title: Drug use and childhood-, military- and post-military trauma exposure among women and men veterans.
abstract: BACKGROUND
  The current study was undertaken to examine whether posttraumatic stress symptoms (PTSS) and depressive symptoms mediated the association between trauma exposure (combat-related trauma and non-combat traumas occurring before, during, and after military service), and drug abuse symptoms use among male and female veterans.
  
  
  METHODS
  Participants were 2304 (1851 male, 453 female) veterans who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC). Path analytic models were used to determine the association between problematic past-year drug use and combat-related and non-combat trauma experienced before, during, or after the military and whether current post-traumatic stress symptoms or depressive symptoms mediated these associations.
  
  
  RESULTS
  For both male and female veterans, depressive symptoms significantly mediated the effects of pre- and post-military trauma on drug abuse symptoms.
  
  
  CONCLUSIONS
  Mental health providers who work with trauma-exposed Iraq and Afghanistan era veterans should assess for drug use, depressive symptoms, and life-span trauma (i.e., not only combat-related traumas) as part of a thorough trauma-based assessment for both men and women.
authors.affiliation: Department of Psychology, Old Dominion University, 5115 Hampton Boulevard, Norfolk, VA 23529, USA. Electronic address: mkelley@odu.edu.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Kelley
authors.affiliation: Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA. Electronic address: Mira.Brancu@va.gov.
authors.forename: Mira
authors.initials: M
authors.lastname: Brancu
authors.affiliation: Virginia Consortium Program in Clinical Psychology, Norfolk, VA 23504, USA. Electronic address: atrobbin@gmail.com.
authors.forename: Allison T
authors.initials: AT
authors.lastname: Robbins
authors.affiliation: Department of Psychology, Old Dominion University, 5115 Hampton Boulevard, Norfolk, VA 23529, USA. Electronic address: gdlima@odu.edu.
authors.forename: Gabrielle M
authors.initials: GM
authors.lastname: D'Lima
authors.affiliation: Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; Mental Health Services, Department of Veterans Affairs, Washington, DC 20420, USA. Electronic address: Jennifer.Strauss@va.gov.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Strauss
authors.affiliation: Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA. Electronic address: John.Curry@va.gov.
authors.forename: John F
authors.initials: JF
authors.lastname: Curry
authors.affiliation: Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA. Electronic address: John.Fairbank2@va.gov.
authors.forename: John A
authors.initials: JA
authors.lastname: Fairbank
authors.affiliation: Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA. Electronic address: Jennifer.Runnals@va.gov.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Runnals
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D003863:Depression / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D000067073:Psychological Trauma / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*; D000067453:War Exposure / Q000706:statistics & numerical data*
keywords: Depressive symptoms; Drug abuse symptoms; PTSS/PTSD; Trauma; Veterans