Alcohol-Related Consequences Mediating PTSD Symptoms and Mental Health–Related Quality of Life in OEF/OIF Combat Veterans

Angkaw, Abigail C.; Haller, Moira; Pittman, James O. E.; Nunnink, Sarah E.; Norman, Sonya B.; Lemmer, Jennifer A.; McLay, Robert N.; Baker, Dewleen G.

doi:10.7205/milmed-d-14-00473

Cited by 25 publications

(19 citation statements)

References 34 publications

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“…As the current study is cross-sectional in nature, causality and directionality of effects cannot be established. Although results from the present study are consistent with cross-sectional and longitudinal evidence suggesting alcohol motivations act as proximal mechanisms through which mental health symptoms are related to alcohol involvement (Angkaw et al, 2015;Cooper et al, 2016;Hien et al, 2010;Miller et al, 2017;Simpson et al, 2014), alcohol use and problems may also contribute to or exacerbate existing PTSD symptomology (McFarlane et al, 2009). Caution should be exercised when interpreting study findings in lieu of this limitation, and future research should examine these relationships longitudinally to determine whether alcohol involvement is associated with later changes in posttraumatic stress symptoms.…”

Section: Limitations and Future Directionssupporting

confidence: 83%

PTSD Symptomology and Motivated Alcohol Use Among Military Service Members: Testing a Conditional Indirect Effect Model of Social Support

McCabe

Mohr

Hammer

et al. 2018

Substance Use & Misuse

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Background: Posttraumatic stress disorder (PTSD) and problematic alcohol use commonly cooccur among military service members. It remains critical to understand why these patterns emerge, and under what conditions. Objectives: This study examined whether PTSD symptoms (PTSS) and alcohol involvement (quantity and frequency of use, heavy episodic drinking, and alcohol problems) are indirectly related through four distinct drinking motivations. A secondary aim was to identify factors, specifically forms of social support, which buffer these associations. Methods: Using baseline data from a randomized-controlled trial of health and well-being among civilian-employed separated service members and reservists, the present study examined these issues using a subsample of 398 current drinkers. Results: Parallel mediation models revealed PTSS-alcohol consumption associations were indirect through coping and enhancement motivations. PTSS was only related to alcohol problems through coping motivations. In addition, the indirect effect of PTSS on average level of consumption via coping motives was conditional on perceived support from friends and family, whereas the indirect effect for alcohol problems was conditional only on friend support. In contrast, the indirect effects of PTSS on alcohol consumption variables (but not problems) via enhancement motives were conditional on perceived support from friends and family. Conclusions/Importance: Future research and screening efforts should attend to individual motivations for drinking as important factors related to alcohol use and problems among service members experiencing PTSS, and emphasize the importance of communication, trust, and effective supports among military and nonmilitary friends and family.

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Section: Limitations and Future Directionssupporting

confidence: 83%

PTSD Symptomology and Motivated Alcohol Use Among Military Service Members: Testing a Conditional Indirect Effect Model of Social Support

McCabe

Mohr

Hammer

et al. 2018

Substance Use & Misuse

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“…There is currently no separate mental health program for female military junior o cers in the ROK Army. Existing mental health programs focus on post-traumatic stress disorder [32], as such, insu cient research and interventions have been implemented to improve the MCS as part of HRQOL. Furthermore, different factors in uence quality of life between male soldiers and junior female o cers, including social support, adjustment to military service, physical environment, and health behaviors [33].…”

Section: Discussionmentioning

confidence: 99%

The Association Between Occupational Factors, Depression, and Health-Related Quality of Life in Military Women in Republic of Korea: A Cross-Sectional Study

