1
|
Mazulyte-Rasytine E, Grigiene D, Gailiene D. Suicide Risk, Alcohol Consumption and Attitudes towards Psychological Help-Seeking among Lithuanian General Population Men, Conscripts and Regular Active Duty Soldiers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3457. [PMID: 36834153 PMCID: PMC9961175 DOI: 10.3390/ijerph20043457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to investigate the relationship between suicide risk, alcohol consumption, and attitudes towards professional psychological help among Lithuanian general population men, conscripts, and regular active duty (AD) soldiers. In total, 1195 Lithuanian adult males participated in the study: 445 men from the general population, 490 conscripts, and 260 regular AD soldiers from the Lithuanian Armed Forces. The study's measures included: general suicide risk, alcohol consumption levels, frequency of using alcohol as a means to suppress difficult thoughts and feelings, and attitudes toward psychological help. Both military samples showed significantly lower suicide risk than men from the general population. Alcohol use as a means to suppress difficult thoughts and feelings was the most significant predictor of suicide risk and a significant mediator between alcohol consumption and suicide risk in all study groups. Another significant suicide risk predictor and mediator between alcohol consumption and suicide risk-i.e., the value of seeking psychological treatment-was found only in the conscript sample. Results of the current study suggest that there is an opportunity for intervention aimed at the attitudes toward seeking professional psychological help for conscripts. However, that might not be the case for regular AD soldiers, nor the general population of Lithuanian men.
Collapse
Affiliation(s)
- Egle Mazulyte-Rasytine
- Suicide Research Centre, Institute of Psychology, Faculty of Philosophy, Vilnius University, 01513 Vilnius, Lithuania
| | | | | |
Collapse
|
2
|
Lee SY, Lee HK, Yoon CG, Jeon H, Saunders JB. Does Drinking Culture Induce Problematic Alcohol Use? Evidence From a Military Representative Survey in Korea. Psychiatry Investig 2022; 19:937-948. [PMID: 36444157 PMCID: PMC9708860 DOI: 10.30773/pi.2021.0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the relationship between problematic alcohol use and contributing factors among Korean professional soldiers. METHODS Cross-sectional data of 2,646 participants collected by 2014 military-wide representative health survey was analyzed. Multivariate logistic models were used to identify contributing factors for problematic alcohol use. Problematic alcohol use was defined by the Alcohol Use Disorders Identification Test (AUDIT) questionnaire as hazardous (8≤ AUDIT <16) or harmful (AUDIT ≥16). Tolerant drinking culture was measured by the Drinking Culture Questionnaire. RESULTS Hazardous alcohol use was found in 56.9% of men and 46.8% of women and harmful use in a further 16.2% of men and 5.4% of women. In univariate analyses, perceived health status, subjective sleep quality, depression, and drinking culture were related to the outcome variable. In multivariate models controlling covariates, the likelihood of problematic alcohol use was significantly increased by man gender, being single, current/past smoking, and tolerant/permissive drinking culture. In those with harmful alcohol consumption, tolerant drinking culture was a particularly powerful influence. CONCLUSION A substantial proportion of Korean professional soldiers demonstrated problematic alcohol use. Tolerant drinking culture was shown to have a significant influence on problematic alcohol use in the military. Our findings underscore the need for public health policies that address this drinking culture to mitigate negative health consequences and preserve the forces' combat readiness.
Collapse
Affiliation(s)
- Seung-Yup Lee
- Department of Medical and Health Operation, Armed Forces Medical Command, Seongnam, Republic of Korea.,Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang-Gyo Yoon
- Department of Medical and Health Operation, Armed Forces Medical Command, Seongnam, Republic of Korea.,Preventive Medicine Program, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hankaram Jeon
- Department of Psychiatry, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - John B Saunders
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia
| |
Collapse
|
3
|
Osborne AK, Wilson-Menzfeld G, McGill G, Kiernan MD. Military service and alcohol use: a systematic narrative review. Occup Med (Lond) 2022; 72:313-323. [PMID: 35674143 PMCID: PMC9272263 DOI: 10.1093/occmed/kqac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Despite research highlighting the role of alcohol in military life, specifically in relation to mental health and certain combat experiences, there is no synthesised evidence looking at the relationship between military service and alcohol use. Aims To synthesize and examine evidence exploring the relationship between military service and alcohol use. Methods Six databases were examined across a 10-year period. Papers were included if they involved a military population and focused on alcohol use. From 4046 papers identified, 29 papers were included in the review. Results Military characteristics and experience were linked to high levels of alcohol use across military populations. Societal and cultural factors also played a role in alcohol use in military populations. Predatory behaviour of alcohol establishments, pressures to conform, an acceptance of alcohol use, and the role of religious services and military affiliated social networks were all considered. Excessive drinking impacted physical and mental health. Those diagnosed with PTSD and associated symptoms appeared to have greater alcohol use. Conclusions This review identified certain characteristics and experiences of military service that are associated with higher levels of alcohol use. It is important to identify risk factors for alcohol misuse to develop appropriate policy, targeting prevention.
