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Childhood adversity, combat experiences, and military sexual trauma: a test and extension of the stress sensitization hypothesis

Published online by Cambridge University Press:  20 April 2022

Jordan P. Davis Open the ORCID record for Jordan P. Davis [Opens in a new window] ,
John Prindle ,
Shaddy Saba ,
Daniel S. Lee ,
Daniel Leightley ,
Denise D. Tran ,
Angeles Sedano ,
Reagan Fitzke ,
Carl A. Castro  and
Eric R. Pedersen
Jordan P. Davis*
Affiliation:
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
John Prindle
Affiliation:
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
Shaddy Saba
Affiliation:
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
Daniel S. Lee
Affiliation:
Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
Daniel Leightley
Affiliation:
Kings College London, London, UK
Denise D. Tran
Affiliation:
Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
Angeles Sedano
Affiliation:
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
Reagan Fitzke
Affiliation:
Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
Carl A. Castro
Affiliation:
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
Eric R. Pedersen
Affiliation:
Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
*
Author for correspondence: Jordan P. Davis, E-mail: jordanpd@usc.edu
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Abstract

Background

U.S. veterans report high rates of traumatic experiences and mental health symptomology [e.g. posttraumatic stress disorder (PTSD)]. The stress sensitization hypothesis posits experiences of adversity sensitize individuals to stress reactions which can lead to greater psychiatric problems. We extend this hypothesis by exploring how multiple adversities such as early childhood adversity, combat-related trauma, and military sexual trauma related to heterogeneity in stress over time and, subsequently, greater risk for PTSD.

Methods

1230 veterans were recruited for an observational, longitudinal study. Veterans responded to questionnaires on PTSD, stress, and traumatic experiences five times over an 18-month study period. We used latent transition analysis to understand how heterogeneity in adverse experiences is related to transition into stress trajectory classes. We also explored how transition patterns related to PTSD symptomology.

Results

Across all models, we found support for stress sensitization. In general, combat trauma in combinations with other types of adverse experiences, namely early childhood adversity and military sexual trauma, imposed a greater probability of transitioning into higher risk stress profiles. We also showed differential effects of early childhood and military-specific adversity on PTSD symptomology.

Conclusion

The present study rigorously integrates both military-specific and early life adversity into analysis on stress sensitivity, and is the first to examine how sensitivity might affect trajectories of stress over time. Our study provides a nuanced, and specific, look at who is risk for sensitization to stress based on previous traumatic experiences as well as what transition patterns are associated with greater PTSD symptomology.

Keywords

Assaultchildhood traumadepressionmilitarystressveteran

Information

Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 9 , July 2023 , pp. 4055 - 4063
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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