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Influence of childhood adversity on health among male UK military personnel

King's Centre for Military Health Research, Department of Psychological Medicine

Nicola T. Fear, DPhil(Oxon)

Academic Centre for Defence Mental Health, Department of Psychological Medicine

Emily Simonoff, MD, FRCPsych

Department of Child and Adolescent Psychiatry

Lisa Hull, MSc, Oded Horn, MSc, Neil Greenberg, MRCPsych, Matthew Hotopf, MRCPsych, PhD, Roberto Rona, FFPH, PhD and Simon Wessely, FRCP, MRCPsych

King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK

Correspondence: Dr Amy C. Iversen, Department of Psychological Medicine, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK. Email: A.Iversen{at}iop.kcl.ac.uk

Declaration of interest N.G. is a full-time active service medical officer seconded to King's Centre for Military Health Research as a liaison officer. S.W. is Honorary Consultant Advisor in Psychiatry to the British Army.

Background Exposure to childhood adversity may explain why only a minority of combatants exposed to trauma develop psychological problems.

Aims To examine the association between self-reported childhood vulnerability and later health outcomes in a large randomly selected male military cohort.

Method Data are derived from the first stage of a cohort study comparing Iraq veterans and non-deployed UK military personnel. We describe data collected by questionnaire from males in the regular UK armed forces (n=7937).

Results Pre-enlistment vulnerability is associated with being single, of lower rank, having low educational attainment and serving in the Army. Pre-enlistment vulnerability is associated with a variety of negative health outcomes. Two main factors emerge as important predictors of ill health: a `family relationships' factor reflecting the home environment and an `externalising behaviour' factor reflecting behavioural disturbance.

Conclusions Pre-enlistment vulnerability is an important individual risk factor for ill health in military men. Awareness of such factors is important in understanding post-combat psychiatric disorder.

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BJP 2007 191: 21. [Full Text]