Adverse childhood experiences and mental health in military recruits: Exploring gender as a moderator.

Adverse childhood experiences (ACEs) have consistently been associated with adult psychopathology and are commonly reported among military populations, with women more likely to report many types of ACEs than men. Limited research has examined the role of gender in the association between ACEs and mental health in military populations. The current study assessed the significance of gender differences in ACEs and mental health and explored the associations among these variables in a sample of Canadian Armed Forces recruits/officer cadets. Analyses with cross-sectional Recruit Health Questionnaire (RHQ) data from 50,603 recruits/officer cadets indicated that women were more likely to report witnessing domestic violence, experiencing sexual abuse, and living with someone with mental health problems or alcohol misuse, odds ratios (ORs) = 1.22-4.35, ps < .001. Women were more likely to screen positive for depression, adjusted (aORs) = 1.25-1.49, p < .001-p = .002, and anxiety, aORs = 2.00-2.33, ps < .001, before basic military training. ACEs were associated with screening positive for probable mental health conditions, aORs = 1.54-6.13, p < .001-p = .017. A significant interaction suggested the association between childhood sexual abuse and depression was stronger for men, aOR = 2.49, p < .001, than women, aOR = 1.63, p = .002, as was the association between childhood sexual abuse and posttraumatic stress disorder, men: aOR = 6.06, p < .001, women: aOR = 3.36, p < .001. These results underscore the importance of considering gender and childhood trauma in mental health interventions with military personnel.

The Mediating Role of Alexithymia in the Association Between Adverse Childhood Experiences and Postdeployment Mental Health in Canadian Armed Forces Personnel.

Recent studies showing an association between adverse childhood experiences and the development of alexithymia in military personnel have generated interest regarding the role of alexithymia in the pathway linking childhood trauma exposure to mental health disorders. Accordingly, the current study was conducted to (a) examine the associations among adverse childhood experiences, alexithymia, and symptoms of depression and posttraumatic stress disorder (PTSD) among recently deployed Canadian military personnel and (b) assess the mediating role of alexithymia in these associations. Data collected from 2,927 members of the Canadian Armed Forces at baseline and after their return from an overseas deployment were subjected to a prospective path analysis. The results of the path analysis, R2 = .35, pointed to a significant direct effect of childhood adversity on postdeployment mental health symptoms. Contrary to our expectations, the results also pointed to a negative indirect effect of childhood neglect, suggesting that childhood neglect contributed to lower levels of postdeployment depression and PTSD symptoms through the dimension of alexithymia related to difficulty in describing feelings. These patterns of associations, for the most part, persisted even when accounting for combat exposure during recent deployments, R2 = .42. The present results are discussed in light of study limitations and methodological considerations, and policy and clinical implications are noted.