title: Problem alcohol use in veterans with mild traumatic brain injury: Associations with cognitive performance and psychiatric symptoms.
abstract: Given that little is known about the associations between alcohol use, cognition, and psychiatric symptoms among veterans with a history of mild traumatic brain injury (mTBI), we aimed to (a) characterize how they differ from veteran controls on a measure of problem drinking; (b) investigate whether problem drinking is associated with demographic or mTBI characteristics; and (c) examine the associations between alcohol use, mTBI history, psychiatric functioning, and cognition.
  
  
  
  We assessed 59 veterans (n = 32 with mTBI history; n = 27 military controls) for problem alcohol use (Alcohol Use Disorders Identification Test: AUDIT), psychiatric symptoms, and neuropsychological functioning.
  
  
  
  Compared to controls, veterans with mTBI history were more likely to score above the AUDIT cutoff score of 8 (p = .016), suggesting a higher rate of problem drinking. Participants with mTBI history also showed elevated psychiatric symptoms (ps < .001) and lower cognitive scores (ps < .05 to < .001). Veterans with higher AUDIT scores were younger (p = .05) and had less education (p < .01) and more psychiatric symptoms (ps < .01), but mTBI characteristics did not differ. After controlling for combat and mTBI history (R(2) = .04, ns) and posttraumatic stress disorder (PTSD) symptoms (ΔR(2) = .08, p = .05), we found that higher AUDIT scores were associated with poorer attention/processing speed, F(9, 37) = 2.55, p = .022; ΔR(2) = .26, p = .03.
  
  
  
  This preliminary study suggested that veterans with mTBI history may be at increased risk for problem drinking. Problem alcohol use was primarily associated with more severe PTSD symptoms and poorer attention/processing speed, though not with combat or mTBI characteristics per se. Importantly, findings emphasize the importance of assessing for and treating problematic alcohol use and comorbid psychiatric symptoms among veterans, including those with a history of neurotrauma.
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|c Veterans Medical Research Foundation , San Diego , CA , USA.|d Department of Psychiatry, School of Medicine , University of California San Diego , San Diego , CA , USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Hanson
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|b Center of Excellence for Stress and Mental Health, VASDHS , San Diego , CA , USA.|d Department of Psychiatry, School of Medicine , University of California San Diego , San Diego , CA , USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Schiehser
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|e San Diego State University Joint Doctoral Program in Clinical Psychology , University of California San Diego , San Diego , CA , USA.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Clark
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.
authors.forename: Scott F
authors.initials: SF
authors.lastname: Sorg
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|c Veterans Medical Research Foundation , San Diego , CA , USA.
authors.forename: Russell T
authors.initials: RT
authors.lastname: Kim
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|c Veterans Medical Research Foundation , San Diego , CA , USA.|d Department of Psychiatry, School of Medicine , University of California San Diego , San Diego , CA , USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Jacobson
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|e San Diego State University Joint Doctoral Program in Clinical Psychology , University of California San Diego , San Diego , CA , USA.
authors.forename: Madeleine L
authors.initials: ML
authors.lastname: Werhane
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|b Center of Excellence for Stress and Mental Health, VASDHS , San Diego , CA , USA.|c Veterans Medical Research Foundation , San Diego , CA , USA.|d Department of Psychiatry, School of Medicine , University of California San Diego , San Diego , CA , USA.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Jak
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|b Center of Excellence for Stress and Mental Health, VASDHS , San Diego , CA , USA.|d Department of Psychiatry, School of Medicine , University of California San Diego , San Diego , CA , USA.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Twamley
authors.affiliation: a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.|b Center of Excellence for Stress and Mental Health, VASDHS , San Diego , CA , USA.|c Veterans Medical Research Foundation , San Diego , CA , USA.|d Department of Psychiatry, School of Medicine , University of California San Diego , San Diego , CA , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Delano-Wood
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000523:psychology; D001924:Brain Concussion / Q000150:complications* / Q000523:psychology; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology; D014728:Veterans / Q000523:psychology*; D055815:Young Adult
keywords: Alcohol; Cognition; Posttraumatic stress disorder; Traumatic brain injury; Veterans