American Veterans in the Era of COVID-19: Reactions to the Pandemic, Posttraumatic Stress Disorder, and Substance Use Behaviors

Pedersen, Eric R.; Davis, Jordan P.; Fitzke, Reagan E; Lee, Daniel S.; Saba, Shaddy

doi:10.1007/s11469-021-00620-0

Cited by 13 publications

(14 citation statements)

References 44 publications

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“…Four studies explored the links between PTSD and alcohol consumption in war veterans during the COVID-19 pandemic [ 26 , 34 , 35 , 36 ] ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review

Mengin

Rolling

Porche

et al. 2022

IJERPH

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Background: Posttraumatic stress symptoms (PTSSs) and alcohol, tobacco, or nicotine use are frequently associated conditions. The COVID-19 pandemic has been a stressful situation globally and has worsened mental health conditions and addictions in the population. Our systematic review explores the links between PTSSs and (1) alcohol use and (2) tobacco or nicotine use during the COVID-19 pandemic. Methods: We searched the PubMed, PsycINFO, and Web of Science databases for studies published between January 2020 and 16 December 2021. We included studies published in English concerning adults or adolescents. Included articles dealt simultaneously with the COVID-19 pandemic, PTSSs, and alcohol, tobacco, or nicotine use. The reports included were cross-sectional, longitudinal, or cohort studies. We categorized the reports according to the population explored. Our main outcomes are the impacts of PTSSs on (1) alcohol use and (2) tobacco and nicotine use and their relation to COVID-19-related stressors (worries, exposure, lockdown, and infection, either of self or relatives). Results: Of the 503 reports identified, 44 were assessed for eligibility, and 16 were included in our review, encompassing 34,408 participants. The populations explored were the general population, healthcare workers, war veterans, patients with substance use disorders, and other vulnerable populations. Most studies were online surveys (14) with cross-sectional designs (11). Every study explored alcohol use, while only two assessed tobacco use. In most populations explored, a high level of PTSSs was associated with alcohol use increase. COVID-19-related stress was frequently correlated with either high PTSSs or alcohol use. In healthcare workers, PTSSs and alcohol use were not associated, while COVID-19 worries were related to both PTSSs and alcohol use. Discussion: 1. PTSSs and increased alcohol use are frequently associated, while COVID-19 worries might trigger both conditions and worsen their association. Alcohol use increase may represent either an inadequate way of coping with PTSSs or a vulnerability amid the COVID-19 pandemic, leading to PTSSs. As most studies were cross-sectional online surveys, longitudinal prospective studies are needed to ascertain the direction of the associations between these conditions. These studies need to be sufficiently powered and control for potential bias and confounders. 2. Our review highlighted that research about PTSSs and tobacco or nicotine use is scarce.

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“…Four studies explored the links between PTSD and alcohol consumption in war veterans during the COVID-19 pandemic [ 26 , 34 , 35 , 36 ] ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review

Mengin

Rolling

Porche

et al. 2022

IJERPH

View full text Add to dashboard Cite

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“…Negative reactions to COVID‐19. On the 6‐ and 9‐month survey, participants were asked how often they felt negative reactions to the pandemic related to emotional, stress, sleep, and relationships using 9 items from prior work on the COVID‐19 pandemic ((Johns Hopkins Bloomberg School of Public Health, 2020 ; Pedersen et al., 2021 )). Items such as ‘was stressed by the restrictions on leaving home’ and ‘felt that your social relationships were suffering’ when considering the pandemic over the past 3 months were rated from ‘not at all’ (0) to ‘a great deal’ (4).…”

Section: Methodsmentioning

confidence: 99%

Changes in perceived stress during the COVID‐19 pandemic among American veterans

et al. 2022

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American veterans are a population that suffer from both context specific stressors as well as many population‐specific major‐life events. The present exploratory study utilises a longitudinal cohort of 1230 U.S. veterans surveyed from February 2020 through February 2021. We sought to understand heterogeneity in perceived stress, using growth mixture modelling, over this time period, how COVID‐specific factors such as negative reactions to the pandemic, loneliness, and employment disruptions influence perceived stress trajectories, and how veterans vary across distal outcomes including posttraumatic stress disorder (PTSD), pain, depression, sleep problems, physical health, and alcohol use disorder. Results revealed a 4‐class solution: Stable High, Stable Low, Steady Increasing, and Steady Decreasing classes. In terms of COVID specific factors, negative reactions to COVID were consistently associated with perceived stress for those in the Stable High and Steady Increasing classes whereas loneliness was associated with stress trajectories for all emergent classes. Finally, in terms of our distal outcomes, results showed a relatively robust pattern with veterans in the Stable High or Steady Increasing classes reporting worse scores across all outcomes including PTSD, pain, sleep problems, physical health, depression, and alcohol use disorder. Understanding the interplay between existing vulnerabilities, ongoing stressors, and behavioural health outcomes among veterans is crucial for prevention and intervention efforts.

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“…This discrepancy coincides with research showing problematic use of substances is perhaps more ubiquitous than during non-pandemic times ( Satre et al, 2020 ), possibly as a means of coping with pandemic-related stressors ( Wardell et al, 2020 ). However, other research suggests the COVID-19 related increases in substance use vary for different veteran populations, such as those with pre-COVID mental health concerns being associated with increased drinking ( Davis et al, 2021 ; Pedersen et al, 2021 ). From a clinical perspective, this increase in substance use may be explained by additional underlying psychological mechanisms, such as cognitive process (e.g., Desire Thinking; Mansueto et al, 2019 ), psychiatric symptom management ( Cosci et al, 2019 ), personality vulnerabilities such as impulsive sensation-seeking or behavioral disinhibition ( Sher et al, 2000 ; Oh et al, 2021 ), and dysfunctional coping strategies (see Cavicchioli et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

“…Given the high possibility that potential recruited responders might be motivated to complete the survey even without being a veteran due to monetary gains, we instituted a series of survey items and validation checks similar to those utilized by Pedersen et al (2017 , 2021 ) when recruiting veteran community samples. To verify veteran status, an initial screening item asked respondents for their current military status (i.e., active duty, not and have never been a member of the military, a veteran, or other).…”

Section: Methodsmentioning

confidence: 99%

“…The combined impact of these factors—pandemic impacts on quality of life (e.g., finances and meeting basic needs)—on the health and well-being of veterans is not yet clear. Though there have been studies on the impact of COVID-19 on veteran substance use ( Fitzke et al, 2021 ; Pedersen et al, 2021 ), none have specifically investigated problematic substance use, COVID-19 related changes in SDH, and functional outcomes. There is also a continued and growing need to understand more precisely COVID-19 health, stressors, and infection-control behaviors, which have occurred in very particular contexts for individuals as they balance maintaining their quality of life and staying safe.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study

et al. 2022

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As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.

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American Veterans in the Era of COVID-19: Reactions to the Pandemic, Posttraumatic Stress Disorder, and Substance Use Behaviors

Cited by 13 publications

References 44 publications

The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review

The Intertwining of Posttraumatic Stress Symptoms, Alcohol, Tobacco or Nicotine Use, and the COVID-19 Pandemic: A Systematic Review

Changes in perceived stress during the COVID‐19 pandemic among American veterans

The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study

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