Collapse
Affiliation(s)
- A K Osborne
- Northern Hub for Veterans and Military Families Research, Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| | - G Wilson-Menzfeld
- Northern Hub for Veterans and Military Families Research, Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| | - G McGill
- Northern Hub for Veterans and Military Families Research, Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| | - M D Kiernan
- Northern Hub for Veterans and Military Families Research, Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle-Upon-Tyne, UK
| |
Collapse
|
4
|
Palmer L, Norton S, Jones M, Rona RJ, Goodwin L, Fear NT. Trajectories of alcohol misuse among the UK Armed Forces over a 12-year period. Addiction 2022; 117:57-67. [PMID: 34288194 PMCID: PMC9292297 DOI: 10.1111/add.15592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/13/2020] [Accepted: 05/26/2021] [Indexed: 11/26/2022]
Abstract
AIM To identify the main trajectories of alcohol misuse among UK military personnel from 12 years after the start of the Iraq war (2003) and the factors associated with each trajectory. DESIGN Longitudinal cohort study with three phases of data collection (2004-06, 2007-09 and 2014-16). SETTING United Kingdom. PARTICIPANTS Serving and ex-serving personnel of the UK Armed Forces (n = 7111) participating at Phase 1 and at least one follow-up phase of the King's Centre for Military Health Research (KCMHR) cohort study. MEASUREMENTS Trajectories of alcohol misuse were derived from scores using the Alcohol Use Disorders Identification Test (AUDIT-10) over three data collection phases. Demographic and military characteristics were collected and, among the key covariates, post-traumatic stress disorder (PTSD) was measured using the PTSD checklist (PCL-C) and childhood interpersonal stress and violence was measured using items from the Adverse Childhood Experiences questionnaire. FINDINGS Five trajectories of alcohol misuse were identified, including 'no misuse' (n = 2249, 31.6%) and 'hazardous' (n = 3398, 47.8%), 'harmful' (n = 832, 11.7%), 'severe-to-hazardous' (n = 258, 5.3%) and 'severe' (n = 374, 3.6%) drinking. Substantial changes were evident only among severe drinkers, where more than half reduced over the study period. The factors most strongly associated with belonging to harmful/severe drinking classes were young age, male gender and childhood adversities and antisocial behaviour. Severe drinkers at Phase 1 were more likely to report probable PTSD and shorter military careers and were less likely to serve as Officers. Persistent severe drinkers were less likely to serve in the RAF compared to the Army and were more likely to be reserves. Not misusing alcohol was also associated with reserve status and having left service. CONCLUSIONS In a cohort of approximately 7000 UK military personnel, trajectories of alcohol misuse appeared stable between 2004 and 2016. More than half of severe drinkers made substantial improvements over the period, but 68% of the cohort continued to drink hazardously or harmfully. Lack of change for the majority of the sample signals the need for strategies to address alcohol misuse and its cultural and psychosocial drivers.
Collapse
Affiliation(s)
- Laura Palmer
- King's Centre for Military Health ResearchInstitute of Psychiatry, Psychology and Neuroscience, King's College London, Weston Education CentreLondonUK
| | - Sam Norton
- Centre for Rheumatic Diseases and Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College London, Weston Education CentreLondonUK
| | - Margaret Jones
- King's Centre for Military Health ResearchInstitute of Psychiatry, Psychology and Neuroscience, King's College London, Weston Education CentreLondonUK
| | - Roberto J. Rona
- King's Centre for Military Health ResearchInstitute of Psychiatry, Psychology and Neuroscience, King's College London, Weston Education CentreLondonUK
| | - Laura Goodwin
- Department of PsychologyUniversity of LiverpoolEleanor Rathbone Building LiverpoolUK,Liverpool Centre for Alcohol ResearchLiverpool Health PartnersLiverpoolUK
| | - Nicola T. Fear
- King's Centre for Military Health ResearchInstitute of Psychiatry, Psychology and Neuroscience, King's College London, Weston Education CentreLondonUK,Academic Department of Military Mental HealthInstitute of Psychiatry, Psychology and Neuroscience, King's College London, Weston Education CentreLondonUK
| |
Collapse
|
5
|
Rhead R, MacManus D, Jones M, Greenberg N, Fear NT, Goodwin L. Mental health disorders and alcohol misuse among UK military veterans and the general population: a comparison study. Psychol Med 2022; 52:292-302. [PMID: 32777197 DOI: 10.1017/s0033291720001944] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND For a small minority of personnel, military service can have a negative impact on their mental health. Yet no studies have assessed how the mental health of UK veterans (who served during the recent operations in Afghanistan or Iraq) compares to non-veterans, to determine if they are at a disadvantage. We examine the prevalence of mental disorders and alcohol misuse in UK veterans compared to non-veterans. METHODS Veteran data were taken from the third phase of the King's Centre for Military Health Research cohort study (n = 2917). These data were compared with data on non-veterans taken from two large general population surveys: 2014 Adult Psychiatric Morbidity Survey (n = 5871) and wave 6 of the UK Household Longitudinal Study (UKHLS, n = 22 760). RESULTS We found that, overall, UK veterans who served at the time of recent military operations were more likely to report a significantly higher prevalence of common mental disorders (CMD) (23% v. 16%), post-traumatic stress disorder (PTSD) (8% v. 5%) and alcohol misuse (11% v. 6%) than non-veterans. Stratifying by gender showed that the negative impact of being a veteran on mental health and alcohol misuse was restricted to male veterans. Being ill or disabled was associated with a higher prevalence of CMD and PTSD for both veterans and non-veterans. CONCLUSION Whilst the same sociodemographic groups within the veteran and non-veteran populations seemed to have an increased risk of mental health problems (e.g. those who were unemployed), male veterans, in particular, appear to be at a distinct disadvantage compared to those who have never served.
