Mental Health Over Time in a Military Sample: The Impact of Alcohol Use Disorder on Trajectories of Psychopathology After Deployment

Abstract

To identify trajectories of posttraumatic stress (PTS) and depression symptom groups after deployment and determine the effect of alcohol use disorder on these trajectories, PTS symptoms were modeled using the PTSD Checklist in 472 Ohio National Guard members, and depression symptoms were modeled using the 9-item Patient Health Questionnaire in 727 Ohio National Guard members. There were 42% of participants who were resistant to PTS symptoms across the 4 years of study and 55.9% were resistant to depression symptoms. There were 19% and 42.2% of participants who showed resilience (experiencing slightly elevated symptoms followed by a decline, according to Bonanno et al., 2004) to depression and PTS symptoms, respectively. Mild and chronic dysfunction constituted the smallest trajectory groups across disorders. Marital status, deployment to an area of conflict, and number of lifetime stressors were associated with membership into different latent groups for depression (unstandardized beta estimates range: 0.69 to 1.37). Deployment to an area of conflict, number of lifetime potentially traumatic events and education predicted membership into different latent groups for PTS (unstandardized beta estimate range: 0.83 to 3.17). Alcohol use disorder was associated with an increase in both symptom outcomes (unstandardized beta estimate range: 0.20 to 9.45). These results suggest that alcohol use disorder may have contributed substantially to trajectories of psychopathology in this population.

Long‐Term Trajectories of PTSD in Vietnam‐Era Veterans: The Course and Consequences of PTSD in Twins

“…We further adjusted for military and 1992 demographic factors (age, race, marital status, education, branch of service, employment, and age at enlistment) using model‐based weighting. Lastly, because comorbidities can affect trajectories (Sampson et al., ), we included psychiatric diagnoses in 1992 (MDD, AUD, SUD, and GAD) in our modeling. In all analyses, significance levels were two‐sided and set at p = .05.…”

“…A recent doubling of PTSD cases among Vietnam‐era veterans seeking VA mental health treatment between 1997 and 2010 suggests an increased prevalence of PTSD in this at risk population (Hermes et al., ), which could be due to late onset or chronicity with late treatment seeking as well as new screening policies for VA primary care. Psychiatric comorbidities, especially alcohol use disorder and depression, could also be implicated, as they have been found to worsen PTSD symptoms (Sampson et al., ).…”

Coincident alcohol dependence and depression increases risk of suicidal ideation among Army National Guard soldiers

“…These civilian findings, along with the relatively common occurrence and comorbidity of both conditions among military service members [28,29], provide strong warrants for investigating their synergy in predicting suicidal ideation among service members. Evidence that alcohol misuse may exacerbate depression symptom trajectories among Army National Guard service members [30] adds further credence.…”

Alcohol Misuse and Co‐Occurring Mental Disorders Among New Soldiers in the U.S. Army

“…Heavy drinking also has been found to be associated with increased risk for suicidal behaviors among Army soldiers (Mash et al, 2014). Similarly, AUDs were associated with increases over time in depressive and posttraumatic stress symptoms among Ohio National Guard members (Sampson et al, 2015). Beyond impacts on individual health and functioning, alcohol misuse burdens the Armed Forces as an organization, with dose-response relationships observed between level of drinking and productivity loss (Mattiko et al, 2011).…”