Murray B Stein1,2, Laura Campbell-Sills1, Joel Gelernter3, Feng He2, Steven G Heeringa4, Matthew K Nock5, Nancy A Sampson6, Xiaoying Sun2, Sonia Jain2, Ronald C Kessler6, Robert J Ursano7. 1. Department of Psychiatry, University of California San Diego, La Jolla, California. 2. Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California. 3. Department of Psychiatry, Yale University, West Haven, Connecticut. 4. University of Michigan, Ann Arbor, Michigan. 5. Department of Psychology, Harvard University, Cambridge, Massachusetts. 6. Harvard Medical School, Boston, Massachusetts. 7. Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Abstract
BACKGROUND: Problem drinking that predates enlistment into military service may contribute to the overall burden of alcohol misuse in the Armed Forces; however, evidence bearing on this issue is limited. This study examines prevalence and correlates of alcohol misuse among new U.S. Army soldiers. METHODS: Cross-sectional survey data were collected from soldiers reporting for basic combat training. The survey retrospectively assessed lifetime alcohol consumption and substance abuse/dependence, enabling estimation of the prevalence of lifetime binge drinking and heavy drinking in a sample of 30,583 soldiers and of probable alcohol use disorder (AUD) among 26,754 soldiers with no/minimal lifetime use of other drugs. Co-occurrence of mental disorders and other adverse outcomes with binge drinking, heavy drinking, and AUD was examined. Discrete-time survival analysis, with person-year the unit of analysis and a logistic link function, was used to estimate associations of AUD with subsequent onset of mental disorders and vice versa. RESULTS: Weighted prevalence of lifetime binge drinking was 27.2% (SE = 0.4) among males and 18.9% (SE = 0.7) among females; respective estimates for heavy drinking were 13.9% (SE = 0.3) and 9.4% (SE = 0.4). Among soldiers with no/minimal drug use, 9.5% (SE = 0.2) of males and 7.2% (SE = 0.5) of females had lifetime AUD. Relative to no alcohol misuse, binge drinking, heavy drinking, and AUD were associated with increased odds of all mental disorders and other adverse outcomes under consideration (adjusted odds ratios [AORs] = 1.5 to 4.6; ps < 0.001). Prior mental disorders and suicidal ideation were associated with onset of AUD (AORs = 2.3 to 2.8; ps < 0.001), and prior AUD was associated with onset of mental disorders and suicidal ideation (AORs = 2.0 to 3.2, ps < 0.005). CONCLUSIONS: Strong bidirectional associations between alcohol misuse and mental disorders were observed in a cohort of soldiers beginning Army service. Conjoint recognition of alcohol misuse and mental disorders upon enlistment may provide opportunities for risk mitigation early in a soldier's career.
BACKGROUND: Problem drinking that predates enlistment into military service may contribute to the overall burden of alcohol misuse in the Armed Forces; however, evidence bearing on this issue is limited. This study examines prevalence and correlates of alcohol misuse among new U.S. Army soldiers. METHODS: Cross-sectional survey data were collected from soldiers reporting for basic combat training. The survey retrospectively assessed lifetime alcohol consumption and substance abuse/dependence, enabling estimation of the prevalence of lifetime binge drinking and heavy drinking in a sample of 30,583 soldiers and of probable alcohol use disorder (AUD) among 26,754 soldiers with no/minimal lifetime use of other drugs. Co-occurrence of mental disorders and other adverse outcomes with binge drinking, heavy drinking, and AUD was examined. Discrete-time survival analysis, with person-year the unit of analysis and a logistic link function, was used to estimate associations of AUD with subsequent onset of mental disorders and vice versa. RESULTS: Weighted prevalence of lifetime binge drinking was 27.2% (SE = 0.4) among males and 18.9% (SE = 0.7) among females; respective estimates for heavy drinking were 13.9% (SE = 0.3) and 9.4% (SE = 0.4). Among soldiers with no/minimal drug use, 9.5% (SE = 0.2) of males and 7.2% (SE = 0.5) of females had lifetime AUD. Relative to no alcohol misuse, binge drinking, heavy drinking, and AUD were associated with increased odds of all mental disorders and other adverse outcomes under consideration (adjusted odds ratios [AORs] = 1.5 to 4.6; ps < 0.001). Prior mental disorders and suicidal ideation were associated with onset of AUD (AORs = 2.3 to 2.8; ps < 0.001), and prior AUD was associated with onset of mental disorders and suicidal ideation (AORs = 2.0 to 3.2, ps < 0.005). CONCLUSIONS: Strong bidirectional associations between alcohol misuse and mental disorders were observed in a cohort of soldiers beginning Army service. Conjoint recognition of alcohol misuse and mental disorders upon enlistment may provide opportunities for risk mitigation early in a soldier's career.
