title: Alcohol use and craving among Veterans with mental health disorders and mild traumatic brain injury.
abstract: Mental health disorders (MHDs), mild traumatic brain injury (mTBI), and alcohol use disorder (AUD) are endemic among recent Veterans, resulting in a population with heterogeneous, co-occurring conditions. While alcohol craving negatively affects rehabilitation and leads to relapse, no studies have examined alcohol craving among Veterans with co-occurring MHDs and mTBI. The purpose of this preliminary cohort study is to describe alcohol craving in a convenience sample of Iraq and Afghanistan Veterans (n = 48), including those exposed to traumatic events and experiencing active symptoms. Veterans completed weekly telephone interviews that included the Alcohol Use Disorder Identification Test, consumption questions (AUDIT-C) (week 1) and the Penn Alcohol Craving Scale (PACS) (weeks 1-6). Sixty percent of the sample screened positive on the AUDIT-C for probable AUD. Using Rasch analysis, the person separation reliability of the PACS was strong (0.87) among AUDIT-C positive Veterans. Higher PACS scores were reported among AUDIT-C positive versus AUDIT-C negative Veterans (mixed effects analysis, p < 0.001). PACS scores were higher among AUDIT-C positive Veterans with MHDs with and without mTBI versus AUDIT-C positive combat comparison Veterans (pairwise comparison, p < 0.001). Rates of hazardous alcohol use are high among Iraq and Afghanistan conflict Veterans and suggest that alcohol craving is elevated among those with MHDs with and without mTBI.
authors.affiliation: Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. Department of Veterans Affairs (VA) Hospital, Hines, IL;
authors.forename: Amy A
authors.initials: AA
authors.lastname: Herrold
authors.forename: Neil
authors.initials: N
authors.lastname: Jordan
authors.forename: Walter M
authors.initials: WM
authors.lastname: High
authors.forename: Judi
authors.initials: J
authors.lastname: Babcock-Parziale
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Chambers
authors.forename: Bridget
authors.initials: B
authors.lastname: Smith
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Xue
authors.initials: X
authors.lastname: Li
authors.forename: Trudy
authors.initials: T
authors.lastname: Mallinson
authors.forename: Shonna
authors.initials: S
authors.lastname: Jenkins
authors.forename: Theresa Louise-Bender
authors.initials: TL
authors.lastname: Pape
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D019973:Alcohol-Related Disorders / Q000150:complications / Q000453:epidemiology*; D016739:Behavior, Addictive / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D066249:Craving; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014481:United States; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Alcohol Use Disorder Identification Test; Penn Alcohol Craving Scale; Veteran; alcohol; anxiety; craving; depression; mild traumatic brain injury; posttraumatic stress disorder; psychometrics