Drug use and hazardous drinking are associated with PTSD symptoms and symptom clusters in US Army Reserve/National Guard Soldiers

Abstract

Background and Objectives: There is strong evidence of the association between Posttraumatic Stress Disorder (PTSD) symptoms and substance use. Previous work has found sex differences in these associations. With revisions to the DSM, it is important to understand how overall PTSD symptoms and the new symptom clusters relate to substance use among Reserve/Guard soldiers-a high risk group. Methods: Data are from the baseline assessment of Operation: SAFETY (Soldiers and Families Excelling Through the Years), a longitudinal study of US Army Reserve/National Guard (USAR/NG) soldiers (N ¼ 389 males, N ¼ 84 females). We examined associations between current substance use (drug use, hazardous drinking, and smoking) and overall PTSD symptoms, and symptom clusters. Additionally, we examined PTSD by sex interactions. Results: Greater overall PTSD symptoms were associated with higher odds of drug use (OR ¼ 1.08; 95%CI: 1.05, 1.12) and hazardous drinking (OR ¼ 1.04; 95%CI: 1.02, 1.07). Greater individual symptom cluster scores were associated with higher odds of drug use (ps < .001) and hazardous drinking (ps < .01). Interaction models revealed no differences in these associations on the basis sex (ps > .05). There were no associations between PTSD symptoms or symptom clusters on smoking (ps > .05). Discussion and Conclusion: Soldiers experiencing PTSD symptoms are reporting current drug and hazardous alcohol use, suggestive of self-medication. Scientific Significance: It is imperative to consider the impact of PTSD on substance use broadly, as this work shows that overall symptoms and symptom clusters have an impact on male and female USAR/NG soldiers.

Lifetime trauma exposure profiles and alcohol use over time among U.S. Reserve and National Guard soldiers

“…The present analyses also suggest that these trauma exposure profiles are important for alcohol use outcomes even after accounting for PTSD, a known contributing factor to alcohol problems among military service members (Banducci et al., 2019; Homish et al., 2019; Walton et al., 2018). Specifically, the results indicate that R/NG soldiers with high levels of IPV exposure, in combination with slightly higher than average levels of combat exposure, are most consistently at risk for problematic alcohol use.…”

Zur Komorbidität von Posttraumatischer Belastungsstörung und Sucht in biopsychosozialer Perspektive

“…Ergebnisse aus Langzeitstudien , die eine häufigere inzidente Substanzkonsumstörung nach Trauma und PTBS, nicht aber nach Trauma-Exposition alleine hervorhoben, gehen mit dieser Sichtweise ebenfalls gut konkordant [ 31 , 158 ]. Belege für eine Selbstmedikationshypothese erbrachten auch Detailstudien, die einen erhöhten Substanzkonsum in Abhängigkeit von definierten PTBS-Symptomclustern (Hyperarousal, Vermeidung, intrusive Wiedererinnerung; negative Trauma-assoziierte Stimmungen und Kognitionen) als Strategien einer Selbstregulation analysierten [ 29 , 57 , 62 , 80 , 124 , 172 , 201 ]. Generell stellte sich ein signifikanter Zusammenhang zwischen dem Gesamt-Score über alle PTBS-Symptomcluster und der Intensität des berichteten Cravings für die untersuchten Substanzen (Alkohol, Stimulantien, Opiate) dar.…”

Intraindividual association of PTSD symptoms with binge drinking among trauma-exposed students.

“…Buckner and colleagues demonstrated that, among participants with PTSD who endorsed clinically significant hyperarousal symptoms, elevations in state anxiety predicted cannabis use (Buckner et al, 2018). PTSD may also be associated with an increased likelihood of using other psychoactive substances (Homish et al, 2019). Therefore, further research is needed to clarify whether PTSD symptom severity is associated specifically with high-risk alcohol use or generally with the use of other psychoactive substances.…”