Authors: Brandon D L Marshall; Marta R Prescott; Israel Liberzon; Marijo B Tamburrino; Joseph R Calabrese; Sandro Galea Journal: Drug Alcohol Depend Date: 2012-02-17 Impact factor: 4.492
Authors: Robert J Ursano; Lisa J Colpe; Steven G Heeringa; Ronald C Kessler; Michael Schoenbaum; Murray B Stein Journal: Psychiatry Date: 2014 Impact factor: 2.458
Authors: Laura Sampson; Gregory H Cohen; Joseph R Calabrese; David S Fink; Marijo Tamburrino; Israel Liberzon; Philip Chan; Sandro Galea Journal: J Trauma Stress Date: 2015-12
Authors: Ronald C Kessler; Steven G Heeringa; Lisa J Colpe; Carol S Fullerton; Nancy Gebler; Irving Hwang; James A Naifeh; Matthew K Nock; Nancy A Sampson; Michael Schoenbaum; Alan M Zaslavsky; Murray B Stein; Robert J Ursano Journal: Int J Methods Psychiatr Res Date: 2013-12 Impact factor: 4.035
Authors: Isabel G Jacobson; Margaret A K Ryan; Tomoko I Hooper; Tyler C Smith; Paul J Amoroso; Edward J Boyko; Gary D Gackstetter; Timothy S Wells; Nicole S Bell Journal: JAMA Date: 2008-08-13 Impact factor: 56.272
Authors: Karen J Derefinko; Robert C Klesges; Zoran Bursac; Melissa A Little; Ann Hryshko-Mullen; Gerald W Talcott Journal: Addict Behav Date: 2016-02-18 Impact factor: 3.913
Authors: Angela Nickerson; J Ben Barnes; Mark Creamer; David Forbes; Alexander C McFarlane; Meaghan O'Donnell; Derrick Silove; Zachary Steel; Richard A Bryant Journal: J Abnorm Psychol Date: 2014-10-06
Authors: Krishnan Radhakrishnan; Mihaela Aslan; Kelly M Harrington; Robert H Pietrzak; Grant Huang; Sumitra Muralidhar; Kelly Cho; Rachel Quaden; David Gagnon; Saiju Pyarajan; Ning Sun; Hongyu Zhao; Michael Gaziano; John Concato; Murray B Stein; Joel Gelernter Journal: Int J Methods Psychiatr Res Date: 2019-02-14 Impact factor: 4.035
Authors: R Polimanti; J Kaufman; H Zhao; H R Kranzler; R J Ursano; R C Kessler; M B Stein; J Gelernter Journal: Acta Psychiatr Scand Date: 2017-12-11 Impact factor: 6.392
Authors: Tamara L Taillieu; Tracie O Afifi; Mark A Zamorski; Sarah Turner; Kristene Cheung; Murray B Stein; Jitender Sareen Journal: Can J Psychiatry Date: 2020-01-29 Impact factor: 4.356
Authors: Sudie E Back; Therese Killeen; Christal L Badour; Julianne C Flanagan; Nicholas P Allan; Elizabeth Santa Ana; Brian Lozano; Kristina J Korte; Edna B Foa; Kathleen T Brady Journal: Addict Behav Date: 2018-11-27 Impact factor: 3.913
Authors: Melanie E Garrett; Xue Jun Qin; Divya Mehta; Michelle F Dennis; Christine E Marx; Gerald A Grant; Murray B Stein; Nathan A Kimbrel; Jean C Beckham; Michael A Hauser; Allison E Ashley-Koch Journal: Front Neurosci Date: 2021-07-29 Impact factor: 5.152
Authors: Mark B Reed; Susan I Woodruff; Gerard DeMers; Michael Matteucci; Sarah J Chavez; Megan Hellner; Suzanne L Hurtado Journal: J Stud Alcohol Drugs Date: 2021-03 Impact factor: 2.582