Childhood adversities and post-traumatic stress: predictive pathways through acute stress disorder

Trauma, a psychological phenomenon, can contribute to several mental health disorders such as acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Understanding the impacts of childhood adversities on mental disorders is essential, since early trauma can profoundly shape an individual's reaction to subsequent trauma.

To study the association between childhood adversities and full-threshold and subthreshold PTSD onset, either directly or through the intermediary role of ASD.

Data were collected longitudinally from healthcare workers aged 18 years and above, working at Saint George Hospital University Medical Center, at three distinct time points: 9-15 days (wave 1), 21-27 days (wave 2) and 6-7 months (wave 3) following the Beirut port blast on 4 August 2020.Childhood adversities, encompassing physical, emotional and sexual abuse, were collected. ASD and PTSD were assessed, respectively, using the Acute Stress Disorder Scale and the PTSD Checklist for DSM-5. Odds ratios, both unadjusted and adjusted, with 95% confidence intervals, were calculated to study the associations.

Emotional abuse was found to be a significant predictor of ASD at wave 2 (21-27 days), and both full-threshold and subthreshold PTSD at wave 3 (6-7 months) post-blast. Individuals with negative ASD status at waves 1 and 2 who experienced emotional abuse in childhood showed approximately double the rates of subthreshold PTSD.

Childhood emotional abuse was a strong predictor of both ASD and PTSD. Screening for past childhood adversities is important, even in individuals without ASD, as they remain more vulnerable to later PTSD.