Psychological Medicine

Original Articles

Adverse childhood experiences in relation to mood and anxiety disorders in a population-based sample of active military personnel

J. Sareena1 c1, C. A. Henriksena2, S.-L. Boltona3, T. O. Afifia4, M. B. Steina5 and G. J. G. Asmundsona6

a1 Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada

a2 Departments of Psychology and Psychiatry, University of Manitoba, Winnipeg, MB, Canada

a3 Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, MB, Canada

a4 Departments of Community Health Sciences, Psychiatry, and Family Social Sciences, University of Manitoba, Winnipeg, MB, Canada

a5 Departments of Psychiatry and Family and Preventive Medicine, University of California San Diego and VA San Diego Healthcare System, San Diego, CA, USA

a6 Department of Psychology and Anxiety and Illness Behaviours Laboratory, University of Regina, Regina, SK, Canada

Background Although it has been posited that exposure to adverse childhood experiences (ACEs) increases vulnerability to deployment stress, previous literature in this area has demonstrated conflicting results. Using a cross-sectional population-based sample of active military personnel, the present study examined the relationship between ACEs, deployment related stressors and mood and anxiety disorders.

Method Data were analyzed from the 2002 Canadian Community Health Survey – Canadian Forces Supplement (CCHS-CFS; n = 8340, age 18–54 years, response rate 81%). The following ACEs were self-reported retrospectively: childhood physical abuse, childhood sexual abuse, economic deprivation, exposure to domestic violence, parental divorce/separation, parental substance abuse problems, hospitalization as a child, and apprehension by a child protection service. DSM-IV mood and anxiety disorders [major depressive disorder, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic attacks/disorder and social phobia] were assessed using the Composite International Diagnostic Interview (CIDI).

Results Even after adjusting for the effects of deployment-related traumatic exposures (DRTEs), exposure to ACEs was significantly associated with past-year mood or anxiety disorder among men [adjusted odds ratio (aOR) 1.34, 99% confidence interval (CI) 1.03–1.73, p < 0.01] and women [aOR 1.37, 99% CI 1.00–1.89, p = 0.01]. Participants exposed to both ACEs and DRTEs had the highest prevalence of past-year mood or anxiety disorder in comparison to those who were exposed to either ACEs alone, DRTEs alone, or no exposure.

Conclusions ACEs are associated with several mood and anxiety disorders among active military personnel. Intervention strategies to prevent mental health problems should consider the utility of targeting soldiers with exposure to ACEs.

(Received April 14 2011)

(Revised April 04 2012)

(Accepted April 09 2012)

(Online publication May 21 2012)

Key words

  • Anxiety;
  • child abuse;
  • depression;
  • military;
  • post-traumatic stress disorder


c1 Address for correspondence: J. Sareen, M.D., PZ430-771 Bannatyne Ave., Winnipeg, MB, Canada R3E 3N4. (Email: