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Traumatic childhood events more common among military volunteers

By Andrew M. Seaman

NEW YORK (Reuters Health) - People who served in the military tend to have experienced more traumatic childhood events, such as being abused or living with an alcohol-dependant parent, than people who are not veterans, according to a new study.

In particular, men who volunteered for the military were more than twice as likely as men without military experience to report at least one adverse event in childhood, which supports a theory that people may use the military to escape from dysfunctional home lives, the researchers write in JAMA Psychiatry.

“It may be a sign of resilience,” John Blosnich said. “They may recognize the military offers training, education and advancement. Our next step is to look at whether or not these adverse childhood experiences are related to their health outcomes.”

Blosnich is the study’s lead author and a researcher at the Center for Health Equity Research and Promotion at the Veterans Affairs Pittsburgh Healthcare System.

Adverse childhood events include a range of negative experiences that have been linked to lifelong consequences such as post-traumatic stress disorder, drug and alcohol abuse, attempted suicide and shortened life expectancy.

If past research suggesting some people may join the military to escape personal problems is true, Blosnich and his colleagues write, adverse childhood experiences may be more common among current and former military members.

That has implications for the current healthcare needs of military personnel and veterans, the authors point out. And, because past trauma may make a person more vulnerable to developing post-traumatic stress disorder after a new adverse event like combat exposure, it suggests elevated risks for poor mental health in the affected soldiers.

To get a sense of how common adverse childhood experiences are among people who served in the military, the researchers analyzed responses to a survey conducted in 10 U.S. states and the District of Columbia by the Centers for Disease Control and Prevention in 2010.

The survey included questions about 11 adverse childhood experiences, including living with a person with a mental illness, living with a person abusing alcohol or drugs, living with someone who was in jail, going through parental divorce, being physically or verbally abused and being sexually abused.

Over 60,000 people, including more than 7,500 with a military history, took the survey and were included in the analysis. The study team distinguished between those who served in the all-volunteer military after 1973 and those who served before 1973, during the draft.

Overall, men who served in the army during the all-volunteer era had more adverse experiences in all 11 categories than those without a history of military service.

That was especially true for sexual abuse with 11 percent of those from the volunteer-era reporting being touched sexually, compared to about 5 percent of non-military people.

Those who served in the volunteer military were also about twice as likely to report childhood experiences of being forced to touch someone sexually and being forced to have sex.

People from the volunteer military were also more likely to report adverse experiences from four of the 11 categories, compared to people without a history of military service.

Having had an increasing number of adverse experiences is important, the researchers write, because the number is tied to the severity of poor health outcomes later on.

There were far fewer differences among men who were drafted into the military, female veterans and people who never served in the military.

In the draft era, the researchers note, men without adverse experiences entering the military would have diluted the effect of volunteers.

Women may not demonstrate the same patterns because female survivors of adverse experiences – especially victims of sexual abuse – may not see the military as an escape, they add.

It’s impossible to know whether those who reported more adverse childhood experiences joined the military because of them or had poorer health as adults, Blosnich said, because the survey didn’t ask those questions.

“I think we just need to know more about this and how it may or may not operate within military health in order to know where to go from here,” he said.

SOURCE: http://bit.ly/1nxhBvE JAMA Psychiatry, online July 23, 2014.

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