results. Using a cross-sectional population-based sample of active military personnel, the present study examined the relationship between ACEs, deployment related stressors and mood and anxiety disorders.
Data were analyzed from the 2002 Canadian Community Health Survey-Canadian Forces Supplement (CCHS-CFS; n = 8340, age 18-54 years, response rate 81%). The following ACEs were self-reported retrospectively: childhood physical abuse, childhood sexual abuse, economic deprivation, exposure to domestic violence, parental divorce/separation, parental substance abuse problems, hospitalization as a child, and apprehension by a child protection service. DSM-IV mood and anxiety disorders [major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic attacks/disorder and social phobia] were assessed using the composite international diagnostic interview (CIDI).
Even after adjusting for the effects of deployment-related traumatic exposures (DRTEs), exposure to ACEs was significantly associated with past-year mood or anxiety disorder among men [adjusted odds ratio (aOR) 1.34, 99% confidence interval (CI) 1.03-1.73, p < 0.01] and women [aOR 1.37, 99% CI 1.00-1.89, p = 0.01]. Participants exposed to both ACEs and DRTEs had the highest prevalence of past-year mood or anxiety disorder in comparison to those who were exposed to either ACEs alone, DRTEs alone, or no exposure.
ACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.
尽管已经有人提出，经历不良的儿童期经历（ACEs）会增加对部署压力的脆弱性，但该领域的先前文献表明结果存在冲突。本研究使用现役军人的横断面基于人群的样本，研究了 ACEs、与部署相关的应激源与情绪和焦虑障碍之间的关系。
对 2002 年加拿大社区健康调查-加拿大部队增编（CCHS-CFS；n=8340，年龄 18-54 岁，应答率 81%）的数据进行了分析。以下 ACEs 通过回顾性自我报告进行评估：儿童期身体虐待、儿童期性虐待、经济贫困、家庭暴力暴露、父母离婚/分居、父母药物滥用问题、儿童住院和儿童保护服务机构干预。使用复合国际诊断访谈（CIDI）评估 DSM-IV 情绪和焦虑障碍[重性抑郁障碍、创伤后应激障碍（PTSD）、广泛性焦虑障碍（GAD）、惊恐发作/障碍和社交恐惧症]。
即使在调整了与部署相关的创伤性暴露（DRTEs）的影响后，ACEs 的暴露与男性[调整后的优势比（aOR）1.34，99%置信区间（CI）1.03-1.73，p<0.01]和女性[aOR 1.37，99%CI 1.00-1.89，p=0.01]过去一年的情绪或焦虑障碍显著相关。与仅暴露于 ACEs、仅暴露于 DRTEs 或无暴露的参与者相比，同时暴露于 ACEs 和 DRTEs 的参与者过去一年出现情绪或焦虑障碍的比例最高。
ACEs 与现役军人的几种情绪和焦虑障碍有关。预防心理健康问题的干预策略应考虑针对有 ACEs 暴露的士兵的效用。
