Adverse childhood experiences and mental health in military recruits: Exploring gender as a moderator

Abstract

Adverse childhood experiences (ACEs) have consistently been associated with adult psychopathology and are commonly reported among military populations, with women more likely to report many types of ACEs than men. Limited research has examined the role of gender in the association between ACEs and mental health in military populations. The current study assessed the significance of gender differences in ACEs and mental health and explored the associations among these variables in a sample of Canadian Armed Forces recruits/officer cadets. Analyses with cross-sectional Recruit Health Questionnaire (RHQ) data from 50,603 recruits/officer cadets indicated that women were more likely to report witnessing domestic violence, experiencing sexual abuse, and living with someone with mental health problems or alcohol misuse, odds ratios (ORs) = 1.22-4.35, ps < .001. Women were more likely to screen positive for depression, adjusted (aORs) = 1.25-1.49, p < .001-p = .002, and anxiety, aORs = 2.00-2.33, ps < .001, before basic military training. ACEs were associated with screening positive for probable mental health conditions, aORs = 1.54-6.13, p < .001-p = .017. A significant interaction suggested the association between childhood sexual abuse and depression was stronger for men, aOR = 2.49, p < .001, than women, aOR = 1.63, p = .002, as was the association between childhood sexual abuse and posttraumatic stress disorder, men: aOR = 6.06, p < .001, women: aOR = 3.36, p < .001. These results underscore the importance of considering gender and childhood trauma in mental health interventions with military personnel.