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Adverse Childhood Experiences More Common among Men with Military Service


BACKGROUND:
Recent research about adverse childhood experiences (ACE) clarifies the serious public health ramifications of early-life stressors such as divorce, household substance abuse, and sexual abuse on future health and wellness as children transition into adulthood. Examples of health consequences include PTSD, substance use, attempted suicide, and various physical health conditions. Those with a history of military service may be a specific subpopulation of interest regarding ACE, as some may enlist to escape personal problems, potentially elevating the prevalence of ACE among military populations. This study sought to compare the prevalence of ACE among individuals with and without histories of military service based on service during the draft era (enlisted prior to 1973) or during the all-volunteer era (enlisted on/after 1973). Investigators used data on 60,598 individuals from 11 states that participated in the CDC's 2010 Behavioral Risk Factor Surveillance System survey and administered the ACE module, an 11-item inventory asking about an array of negative experiences prior to age 18.

FINDINGS:

  • Men with military service during the all-volunteer era had a higher prevalence of all 11 ACE items than men without military service in this era. Notably, men with military service during this era had more than twice the odds of men without military service history of reporting household drug or alcohol abuse while growing up, suffering physical abuse or witnessing domestic violence, or some form of sexual abuse (being touched or being forced to touch, or to have sex before age 18). During this era, men with military service had more than twice the prevalence of experiencing 4 or more ACE categories (27% vs. 13%) compared to those without military service.
  • Markedly fewer differences in ACE were found among women with and without military service histories across either era. Women with military service histories from both eras had similar patterns of elevated odds for physical abuse, household alcohol abuse, exposure to domestic violence, and emotional abuse compared with women without military service.

LIMITATIONS:

  • Participant samples came from individual US states and may not be nationally representative.
  • The ACE inventory specifically asks about experiences before the age of 18 and may be prone to recall bias, cohort effects, and social norms (e.g., divorce being less common in the 1960s).
  • Military service was self-reported and could not be corroborated with official records of service.
  • As cross-sectional data, there is no way to demonstrate causation between ACE and enlistment in military service. Further, the survey does not collect information about motivations to enlist.

IMPLICATIONS:
Identifying the presence of ACE among military service members and Veterans may aid in better understanding the etiology of trauma-related mental and behavioral health conditions as well as the cumulative impact of trauma.


PubMed Logo Blosnich J, Dichter M, Cerulli C, Batten S, Bossarte R. Disparities in Adverse Childhood Experiences among Individuals with a History of Military Service. JAMA Psychiatry September 1, 2014;71(9):1041.48.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.