Childhood trauma differentially impacts depression and stress associations with reintegration challenges among post-9/11 U.S. veterans

Abstract

Background: Post-9/11 veterans exhibit high prevalence of deployment stress, psychological conditions, and traumatic brain injury (TBI) which impact reintegration, especially among those with a history of interpersonal early life trauma (I-ELT). The relative importance of each risk factor is unclear.

Purpose: We examined major deployment and clinical exposures of reintegration challenges among veterans with and without I-ELT.

Method: We analyzed cross-sectional data of 155 post-9/11 veterans from the Translational Research Center for TBI and Stress Disorders study.

Findings: Depression severity had the strongest association with reintegration challenges, followed by posttraumatic stress disorder (PTSD) severity, post-deployment stress, and deployment safety concerns. Deployment safety concerns had a stronger, significant association among veterans with I-ELT. In nearly every model, PTSD and depression severities were weaker for veterans with I-ELT, compared to those without.

Discussion: Clinicians should consider the relative risk of concurrent clinical conditions and trauma histories when considering veterans' reintegration needs.

Keywords: Childhood trauma; Deployment; Reintegration; Resilience; Veterans.