More things they carried: Adverse childhood experiences and mental health indicators among current and former military men

Adverse childhood experiences (ACEs)  (e.g., parental divorce, physical and sexual abuse) are linked robustly with poor mental health such as depression and suicidality in adults. Current and former military personnel have higher prevalence of ACEs than their non-military experienced peers. It is unclear how ACEs may explain differences in mental health between persons with and without military service history.

Method: To examine how ACEs associated with mental health among military-experienced men, we examined 2010 Behavioral Risk Factor Surveillance System data for men from eleven states that used the 11-item ACEs inventory (n=23,851). We used multivariable logistic regression, adjusted for age, race/ethnicity, education, and income, to test the association of military status with four mental health indicators (low social support, inadequate sleep, low satisfaction with life, and mental distress), current smoking, and heavy alcohol use. Adjusted Wald tests were used to examine the salience of military status before and after adjusting for ACEs. All analyses were weighted for complex survey design.

Findings: Men with military service history reported higher mean scores on the ACEs inventory than non-military men (2.49 vs. 1.49, p<.001) and had higher odds of inadequate sleep, mental distress, and current smoking. ACEs significantly attenuated the association of military status with inadequate sleep and current smoking, and decreased the association with mental distress from OR=2.02 (1.45-2.81) to OR=1.49 (1.08-2.04).

Implications: Early life trauma in the form of adverse childhood experiences may be an overlooked facet of current and former military personnel mental health.