Alcohol use and trauma exposure among male and female veterans before, during, and after military service

Abstract

The present study examined lifespan and combat-related trauma exposure as predictors of alcohol use among male and female veterans. Posttraumatic stress and depressive symptoms were examined as mediators of the effects of trauma exposure on alcohol use. Data were examined from 1825 (1450 male, 375 female) veterans and active duty service members who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Centers (VISN 6 MIRECC). For both men and women, depressive symptoms significantly mediated the effects of non-combat trauma exposure experienced before, during and after the military, as well as combat- exposure, on alcohol use. With posttraumatic stress symptoms, the models for men and women differed. For men, the effects of non-combat trauma exposure during and after military service, and combat exposure, on alcohol use were mediated by PTSD symptoms; however, for women, PTSD symptoms did not mediate these relationships. Findings are discussed in the context of potential gender differences in response to trauma such as use of alcohol to cope with traumatic events.

Drug use and childhood-, military- and post-military trauma exposure among women and men veterans

“…We adapted the TLEQ to indicate whether each trauma was experienced (a) before the military, (b) during the military, and/or (c) after the military (Clancy et al, 2006;Dedert et al, 2009); thus, three scores were derived reflecting the mean number of trauma experiences that occurred for each time-period (pre-military, during the military, and post-military). Consistent with previous work (Kelley et al, 2013) and with DSM-IV diagnostic Note: OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom. a The majority of veterans were both active duty and Reserve/National Guard members at different points.…”

“…For example, childhood trauma exposure (Danielson et al, 2009;Rosen and Martin, 1998) and mental health symptoms before deployment (Jacobson et al, 2008) are associated with alcohol use (Kelley et al, 2013). Whether combat and noncombat-related trauma exposure confers differential risk for mental health disorders, and thus possibly differential risk for self-medication with substances for female versus male veterans, is inconclusive (e.g., Irish et al, 2010;Tanielian and Jaycox, 2008;Vogt et al, 2011).…”

The Post‐Deployment Mental Health (PDMH) study and repository: A multi‐site study of US Afghanistan and Iraq era veterans

“…Furthermore, MDD usually followed the onset of other comorbid disorders among women veterans, indicating the need to assess for earlier lifetime disorders in veterans with MDD. Runnals et al, 2013 Women were more likely to endorse back pain and headaches than men. See pain section earlier. Kelley et al, 2013; Kelley et al, 2015 PTSD symptoms were found to mediate the effects of trauma exposure on alcohol differently for men and women. See substance use section earlier. Schry et al, 2015 Male veterans who reported MSA (the most egregious form of military sexual trauma experiences, involving force or penetration) endorsed higher levels of Department of Veterans Affairs (VA) service-connected disability, recent outpatient mental-health treatment utilization, PTSD symptoms, depression symptoms, and suicidality than the general OEF/OIF sample without MSA.…”

“…The distress factor in particular was significant for suicidality and suicide attempts. Vulnerability: Youssef et al, 2013a Childhood trauma exposures were found to be associated with depressive symptoms and suicidal ideation. Violence Elbogen et al, 2010 Aggressive impulses or urges, difficulty managing anger, and perceived problems controlling violent behavior were each significantly associated with PTSD hyperarousal symptoms. Substance use Smoking: Calhoun et al, 2011; McClernon et al, 2013 PTSD symptoms affected the expectancies veterans had regarding the benefits of smoking, including beliefs that smoking could reduce negative affect and boredom or increase social facilitation (Calhoun et al, 2011). The risk of smoking increased as a function of the number of comorbid psychiatric illnesses with similar reported expectancies (McClernon et al, 2013) suggesting that both PTSD as well as co-occurring psychiatric conditions affect smoking habits. Alcohol and other drug use: Kelley et al, 2013; Kelley et al, 2015 Depressive symptoms significantly mediated the effects of combat and noncombat exposure on both alcohol and drug use. Similarly, PTSD symptoms served as a similar mediator between trauma exposure and alcohol, but only for men and not for other drug use.…”

Food insecurity in veteran households: findings from nationally representative data

“…First, this split between older and more recent veterans may reflect differences in the composition of the US Armed Forces coinciding with the onset of an all-volunteer force. Thus, the differences in FI may reflect these compositional differences such as higher proportions of volunteers from impoverished communities, families with dysfunction (42,43) and greater numbers of women. Further, the group of oldest veterans have accumulated a lifetime of advantages from the GI Bill and mortgage and healthcare programmes.…”