Posttraumatic Stress Disorder (PTSD) and alcohol abuse both are negatively associated with health, and alcohol misuse may mediate the relationship between PTSD and functional health outcomes. The present study tested for such mediation using self-report measures of PTSD symptoms, hazardous alcohol use, and health functioning in 151 U.S. veterans (136 men and 15 women) of the wars in Iraq and Afghanistan recruited from a Veterans Affairs primary care clinic. On the basis of established cut scores, 39.1% screened positive for PTSD and 26.5% screened positive for hazardous drinking. PTSD symptoms and hazardous drinking were significantly correlated with each other and with health functioning. Hazardous drinking was found to partially mediate the relationship between PTSD and functional mental health, but not physical health.Veterans of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) are at risk for posttraumatic stress disorder (PTSD) and other adverse psychological and physical health outcomes. Epidemiological studies of OEF/OIF veterans have estimated the prevalence of PTSD to range from 11.2% to 24.5% depending on the instrument used, the time since returning from deployment and whether the sample was comprised of active duty or reserve troops (Hoge, Terhakopian, Castro, Messer, & Engel, 2007;Milliken, Auchterlonie, & Hoge, 2007). Studies of OEF/OIF veterans presenting to Veterans Affairs Medical Centers (VAMC) have reported even higher rates. For example, a study of OEF/OIF veterans recruited from an integrated medical/mental health clinic, found that 37% screened positive for PTSD and 23.4% endorsed at least one problem drinking item (Jakupcak, Luterek, Hunt, Conybeare, & McFall, 2008).Evidence from traumatized samples indicates that PTSD is negatively associated with functional health or health-related quality of life (e.g., Malik et al., 1999;Berger et al., 2007). With regard to OEF/OIF troops in particular, an epidemiological study reported a number of statistically significant relationships between PTSD and aspects of health functioning even after controlling for physical injury . There also is evidence of an association between alcohol misuse and functional health (e.g., Bridevaux, Bradley, Bryson, McDonnell, & Fihn, 2004). Given that PTSD is associated with high rates of alcohol use disorders (Jacobsen, Southwick, & Kosten, 2001), some have speculated that alcohol misuse may be responsible for the apparent link between PTSD symptoms and adverse health outcomes (Rheingold, Acierno, & Resnick, 2004). Although this model has intuitive appeal, empirical studies have, to date, not found evidence for mediation of the relationship between PTSD and functional health by alcohol misuse (e.g., Vasterling et al., 2008). NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThis investigation examined the relations among PTSD symptoms, hazardous drinking, and functional health in a sample of OEF/OIF veterans presenting for primary care services. We hypothesized that PTSD symptoms...

Victims to Victory We investigated the psychological impact of homicide bereavement in a sample of 54 African Americans (88.9% female) who had experienced the murder of a loved one within the past 5 years. Participants were recruited from a victims' services agency. The majority of participants (n ϭ 34, 63%) were parents of the deceased. Using a cutoff of 50 on the PTSD Checklist (Weathers, Litz, Herman, Huska, & Keane, 1993), 10 participants (18.5%) screened positive for PTSD. On the Beck Depression Inventory-II, 54% of the sample (n ϭ 29) had scores suggesting at least mild depression. On the Inventory of Complicated Grief (Prigerson & Jacobs, 2001), 24 (54.5%) of those for whom the homicide occurred 6 months or more prior to assessment screened positive for complicated grief. There was a high degree of overlap across these categories, with nearly all of the PTSD-positive cases screening positive for complicated grief and depression. Participants who were within 2 years of a homicide loss showed significantly higher levels of PTSD and anxiety severities than those who were 2 or more years beyond the loss. In contrast, levels of complicated grief and depression did not differ significantly between those early and late in bereavement. In regression analyses, time since the homicide was a significant predictor for anxiety and approached significance in predicting PTSD. However, time since homicide was not significantly associated with depression or complicated grief. Clinical and research implications of these findings are discussed, including the possible impact of stigma associated with homicidal bereavement.

This study aims to explore rates of bereavement-related mental health outcomes and diagnostic comorbidity along with the associations between mental health outcomes, perceived social support, knowledge of services, and service use among a diverse sample of 47 survivors 2 years post loss. Findings are consistent with prior studies in that homicide is associated with an overlapping of significant symptom presentation of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and complicated grief (CG). Lack of grief-specific social support was demonstrated to be associated with PTSD and MDD but not with CG. Although a significant number of survivors reported poor mental health outcomes, a limited number were using services.

Objective The purpose of this study was to test the efficacy of two brief interventions for alcohol misuse in a sample of combat veterans of the wars in Iraq and Afghanistan. Method Participants were 68 combat veterans (91.2% male; 64.7% White, 27.9% Black) with a mean age of 32.31 years (SD = 8.84) who screened positive for hazardous drinking in a Veterans Affairs Medical Center primary care clinic using the Alcohol Use Disorders Identification Test. More than half of the sample (57.4%) met criteria for PTSD (based on the Clinician-Administered PTSD Scale). Eligible veterans who elected to participate completed a baseline assessment and were randomized to receive one of two interventions (personalized feedback delivered with or without a motivational interviewing counseling session). Both interventions included information on hazardous drinking, PTSD symptoms, depression, and coping. Follow up assessments were conducted at 6 weeks and 6 months post-intervention. Results Both conditions resulted in statistically significant reductions in quantity and frequency of alcohol use, as well as frequency of binge drinking. Within group effect sizes (d) were in the small to medium range (.34 to .55) for quantity and frequency of alcohol use. There were no condition by time interactions, suggesting that both interventions were similarly effective. PTSD and Non-PTSD veterans responded equally well to both interventions, but veterans with PTSD assigned to Feedback+MI reported greater reductions in weekly drinking at the 6-week follow up. Conclusions These findings suggest that brief interventions for alcohol misuse may be effective for reducing drinking, even in an OEF/OIF Veteran population with a high degree of PTSD.