Childhood Trauma and Adverse Childhood Experiences Among Veterans: The Importance of Assessing for Traumatic Experiences across the Lifespan

Background: While combat is frequently cited as a source of trauma among veterans, traumatic experiences prior to military service remain unexplored and may be a source of distress for veterans. The VA estimates the prevalence of PTSD in veterans of Operation Enduring Freedom/Operation Iraqi Freedom at 13.8% (VA, 2018), compared to the national average of 7-8% (VA, 2018). Despite higher rates than the general population, current research suggests that veterans are less responsive to typical trauma-based or PTSD treatment (Hoge et al., 2014), are more likely to drop out early into treatment (Shulman et al., 2019), and are more likely to report the treatment as ineffective (Hoge et al., 2014). The lack of adequate trauma-based treatment puts veterans at higher risk of other anxiety and/or mood disorders (Armenta et al., 2019), substance use disorders (Curry et al., 2019), difficulties in interpersonal relationships (Sheriff et al., 2020), difficulties transitioning back into civilian life (Sheriff et al., 2020), and increased physical health problems such as chronic pain (Curry et al., 2019), etc.

Current literature on trauma disorders and related care have highlighted the significance of trauma throughout an individual’s life, rather than focusing on a singular event, as the number of traumatic experiences are correlated with severity of trauma symptoms (Scott, 2007). Similarly, literature suggests that childhood trauma also contributes to levels of emotional distress (Sheriff et al., 2020). In keeping with current trauma-based research, and in finding more effective treatment for veterans, this study seeks to further describe traumatic experiences, including ACES, combat experiences, and other lifespan traumas, among military veterans.

Methods: A convenience sample of veterans (n=396) completed the Adverse Childhood Experiences Scale, Form A of the PCL-5, and Combat Experiences Scale. Participants were provided with a list of mental health and medical resources at the beginning and end of the study. Our university’s Institutional Review Board approved study protocol.

Results: Veterans reported a median score of 4 ACES each; 8 potentially traumatic experiences on Form A; and a mean score of 23.6 on the CES, which corresponds to moderate heavy combat. Higher total ACES, CES, and Form A scores were significantly associated with measures of alcohol problems (r=.63**), depression (r=.41**), and PTSD (r=.15*).

Implications: Traumatic stressors can occur throughout the lifespan. For veterans, it is important to recognize that traumatic stressors may occur prior, during, and after military service and the cumulative effects of these experiences influence emotional distress. Thorough assessments that encompass the entire lifespan are needed to ensure that veterans receive appropriate treatment.