Publication year
2017
Citation Title
Combat exposure, emotional and physical role limitations, and substance use among male United States Army Reserve and National Guard soldiers.
Journal Name
Quality of Life Research
DOI
10.1007/s11136-017-1706-2
Summary
Combat exposure is a risk factor for poor quality of life for Service members; however, the role of unhealthy life style (e.g., heavy drinking, substance abuse) in the association between combat exposure and quality of life is unknown. Male Soldiers completed an on-line survey regarding their combat exposure, quality of life, and drinking and substance use behaviors to explore this association. Results revealed a negative association between Soldiers' combat exposure and quality of life, and also indicated that heavy drinking and substance abuse behaviors amplified the negative association.
Key Findings
Soldiers who had greater combat exposure were more likely to have limited daily activities due to physical and emotional issues than Soldiers who had less combat exposure.
The association between combat exposure and physical and emotional role limitations (i.e., daily activity limitations due to physical and emotional reasons) was stronger for Soldiers who had frequent heavy drinking problems than Soldiers who were not heavy drinkers.
Soldiers who were exposed to combat and used illicit drugs were more likely to have physical role limitations than Soldiers who had combat exposure but no substance abuse issues.
Implications for Program Leaders
Offer support groups for Service members whose quality of life is negatively impacted by their combat experiences (e.g., witnessing someone being seriously wounded or killded)
Develop workshops for Service members and their families on effective ways to increase their quality of life
Train professionals who work with Service members about how to screen for frequent heavy drinking and non-medical use of prescription drugs
Implications for Policy Makers
Recommend professional development for professionals working with Service members to better understand the negative effect of heavy drinking on Service members who had combat exposure
Encourage collaboration between military and civilian health care professionals to enhance their awareness of the connections between military services and patients' well-being
Raise awareness on military bases regarding the potential negative impact of combat exposure on Service members' quality of life
Methods
Participants were recruited from 47 units across New York; the method of recruitment was not indicated in the article, and all participants were either married or co-habitating.
Participants completed an on-line survey, and measures included combat exposure, physical and emotional role limitations, frequency of heavy drink, and lifetime substance abuse.
Data were analyzed to examine the relationship between combat exposure, substance abuse, and emotional and physical role limitations.
Participants
Participants were 248 male Army Reserve or Army National Guard Soldiers with an average age of 33.39 years (SD = 6.2).
The majority of participants were White (87%); the race/ethnicity of the other 13% of participants was not reported.
All participants had a history of deployment; the average time interval between their return from the last deployment and the study was 4.6 years (SD = 3.2).
Limitations
Participants were only male Soldiers; therefore, results of the study cannot be applied to female Service members or Service members in other military branches.
The cross-sectional design of the study does not allow for examining the potential causal relationships between combat exposure, heavy drinking, substance abuse, and quality of life.
Only self-report data were collected; therefore, the study may be subject to memory bias and social-desirability bias.
Avenues for Future Research
Recruit both male and female participants so that the results of the study can be better generalized
Conduct longitudinal studies to examine the causal relationship between combat exposure, heavy drinking, substance abuse, and quality of life
Examine whether separating from the military has any effect on Soldiers' quality of life
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Combat-exposed soldiers are at an increased risk for health problems that diminish quality of life (QOL) and substance use. We explored the cross-sectional associations between combat exposure and two measures of QOL, and the effect of substance use on those associations. Data are from the baseline wave of Operation: SAFETY, an ongoing survey-based study of United States Army Reserve/National Guard (USAR/NG) soldiers and their partners. Our sample consisted of male USAR/NG soldiers with a history of deployment (N = 248). Limitations in usual activity due to physical and emotional problems were assessed using the 36-Item Short-Form Health Survey (SF-36). Greater combat exposure was independently associated with limitations in usual activity due to physical
(regression coefficient = −0.35, 95% CI −0.55 to −0.16,R2 = 0.09; p < 0.01) and emotional (regression coefficient = −0.32, 95% CI −0.56 to −0.09, R2 = 0.09; p < 0.01) problems. Combat exposure had a significant interaction with frequent heavy drinking on physical role limitations (regression coefficient = −0.65, 95% CI −1.18 to −0.12, R2 = 0.12; p < 0.05) and emotional role limitations (regression
coefficient = −0.83, 95% CI −1.46 to −0.19, R2 = 0.12; p < 0.05). Combat exposure also had a significant interaction with lifetime non-medical use of prescription drugs on physical role limitations (regression coefficient = 0.81, 95% CI 0.18–1.45, R2 = 0.11; p < 0.05). Combat is an unmodifiable risk factor for poor QOL among soldiers; however, frequent heavy drinking and non-medical use of prescription drugs modifies the relationship between combat exposure and QOL. Therefore, substance use is a potential point of intervention to improve QOL among soldiers.
(regression coefficient = −0.35, 95% CI −0.55 to −0.16,R2 = 0.09; p < 0.01) and emotional (regression coefficient = −0.32, 95% CI −0.56 to −0.09, R2 = 0.09; p < 0.01) problems. Combat exposure had a significant interaction with frequent heavy drinking on physical role limitations (regression coefficient = −0.65, 95% CI −1.18 to −0.12, R2 = 0.12; p < 0.05) and emotional role limitations (regression
coefficient = −0.83, 95% CI −1.46 to −0.19, R2 = 0.12; p < 0.05). Combat exposure also had a significant interaction with lifetime non-medical use of prescription drugs on physical role limitations (regression coefficient = 0.81, 95% CI 0.18–1.45, R2 = 0.11; p < 0.05). Combat is an unmodifiable risk factor for poor QOL among soldiers; however, frequent heavy drinking and non-medical use of prescription drugs modifies the relationship between combat exposure and QOL. Therefore, substance use is a potential point of intervention to improve QOL among soldiers.
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