February 16, 2012 -- Soldiers in the National Guard with no history of alcohol abuse are at significant risk of developing alcohol-related problems during and after deployment, according to a new study published in Drug and Alcohol Dependence journal. Researchers at Columbia University's Mailman School of Public Health and colleagues at three other institutions found that the soldiers at greatest risk of developing alcohol-related problems also experienced depression and/or PTSD during or after deployment.
Alcohol-related behaviors are common among the military, yet few studies have looked at how issues like PTSD and depression contribute to the risk for abuse during or following their service. The knowledge gap is even greater for army guard soldiers.
The researchers based their findings on data collected between June 2008 and February 2009 from 963 soldiers of the Ohio Army National Guard and who said they had never abused alcohol prior to active duty. The investigators found that 113 (11.7%) of the soldiers reported alcohol abuse disorder that first occurred during or post deployment.
The 113 respondents were also screened for depression and PTSD based on standard criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Among this group, 35 (31%) also reported depression, 23 (20.4%) reported PTSD, and 15 (13.3%) reported both psychiatric conditions. Interestingly, the study shows that alcohol abuse was uncommon among the small number of participants who had a history of depression or PTSD prior to their deployment.
The soldiers at risk for new onset alcohol abuse were mostly male (97%), less than 35 years of age (74%), and single (45%). The majority had been deployed only once and most recently to a conflict setting.
"A novel finding of our study is that developing depression or PTSD during or after deployment were strong risk factors for having alcohol problems during the same time period," said Brandon Marshall, PhD, of the Department of Epidemiology at Columbia's Mailman School and lead author of the study. Because new onset alcohol abuse was most common among service members experiencing depression and PTSD, one possible explanation is that soldiers who experienced depression or PTSD self-medicate with alcohol to cope with negative feelings and the stress of deployment.
These findings have important implications for intervention and policy, according to Dr. Marshall and colleagues. Historically, few active soldiers seek treatment services for alcohol abuse, mainly because information is non-confidential and may be perceived as having negative career consequences. "The high prevalence of alcohol abuse during and after deployment observed here suggests that policies that promote improved access to care and confidentiality merit strong consideration," noted Dr. Marshall.
Previous studies have found that National Guard soldiers are more likely to engage in alcohol-related behavior compared to active army personnel. They are also less likely to enter substance abuse treatment after they return from active duty. "These findings indicate the urgent need to evaluate the availability and uptake of alcohol treatment interventions for this population," noted Sandro Galea, MD, DrPH, chair of the Mailman School Department of Epidemiology and senior author.
The investigators caution that the timing of new onset alcohol abuse in relation to a psychiatric disorder was self-reported. They also note that there were few women included in the study.
In addition to the researchers at Columbia's Mailman School of Public Health, co-authors included investigators at the University of Michigan, University of Toledo College of Medicine and Case Western Reserve University. The study was supported by the United States Department of Defense.
About Columbia University's Mailman School of Public Health
Founded in 1922 as one of the first three public health academies in the nation, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,000 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including the International Center for AIDS Care and Treatment Programs (ICAP), the National Center for Disaster Preparedness, and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu