Publication year
2007
Citation Title
Posttraumatic stress disorder and service utilization in a sample of service members from Iraq and Afghanistan.
Journal Name
Military Medicine
Journal Volume
172
Issue Number
4
Page Numbers
359-363
DOI
10.7205/MILMED.172.4.359
Summary
Veterans participated in a study examining how posttraumatic stress disorder (PTSD), depression, and alcohol abuse impact quality of life and mental health utilization. PTSD, and to a lesser degree depression, were associated with lower quality of life in multiple domains.
Key Findings
The rate of PTSD (12%) was similar to other studies, and rates of risky drinking (33% classified as hazardous) were relatively high.
Among those screening positive for PTSD, 56% reported receiving individual or group therapy and/or psychiatric medication since their return from Iraq or Afghanistan.
Among risky drinkers, only 18% reported receiving any mental health services and only 3% reported receiving chemical dependency treatment.
General distress and negative affect as described in the depression questionnaire, but not PTSD symptoms, were associated with seeking psychiatric services.
Implications for Program Leaders
Host informational sessions for Service members and families about how to recognize mental and chemical health problems and to how to talk to a loved one about addiction
Offer support groups for family members impacted by mental or chemical health problems in their Service members
Offer workshops during reintegration to help families and Service members adjust to the Service member’s return, especially when the deployment has included combat exposure
Implications for Policy Makers
Recommend that all returning Service members be screened for alcohol use, depression, and PTSD, both upon return from deployment and over time
Encourage the development and continuation of programs that can promote resilience in Service members, their partners, and children
Recommend integrating substance abuse prevention education into existing service delivery systems for military families
Methods
OIF/OEF returnees who enrolled for care at the Minneapolis VA Medical Center were contacted via telephone and asked to participate; 92% of those contacted agreed to participate.
Those who agreed to participate completed (via mail) measures of post-traumatic stress, depression, alcohol use, quality of life, use of mental health services, and psychiatric medications before, during, and after deployment; 55% returned completed surveys.
Participants were classified into groups: PTSD-positive and negative; presence or absence of hazardous drinking.
Statistical analyses were used to compare PTSD and hazardous drinking groups on outcome variables, and to examine the relative contributions of depression, PTSD, and alcohol use to predict service utilization.
Participants
One-hundred twenty Veterans participated (86% male).
Among the participants, 54% were single, 28% were married, and 8% were divorced.
Participants' average age was 27.50 years, and 49% reported some college, 29% had a two or four year degree, and 10% had a graduate degree.
In this sample, 91% were in the Army (81% were Guard or Reserves), 5% Marines, 2% Air Force, and 2% Navy.
Limitations
There was limited demographic information presented, and the generalizability of these findings is unknown.
Veterans who were seeing mental health providers at the time were excluded from the study which may have biased the results.
Patients were divided into groups which diminishes the amount of information used from the data.
Results may not pertain to OIF/OEF Veterans who did not sign up for VA medical care or participate.
Avenues for Future Research
Use longitudinal designs to assess multiple domains of functioning such as depression, PTSD, and alcohol use to determine how they influence each other over time
Evaluate the effectiveness of a range of interventions for PTSD, both as a single diagnosis and when there are comorbid conditions such as alcohol abuse and mood disorders
Collect data on cultural variables such as racial identity to explore the extent to which these variables impact psychological functioning among Service members
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Abstract
Objective: The purpose of this study was to evaluate levels of post-traumatic stress disorder (PTSD), depression, alcohol abuse, quality of life, and mental health service utilization among returnees from Operation Enduring Freedom and Operation Iraqi Freedom. Methods: One hundred twenty returnees, enrolled for health care at a midwestern Veterans Affairs medical center, completed questionnaires approximately 6 months after their return from deployment. Results: PTSD levels (12%) were consistent with previous research while problematic drinking levels were also elevated (33%). PTSD and, to a lesser degree, alcohol abuse were associated with lower quality of life in multiple domains, even when controlling for the influence of depression. Of those screening positive for PTSD, 56% reported using mental health services. Only 18% of those screening positive for alcohol abuse reported using such services. Conclusions: PTSD and alcohol problems are prevalent in Operation Enduring Freedom/Operation Iraqi Freedom returnees and associated with lower quality of life. Mental health service utilization is limited, even among returnees enrolled for Veterans Affairs health care.
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