title: Changes in alcohol use after traumatic experiences: the impact of combat on Army National Guardsmen.
abstract: OBJECTIVE
  This research documents the impact of combat experiences on alcohol use and misuse among National Guard soldiers. Whereas much research regarding combat personnel is based on post-experience data, this study's design uses both pre- and post-deployment data to identify the association between different types of combat experiences and changes in substance use and misuse.
  
  
  METHODS
  A National Guard Infantry Brigade Combat Team was surveyed before and after its deployment to Iraq in 2005-2006. Members of the unit completed anonymous surveys regarding behavioral health and alcohol use and, in the post-survey, the combat experiences they had during deployment. The unit was surveyed 3 months prior to its deployment and 3 months after its deployment.
  
  
  RESULTS
  Prevalence rates of alcohol use increased from 70.8% pre-deployment to 80.5% post-deployment. Prevalence rates of alcohol misuse more than doubled, increasing from 8.51% before deployment to 19.15% after deployment. However, among the combat experiences examined in this study, changes in alcohol misuse post-deployment appear to be solely affected by the combat experience of killing. Alcohol misuse decreased amongst those who experienced killing during combat.
  
  
  CONCLUSIONS
  This study highlights the role of combat experiences on substance use.
authors.affiliation: Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States; Uniformed Services University, F. Edward Hebert School of Medicine, Department of Psychiatry, 4301 Jones Bridge Road, Bethesda, MD 20814, United States. Electronic address: dale.w.russell1.mil@mail.mil.
authors.forename: Dale W
authors.initials: DW
authors.lastname: Russell
authors.affiliation: American University, 4400 Massachusetts Avenue, NW Washington, DC 20016, United States.
authors.forename: Cristel Antonia
authors.initials: CA
authors.lastname: Russell
authors.affiliation: Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States.
authors.forename: Lyndon A
authors.initials: LA
authors.lastname: Riviere
authors.affiliation: Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Thomas
authors.affiliation: Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Wilk
authors.affiliation: Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Bliese
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology / Q000209:etiology; D003130:Combat Disorders / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D054542:Iraq War, 2003-2011; D008016:Life Change Events; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Longitudinal; Military; National Guard