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Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers

Published online by Cambridge University Press:  17 October 2017

Laura Campbell-Sills ,
Robert J. Ursano ,
Ronald C. Kessler ,
Xiaoying Sun ,
Steven G. Heeringa ,
Matthew K. Nock ,
Nancy A. Sampson ,
Sonia Jain  and
Murray B. Stein
Laura Campbell-Sills*
Affiliation:
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
Robert J. Ursano
Affiliation:
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
Ronald C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Xiaoying Sun
Affiliation:
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
Steven G. Heeringa
Affiliation:
University of Michigan, Institute for Social Research, Ann Arbor, MI, USA
Matthew K. Nock
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Nancy A. Sampson
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Sonia Jain
Affiliation:
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
Murray B. Stein
Affiliation:
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA VA San Diego Healthcare System, San Diego, CA, USA
*
Author for correspondence: L. Campbell-Sills, Ph.D., E-mail: [email protected]
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Abstract

Background

Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse.

Methods

Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1–2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1–2×/week) and alcohol or substance use disorder (AUD/SUD).

Results

Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) – but not combat stress – was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06–1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25–1.89, p < 0.0005); and persistence of AUD/SUD at T2 and T3 (AOR = 1.30, 95% CI 1.08–1.56, p = 0.005). Any BD pre-deployment was associated with post-deployment onset of HD (AOR = 3.21, 95% CI 2.57–4.02, p < 0.0005) and AUD/SUD (AOR = 1.85, 95% CI 1.27–2.70, p = 0.001).

Conclusions

Alcohol misuse is common during the months preceding and following deployment. Timely intervention aimed at alleviating/managing personal stressors or curbing risky drinking might reduce risk of alcohol-related problems post-deployment.

Keywords

Alcohol-related disordersbinge drinkingrisk factorslife stressmilitary personnel
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 10 , July 2018 , pp. 1624 - 1633
Copyright
Copyright © Cambridge University Press 2017 

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