Lifetime trauma exposure in veterans with military-related posttraumatic stress disorder: association with current symptomatology.
OBJECTIVE
This study examined whether trauma exposure before, during, and/or after military service contributed to current levels of post-traumatic stress disorder (PTSD) and adjustment. Further, we investigated whether trauma exposure before military service was mediated or moderated by military trauma in its effects on current PTSD and adjustment.


METHODS
In this retrospective study, archival data from the medical records of 422 male veterans diagnosed with PTSD between December 2001 and July 2004 at a Veterans Administration Medical Center PTSD clinic were analyzed. Measures included the Clinician-Administered PTSD Scale interview as well as self-report measures assessing trauma history, health problems, and general psychopathology (including PTSD).


RESULTS
Findings indicated that nonmilitary-related trauma was prevalent in this sample (90%). Regression analyses for PTSD symptom severity revealed that age, greater combat exposure, and a history of physical assault after military service were significantly associated with more severe PTSD symptoms. Childhood physical abuse, adult sexual trauma, and a history of being physically assaulted during military service were also significantly associated with PTSD symptom severity. Mediational analyses indicated that childhood trauma was associated with both adult trauma and increased symptomatology on various outcome measures. Moderational analyses indicated that adult trauma exposure moderated the effect of childhood trauma exposure on health complaints.


CONCLUSIONS
Results suggest that several variables, including age, greater combat exposure, and premilitary and postmilitary traumas, are associated with increased PTSD symptomatology. This finding underscores the importance of conducting a thorough assessment of trauma when diagnosing PTSD.
Clancy
Carolina P
CP
Durham Veterans Affairs, Durham, NC 27705, USA. Carolina.Clancy@med.va.gov
Graybeal
Anna
A
Tompson
Whitney P
WP
Badgett
Kourtni S
KS
Feldman
Michelle E
ME
Calhoun
Patrick S
PS
Erkanli
Alaattin
A
Hertzberg
Michael A
MA
Beckham
Jean C
JC
D000223:Adaptation, Psychological; D000328:Adult; D003130:Combat Disorders / Q000175:diagnosis* / Q000523:psychology; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data