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Am J Psychiatry 1993; 150:235-239
Copyright © 1993 by American Psychiatric Association
Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans
JD Bremner, SM Southwick, DR Johnson, R Yehuda and DS Charney
National Center for Post-traumatic Stress Disorder, West Haven VA Medical Center, CT 06516.
OBJECTIVE: Early trauma in the form of childhood physical or sexual abuse
has been associated with adult psychopathology. The purpose of this study
was to compare rates of childhood abuse in Vietnam veterans with and
without combat-related posttraumatic stress disorder (PTSD). METHOD:
Premilitary stressful and traumatic events including childhood abuse and
other potential predisposing factors were assessed in Vietnam combat
veterans who sought treatment for PTSD (N = 38) and Vietnam combat veterans
without PTSD who sought treatment for medical disorders (N = 28). Stressful
and traumatic events including childhood physical abuse were assessed with
the Checklist of Stressful and Traumatic Events and a
clinician-administered interview for the assessment of childhood abuse.
Level of combat exposure was measured with the Combat Exposure Scale.
RESULTS: Vietnam veterans with PTSD had higher rates of childhood physical
abuse than Vietnam veterans without PTSD (26% versus 7%). The association
between childhood abuse and PTSD persisted after controlling for the
difference in level of combat exposure between the two groups. Patients
with PTSD also had a significantly higher rate of total traumatic events
before joining the military than patients without PTSD (mean = 4.6, SD =
4.5, versus mean = 2.8, SD = 2.9). CONCLUSIONS: These findings suggest that
patients seeking treatment for combat-related PTSD have higher rates of
childhood physical abuse than combat veterans without PTSD. Childhood
physical abuse may be an antecedent to the development of combat-related
PTSD in Vietnam combat veterans.
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