Collapse
Affiliation(s)
- Rebecca Rhead
- Department of Forensic and Neurodevelopmental Science, King's College London, London, UK
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
| | - Deirdre MacManus
- Department of Forensic and Neurodevelopmental Science, King's College London, London, UK
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
| | - Margaret Jones
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
| | - Neil Greenberg
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
| | - Nicola T Fear
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
- Academic Department of Military Mental Health, Department of Psychological Medicine, King's College London, London, UK
| | - Laura Goodwin
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| |
Collapse
|
6
|
Thandi G, Phillips A, Greenberg N, Maguire N, Fear NT. Evaluation of the Warrior Programme intervention among UK ex-service personnel. Occup Med (Lond) 2021; 72:91-98. [PMID: 34951474 DOI: 10.1093/occmed/kqab153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research has shown that of the myriad services available to veterans in the UK, very few have been independently evaluated. This report presents the results of a randomized controlled trial assessing the impact of Time Line Therapy™ delivered by the Warrior Programme (a third-sector organization). AIMS This study was aimed to determine if the intervention is effective in reducing emotional and functional difficulties in ex-service personnel. METHODS A mixed-design analysis of variance model was used to investigate whether the Warrior Programme had a statistically significant impact on self-reported scores. The intervention and control group provided data on measures prior to and immediately after the intervention, and at 3-month follow-up. RESULTS Those in the intervention group (n = 23) reported statistically significant improvements in self-reported scores immediately following intervention: the Clinical Outcomes in Routine Evaluation (CORE) scores (CORE global distress mean difference [MD] = 45.0, 95% confidence interval [CI] 31-60) (CORE subjective well-being MD = 5.9, 95% CI 3.5-8.3) (CORE functioning MD = 16.7, 95% CI 11.4-21.9) (CORE problems/symptoms MD = 19.4, 95% CI 13.1-25.7), general self-efficacy (MD = -9.8, 95% CI -13.6 to -6.8), anxiety (MD = 8.6, 95% CI 5.2-12.1), depression (MD = 10, 95% CI 6.6-13.5), post-traumatic stress disorder (MD = 26.3, 95% CI 17-25) and functional impairment (MD = 11.1, 95% CI 5.3-16.8) over time, compared to the control group (n = 29). However, score improvement was not sustained over time or statistically significant at follow-up. CONCLUSIONS The Warrior Programme was effective in reducing emotional and functional difficulties in ex-service personnel immediately after the intervention, but the effect was not sustained at 3-month follow-up.
Collapse
Affiliation(s)
- G Thandi
- King's Centre for Military Health Research, King's College London, UK.,Academic Department of Military Mental Health, King's College London, UK
| | - A Phillips
- King's Centre for Military Health Research, King's College London, UK.,Academic Department of Military Mental Health, King's College London, UK
| | - N Greenberg
- King's Centre for Military Health Research, King's College London, UK.,Academic Department of Military Mental Health, King's College London, UK
| | - N Maguire
- Department of Psychology, University of Southampton, Southampton, UK
| | - N T Fear
- King's Centre for Military Health Research, King's College London, UK.,Academic Department of Military Mental Health, King's College London, UK
| |
Collapse
|
7
|
Goldner L, Shelef L, Goldstein BA, Scharf M. Understanding processes that advance suicidal behavior among Israeli active duty soldiers: A mediation model. J Clin Psychol 2021; 78:590-601. [PMID: 34380174 DOI: 10.1002/jclp.23237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/08/2021] [Accepted: 07/28/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The current study was aimed to identify the factors and mechanisms that promote nonsuicidal self-injury and suicidal ideation (SI) as precursors of suicidal behaviors in a sample of 553 Israeli active-duty soldiers. METHODS A mediation model was used to examine the contribution of posttraumatic stress disorder (PTSD) symptoms, emotion-regulation difficulties, habituation, and risk-taking behaviors to soldiers' self-injury and SI. RESULTS Results indicated direct effects between PTSD symptoms and self-injury and SI, as well as between emotion regulation difficulties and self-injury. Indirect effects were found between PTSD symptoms and nonsuicidal self-injury (NSSI) through the mechanisms of habituation and risk-taking behavior and between difficulties in emotion regulation and NSSI through the mechanism of risk-taking behaviors. CONCLUSION To tackle soldiers' suicidal behaviors, clinicians might assess soldiers' PTSD symptoms and difficulties in emotion regulation and intervene by lessening their access to thrill-seeking situations and situations that increase habituation to pain and death.
