title: Predictors of continued problem drinking and substance use following military discharge.
abstract: OBJECTIVE
  The goals of the present study were to (a) examine change in rates of problem alcohol/substance use among a sample of veterans between their last year of military service and their first year following separation, (b) identify predictors of continued problem use in the first year after separation, and (c) evaluate the hypothesis that avoidant coping, posttraumatic stress disorder (PTSD) symptoms, and chronic stress place individuals at particularly high risk for continued problem use.
  
  
  METHODS
  Participants (N = 1,599) completed self-report measures before and during the year following separation. Participants who endorsed either having used more than intended or wanting or needing to cut down during the past year were considered to have problem use.
  
  
  RESULTS
  Of 742 participants reporting problem substance use at baseline, 42% reported continued problem substance use at follow-up ("persistors"). Persistors reported more trouble adjusting to civilian life, had a greater likelihood of driving while intoxicated, and had a greater likelihood of aggression. Multivariate analyses showed that avoidant coping score at baseline and higher PTSD symptom score and greater sensation seeking at follow up predicted continued problem use.
  
  
  CONCLUSIONS
  Understanding risk factors for continued problem use is a prerequisite for targeted prevention of chronic problems and associated negative life consequences.
authors.affiliation: National Center for PTSD, Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, California, School of Medicine, University of California, San Diego, San Diego, California.
authors.forename: Sonya B
authors.initials: SB
authors.lastname: Norman
authors.affiliation: Naval Health Research Center, San Diego, California.
authors.forename: Emily
authors.initials: E
authors.lastname: Schmied
authors.affiliation: Naval Health Research Center, San Diego, California.
authors.forename: Gerald E
authors.initials: GE
authors.lastname: Larson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000374:Aggression; D000428:Alcohol Drinking / Q000453:epidemiology*; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D001334:Automobile Driving / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008889:Military Personnel / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult