EMBARGOED FOR RELEASE: 3 P.M. (CT), WEDNESDAY, JULY 23, 2014

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JAMA Psychiatry

Bottom Line: Men and women who have served in the military have a higher prevalence of adverse childhood events (ACEs), suggesting that enlistment may be a way to escape adversity for some.

Authors: John R. Blosnich, Ph.D., M.P.H., of the Veterans Affairs Pittsburgh Healthcare System, and colleagues.

Background: The prevalence of ACEs among U.S. military members and veterans is largely unknown. ACEs can result in severe adult health consequences such as posttraumatic stress disorder, substance use and attempted suicide.

How the Study Was Conducted: Authors compared the prevalence of ACEs among individuals with and without a history of military service using data from a behavioral risk surveillance system, along with telephone interviews, for an analytic sample of more than 60,000 people. ACEs in 11 categories were examined, including living with someone who is mentally ill, alcoholic or incarcerated, as well as witnessing partner violence, being physically abused, touched sexually or forced to have sex. Authors considered military service during the all-volunteer era (since 1973) vs. the draft era.

Results: In the sample, 12.7 percent of the individuals reported military service, which was more common among men (24 percent) than women (2 percent). During the all-volunteer-era, men with military service had a higher prevalence of ACEs in all 11 categories than men without military service. For example, men with a history of military service had twice the prevalence of all forms of sexual abuse than their nonmilitary male peers: being touched sexually (11 percent vs. 4.8 percent), being forced to touch another sexually (9.6 percent vs. 4.2 percent) and being forced to have sex (3.7 percent vs. 1.6 percent). During the draft era, the only difference among men was in household drug use, where men with military service had a lower prevalence than men without military service.

Fewer differences in ACEs were found among women with and without military service than among men. Women with a history of military service in both eras had similar patterns of elevated odds for physical abuse, household alcohol abuse, exposure to domestic violence and emotional abuse compared with women who had not been in the military. Women who served in the military during the all-volunteer era also were more likely to report being touched sexually.

Discussion: “Further research is needed to understand how best to support service members and veterans who may have experienced ACEs.”

(JAMA Psychiatry. Published online July 23, 2014. doi:10.1001/jamapsychiatry.2014.724. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: This work was funded by a variety of sources. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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