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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
To better understand the associations of childhood trauma and childhood disorder with past-year suicidality (thoughts, plans or attempts), we compared male military and civilian populations aged 18–60 years old.
Data derived from the 2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study and the 2007 Australian Bureau of Statistics Australian National Survey of Mental Health and Wellbeing were compared using logistic regression and Generalized Structural Equation Modelling (GSEM).
A greater proportion of the ADF experienced suicidality than civilians. Those who experienced childhood trauma that was not interpersonal in nature were not at increased odds of suicidality, in either population. A higher proportion of the ADF experienced three or more types of trauma in childhood and first experienced three or more types of trauma in adulthood. Both were associated with suicidality in the ADF and civilians. Childhood anxiety had a strong and independent association with suicidality in the ADF (controlling for demographics and childhood trauma, adult trauma and adult onset disorder). Childhood anxiety fully mediated the relationship between childhood trauma and suicidality in the ADF, but not in civilians.
These data highlight the need to take a whole life approach to understanding suicidality, and the importance of categorizing the nature of childhood trauma exposure. Importantly, childhood anxiety was not only associated with suicidality, it fully mediated the relationship between childhood trauma and suicidality in the more trauma exposed (military) population only. These findings have the potential to inform the development of strategies for suicide prevention.
The mental health and social functioning of millions of forcibly displaced individuals worldwide represents a key public health priority for host governments. This is the first longitudinal study with a representative sample to examine the impact of interpersonal trust and psychological symptoms on community engagement in refugees.
Participants were 1894 resettled refugees, assessed within 6 months of receiving a permanent visa in Australia, and again 2–3 years later. Variables measured included post-traumatic stress disorder symptoms, depression/anxiety symptoms, interpersonal trust and engagement with refugees’ own and other communities.
A multilevel path analysis was conducted, with the final model evidencing good fit (Comparative Fit Index = 0.97, Tucker–Lewis Index = 0.89, Root Mean Square Error of Approximation = 0.05, Standardized Root-Mean-Square-Residual = 0.05). Findings revealed that high levels of depression symptoms were associated with lower subsequent engagement with refugees’ own communities. In contrast, low levels of interpersonal trust were associated with lower engagement with the host community over the same timeframe.
Findings point to differential pathways to social engagement in the medium-term post-resettlement. Results indicate that depression symptoms are linked to reduced engagement with one's own community, while interpersonal trust is implicated in engagement with the broader community in the host country. These findings have potentially important implications for policy and clinical practice, suggesting that clinical and support services should target psychological symptoms and interpersonal processes when fostering positive adaptation in resettled refugees.
Studies examining the impact of childhood disaster exposure on the
development of adult psychopathology report increased rates of
post-traumatic stress disorder (PTSD) and other psychopathology.
To examine the rates of PTSD and other lifetime DSM–IV disorders in
adults exposed to an Australian bushfire disaster as children in 1983
using a matched control sample recruited at the time of the original
A total of 1011 adults recruited from an original sample of 1531 were
assessed 20 years following the fires using the Composite International
Diagnostic Interview (CIDI–2.1).
Results showed only a small direct impact of the fires on adult
psychiatric morbidity. A higher proportion of bushfire survivors met
criteria for ‘any DSM–IV disorder’ and ‘any anxiety’.
Findings suggest that the long-term impact of a prominent trauma in
childhood should be assessed in the context of other lifetime trauma in
order to provide a more accurate account of PTSD prevalence rates.
This chapter focuses on the prevalence and etiology of anxiety disorders, including posttraumatic stress disorder (PTSD), following disasters. Recently a number of large national mental health surveys have estimated the prevalence of psychiatric disorders. The anxiety disorders that have been associated with disasters are generalized anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), social phobia, and specific phobia. The discussion of these matters is influenced by the fact that the conventions for recording patterns of comorbidity have changed between Diagnostic and Statistical Manual (DSM)-III and DSM-IV. The relationship between PTSD and the associated comorbidities with other anxiety and depressive disorders is important in determining the chronicity of morbidity following disasters. Anxiety disorders other than PTSD have been looked at in more detail in children, in part because of the potential developmental impact of disorders such as separation anxiety.
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