Childhood adversities and risk of posttraumatic stress disorder and major depression following a motor vehicle collision in adulthood

H N Ziobrowski; B Holt-Gosselin; M V Petukhova; A J King; S Lee; S L House; F L Beaudoin; X An; J S Stevens; D Zeng; T C Neylan; G D Clifford; S D Linnstaedt; L T Germine; K A Bollen; S L Rauch; J P Haran; A B Storrow; C Lewandowski; P I Musey; P L Hendry; S Sheikh; C W Jones; B E Punches; M C Kurz; R A Swor; L A Hudak; J L Pascual; M J Seamon; E Harris; C Pearson; R C Merchant; R M Domeier; N K Rathlev; B J O'Neil; P Sergot; L D Sanchez; S E Bruce; M W Miller; R H Pietrzak; J Joormann; D M Barch; D A Pizzagalli; S E Harte; J M Elliott; K J Ressler; S A McLean; K C Koenen; R C Kessler

doi:10.1017/S2045796022000798

Childhood adversities and risk of posttraumatic stress disorder and major depression following a motor vehicle collision in adulthood

Epidemiol Psychiatr Sci. 2023 Jan 10:32:e1. doi: 10.1017/S2045796022000798.

Authors

H N Ziobrowski¹, B Holt-Gosselin^{2

3}, M V Petukhova¹, A J King¹, S Lee¹, S L House⁴, F L Beaudoin⁵, X An⁶, J S Stevens⁷, D Zeng⁸, T C Neylan⁹, G D Clifford^{10

11}, S D Linnstaedt⁶, L T Germine^{12

13

14}, K A Bollen¹⁵, S L Rauch^{12

14

16}, J P Haran¹⁷, A B Storrow¹⁸, C Lewandowski¹⁹, P I Musey²⁰, P L Hendry²¹, S Sheikh²¹, C W Jones²², B E Punches^{23

24}, M C Kurz^{25

26

27}, R A Swor²⁸, L A Hudak²⁹, J L Pascual^{30

31}, M J Seamon^{31

32}, E Harris³³, C Pearson³⁴, R C Merchant³⁵, R M Domeier³⁶, N K Rathlev³⁷, B J O'Neil³⁸, P Sergot³⁹, L D Sanchez^{35

40}, S E Bruce⁴¹, M W Miller^{42

43}, R H Pietrzak^{44

45}, J Joormann², D M Barch⁴⁶, D A Pizzagalli^{14

47}, S E Harte^{48

49}, J M Elliott^{50

51

52}, K J Ressler^{14

47}, S A McLean^{53

54}, K C Koenen⁵⁵, R C Kessler¹

Affiliations

¹ Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
² Department of Psychology, Yale University, New Haven, CT, USA.
³ Interdepartmental Neuroscience Graduate Program, Yale School of Medicine, New Haven, CT, USA.
⁴ Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.
⁵ Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA.
⁶ Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁷ Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
⁸ Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
⁹ Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA.
¹⁰ Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA.
¹¹ Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
¹² Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA.
¹³ The Many Brains Project, Belmont, MA, USA.
¹⁴ Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
¹⁵ Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹⁶ Department of Psychiatry, McLean Hospital, Belmont, MA, USA.
¹⁷ Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
¹⁸ Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
¹⁹ Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, USA.
²⁰ Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
²¹ Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA.
²² Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA.
²³ Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA.
²⁴ Ohio State University College of Nursing, Columbus, OH, USA.
²⁵ Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, USA.
²⁶ Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, USA.
²⁷ Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, USA.
²⁸ Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
²⁹ Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.
³⁰ Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.
³¹ Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
³² Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA.
³³ Department of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, USA.
³⁴ Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA.
³⁵ Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
³⁶ Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, USA.
³⁷ Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA.
³⁸ Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA.
³⁹ Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, USA.
⁴⁰ Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA.
⁴¹ Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA.
⁴² National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA.
⁴³ Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
⁴⁴ National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA.
⁴⁵ Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
⁴⁶ Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
⁴⁷ Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
⁴⁸ Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
⁴⁹ Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA.
⁵⁰ Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia.
⁵¹ Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Australia.
⁵² Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
⁵³ Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁵⁴ Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁵⁵ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.

Abstract

Aims: Childhood adversities (CAs) predict heightened risks of posttraumatic stress disorder (PTSD) and major depressive episode (MDE) among people exposed to adult traumatic events. Identifying which CAs put individuals at greatest risk for these adverse posttraumatic neuropsychiatric sequelae (APNS) is important for targeting prevention interventions.

Methods: Data came from n = 999 patients ages 18-75 presenting to 29 U.S. emergency departments after a motor vehicle collision (MVC) and followed for 3 months, the amount of time traditionally used to define chronic PTSD, in the Advancing Understanding of Recovery After Trauma (AURORA) study. Six CA types were self-reported at baseline: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect and bullying. Both dichotomous measures of ever experiencing each CA type and numeric measures of exposure frequency were included in the analysis. Risk ratios (RRs) of these CA measures as well as complex interactions among these measures were examined as predictors of APNS 3 months post-MVC. APNS was defined as meeting self-reported criteria for either PTSD based on the PTSD Checklist for DSM-5 and/or MDE based on the PROMIS Depression Short-Form 8b. We controlled for pre-MVC lifetime histories of PTSD and MDE. We also examined mediating effects through peritraumatic symptoms assessed in the emergency department and PTSD and MDE assessed in 2-week and 8-week follow-up surveys. Analyses were carried out with robust Poisson regression models.

Results: Most participants (90.9%) reported at least rarely having experienced some CA. Ever experiencing each CA other than emotional neglect was univariably associated with 3-month APNS (RRs = 1.31-1.60). Each CA frequency was also univariably associated with 3-month APNS (RRs = 1.65-2.45). In multivariable models, joint associations of CAs with 3-month APNS were additive, with frequency of emotional abuse (RR = 2.03; 95% CI = 1.43-2.87) and bullying (RR = 1.44; 95% CI = 0.99-2.10) being the strongest predictors. Control variable analyses found that these associations were largely explained by pre-MVC histories of PTSD and MDE.

Conclusions: Although individuals who experience frequent emotional abuse and bullying in childhood have a heightened risk of experiencing APNS after an adult MVC, these associations are largely mediated by prior histories of PTSD and MDE.

Keywords: Depression; Trauma; mental health; post traumatic stress disorder.

MeSH terms

Adolescent
Adult
Aged
Depression / psychology
Depressive Disorder, Major* / psychology
Humans
Middle Aged
Motor Vehicles
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / epidemiology
Stress Disorders, Post-Traumatic* / etiology
Surveys and Questionnaires
Young Adult

Abstract

MeSH terms

Grants and funding