G Bandoli1, L Campbell-Sills2, R C Kessler3, S G Heeringa4, M K Nock5, A J Rosellini3, N A Sampson3, M Schoenbaum6, R J Ursano7, M B Stein2. 1. Department of Pediatrics,University of California San Diego,La Jolla, CA,USA. 2. Department of Psychiatry,University of California San Diego,La Jolla, CA,USA. 3. Department of Health Care Policy,Harvard Medical School,Boston, MA,USA. 4. University of Michigan, Institute for Social Research,Ann Arbor, MI,USA. 5. Department of Psychology,Harvard College,Cambridge, MA,USA. 6. National Institute of Mental Health,Bethesda, MD,USA. 7. Department of Psychiatry,Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences,Bethesda, MD,USA.
Abstract
BACKGROUND: The stress sensitization theory hypothesizes that individuals exposed to childhood adversity will be more vulnerable to mental disorders from proximal stressors. We aimed to test this theory with respect to risk of 30-day major depressive episode (MDE) and generalized anxiety disorder (GAD) among new US Army soldiers. METHODS: The sample consisted of 30 436 new soldier recruits in the Army Study to Assess Risk and Resilience (Army STARRS). Generalized linear models were constructed, and additive interactions between childhood maltreatment profiles and level of 12-month stressful experiences on the risk of 30-day MDE and GAD were analyzed. RESULTS: Stress sensitization was observed in models of past 30-day MDE (χ2 8 = 17.6, p = 0.025) and GAD (χ2 8 = 26.8, p = 0.001). This sensitization only occurred at high (3+) levels of reported 12-month stressful experiences. In pairwise comparisons for the risk of 30-day MDE, the risk difference between 3+ stressful experiences and no stressful experiences was significantly greater for all maltreatment profiles relative to No Maltreatment. Similar results were found with the risk for 30-day GAD with the exception of the risk difference for Episodic Emotional and Sexual Abuse, which did not differ statistically from No Maltreatment. CONCLUSIONS: New soldiers are at an increased risk of 30-day MDE or GAD following recent stressful experiences if they were exposed to childhood maltreatment. Particularly in the military with an abundance of unique stressors, attempts to identify this population and improve stress management may be useful in the effort to reduce the risk of mental disorders.
BACKGROUND: The stress sensitization theory hypothesizes that individuals exposed to childhood adversity will be more vulnerable to mental disorders from proximal stressors. We aimed to test this theory with respect to risk of 30-day major depressive episode (MDE) and generalized anxiety disorder (GAD) among new US Army soldiers. METHODS: The sample consisted of 30 436 new soldier recruits in the Army Study to Assess Risk and Resilience (Army STARRS). Generalized linear models were constructed, and additive interactions between childhood maltreatment profiles and level of 12-month stressful experiences on the risk of 30-day MDE and GAD were analyzed. RESULTS: Stress sensitization was observed in models of past 30-day MDE (χ2 8 = 17.6, p = 0.025) and GAD (χ2 8 = 26.8, p = 0.001). This sensitization only occurred at high (3+) levels of reported 12-month stressful experiences. In pairwise comparisons for the risk of 30-day MDE, the risk difference between 3+ stressful experiences and no stressful experiences was significantly greater for all maltreatment profiles relative to No Maltreatment. Similar results were found with the risk for 30-day GAD with the exception of the risk difference for Episodic Emotional and Sexual Abuse, which did not differ statistically from No Maltreatment. CONCLUSIONS: New soldiers are at an increased risk of 30-day MDE or GAD following recent stressful experiences if they were exposed to childhood maltreatment. Particularly in the military with an abundance of unique stressors, attempts to identify this population and improve stress management may be useful in the effort to reduce the risk of mental disorders.
Entities:
Keywords:
Major depressive episode; generalized anxiety disorder; stress sensitization
Authors: Robert M Bray; Michael R Pemberton; Marian E Lane; Laurel L Hourani; Mark J Mattiko; Lorraine A Babeu Journal: Mil Med Date: 2010-06 Impact factor: 1.437
Authors: Robert J Ursano; Lisa J Colpe; Steven G Heeringa; Ronald C Kessler; Michael Schoenbaum; Murray B Stein Journal: Psychiatry Date: 2014 Impact factor: 2.458
Authors: Katie A McLaughlin; Laura D Kubzansky; Erin C Dunn; Robert Waldinger; George Vaillant; Karestan C Koenen Journal: Depress Anxiety Date: 2010-12 Impact factor: 6.505
Authors: Jodie G Katon; Keren Lehavot; Tracy L Simpson; Emily C Williams; Sarah Beth Barnett; Joel R Grossbard; Mark B Schure; Kristen E Gray; Gayle E Reiber Journal: Am J Prev Med Date: 2015-06-16 Impact factor: 5.043
Authors: Murray B Stein; Laura Campbell-Sills; Robert J Ursano; Anthony J Rosellini; Lisa J Colpe; Feng He; Steven G Heeringa; Matthew K Nock; Nancy A Sampson; Michael Schoenbaum; Xiaoying Sun; Sonia Jain; Ronald C Kessler Journal: J Clin Psychiatry Date: 2018 Mar/Apr Impact factor: 4.384
Authors: N Mullins; R A Power; H L Fisher; K B Hanscombe; J Euesden; R Iniesta; D F Levinson; M M Weissman; J B Potash; J Shi; R Uher; S Cohen-Woods; M Rivera; L Jones; I Jones; N Craddock; M J Owen; A Korszun; I W Craig; A E Farmer; P McGuffin; G Breen; C M Lewis Journal: Psychol Med Date: 2015-11-03 Impact factor: 7.723
Authors: Alexandra M Rodman; Jessica L Jenness; David G Weissman; Daniel S Pine; Katie A McLaughlin Journal: Biol Psychiatry Date: 2019-05-10 Impact factor: 13.382
Authors: Pedro Kremer; Monica Ulibarri; Natalie Ferraiolo; Miguel Pinedo; Adriana Carolina Vargas-Ojeda; Jose Luis Burgos; Victoria D Ojeda Journal: Perm J Date: 2018
Authors: Carol Chu; Chelsey R Wilks; Kelly L Zuromski; Samantha L Bernecker; Andrew King; Peter M Gutierrez; Thomas E Joiner; Matthew K Nock; Robert J Ursano; Ronald C Kessler Journal: Psychiatry Date: 2020 Impact factor: 2.458
Authors: Melanie L Hill; Brandon Nichter; Peter J Na; Sonya B Norman; Leslie A Morland; John H Krystal; Robert H Pietrzak Journal: Psychol Med Date: 2021-06-14 Impact factor: 7.723