The Influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans

Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 04/2012; 25(2):216-9. DOI: 10.1002/jts.21686
Source: PubMed


The present study evaluated the impact of combat and interpersonal trauma exposure in a sample of 115 U.S. women veterans from Gulf War I and the Iraq and Afghanistan wars on 3 postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Patients presenting for healthcare services at a Veterans Affairs postdeployment health specialty clinic completed screening questionnaires that assessed combat exposure, lifetime interpersonal trauma history of childhood neglect, physical, or sexual abuse, and adult sexual and physical assault. In a regression model, combat exposure was the only significant independent variable associated with PSS, DSS, and alcohol misuse (β = .42, .27 and B = 1.58, respectively) even after adding lifetime interpersonal assault exposure to the model. Results highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Incorporating combat exposure into routine screening procedures for Gulf War and Iraq and Afghanistan war women veterans can aid in mental health treatment planning.

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    • "Women's utilization of substance abuse services is of particular concern because women veterans are less likely than men to seek substance use services, including intensive outpatient programs (Davis, Bush, Kivlahan, Dobie, & Bradley, 2003; Ross, Fortney, Lancaster, & Booth, 1998; Stecker, Han, Curran, & Booth, 2007). This trend is problematic because women veterans exposed to trauma tend to misuse alcohol more frequently (Hassija et al., 2012) and are more likely to experience comorbid depression with anxiety and substance use disorders (Curry, Aubuchon-Endsley, Brancu, Runnals, & Fairbank, 2014); a strong link has also been found between substance abuse and completed suicide in women veterans (Chapman & Wu, 2014). Reduced use of substance use services is important given data linking engagement in treatment for substance abuse to reduced likelihood of making a suicide attempt (Ilgen, Harris, Moos, & Tiet, 2007). "
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    ABSTRACT: Combat exposure and military sexual trauma (MST) are prevalent among returning women veterans and are associated with increased alcohol use and psychological distress. However, it remains unclear the extent to which combat exposure and MST are associated with utilization of health care in the Veterans Health Administration (VHA). The current study explored the relationships among alcohol use and distress in women who deployed in support of Operations Enduring Freedom, Iraqi Freedom, and New Dawn. It was hypothesized that increased posttraumatic stress disorder (PTSD) and depression symptomatology and trauma exposure would be related to greater VHA utilization, whereas alcohol misuse would predict lower VHA use. Participants (N = 133) completed an Internet-based survey of deployment experiences, substance use, mental health, and utilization of VHA services. In this sample, 33% endorsed MST exposure, 64% endorsed combat exposure, and 78% indicated exposure to the aftermath of battle. Multiple regression models found combat exposure-but not MST or aftermath-to be significantly associated with alcohol use and symptoms of PTSD and depression. Only 37% of participants reported use of VHA services, and logistic regression models indicated that PTSD symptomatology was the only unique predictor of VHA use. Findings suggest potential barriers for women who endured sexually based trauma in a military setting in seeking treatment at the VHA. (PsycINFO Database Record
    Full-text · Article · Nov 2015 · Psychological Services
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    • "When combat stressors, selfreported stress reactions and exposures to other stressful events in theater were quantified, these variables did not explain or predict diagnosis of GWI Table 3. These studies have concluded that PTSD symptom severity was associated with poorer physical health after deployment (Hassija, Jakupcak, Maguen, & Shipherd, 2012), that exposure to war casualties was associated with greater mental health decline (Gade & Wenger, 2011) and that combat exposure was related to PTSD, depressive symptoms and alcohol abuse (Hassija et al., 2012). Problem drinking in the GW population was found to be associated with PTSD, major depression and multisymptom illness (Coughlin, Kang, & Mahan, 2011). "
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    ABSTRACT: Veterans of Operation Desert Storm/Desert Shield − the 1991 Gulf War (GW) − are a unique population who returned from theater with multiple health complaints and disorders. Studies in the U.S. and elsewhere have consistently concluded that approximately 25–32% of this population suffers from a disorder characterized by symptoms that vary somewhat among individuals and include fatigue, headaches, cognitive dysfunction, musculoskeletal pain, and respiratory, gastrointestinal and dermatologic complaints. Gulf War illness (GWI) is the term used to describe this disorder. In addition, brain cancer occurs at increased rates in subgroups of GW veterans, as do neuropsychological and brain imaging abnormalities.
    Full-text · Article · Sep 2015 · Cortex
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    • "Stein et al. (2012) "
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    ABSTRACT: Recent research has provided compelling evidence of mental health problems in military spouses and children, including post-traumatic stress disorder (PTSD), related to the war-zone deployments, combat exposures, and post-deployment mental health symptoms experienced by military service members in the family. One obstacle to further research and federal programs targeting the psychological health of military family members has been the lack of a clear, compelling, and testable model to explain how war-zone events can result in psychological trauma in military spouses and children. In this article, we propose a possible mechanism for deployment-related psychological trauma in military spouses and children based on the concept of moral injury, a model that has been developed to better understand how service members and veterans may develop PTSD and other serious mental and behavioral problems in the wake of war-zone events that inflict damage to moral belief systems rather by threatening personal life and safety. After describing means of adapting the moral injury model to family systems, we discuss the clinical implications of moral injury, and describe a model for its psychological treatment.
    Full-text · Article · Jul 2013 · Clinical Child and Family Psychology Review
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