Relationships among adverse childhood experiences, posttraumatic stress disorder symptom clusters, and health in women veterans.

Adverse childhood experiences (ACEs) increase risk for negative health outcomes. The goal of this study was to examine the relationships among cumulative ACEs, ACEs type, posttraumatic stress disorder (PTSD) symptoms, PTSD symptom clusters, and physical health symptoms in a sample of women veterans (N = 76). Bivariate correlations were used to determine which ACE domains were associated with PTSD and physical health symptoms. Follow-up linear regressions indicated cumulative ACEs were significantly associated with total PTSD symptoms. Cumulative ACEs were also significantly associated with the avoidance and hyperarousal symptom clusters, but not the re-experiencing symptom cluster. Total PTSD symptoms were significantly related to physical health symptoms. Of the three symptom clusters, only hyperarousal was significantly associated with physical health symptoms. Cross-sectional mediation analyses indicated the total and direct effects of ACEs on physical health were not significant. However, the indirect effect through PTSD was significant (b = 0.46, [95% CI: 0.02, 0.91]), as well as through the avoidance (b = 0.47, [95% CI: 0.06, 0.90]), and hyperarousal symptom clusters (b = 0.56, [95% CI: 0.11, 1.04]). This study highlights the potential impact of ACEs on PTSD symptoms and physical health and suggests that hyperarousal symptoms of PTSD, may play a potential role in the development of physical health problems.