Collapse
Affiliation(s)
- Limor Goldner
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Leah Shelef
- Mental Health Unit, Medical Corps, Israel Defense Forces, Ramat Gan, Israel
| | - Becky Amit Goldstein
- Mental Health Unit, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.,Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Miri Scharf
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| |
Collapse
|
8
|
Irizar P, Stevelink SAM, Pernet D, Gage SH, Greenberg N, Wessely S, Goodwin L, Fear NT. Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study. Eur J Psychotraumatol 2021; 12:1891734. [PMID: 33968324 PMCID: PMC8079084 DOI: 10.1080/20008198.2021.1891734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background: British Armed Forces' and Police Forces' personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress disorder (PTSD), which is often comorbid with harmful alcohol use. Objective: We aimed to assess the proportions, and associations, of probable PTSD and harmful alcohol use among a covariate-balanced sample of male military personnel and police employees. Methods: Proportions of probable PTSD, harmful alcohol use, and daily binge drinking, were explored using data from the police Airwave Health Monitoring Study (2007-2015) (N = 23,826) and the military Health and Wellbeing Cohort Study (phase 2: 2007-2009, phase 3: 2014-2016) (N = 7,399). Entropy balancing weights were applied to the larger police sample to make them comparable to the military sample on a range of pre-specified variables (i.e. year of data collection, age and education attainment). Multinomial and logistic regression analyses determined sample differences in outcome variables, and associated factors (stratified by sample). Results: Proportions of probable PTSD were similar in military personnel and police employees (3.67% vs 3.95%), although the large sample size made these borderline significant (Adjusted Odds Ratio (AOR): 0.84; 95% Confidence Intervals (CI): 0.72 to 0.99). Clear differences were found in harmful alcohol use among military personnel, compared to police employees (9.59% vs 2.87%; AOR: 2.79; 95% CI: 2.42 to 3.21). Current smoking, which was more prevalent in military personnel, was associated with harmful drinking and binge drinking in both samples but was associated with PTSD in military personnel only. Conclusions: It is generally assumed that both groups have high rates of PTSD from traumatic exposures, however, low proportions of PTSD were observed in both samples, possibly reflecting protective effects of unit cohesion or resilience. The higher level of harmful drinking in military personnel may relate to more prominent drinking cultures or unique operational experiences.
Collapse
Affiliation(s)
- Patricia Irizar
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Sharon A M Stevelink
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - David Pernet
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Suzanne H Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Neil Greenberg
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Simon Wessely
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Laura Goodwin
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Nicola T Fear
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| |
Collapse
|
9
|
Associations of alcohol use, mental health and socioeconomic status in England: Findings from a representative population survey. Drug Alcohol Depend 2021; 219:108463. [PMID: 33421804 DOI: 10.1016/j.drugalcdep.2020.108463] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Alcohol use and mental health problems often co-occur, however, little is known about how this varies by type of mental health problem and to what extent associations are explained by socioeconomic status (SES). Our study examined the prevalence and associations of non-drinking, hazardous use, and harmful/probable dependence in individuals who do and do not meet criteria for different mental health problems and whether associations remained after adjustment for SES. METHODS A secondary analysis of an English dataset, 2014 Adult Psychiatric Morbidity Survey (N = 7,218), was conducted. The Alcohol Use Disorder Identification Test was used to categorise participants as non-drinking, low risk, hazardous use and harmful/probable dependence. Mental health problems were screened using a range of validated tools. Multinomial logistic regression analyses were used to address study aims. RESULTS The prevalence of non-drinking, hazardous and harmful/probable dependence was higher among those meeting criteria for a mental health problem. After adjustment for SES, non-drinking was most common in those meeting criteria for probable psychotic disorder (MOR = 3.42, 95 %CI = 1.74-6.70), hazardous use in those meeting criteria for anti-social personality disorder (MOR = 2.66, 95 %CI = 1.69-4.20) and harmful/probable dependence in those meeting criteria for borderline personality disorder (MOR = 9.77, 95 % CI = 4.81-19.84). CONCLUSIONS There were marked increases in the odds of reporting both non-drinking and harmful drinking among those meeting criteria for a mental health problem, particularly more severe problems. Our findings indicate that the relationship between alcohol and mental health is more complex and comorbid alcohol and mental health problems should be treated in parallel with access to both services.
