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Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers

Published online by Cambridge University Press:  17 October 2017

Laura Campbell-Sills ,
Robert J. Ursano ,
Ronald C. Kessler ,
Xiaoying Sun ,
Steven G. Heeringa ,
Matthew K. Nock ,
Nancy A. Sampson ,
Sonia Jain  and
Murray B. Stein
Laura Campbell-Sills*
Affiliation:
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
Robert J. Ursano
Affiliation:
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Ronald C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Xiaoying Sun
Affiliation:
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
Steven G. Heeringa
Affiliation:
University of Michigan, Institute for Social Research, Ann Arbor, MI, USA
Matthew K. Nock
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Nancy A. Sampson
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Sonia Jain
Affiliation:
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
Murray B. Stein
Affiliation:
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA VA San Diego Healthcare System, San Diego, CA, USA
*
Author for correspondence: L. Campbell-Sills, Ph.D., E-mail: campbell-sills@ucsd.edu
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Abstract

Background

Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse.

Methods

Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1–2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1–2×/week) and alcohol or substance use disorder (AUD/SUD).

Results

Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) – but not combat stress – was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06–1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25–1.89, p < 0.0005); and persistence of AUD/SUD at T2 and T3 (AOR = 1.30, 95% CI 1.08–1.56, p = 0.005). Any BD pre-deployment was associated with post-deployment onset of HD (AOR = 3.21, 95% CI 2.57–4.02, p < 0.0005) and AUD/SUD (AOR = 1.85, 95% CI 1.27–2.70, p = 0.001).

Conclusions

Alcohol misuse is common during the months preceding and following deployment. Timely intervention aimed at alleviating/managing personal stressors or curbing risky drinking might reduce risk of alcohol-related problems post-deployment.

Keywords

Alcohol-related disordersbinge drinkingrisk factorslife stressmilitary personnel
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 10 , July 2018 , pp. 1624 - 1633
Copyright
Copyright © Cambridge University Press 2017 

