Juvenile conduct disorder as a risk factor for trauma exposure and posttraumatic stress disorder

Authors

  • Karestan C. Koenen,

    Corresponding author
    1. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts.
    2. Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
    • Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue, Kresge 613, Boston, Massachusetts 02115
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  • Qiang John Fu,

    1. Missouri Alcoholism Research Center, Department of Psychiatry, Washington University, St. Louis, Missouri
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  • Michael J. Lyons,

    1. Department of Psychology, Boston University, Boston, Massachusetts
    2. Harvard Institute of Psychiatric Epidemiology and Genetics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    3. Department of Psychiatry, Harvard Medical School at Massachusetts, Mental Health Center, Boston, Massachusetts
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  • Rosemary Toomey,

    1. Harvard Institute of Psychiatric Epidemiology and Genetics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School at Massachusetts, Mental Health Center, Boston, Massachusetts
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  • Jack Goldberg,

    1. Seattle VA ERIC/Vietnam Era Twin Registry, Seattle, Washington
    2. Department of Epidemiology, University of Washington, Seattle, Washington.
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  • Seth A. Eisen,

    1. St. Louis Veterans Affairs Medical Center, Research and Medical Services, St. Louis, Missouri
    2. Department of Internal Medicine, Washington University, Division of General Medical Sciences, St. Louis, Missouri
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  • William True,

    1. Department of Internal Medicine, Washington University, Division of General Medical Sciences, St. Louis, Missouri
    2. School of Public Health, St. Louis, Missouri
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  • Ming Tsuang

    1. Harvard Institute of Psychiatric Epidemiology and Genetics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School at Massachusetts, Mental Health Center, Boston, Massachusetts
    3. Department of Psychiatry, Institute of Human Behavioral Genomics, University of California, San Diego, and VA San Diego Health Care System
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Abstract

Juvenile conduct disorder (CD) is a well-documented risk factor for posttraumatic stress disorder (PTSD). This study examines the mechanisms underlying this relationship by using data from 3,315 twin pairs in the Vietnam Era Twin Registry. Results indicate the number of conduct disorder symptoms increased risk of trauma exposure and PTSD in a dose–response fashion. This increased risk was mediated in part by the positive association between CD and lifestyle factors and was not due to confounding by shared genetic or familial vulnerability. The findings suggest CD increases risk for trauma exposure and PTSD among male veterans through direct and indirect mechanisms. Veterans who have a history of CD are at high risk for trauma exposure and development of PTSD.

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