Collapse
|
10
|
Watterson JR, Gabbe B, Rosenfeld JV, Ball H, Romero L, Dietze P. Workplace intervention programmes for decreasing alcohol use in military personnel: a systematic review. BMJ Mil Health 2020; 167:192-200. [PMID: 33361438 DOI: 10.1136/bmjmilitary-2020-001584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/11/2020] [Accepted: 11/15/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Harmful or risky-single occasion drinking (RSOD) alcohol use in the military is a significant problem. However, most studies of interventions have focused on veterans, representing a missed opportunity for intervention with active military personnel. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, the aim of this systematic review was to analyse and synthesise the evidence related to workplace-based interventions for reducing alcohol use in active-duty military personnel. METHODS Four electronic databases and reference lists of relevant articles were searched from database inception until 20 January 2020. This review focused on experimental and quasi-experimental studies of active-duty military personnel. Data extraction and methodological quality assessment were independently performed by two reviewers using a standardised checklist. A third reviewer was used to arbitrate the disputed studies for final selection. RESULTS The search yielded seven studies from an initial 1582 records identified. A range of interventions were used in these studies (four randomised controlled trials, two non-randomised trials and one before and after cohort study), including web-based approaches, telephone-delivered interventions and individual and group-based face-to-face interventions. Seven studies found decreased drinking, measured using a range of outcomes, following the intervention. However, this was not sustained in the longer term in any of the studies. CONCLUSIONS The low methodological rigour of most studies limited the capacity to demonstrate the efficacy of the interventions studied. Given the importance of reducing harmful or RSOD use of alcohol in the military, future studies would benefit from improved methodological rigour including ensuring adequate study power, randomisation, selection of validated outcome measures, including measures other than consumption (eg, attitudinal measures), and longer-term follow-up. There is also a need to develop methods that ensure participant loss to follow-up is minimised.
Collapse
Affiliation(s)
- Jason R Watterson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia .,Department of Intensive Care and Hyperbaric Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - B Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J V Rosenfeld
- Department of Neurosurgery, Alfred Health, Melbourne, Victoria, Australia.,Department of Surgery, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - H Ball
- National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia
| | - L Romero
- Library Services, Alfred Health, Melbourne, Victoria, Australia
| | - P Dietze
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia
| |
Collapse
|
11
|
Jeong H, Lee HK, Kwon YS, Yim HW, Lee SY. Gaming disorder and bidirectional relationships with aggression and impulsivity. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
12
|
Phillips R. The Stigmatized Hero? A Review of UK Opinion Polls and Surveys on Perceptions of British Veterans in UK Society. JOURNAL OF VETERANS STUDIES 2020. [DOI: 10.21061/jvs.v6i1.150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
13
|
Exploring patterns of alcohol misuse in treatment-seeking UK veterans: A cross-sectional study. Addict Behav 2019; 92:14-19. [PMID: 30572207 DOI: 10.1016/j.addbeh.2018.11.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/05/2018] [Accepted: 11/28/2018] [Indexed: 11/22/2022]
Abstract
AIMS To explore patterns of alcohol misuse in a sample of treatment-seeking veterans compared to the UK Armed Forces personnel population and the general public. Furthermore, the present study investigated which variables were associated with alcohol misuse in this sample, and in particular what factors were associated with increased or decreased severity of alcohol misuse. METHOD The present study investigated alcohol misuse in treatment-seeking veterans and compared it with the UK Armed Forces and the general public. In addition, it explored associations between sociodemographic, physical health and mental health variables and alcohol misuse. RESULTS Results suggested that treatment-seeking veterans report different patterns of alcohol misuse compared to the UK Armed Forces and the general public. This group was more likely to report alcohol dependence and alcohol-related harm. They also reported higher levels of overall alcohol misuse than the general public. Mental health problems including PTSD, anxiety and depression, as well as anger, functional impairment and being single were all related to greater alcohol misuse. Being older and not in work were related to reduced alcohol misuse. CONCLUSIONS These findings add further weight to the importance of ensuring appropriate support is provided to personnel leaving the Armed Forces. Treatment-seeking veterans have specific patterns of alcohol-related needs that should be addressed. Knowing more about the common alcohol-related problems in this group can help inform and improve mental health interventions. Findings on related variables will help in identifying those individuals who may be at most risk of alcohol-related problems.
