Identifying at-risk marines: A person-centered approach to adverse childhood experiences, mental health, and social support
APA Citation:
Reed-Fitzke, K., LeardMann, C. A., Wojciak, A. S., Ferraro, A. J., Hamilton, A., Duncan, J. M., & Rull, R. P. (2023). Identifying at-risk marines: A person-centered approach to adverse childhood experiences, mental health, and social support. Journal of Affective Disorders, 325, 721–731. https://doi.org/10.1016/j.jad.2023.01.020
Focus:
Mental health
Trauma
Branch of Service:
Marine Corps
Military Affiliation:
Active Duty
Subject Affiliation:
Active duty service member
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Authors:
Reed-Fitzke, Kayla, LeardMann, Cynthia A., Wojciak, Armeda Stevenson, Ferraro, Anthony J., Hamilton, Alexus, Duncan, James M., Rull, Rudolph P.
Abstract:
Background Previous research indicates an association between adverse childhood experiences (ACES) and health outcomes; however, most of these studies rely on variable-centered techniques. This study implemented a person-centered approach to provide a more nuanced understanding of these relations. Methods The sample consisted of 3611 male Marines who completed two surveys, one prior to service and another during or after service. A series of latent class analyses were conducted to identify homogenous subgroups, using ACE categories as indicators. Hierarchical regressions were conducted to examine the relationships between classes, deployment experiences, depression and PTSD, and social support problems. Results Five classes were identified: Low Adversity (48.8 %), Low Adversity – Parental Separation (PS; 33.1 %), Elevated Adversity (7.0 %), Moderate Adversity – Violence/Safety (5.7 %), and Moderate Adversity – Parental Loss (PL; 5.4 %). Several classes were associated with outcomes; in reference to Low Adversity, Moderate Adversity – PL was associated with depression and PTSD, Elevated Adversity was associated with PTSD and social support problems, and Low Adversity – PS was associated with social support problems. Experiencing moderate to high combat appeared to modify the associations between Moderate Adversity – PL and depression and PTSD. Limitations Study sample was limited to U.S. Marines; ACEs indicators were limited to specific categories, not allowing for a full range of potential childhood traumatic experiences. Conclusions Findings suggest a nuanced connection between ACEs and mental health; using specific patterns of ACEs, particularly multifaceted indicators of adversity that are inclusive of parental absence may have more utility than the sheer number of ACEs as an indicator for those who may at a heightened risk for mental health concerns.
Publication Type:
Article
Keywords:
military, depression, PTSD, combat, social support, adverse childhood experiences