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

Abstract

This study examines whether the relationship between traumatic brain injury (TBI) and post-deployment binge drinking is independent of screening positive for mental health problems among male and female service members. Data are from the Substance Use and Psychological Injury Combat Study of Army members returning from deployment to Afghanistan or Iraq in fiscal years 2008-2011. The sample consists of 240,694 male and 26,406 female active duty members who completed initial and follow-up questionnaires. The initial questionnaire, completed at the end of deployment, included screens for TBI and mental health problems (post-traumatic stress disorder, depression, harmful thoughts). The dependent variable, frequent binge drinking (six or more drinks on one occasion, at least monthly), was assessed on the follow-up questionnaire on average 3-9 months post-deployment. More than 21% of males and 7% of females reported frequent binge drinking. Male members were more likely to screen positive for TBI, compared with females (7.5% vs. 4.4%). Females with both TBI and mental health positive screens had more than double the risk of frequent binge drinking, compared with those without either problem (15.8% vs. 6.6%), and males with both problems had almost double the risk, compared with males with neither problem (33.6% vs. 19.7%). In multivariable logistic regression models, having a TBI and a comorbid positive mental health screen was associated with increased odds of frequent binge drinking among both males and females (adjusted odds ratio [AOR] = 1.59, CI: 1.50-1.69, and AOR = 2.11, CI: 1.57-2.83, respectively), compared with those with neither condition. More research is needed on the interaction of gender and binge drinking, especially when TBI and mental health problems co-exist.

Alcohol Use Among Never‐Deployed U.S. Army Reserve and National Guard Soldiers: The Effects of Nondeployment Emotions and Sex

“…Among young veterans, the prevalence of binge drinking among males is nearly twice that of their female counterparts (43.2% vs. 22.9%) (SAMHSA, 2010). Consistent with these findings, the prevalence of frequent binge drinking among male soldiers returning from deployment is 3 times that of females (21.2% vs. 7.4%) (Sayko Adams et al, 2017). Other research in non-US military samples also suggests that male military personnel are significantly more likely to have problems with alcohol than their female counterparts (Waller et al, 2015).…”

“…Given the gaps identified in the literature and emerging evidence on the well-being of never-deployed service members, the goal of this study was to examine the potential relations between non-deployment emotions and a range of alcohol use outcomes among a sample of male and female never-deployed USAR/NG soldiers. We also aimed to explore the interactions between non-deployment emotions and sex on these alcohol outcomes, given the difference in drinking behaviors between male and female service members (SAMHSA, 2010, Sayko Adams et al, 2017, Waller et al, 2015).…”

The intersection of lifetime history of traumatic brain injury and the opioid epidemic

“…Neural networks connecting these areas of the prefrontal cortex to the basal ganglia and midbrain constitute the reward circuit, which have been implicated in substance abuse (Casement, Shaw, Sitnick, Musselman, & Forbes, 2014;Forbes, Rodriguez, Musselman, & Narendran, 2014). Specifically, damage to the orbital frontal cortex has been associated with reduced ability to control impulsive behavior (Sellitto, Ciaramelli, & di Pellegrino, 2010), which may influence self-regulation of substance use (Adams, Corrigan, Mohr, Williams, & Larson, 2017). We propose that TBI can have unrecognized consequences that may increase the risk for opioid use disorders (OUD).…”

Gender Differences in Outcomes after Traumatic Brain Injury among Service Members and Veterans

“…Three retrospective cohort studies reported on alcohol use among active duty service members or veterans with a history of TBI ( n = 19 240; 6.0% female; n = 30 197; 6.1% female; n = 402; 7.0% female). In all three, male veterans engaged in risky drinking behaviors at significantly higher rates than female veterans.…”