Dr. Shannon Blakey, a postdoctoral fellow at the Mid-Atlantic Mental Illness, Research, Education and Clinical Center (MIRECC) in Durham, VA, North Carolina, led the study. Photo credit: Joshua Edson

A new Veterans Affairs study shows that fighting experiences are linked to a higher risk of consuming alcohol to manage PTSD symptoms. However, the connection is weaker when the severity of the PTSD is considered.

The results were published online in the Journal of Dual Diagnosis in March 2021.

In an observational study of more than 11,000 men with at least one traumatic experience, the researchers found that those with combat experience were much more likely than those without alcohol to cope with PTSD. The variety of traumatic experiences, the severity of PTSD, and diagnoses of alcohol abuse or addiction were all significantly linked to drinking to cope with PTSD.

However, the fighting experience wasn’t heavily linked to drinking to deal with when the researchers adjusted a person’s total number of PTSD symptoms.

The researchers write: “Our results suggest that although men with combat experience consume alcohol more frequently to deal with PTSD symptoms and the associated stress than traumatically exposed men without military combat experience, this can in part be attributed to an overall higher post-traumatic stress severity may be among men who experienced military fighting.

“This interpretation is supported by higher rates of PTSD and higher PTSD symptom totals in men [combat experience] compared to those without in our sample, as well as previous research linking PTSD severity to both controlling exposure and consuming dangerous alcohol. Alcohol use may be viewed by military veterans as an effective, socially acceptable strategy for managing PTSD symptoms and associated distress, possibly due to certain personality factors, masculinity-related gender norms, or general attitudes toward alcohol common in the military. These and other possible interpretations require additional research attention. “

Dr. Shannon Blakey, a postdoctoral fellow at the Mid Atlantic Center for Mental Illness, Research, Education and Clinic of Durham, VA, North Carolina Health System, led the study. Dr. Jack Tsai and Dr. Eric Elbogen, both of the VA National Center on Homelessness Among Veterans, were the co-authors.

Blakey was most surprised by two of the results.

“First, the association between combat experience and alcohol use was statistically significant when considering the presence or absence of a PTSD diagnosis, but not when adjusting the number of PTSD symptoms,” she says. “This suggests that drinking to cope with traumatized men is more closely linked to the severity of PTSD than the mere presence of PTSD.”

“Second, our analyzes have shown that traumatically exposed men with no combat experience are more likely than men with combat experience to report an alcohol use disorder,” she adds. “This is inconsistent with previous research and underscores the complexity of the relationships between trauma exposure, post-traumatic experiences, alcohol use, and the severity of alcohol use in trauma survivors.”

Understanding the intricacies of PTSD is one of the most pressing challenges facing VA. A large percentage of veterans who have fought in Vietnam, the Gulf War, Iraq and Afghanistan have had PTSD at some point in their life. Symptoms include flashbacks, nightmares, hypervigilance, aggressive behavior, and anxiety.

Studies have shown that PTSD increases the risk of alcohol problems. However, little research has been done on whether combat experience is related to alcohol use to manage PTSD.

Blakey’s team used data from men who had participated in the National Epidemiological Survey on Alcohol and Related Diseases. The survey recruited a nationally representative sample of adults in the United States between 2004 and 2005, including veterans and non-veterans.

The researchers mainly focused on the answers to the yes-no question, “Have you ever drank alcohol to improve your mood or to make yourself feel better than you were?” [experiencing PTSD symptoms]”They adjusted whether the men met the criteria for an alcohol use disorder. This way, they were able to measure both alcohol consumption and drinking severity to deal with PTSD symptoms in their analyzes.

The poll also asked participants if they were ever in combat. Almost 1,400 reported having combat experience and more than 10,000 reported not. It is possible that some in the latter group were non-combat veterans. One analysis found that drinking to manage PTSD symptoms was more than twice as common in men with combat experience as in men without combat experience (6.46% versus 2.37%).

According to Blakey, the results raise questions that can be explored in future studies.

“Is there anything unique about combat trauma, compared to other types of trauma, that increases the likelihood that men will use substances like alcohol to relieve their PTSD symptoms. Men who experience a fight are more likely than men without combat experience to be positive Sociocultural beliefs advocating acceptability and helpfulness of alcohol in coping with PTSD symptoms? Are men who take on combat roles at greater risk of drinking because of another pre-existing risk factor? “

Although a large sample size was a strength of Blakey’s study, the research had limitations. One of these was that participants were asked specifically about their combat experience rather than their entire military service history. Therefore, it was not known how many of the men with no combat experience were veterans. The study also did not include women.

“Hopefully, future research can compare the risk factors and outcomes of PTSD-related alcohol use among combat veterans, non-combat veterans, and non-veterans,” Blakey said. “For future studies, it would also be important to recruit enough female veterans to examine the possible influence of gender and gender on these relationships.”

Childhood experiences and combat exposure related to poor mental health

More information:
Shannon M. Blakey et al., Drinking to Cope with Post-Traumatic Stress: A Nationally Representative Study of Men With and Without Military Combat Experience, Journal of Dual Diagnosis (2021). DOI: 10.1080 / 15504263.2021.1891360

Provided by Veterans Affairs Research Communications

Quote: The study sheds light on the interplay between PTSD, combat experience and alcohol consumption (2021, April 2), accessed on April 2, 2021 from https://medicalxpress.com/news/2021-04-interplay-ptsd-combat-alcohol.html

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