Collapse
|
14
|
Ram-Vlasov N, Goldner L, Lev-Wiesel R. Preliminary validation of the peri-traumatic dissociation trauma drawing assessment (PDTDA): The case of military trauma. ARTS IN PSYCHOTHERAPY 2019. [DOI: 10.1016/j.aip.2018.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
15
|
Senior SL. Health needs of ex-military personnel in the UK: a systematic review and qualitative synthesis. J ROY ARMY MED CORPS 2018; 165:410-415. [DOI: 10.1136/jramc-2018-001101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/09/2018] [Accepted: 11/15/2018] [Indexed: 12/31/2022]
Abstract
BackgroundDespite all local authorities in England signing up to the Armed Forces Covenant, only a small proportion of Joint Strategic Needs Assessments (JSNAs) include detailed consideration of the health of the local ex-military population. This article supports improvements to JSNAs by systematically reviewing published research for evidence of differences in health between the ex-military population and the general public.MethodsSystematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology for qualitative synthesis of mixed study designs. SCOPUS, PubMed and Google Scholar were searched for published research on health outcomes among UK ex-military populations. All study designs were included.Results43 studies met the inclusion criteria. Rates of mental illness and hearing loss are higher among ex-military populations compared with the general public, while rates of cancer among ex-military personnel born after 1960 are lower. Despite high rates of hazardous drinking among serving personnel, rates of alcohol-related harm among ex-military populations are no higher than the general public. There is a subpopulation at increased risk of a range of adverse outcomes. This group is variously identified as younger, male, less educated, more likely to have served in a combat role and/or left service early.ConclusionsThis review found evidence of areas of increased and reduced disease burden among ex-military populations. More detailed information on the make-up of the local ex-service population would support more meaningful needs assessments. The Ministry of Defence and local authorities and service providers should work together to support early identification and targeted support for those at the highest risk of adverse outcomes.
Collapse
|
16
|
Leightley D, Williamson V, Darby J, Fear NT. Identifying probable post-traumatic stress disorder: applying supervised machine learning to data from a UK military cohort. J Ment Health 2018; 28:34-41. [PMID: 30445899 DOI: 10.1080/09638237.2018.1521946] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Early identification of probable post-traumatic stress disorder (PTSD) can lead to early intervention and treatment. AIMS This study aimed to evaluate supervised machine learning (ML) classifiers for the identification of probable PTSD in those who are serving, or have recently served in the United Kingdom (UK) Armed Forces. METHODS Supervised ML classification techniques were applied to a military cohort of 13,690 serving and ex-serving UK Armed Forces personnel to identify probable PTSD based on self-reported service exposures and a range of validated self-report measures. Data were collected between 2004 and 2009. RESULTS The predictive performance of supervised ML classifiers to detect cases of probable PTSD were encouraging when compared to a validated measure, demonstrating a capability of supervised ML to detect the cases of probable PTSD. It was possible to identify which variables contributed to the performance, including alcohol misuse, gender and deployment status. A satisfactory sensitivity was obtained across a range of supervised ML classifiers, but sensitivity was low, indicating a potential for false negative diagnoses. CONCLUSIONS Detection of probable PTSD based on self-reported measurement data is feasible, may greatly reduce the burden on public health and improve operational efficiencies by enabling early intervention, before manifestation of symptoms.
Collapse
Affiliation(s)
- Daniel Leightley
- a King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience , King's College , London , UK
| | - Victoria Williamson
- a King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience , King's College , London , UK
| | - John Darby
- b School of Computing, Mathematics and Digital Technology , Manchester Metropolitan University
| | - Nicola T Fear
- a King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience , King's College , London , UK.,c Academic Department of Military Mental Health , Institute of Psychiatry, Psychology & Neuroscience, King's College , London , UK
| |
Collapse
|
17
|
Rushton R, Lynch K. Development of alcohol treatment for UK military personnel. J ROY ARMY MED CORPS 2018; 165:98-101. [PMID: 30415214 DOI: 10.1136/jramc-2018-001050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 12/11/2022]
Abstract
The consumption of alcohol in the UK Armed Forces (AF) as 'an agent to assist cohesion and informal operational debriefing' is a social and psychological conceptualisation that has some empirical support. Indisputable data exist to suggest that high levels of alcohol misuse and related problems are prevalent among UK AF. Recent research indicates that the overall level of hazardous alcohol consumption remains high in the UK military, with little evidence of reduced consumption over time. Meanwhile, risky drinking in the general population appears to be decreasing. This paper describes work to develop a key aspect of an integrated care pathway for UK military personnel at all levels of alcohol risk. The project focuses on the development of an evidence-based treatment response across primary care and mental health services that will link with preventative initiatives. Specialist (ie, substance misuse) input from the Defence Clinical Psychology Service across and within Departments of Community Mental Health lends an overarching perspective to a major healthcare and organisational concern for the UK AF. Work towards a consistent treatment pathway for alcohol misuse is also benefiting from collaboration between the Ministry of Defence and Public Health England.