Kwon

Park

Kim

et al. 2021

Preprint

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Background: Health-related quality of life (HRQOL) is an important concept to consider both individuals' ability to manage their daily lives and health status across the lifespan. Despite this variable's importance, there is a lack of clarification on the factors associated with HRQOL, especially for military women. The aim of this study was to examine factors associated with HRQOL of military women in the Korea Army.Methods: This cross-sectional study included 196 participants who were currently within their 5-year service period. Differences in HRQOL according to general and occupational factors were analyzed using the independent t-test and analysis of variance. Multiple linear regression analysis was performed to identify factors associated with the HRQOL of women serving as military junior officers.Results: The mean score for the physical component summary (PCS) of HRQOL was 56.0±5.8, and that for the mental component summary (MCS) of HRQOL was 47.2±10.0. For depression, the mean score was 5.4±5.2, whereas 19.4% of the participants scored more than 10 out of 27 points, which means moderate to severe. No variables showed statistically significant relationships with the PCS. However, significant relationships with the MCS were found for rank (β = -3.63, p <. 001), duty time (β = -4.93, p = .029), perceived stress (β = -0.61, p <. 001), and depression (β = -0.90, p <. 001).Conclusions: Although depression levels were not severe, it was a significant factor of HRQOL and thus the need for depression screening and regular depression management in women serving in the ROK Army to improve their HRQOL. Considering these results, nursing officers should conduct frequent testing related to mental health and take steps to manage high-risk groups. This study also contributes to the literature by providing basic data for the establishment of an appropriate health service environment and systematic health management policies.

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“…Considerable proportions of OEF/OIF veterans meet criteria for PTSD (23%; Fulton et al, ), depression (39%; Haskell et al, ), and AUDs (13%; Kehle et al, ). Furthermore, PTSD, depression, and AUD often lead to impaired social and occupational functioning, as well as reductions in quality of life (Angkaw et al, ; Breslau, Lucia, & Davis, ; Gill et al, ; Meyer & Mutambudzi, ; Moos & Moos, ; Nietlisbach & Maercker, ; Pittman, Goldsmith, Lemmer, Kilmer, & Baker, ; Wells et al, ; Wingo et al, ).…”

Section: Introductionmentioning

confidence: 99%

Heterogeneity of treatment dropout: PTSD, depression, and alcohol use disorder reductions in PTSD and AUD/SUD treatment noncompleters

Szafranski

Grös

Acierno

et al. 2018

Clin Psychology and Psychoth

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Treatment dropout is often assumed to be due to worsening or lack of symptom improvement, despite minimal research examining symptom change among treatment dropouts. Thus, the present study examined symptom change in veterans who discontinued evidence‐based treatment for comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Participants were veterans who completed at least one session of a 12‐session Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure (COPE) for comorbid PTSD/AUD. The study analyses investigated the 43% of the sample (n = 22) that did not complete the full 12‐session protocol and were therefore considered treatment dropouts. Symptom changes in PTSD, AUD, and depression were examined among dropouts using two methods: (a) clinically significant change criteria and (b) good end‐state criteria. Results indicated that a significant proportion of treatment dropouts displayed clinically significant improvement and/or met good end‐state criteria for PTSD (40–59%), AUD (66%), and depression (45–68%) prior to dropping out. The results revealed that participants who displayed symptom improvement attended more treatment sessions and completed more imaginal exposures than participants who did not experience significant improvement. Together, the findings add to a growing body of literature suggesting that a large proportion of treatment dropouts may actually improve. Although preliminary, the findings challenge the notion that treatment dropout is always associated with negative outcomes.

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Alcohol-Related Consequences Mediating PTSD Symptoms and Mental Health–Related Quality of Life in OEF/OIF Combat Veterans

Cited by 25 publications

References 34 publications

PTSD Symptomology and Motivated Alcohol Use Among Military Service Members: Testing a Conditional Indirect Effect Model of Social Support

PTSD Symptomology and Motivated Alcohol Use Among Military Service Members: Testing a Conditional Indirect Effect Model of Social Support

The Association Between Occupational Factors, Depression, and Health-Related Quality of Life in Military Women in Republic of Korea: A Cross-Sectional Study

Heterogeneity of treatment dropout: PTSD, depression, and alcohol use disorder reductions in PTSD and AUD/SUD treatment noncompleters

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