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References

Boulos, D and Zamorski, MA (2016) Contribution of the mission in Afghanistan to the burden of past-year mental disorders in Canadian Armed Forces personnel, 2013. Canadian Journal of Psychiatry 61, 64S–76S.CrossRefGoogle Scholar
Bray, RM, Brown, JM and Williams, J (2013) Trends in binge and heavy drinking, alcohol-related problems, and combat exposure in the U.S. military. Substance Use & Misuse 48, 799–810.CrossRefGoogle ScholarPubMed
Cerda, M, Richards, C, Cohen, GH, Calabrese, JR, Liberzon, I, Tamburrino, M, Galea, S and Koenen, KC (2014) Civilian stressors associated with alcohol use disorders in the National Guard. American Journal of Preventive Medicine 47, 461–466.CrossRefGoogle ScholarPubMed
Fink, DS, Calabrese, JR, Liberzon, I, Tamburrino, MB, Chan, P, Cohen, GH, Sampson, L, Reed, PL, Shirley, E, Goto, T, D'Arcangelo, N, Fine, T and Galea, S (2016) Retrospective age-of-onset and projected lifetime prevalence of psychiatric disorders among U.S. Army National Guard soldiers. Journal of Affective Disorders 202, 171–177.CrossRefGoogle ScholarPubMed
Grant, BF, Goldstein, RB, Saha, TD, Chou, SP, Jung, J, Zhang, H, Pickering, RP, Ruan, WJ, Smith, SM, Huang, B and Hasin, DS (2015) Epidemiology of DSM-5 alcohol use disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry 72, 757–766.CrossRefGoogle ScholarPubMed
Harbertson, J, Hale, BR, Watkins, EY, Michael, NL and Scott, PT (2016) Pre-deployment alcohol misuse among shipboard active-duty U.S. military personnel. American Journal of Preventive Medicine 51, 185–194.CrossRefGoogle ScholarPubMed
Heeringa, SG, West, BT and Berglund, PA (2010) Applied Survey Data Analysis. Boca Raton, FL: Chapman and Hall.Google Scholar
Hurt, L (2015) Post-deployment screening and referral for risky alcohol use and subsequent alcohol-related and injury diagnoses, active component, U.S. Armed Forces, 2008–2014. Medical Surveillance Monthly Report 22, 7–13.Google ScholarPubMed
Jacobson, IG, Ryan, MA, Hooper, TI, Smith, TC, Amoroso, PJ, Boyko, EJ, Gackstetter, GD, Wells, TS and Bell, NS (2008) Alcohol use and alcohol-related problems before and after military combat deployment. Journal of the American Medical Association 300, 663–675.CrossRefGoogle ScholarPubMed
Kehle, SM, Ferrier-Auerbach, AG, Meis, LA, Arbisi, PA, Erbes, CR and Polusny, MA (2012) Predictors of postdeployment alcohol use disorders in National Guard soldiers deployed to Operation Iraqi Freedom. Psychology of Addictive Behaviors 26, 42–50.CrossRefGoogle ScholarPubMed
Kessler, RC, Colpe, LJ, Fullerton, CS, Gebler, N, Naifeh, JA, Nock, MK, Sampson, NA, Schoenbaum, M, Zaslavsky, AM, Stein, MB, Ursano, RJ and Heeringa, SG (2013a) Design of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). International Journal of Methods in Psychiatric Research 22, 267–275.CrossRefGoogle ScholarPubMed
Kessler, RC, Heeringa, SG, Colpe, LJ, Fullerton, CS, Gebler, N, Hwang, I, Naifeh, JA, Nock, MK, Sampson, NA, Schoenbaum, M, Zaslavsky, AM, Stein, MB and Ursano, RJ (2013b) Response bias, weighting adjustments, and design effects in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). International Journal of Methods in Psychiatric Research 22, 288–302.CrossRefGoogle ScholarPubMed
Kessler, RC, Santiago, PN, Colpe, LJ, Dempsey, CL, First, MB, Heeringa, SG, Stein, MB, Fullerton, CS, Gruber, MJ, Naifeh, JA, Nock, MK, Sampson, NA, Schoenbaum, M, Zaslavsky, AM and Ursano, RJ (2013c) Clinical reappraisal of the Composite International Diagnostic Interview Screening Scales (CIDI-SC) in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). International Journal of Methods in Psychiatric Research 22, 303–321.CrossRefGoogle ScholarPubMed
Kessler, RC and Ustun, TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.CrossRefGoogle ScholarPubMed
LeardMann, CA, Powell, TM, Smith, TC, Bell, MR, Smith, B, Boyko, EJ, Hooper, TI, Gackstetter, GD, Ghamsary, M and Hoge, CW (2013) Risk factors associated with suicide in current and former US military personnel. Journal of the American Medical Association 310, 496–506.CrossRefGoogle ScholarPubMed
Mash, HB, Fullerton, CS, Ramsawh, HJ, Ng, TH, Wang, L, Kessler, RC, Stein, MB and Ursano, RJ (2014) Risk for suicidal behaviors associated with alcohol and energy drink use in the US Army. Social Psychiatry and Psychiatric Epidemiology 49, 1379–1387.CrossRefGoogle ScholarPubMed
Mattiko, MJ, Olmsted, KL, Brown, JM and Bray, RM (2011) Alcohol use and negative consequences among active duty military personnel. Addictive Behaviors 36, 608–614.Google ScholarPubMed
Okoro, CA, Brewer, RD, Naimi, TS, Moriarty, DG, Giles, WH and Mokdad, AH (2004) Binge drinking and health-related quality of life: do popular perceptions match reality? American Journal of Preventive Medicine 26, 230–233.CrossRefGoogle ScholarPubMed
Posner, K, Brown, GK, Stanley, B, Brent, DA, Yershova, KV, Oquendo, MA, Currier, GW, Melvin, GA, Greenhill, L, Shen, S and Mann, JJ (2011) The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry 168, 1266–1277.CrossRefGoogle ScholarPubMed
R Core Team (2013) R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
Sacks, JJ, Gonzales, KR, Bouchery, EE, Tomedi, LE and Brewer, RD (2015) 2010 national and state costs of excessive alcohol consumption. American Journal of Preventive Medicine 49, e73–e79.CrossRefGoogle ScholarPubMed
Sampson, L, Cohen, GH, Calabrese, JR, Fink, DS, Tamburrino, M, Liberzon, I, Chan, P and Galea, S (2015) Mental health over time in a military sample: the impact of alcohol use disorder on trajectories of psychopathology after deployment. Journal of Traumatic Stress 28, 547–555.CrossRefGoogle Scholar
Stein, MB, Campbell-Sills, L, Gelernter, J, He, F, Heeringa, SG, Nock, MK, Sampson, NA, Sun, X, Jain, S, Kessler, RC, Ursano, RJ and Army, SC (2017) Alcohol misuse and co-occurring mental disorders among new soldiers in the U.S. Army. Alcoholism: Clinical and Experimental Research 41, 139–148.CrossRefGoogle ScholarPubMed
Thandi, G, Sundin, J, Ng-Knight, T, Jones, M, Hull, L, Jones, N, Greenberg, N, Rona, RJ, Wessely, S and Fear, NT (2015) Alcohol misuse in the United Kingdom Armed Forces: a longitudinal study. Drug and Alcohol Dependence 156, 78–83.CrossRefGoogle ScholarPubMed
Thomas, JL, Wilk, JE, Riviere, LA, McGurk, D, Castro, CA and Hoge, CW (2010) Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. Archives of General Psychiatry 67, 614–623.CrossRefGoogle ScholarPubMed
Ursano, RJ, Colpe, LJ, Heeringa, SG, Kessler, RC, Schoenbaum, M, Stein, MB and Army, SC (2014) The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Psychiatry 77, 107–119.CrossRefGoogle ScholarPubMed
Warner, CH, Appenzeller, GN, Grieger, T, Belenkiy, S, Breitbach, J, Parker, J, Warner, CM and Hoge, C (2011) Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. Archives of General Psychiatry 68, 1065–1071.CrossRefGoogle ScholarPubMed
Weathers, F, Litz, B, Herman, D, Huska, J and Keane, T (1993) The PTSD Checklist (PCL): Reliability, Validity, and Diagnostic Utility. Meeting of the International Society for Traumatic Stress Studies. San Antonio, TX.Google Scholar
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