Poster #61 - Posttraumatic Stress Disorder in the Association between Childhood Trauma and Somatic Symptoms

• In Event: 3-053 - Poster Session 10
  In Poster Session: PS 10 Section - Developmental Psychopathology

Integrative Statement

Mounting research has informed the relations between childhood trauma and adult physical functioning (e.g., Felitti et al., 1998); however, the mechanism underlying the relations remain unclear. Identifying mechanisms linking childhood trauma and poor health outcomes is important to effective interventions and preventative strategies. Recent research has pointed to posttraumatic stress disorder (PTSD) as a potential factor through which childhood adversity relates to physical health symptoms (e.g., Afari, 2014; McCall-Hosenfeld et al., 2014). Using data from a project examining associations between childhood experiences and adult physical and psychosocial functioning in college students, this study investigated the role of PTSD symptoms in the associations between childhood trauma and a range of common somatic symptoms.

Participants included 483 college students (361 female, mean age = 20.7, SD = 4.0). The study was conducted using a computer-based survey. Self-report measures included (1) The Adverse Childhood Experiences scale (ACEs; Felitti et al., 1998; 10 items), examining childhood trauma that occurred prior to one’s eighteenth birthday, (2) the Cohen-Hoberman Inventory of Physical Symptoms (CHIPS; Cohen & Hoberman, 1983, 33 items), assessing participants’ somatic symptoms experienced during the last two weeks, (3) the Depression Anxiety Stress Scales (Lovibond & Lovibond, 1995; 21 items) evaluating current symptoms of depression, anxiety, and stress, and (4) the Life Events Checklist for DSM-5 (Weathers et al., 2013a), determining direct or indirect exposure to a variety of Criterion A traumatic events, and (5) the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5; Weathers et al., 2013b, 20 items) evaluating DSM-5 symptoms of PTSD.
The first step of a hierarchical regression analysis showed ACEs as a significant predictor for CHIPS (b = .11, p = .01) above and beyond gender, Criterion A trauma, depression, and anxiety (as identified covariates, e.g., Berghoffa, Tulla, DiLillob, Messman-Moore, & Gratza, 2016), R2 = .29, F(5, 450) = 32.80, p < .0001. The inclusion of PCL-5 in the second step significantly improved the model, Δ R2 = .02, F(1, 449) = 14.37, p = .0002, wherein PCL-5 positively predicted CHIPS (b = .11, p = .01) but ACEs became a nonsignificant predictor (b = .05, p = .26). The model revealed a mediational pathway from ACEs to CHIPS through PTSD symptoms above and beyond all the covariates, indirect effect = .06, 95% confidence interval: [.03, .10], revealed by a bootstrapping procedure with 5000 resamples.

The findings underscored the role of PTSD in the link between childhood adversity and somatic symptoms and were in line with the argument that PTSD is the mechanism through which trauma is connected to adverse physical health (Schnurr & Green, 2004). For individuals who experienced childhood adversity and later developed PTSD, alterations in stress reaction patterns resulting in disrupted neuroendocrine systems (e.g., the locus coeruleus/norepinephrine-sympathetic system and hypothalamic-pituitary-adrenal systems) may confer risks for poor physical functioning (Friedman & McEwen, 2004). To improving chronic somatic symptoms, screening for exposure to childhood trauma and PTSD symptoms may be essential for intervention effectiveness.

Authors

• Hung-Chu Lin, University of Louisiana at Lafayette
  Presenting Author

• Mike McDermott, Universtiy of Louisiana at Lafayette
  Non-Presenting Author

• Paula Zeanah, Universtiy of Louisiana at Lafayette
  Non-Presenting Author

• Lindsey Held, Universtiy of Louisiana at Lafayette
  Non-Presenting Author