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

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