Publication year
2010
Citation Title
Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war.
Journal Name
Drug and Alcohol Dependence
Journal Volume
108
Issue Number
1-2
Page Numbers
115-121
DOI
10.1016/j.drugalcdep.2009.12.003
Summary
One thousand one hundred twenty Soldiers who recently returned from Iraq completed surveys three to four month after homecoming to examine the association between specific types of combat experiences and alcohol misuse. Combat experiences were categorized as: (1) Fighting; (2) Killing; (3) Threat to Oneself; (4) Death-injury of others; (5) Atrocities; and (6) Positive experiences. Most combat experiences were significantly related to alcohol misuse.
Key Findings
Twenty-five percent of the Soldiers screened positive for alcohol misuse 3-4 months following redeployment. Twelve percent screened positive and revealed that they had experienced alcohol-related behavioral problems.
The overall level of combat experience and five of the six individual combat questions were significantly related to alcohol misuse. Further, an increased rate of exposure to threat of death or injury to one’s self explained the most variance in alcohol use.
Experiencing hostile reactions from civilians did not significantly predict alcohol misuse.
When using a more strict definition of alcohol use that included alcohol-related behavioral problems, all six combat exposure factors were significantly related to an increased likelihood of screening positive for misuse; experiencing atrocities explained the most variance in alcohol misuse.
Implications for Program Leaders
Offer classes to Service members upon homecoming from a combat deployment about the range of possible challenges some people experience, including alcohol misuse
Provide workshops for family members of recently deployed Service members, including information about possible difficulties their loved one may face in the reintegration process, the dangers of alcohol misuse. and how family members can be supportive in those circumstances
Educate couples who have a history of trauma and substance abuse before deployment on positive coping skills
Implications for Policy Makers
Recommend that Service members returning from a combat deployment be assessed for a range of risky behaviors (including alcohol misuse), both upon homecoming and over the next year
Encourage training for unit leaders and service providers about the dangers of alcohol misuse of their unit and available resources
Continue to support programs for identification and prevention of substance abuse in military families
Methods
Soldiers who had returned from an Iraq deployment three to four months prior were recruited from a large Army post in May of 2006. Soldiers were asked to complete an anonymous survey.
The survey examined their experiences in combat, physical and mental health, perceptions of their unit and leaders, status of their relationship with their family, and the health of their family members.
Statistical analyses assessed the relationships between demographic, military, and mental health variables.
Participants
One thousand one hundred twenty Soldiers recently returned from Iraq participated in the survey (96% male).
Fifty-nine percent were married and 59% were White, and the age breakdown of the sample is as follows: 41% were 18-24 years old, 30% were 25-29 years old, 25% were 30-39 years old.
Among the sample, 48% were junior enlisted, while 68% had deployed once and 32% had deployed more than once.
Limitations
The data were cross-sectional, and causal conclusions cannot be determined.
All measures were self-report which may introduce biases.
The alcohol measure was a screening tool and may not reflect actual alcohol use problems.
These results are not generalizable to the entire Army as only members of infantry Brigade Combat Teams participated.
Avenues for Future Research
Use broader, more in-depth measures of alcohol use (rather than just a screener) to gather more nuanced data of substance abuse
Conduct longitudinal studies that follow Soldiers from pre-deployment to reintegration in order to make stronger causal claims
Gather data on personality factors that may impact Service members' substance abuse, especially alcohol abuse
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: Studies have shown a relationship between combat experiences and alcohol misuse in military personnel; it is not known if there are specific combat experiences that confer a greater risk. The current study examined the association of specific types of combat experiences with a positive screen for alcohol misuse. Methods: 1120 U.S. soldiers who were members of brigade combat infantry teams were surveyed anonymously 3–4 months after returning from deployment to Iraq regarding their experiences in combat and their physical and mental health. Combat items were independently rated and placed into the following categories: (1) Fighting; (2) Killing; (3) Threat to oneself; (4) Death/injury of others; (5) Atrocities; and, (6) Positive experiences. Alcohol misuse was measured using a 2-item alcohol screen combined with alcohol-related behavioral items. Results: Of the soldiers sampled, 25% (N= 275) screened positive for alcohol misuse 3–4 months postdeployment; 12% (N= 125) screened positive and exhibited alcohol-related behavioral problems. Most combat exposure factors were significantly related to alcohol misuse individually. When factors were analyzed simultaneously, soldiers who had higher rates of exposure to the threat of death/injury were significantly more likely to screen positive for alcohol misuse; exposure to atrocities predicted misuse of alcohol with alcohol-related behavioral problems. Conclusions: High exposure to threatening situations and atrocities was associated with a positive screen for alcohol misuse. Clinicians treating combat veterans should be aware of the potential association of alcohol misuse with specific types of experiences and closely follow those soldiers upon their return home.
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