title: Relationship of combat experiences to alcohol misuse among U.S. soldiers returning from the Iraq war.
abstract: OBJECTIVE
  Studies have shown a relationship between combat experiences and alcohol misuse in military personnel; it is not known if there are specific combat experiences that confer a greater risk. The current study examined the association of specific types of combat experiences with a positive screen for alcohol misuse.
  
  
  METHODS
  1120 U.S. soldiers who were members of brigade combat infantry teams were surveyed anonymously 3-4 months after returning from deployment to Iraq regarding their experiences in combat and their physical and mental health. Combat items were independently rated and placed into the following categories: (1) Fighting; (2) Killing; (3) Threat to oneself; (4) Death/injury of others; (5) Atrocities; and, (6) Positive experiences. Alcohol misuse was measured using a 2-item alcohol screen combined with alcohol-related behavioral items.
  
  
  RESULTS
  Of the soldiers sampled, 25% (N=275) screened positive for alcohol misuse 3-4 months post-deployment; 12% (N=125) screened positive and exhibited alcohol-related behavioral problems. Most combat exposure factors were significantly related to alcohol misuse individually. When factors were analyzed simultaneously, soldiers who had higher rates of exposure to the threat of death/injury were significantly more likely to screen positive for alcohol misuse; exposure to atrocities predicted misuse of alcohol with alcohol-related behavioral problems.
  
  
  CONCLUSIONS
  High exposure to threatening situations and atrocities was associated with a positive screen for alcohol misuse. Clinicians treating combat veterans should be aware of the potential association of alcohol misuse with specific types of experiences and closely follow those soldiers upon their return home.
authors.affiliation: Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, U.S. Army Medical Research and Materiel Command, Silver Spring, MD 20910, United States. joshua.wilk@amedd.army.mil
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Wilk
authors.forename: Paul D
authors.initials: PD
authors.lastname: Bliese
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Kim
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Thomas
authors.forename: Dennis
authors.initials: D
authors.lastname: McGurk
authors.forename: Charles W
authors.initials: CW
authors.lastname: Hoge
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology; D003130:Combat Disorders / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000150:complications / Q000523:psychology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008889:Military Personnel; D016017:Odds Ratio; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans; D055815:Young Adult