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Childhood trauma may play larger role in combat soldiers’ PTSD

A team of Danish and American researchers found that traumatic experiences in childhood, and not combat, may predict which servicemen develop posttraumatic stress disorder.

“Most studies on PTSD in soldiers following service in war zones do not include measures of PTSD symptoms prior to deployment and thus suffer from a baseline problem,” study researcher Dorthe Berntsen, PhD, professor of psychology at Aarhus University in Denmark, said in a press release. “Only a few studies have examined pre- to post-deployment changes in PTSD symptoms, and most only use a single before-and-after measure.”

Berntsen and colleagues examined PTSD symptoms in a group of 746 Danish soldiers on five separate occasions before, during and after the soldiers’ deployment to Afghanistan. In addition to completing a battery of tests that inventoried PTSD and depression, the soldiers also completed a questionnaire about traumatic life events, which included family violence, physical punishment and spousal abuse.

A majority of soldiers (86%) exhibited low levels of PTSD symptoms with no changes during the study period, designated as “resilient” or “extremely resilient.” The PTSD-symptom trajectories of the remaining soldiers deviated in unique ways, according to the researchers. Approximately 4% of soldiers were identified in a “new-onset” group, showing few PTSD symptoms before and during deployment but later increased considerably across the five time points when compared with normal symptom trajectories. The PTSD symptoms in soldiers in the new-onset group did not appear to follow any specific traumatic event. The three remaining groups — making up about 13% of total study population — showed temporary symptom improvement either during or shortly following deployment, but their PTSD symptoms increased again 3 or 7 months after deployment.

Non-resilient soldiers, including those in the new-onset group, were more likely to have had previous traumas (OR=0.90; 95% CI, 0.85-0.96) and previous emotional problems (OR=0.34; 95% CI, 0.13-0.90) vs. resilient soldiers. Childhood traumas, including physical punishments resulting in bruises, burns, cuts or broken bones, predicted PTSD symptoms in these soldiers (P<.0001), as did witnessing family violence (P<.0001). They were also more likely to have been slapped, kicked, punched or beaten up by a spouse or intimate partner (P<.005). Compared with the resilient soldiers, new-onset soldiers were significantly more likely to have witnessed family violence while growing up (OR=1.92; 95% CI, 1.11-3.33).

According to the researchers, the study results challenge previous assumptions that combat and other war-related experiences are the primary cause of PTD.

“We were surprised that stressful experiences during childhood seemed to play such a central role in discriminating the resilient versus non-resilient groups,” Berntsen said. “These results should make psychologists question prevailing assumptions about PTSD and its development.”

Disclosure: The researchers reported no relevant financial disclosures.