Early Adolescent Binge Drinking Increases Risk of Psychopathology in Post-9/11 Veterans and Mild Traumatic Brain Injury Exacerbates Symptom Severity

Abstract

Aims To demonstrate that early adolescent binge drinking (BD) increases the risk for and/or severity of psychopathology in post-9/11 Veterans and determine if mild traumatic brain injury (mTBI) modifies risk. Methods Post-9/11 Veterans (n = 375) were classified into two groups: 57 Veterans with a history of early adolescent BD (E-BD; age of onset <15) and 318 who did not BD until age 15 or older (late-BD or L-BD; age of onset ≥15). History of military mTBI and mental health disorders were also assessed following military service. Results Logistic regression and analysis of variance (ANOVA) analyses revealed that the E-BD’s had significantly higher prevalence of alcohol use disorders (AUDs) and more severe symptoms of AUD, substance use disorder (SUD), depression and stress. Two-way ANOVAs showed that history of military mTBI was differentially associated with posttraumatic stress disorder (PTSD) incidence and severity among Veterans who had engaged in early adolescent BD. Specifically, Veterans with a history of both early adolescent BD and military mTBI were at greater risk for a PTSD diagnosis and had more severe symptoms of PTSD than those with only a history of adolescent BD. The greater PTSD symptom severity in the comorbid group was driven by hyperarousal symptoms. Conclusions A history of BD during early adolescence is prevalent among Veterans and is related to higher risk for AUD and more severe AUD, SUD, mood and stress symptoms later in life. Veterans with early BD and military mTBI showed greater incidence and severity of PTSD, indicating that mTBI, a common comorbidity among post-9/11 Veterans, exacerbates risk.

Age of onset of adolescent binge drinking is differentially associated with cortical thickness in post‐9/11 adult Veterans

“…Additionally, both groups had very low exposure to early life trauma (Table 2). As shown in Table 2 and described recently by Fortier et al (2020), there was a greater prevalence of psychiatric diagnoses in the early‐onset adolescent binge group with 33 (66%) diagnosed with PTSD. Even though each of the clinical conditions in Table 2 showed a higher prevalence in EBDs relative to LBDs, none of the group differences reached statistical significance.…”

“…There is already increasing evidence that binge drinking during adolescence may have devastating, life‐long neurobiological, and cognitive consequences. Moreover, the cognitive impairment incurred over the years of adolescent binge drinking could potentially increase the risk for alcohol disorders by damaging neural and cognitive systems that would normally function to help an individual refrain from chronic abuse (Fortier et al, 2020). Although the current study cannot report conclusions regarding causation, these findings can help serve as a framework for future research which can help understand the mechanisms promoting alcohol abuse and lead to developments of interventions targeted to those at greatest risk for the development of chronic abuse.…”

“…As was done in Maksimovskiy et al (2019) and Fortier et al (2020), we defined a binge drinker as an individual who reported a pattern of consuming four or more drinks per day (females) or five or more drinks per day (males) using the lifetime drinking history (LDH) questionnaire (Skinner & Sheu, 1982). Early‐onset adolescent binge drinkers (EBD) consisted of individuals who reported any binge drinking on the LDH prior to age 15 ( n = 50; EBD = 1 + BD day <15 years of age).…”

“…Many Veterans who served in the United States military following the attacks on September 11, 2001, were adolescents only a short time before beginning their military service and, like many of their peers, engaged in binge drinking (BD). In a recently published manuscript, we demonstrated that an onset of adolescent binge drinking prior to age 15 was associated with an increased risk for adult alcohol use disorders, as well as other psychopathologies (Fortier et al, 2020). The purpose of the current paper was to determine whether Veterans who engaged in early‐onset adolescent binge drinking also demonstrate changes in brain morphometry as adults.…”

“…Early initiation of alcohol use has most often been defined as drinking alcohol by age 14 (DeWit et al, 2000; King & Chassin, 2007; McGue & Iacono, 2005; McGue et al, 2006; Trujillo et al, 2019), and this maps on to the human development phase of “early adolescence” that occurs from age 10 to 14 (McIntosh, Helms, & Smyth, 2003). In fact, problem behaviors such as alcohol misuse before age 15 have been associated with elevated risk for developing adult psychopathology (Fortier et al, 2020; McGue & Iacono, 2005).…”