Adverse Childhood Experiences and Disease Activity Are Associated with Post-Traumatic Stress Symptoms in Crohn's...

Crohn's disease (CD) is a chronic inflammatory bowel disease associated with a substantial psychological burden, including post-traumatic stress symptoms (PTSS). However, PTSS do not develop in all patients, suggesting individual vulnerability factors. Adverse childhood experiences (ACEs) are a transdiagnostic risk factor for stress-related psychopathology and may influence psychological responses to chronic disease. We examined whether ACEs moderate the relationship between clinical disease activity and PTSS in patients with CD.

In this cross-sectional study, outpatients with CD completed self-report measures assessing PTSS and ACEs. Clinical disease activity was assessed using the Harvey-Bradshaw Index. Data were analyzed using Pearson correlation coefficients and hierarchical moderated regression analyses.

A total of 161 outpatients with CD were included. Clinically significant PTSS were observed in 32.1% of the sample. Disease activity was positively associated with PTSS (r = .33, p < .01), as was cumulative ACE exposure (r = .38, p < .01). In regression analyses, both disease activity (β = .22, p = .013) and ACEs (β = .35, p < .001) independently predicted PTSS, whereas disease duration was inversely associated (β =  - .19, p = .047). A significant interaction between disease activity and ACEs emerged (ΔR² = .034, p = .013), indicating a stronger association between disease activity and PTSS among patients with greater childhood adversity.

Early-life adversity appears to increase vulnerability to PTSS in the context of active CD. ACE-informed assessments may help identify patients at higher psychological risk and guide trauma-informed clinical care.