Combat-Acquired Traumatic Brain Injury, Posttraumatic Stress Disorder, and Their Relative Associations With Postdeployment Binge Drinking

Abstract

Objective To examine whether experiencing a traumatic brain injury (TBI) on a recent combat deployment was associated with postdeployment binge drinking, independent of posttraumatic stress disorder (PTSD). Methods Using the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, an anonymous survey completed by 28,546 personnel, the study sample included 6,824 personnel who had a combat deployment in the past year. Path analysis was used to examine whether PTSD accounted for the total association between TBI and binge drinking. Main Measures The dependent variable, binge drinking days, was an ordinal measure capturing the number of times personnel drank 5+ drinks on one occasion (4+ for women) in the past month. TBI-level captured the severity of TBI after a combat injury event exposure: TBI-AC (altered consciousness only), TBI-LOC≤20 (loss of consciousness up to 20 minutes), and TBI-LOC>20 (loss of consciousness greater than 20 minutes). APTSD positive screen relied on the standard diagnostic cutoff of 50+ on the PCL-C. Results The final path model found that while the direct effect of TBI (0.097) on binge drinking was smaller than that of PTSD (0.156), both were significant. Almost 70% of the total effect of TBI on binge drinking was from the direct effect; only 30% represented the indirect effect through PTSD. Conclusion Further research is needed to replicate these findings and to understand the underlying mechanisms that explain the relationship between TBI and increased postdeployment drinking.

Longitudinal Associations between Sleep, Intrusive Thoughts, and Alcohol Problems Among Veterans

“…Separate lines of research have documented associations between PTSD and alcohol problems, sleep and alcohol problems, and PTSD and sleep. In cross‐sectional models, PTSD symptoms are associated with more frequent binge drinking (Adams et al., ; Calhoun et al., ) and problems such as passing out or taking foolish risks as a result of drinking (Fuehrlein et al., ). Similarly, at the daily level, daytime PTSD symptoms are associated with greater alcohol consumption and more alcohol‐related problems (e.g., fighting) that night (Gaher et al., ; Langdon et al., ).…”

Traumatic Brain Injury and Post-Deployment Binge Drinking among Male and Female Army Active Duty Service Members Returning from Operation Enduring Freedom/Operation Iraqi Freedom

“…7 Prevalence of binge drinking is higher when assessed on DoD anonymous surveys, with 54% of active duty members returning from a combat deployment in 2007-2008 reporting binge drinking. 8 Binge drinking is associated with negative drinking-related consequences among military members, including drinking-related injuries and job-performance problems. [9][10][11][12] Female members represent approximately 10% of OEF/OIF deployments.…”

“…3,14 Understanding deployment-related risk factors for postdeployment binge drinking is important for targeted prevention strategies. Studies suggest that experiencing a traumatic brain injury (TBI) while deployed increases the risk for post-deployment frequent (at least monthly) binge drinking, 8,15 alcohol misuse, 16 and negative drinking-related consequences. 9 It is well-established that a TBI of sufficient force will damage the frontal lobes, ventral medial prefrontal cortex, and orbital frontal cortex regardless of the location of head impact.…”

“…Further complicating the relationship between TBI and postdeployment binge drinking are common comorbidities, including post-traumatic stress disorder (PTSD), depression, and harmful thoughts. 8,[30][31][32][33][34][35] In particular, TBI and PTSD are commonly comorbid within this population, 32,[35][36][37] and PTSD is a known risk factor for unhealthy drinking. 33,38,39 One study of active duty members examined whether experiencing a TBI on a deployment ending in 2007-2008 was associated with post-deployment binge drinking, independent of PTSD, and found that both TBI and PTSD had direct effects on binge drinking.…”

“…33,38,39 One study of active duty members examined whether experiencing a TBI on a deployment ending in 2007-2008 was associated with post-deployment binge drinking, independent of PTSD, and found that both TBI and PTSD had direct effects on binge drinking. 8 Yet almost 70% of the total effect of TBI on binge drinking was from the direct effect, with only 30% represented through the indirect effect through PTSD. It is unknown if these relationships were impacted by gender.…”