Military veterans have greater exposure to adverse childhood experiences (ACEs) than civilians and many also encounter warfare exposures, which can increase the likelihood of mental health problems. The purpose of this study was to test an interaction between childhood traumas and warfare exposures on the mental health of a sample of nearly 10,000 new post-9/11 veterans. Results revealed that male veterans exposed to one or two ACEs, but no warfare, were more likely to experience anxiety, depression, suicidal thinking, and angry outbursts than the reference group (i.e., no ACEs and no warfare exposure). Female veterans exposed to one or two ACEs, but no warfare, were only more likely to experience suicidal thinking. Male and female veterans exposed to three or more ACEs and no warfare were more likely to experience probable posttraumatic stress disorder (PTSD), anxiety, depression, suicidality, and angry outbursts. Among those veterans who experienced corollaries of combat only (e.g., seeing someone killed or seriously wounded), male, but not female veterans were more likely to have probable PTSD, anxiety, and depression. Veterans exposed to warfare (i.e., combat and the corollaries of combat), irrespective of ACEs exposure, were the most likely to report mental health symptoms. Implications for community-based mental health services are discussed.

中文翻译：

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接触不良童年和战斗经历对 9/11 后新退伍军人当前心理健康的相互作用

与平民相比，退伍军人更容易受到不良童年经历 (ACE) 的影响，而且许多人还遭遇过战争，这会增加出现心理健康问题的可能性。这项研究的目的是测试童年创伤和战争暴露对近 10,000 名 9/11 后新退伍军人样本心理健康的相互作用。结果显示，与参考组（即没有 ACE 和没有战争暴露）相比，暴露于一两个 ACE 但没有战争的男性退伍军人更有可能经历焦虑、抑郁、自杀念头和愤怒的爆发。暴露于一两个 ACE，但没有战争的女性退伍军人更有可能产生自杀念头。暴露于三个或更多 ACE 并且没有战争的男性和女性退伍军人更有可能经历可能的创伤后应激障碍 (PTSD)、焦虑、抑郁、自杀和愤怒的爆发。在那些只经历过战斗必然结果（例如，看到有人被杀或重伤）的退伍军人中，男性而不是女性退伍军人更有可能患有可能的 PTSD、焦虑和抑郁。暴露于战争（即战斗和战斗的必然结果）的退伍军人，无论 ACEs 暴露如何，最有可能报告心理健康症状。讨论了以社区为基础的心理健康服务的意义。但不是女性退伍军人更有可能患有创伤后应激障碍、焦虑和抑郁。暴露于战争（即战斗和战斗的必然结果）的退伍军人，无论 ACEs 暴露如何，最有可能报告心理健康症状。讨论了以社区为基础的心理健康服务的意义。但不是女性退伍军人更有可能患有创伤后应激障碍、焦虑和抑郁。暴露于战争（即战斗和战斗的必然结果）的退伍军人，无论 ACEs 暴露如何，最有可能报告心理健康症状。讨论了以社区为基础的心理健康服务的意义。