Collapse
Affiliation(s)
| | - K Lynch
- Public Health England, London, UK
| |
Collapse
|
18
|
Campbell-Sills L, Ursano RJ, Kessler RC, Sun X, Heeringa SG, Nock MK, Sampson NA, Jain S, Stein MB. Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers. Psychol Med 2018; 48:1624-1633. [PMID: 29039285 PMCID: PMC6620021 DOI: 10.1017/s0033291717003105] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse. METHODS Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1-2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1-2×/week) and alcohol or substance use disorder (AUD/SUD). RESULTS Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) - but not combat stress - was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06-1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25-1.89, p < 0.0005); and persistence of AUD/SUD at T2 and T3 (AOR = 1.30, 95% CI 1.08-1.56, p = 0.005). Any BD pre-deployment was associated with post-deployment onset of HD (AOR = 3.21, 95% CI 2.57-4.02, p < 0.0005) and AUD/SUD (AOR = 1.85, 95% CI 1.27-2.70, p = 0.001). CONCLUSIONS Alcohol misuse is common during the months preceding and following deployment. Timely intervention aimed at alleviating/managing personal stressors or curbing risky drinking might reduce risk of alcohol-related problems post-deployment.
Collapse
Affiliation(s)
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of
Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD,
USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School,
Boston, MA, USA
| | - Xiaoying Sun
- Department of Family Medicine and Public Health, University
of California San Diego, La Jolla, CA, USA
| | - Steven G. Heeringa
- University of Michigan, Institute for Social Research, Ann
Arbor, MI, USA
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge,
MA, USA
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School,
Boston, MA, USA
| | - Sonia Jain
- Department of Family Medicine and Public Health, University
of California San Diego, La Jolla, CA, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San
Diego, La Jolla, CA, USA
- Department of Family Medicine and Public Health, University
of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| |
Collapse
|
19
|
Bartone PT, Johnsen BH, Eid J, Hystad SW, Laberg JC. Hardiness, avoidance coping, and alcohol consumption in war veterans: A moderated-mediation study. Stress Health 2017; 33:498-507. [PMID: 27885790 DOI: 10.1002/smi.2734] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/17/2016] [Accepted: 10/25/2016] [Indexed: 11/09/2022]
Abstract
Military personnel often engage in excessive alcohol use after returning from deployments. Thus far, research has paid scant attention to personality factors that may increase or diminish the risk for increased alcohol consumption in this population. The present study explores how psychological hardiness, avoidance coping, and stress exposure may interact to influence alcohol consumption patterns in soldiers following deployment. U.S. Army National Guard soldiers (N = 357) were surveyed shortly after returning from combat operations in Afghanistan. Conditional process analysis was used to test for mediation and moderation effects. Mediation effects were further tested in a replication sample of Norwegian Army soldiers (N = 230) deployed to Kosovo. Findings show that hardiness is a significant (negative) predictor of increased alcohol use and that this relation is mediated by avoidance coping. Further, this effect was moderated by combat stress exposure in the U.S. sample, such that the mediation is stronger for those with greater exposure (moderated-mediation). Avoidance coping also mediated the effects of hardiness on alcohol consumption in the Norwegian sample. These findings suggest that avoidance coping and hardiness may be fruitful areas for interventions aimed at reducing risky drinking in high-stress groups like the military.
Collapse
Affiliation(s)
- Paul T Bartone
- Center for Technology and National Security Policy, National Defense University, Washington, DC, USA.,Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
| | - Bjorn H Johnsen
- Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
| | - Jarle Eid
- Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
| | - Sigurd W Hystad
- Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
| | - Jon C Laberg
- Department of Psychosocial Sciences, University of Bergen, Bergen, Norway
| |
Collapse
|
20
|
Goodwin L, Norton S, Fear N, Jones M, Hull L, Wessely S, Rona R. Trajectories of alcohol use in the UK military and associations with mental health. Addict Behav 2017; 75:130-137. [PMID: 28734152 DOI: 10.1016/j.addbeh.2017.07.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 05/28/2017] [Accepted: 07/10/2017] [Indexed: 12/14/2022]
Abstract
INTRODUCTION There are higher levels of alcohol misuse in the military compared to the general population. Yet there is a dearth of research in military populations on the longitudinal patterns of alcohol use. This study aims to identify group trajectories of alcohol consumption in the UK military and to identify associations with childhood adversity, deployment history and mental disorder. METHODS Data on weekly alcohol consumption across an eight year period and three phases of a UK military cohort study (n=667) were examined using growth mixture modelling. RESULTS Five alcohol trajectory classes were identified: mid-average drinkers (55%), abstainers (4%), low level drinkers (19%), decreasing drinkers (3%) and heavy drinkers (19%). Alcohol consumption remained stable over the three periods in all classes, other than in the small decreasing trajectory class. Individuals in the heavy drinking class were more likely to have deployed to Iraq. Abstainers and heavy drinkers were more likely to report post-traumatic stress disorders at baseline compared to average drinkers. CONCLUSIONS Heavy drinkers in the UK military did not change their drinking pattern over a period of eight years. This highlights the need to develop effective preventive programmes to lessen the physical and psychological consequences of long-term heavy alcohol use. Individuals with a mental health problem appeared more likely to either be drinking at a high level or to be abstaining from use.
