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.
Psychol Med. 2020 Apr;50(5):818-826. doi: 10.1017/S0033291719000655. Epub 2019 Apr 5.
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.
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.
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.
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.
童年逆境与军事部署后精神障碍有关。然而，目前尚不清楚不同的童年创伤类型与形成部署后障碍有何关系。我们前瞻性地研究了童年创伤，以确定新的部署后可能的障碍。
共有 1009 名来自澳大利亚国防军（ADF）中东行动区（MEA）前瞻性研究的男性 ADF 现役人员提供了部署前和部署后的自我报告数据。使用逻辑回归和广义结构方程模型来研究童年创伤与新的部署后可能出现的障碍之间的关联，以及通过部署前症状的可能中介途径。
部署前可能出现障碍的比率较低。新的部署后可能出现障碍与童年创伤、指数部署因素（战斗角色和部署创伤）和部署前症状有关，但与指数部署前的人口统计学、服务或成人因素（包括创伤、战斗或以前的部署）无关。即使在控制了指数部署前的人口统计学、服务和成人因素以及指数部署创伤后，童年创伤仍然是新的部署后可能出现障碍的一个重要决定因素。GSEM 表明，童年期人际创伤与新的部署后可能出现障碍之间的关联完全由部署前症状中介。对于那些经历过非人际性质的童年创伤的人来说，情况并非如此。
要确定出现部署后障碍的风险，了解所经历的童年创伤类型至关重要，仅进行部署前症状筛查是不够的。