Collapse
|
21
|
Murphy D, Ashwick R, Palmer E, Busuttil W. Describing the profile of a population of UK veterans seeking support for mental health difficulties. J Ment Health 2017; 28:654-661. [PMID: 28982279 DOI: 10.1080/09638237.2017.1385739] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Evidence suggests that veterans with mental health issues have poorer treatment outcomes than civilian counterparts. Understanding the difficulties faced by veterans could help focus treatments and improve outcomes.Aims: To survey a representative sample of treatment-seeking veterans to explore their mental health needs.Methods: A random sample of UK veterans who had engaged with a national mental health charity in the UK was drawn. Individuals completed questionnaires about their health, military experiences and pre-enlistment vulnerabilities.Results: Four hundred and three out of six hundred (67.2%) participants returned completed questionnaires. PTSD was the most commonly endorsed mental health difficulty (82%), followed by problems with anger (74%), common mental health difficulties (72%) and alcohol misuse (43%). Comorbidity was frequent; with 32% of those with PTSD meeting criteria for three other health outcomes versus only 5% with PTSD alone.Conclusions: Results indicate the complexity of presentations within treatment seeking veterans. These difficulties may partly explain the poorer treatment outcomes reported in veterans in comparison to the general public. As such, it would be prudent for interventions targeted at veterans with mental health difficulties to attempt to address the range of issues faced by this population rather than focus on a particular presenting problem.
Collapse
Affiliation(s)
- Dominic Murphy
- Combat Stress, Leatherhead, UK and.,King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
| | | | | | | |
Collapse
|
22
|
Wesemann U, Kahn C, Zimmermann PL, Willmund GD, Schomerus G. Self-stigma in military personnel with alcohol dependence: comparison with a civilian sample before qualified withdrawal treatment. DRUGS AND ALCOHOL TODAY 2017. [DOI: 10.1108/dat-08-2016-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to highlight the differences in self-stigma between a military and a civilian sample in order to infer military-specific aspects of the stigmatization process.
Design/methodology/approach
Before undergoing a three-week course of qualified withdrawal treatment, 55 German military personnel were examined in terms of self-stigma, abstinence self-efficacy, duration of alcohol abuse, severity of alcohol dependence, and current mental disorders. Afterwards, the participants were compared with a non-military sample of 173 subjects with alcohol dependence in a civilian psychiatric clinic that had not yet undergone qualified withdrawal treatment.
Findings
While awareness of stigmatization is significantly greater among military personnel than in the civilian comparison group (t(171)=3.83, p<0.01), there is far less agreement with such stigmatization (t(170)=−3.20, p<0.01). More severe mental disorders and low abstinence self-efficacy have a significant influence on self-esteem decrement for the entire group.
Research limitations/implications
Both samples only consisted of male participants who wanted to receive treatment.
Originality/value
Since most studies refer to civilian patients, a comparative study of the influence of stigmatization of alcohol use disorders in the armed forces is of particular interest. The study indicates that military personnel are more aware of stigmatization by colleagues and superiors than is the case among civilian patients. This could be a significant obstacle when it comes to seeking professional help. Prevention programs need to give greater priority to this subject.
Collapse
|
23
|
Do Alcohol Misuse, Service Utilisation, and Demographic Characteristics Differ between UK Veterans and Members of the General Public Attending an NHS General Hospital? J Clin Med 2016; 5:jcm5110095. [PMID: 27827830 PMCID: PMC5126792 DOI: 10.3390/jcm5110095] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 10/17/2016] [Accepted: 10/21/2016] [Indexed: 11/29/2022] Open
Abstract
The aim of this paper was to provide insights into alcohol misuse within UK veterans to inform as to whether their presentations differ from the general public. This was done by exploring differences in the severity of alcohol misuse between UK veterans and the general public admitted to a general NHS hospital over an 18 month period using retrospective data. All patients admitted to the hospital were screened for alcohol misuse. Those deemed as experiencing problems were referred for specialist nurse-led support. A total of 2331 individuals were referred for this supported and administered with a standardised assessment that included measures of the severity of alcohol difficulties (AUDIT), dependency levels (LDQ), and assessed for the presence of withdrawal symptoms (CIWA-Ar). In addition, information was collected on service utilisation, referral category (medical or mental health), other substance misuse, and demographic characteristics. No differences were found between the severity of reported alcohol difficulties between veterans and non-veterans. Evidence was found to suggest that veterans were more likely to be referred for support with alcohol difficulties at an older age and to be admitted to hospital for longer periods of time. This could have considerable cost implications for the NHS. It was more common for veterans to present at hospital with physical health difficulties prior to being referred for support for alcohol.
Collapse
|