Bensley, Kara M., PhD, MSc; Seelig, Amber D., MPH; Armenta, Richard F., PhD, MPH; Rivera, Anna C., MPH; Peterson, Arthur V., PhD; Jacobson, Isabel G., MPH; Littman, Alyson J., PhD; Maynard, Charles, PhD; Bricker, Jonathan B., PhD; Boyko, Edward J., MD, MPH; Rull, Rudolph P., PhD, MPH; Williams, Emily C., PhD, MPHJournal of Addiction Medicine: September/October 2018 – Volume 12 – Issue 5 – p 353–362doi: 10.1097/ADM.0000000000000420Original Research
Objectives: Posttraumatic stress disorder (PTSD) and unhealthy alcohol use are commonly associated conditions. It is unknown whether specific symptoms of PTSD are associated with subsequent initiation of unhealthy alcohol use.
Methods: Data from the first 3 enrollment panels (n = 151,567) of the longitudinal Millennium Cohort Study of military personnel were analyzed (2001–2012). Complementary log-log models were fit to estimate whether specific PTSD symptoms and symptom clusters were associated with subsequent initiation of 2 domains of unhealthy alcohol use: risky and problem drinking (experience of 1 or more alcohol-related consequences). Models were adjusted for other PTSD symptoms and demographic, service, and health-related characteristics.
Results: Eligible study populations included those without risky (n = 31,026) and problem drinking (n = 67,087) at baseline. In adjusted analyses, only 1 PTSD symptom—irritability/anger—was associated with subsequent increased initiation of risky drinking (relative risk [RR] 1.05, 95% confidence interval [CI] 1.00–1.09) at least 3 years later. Two symptom clusters (dysphoric arousal [RR 1.17, 95% CI 1.11–1.23] and emotional numbing [RR 1.30, 95% CI 1.22–1.40]) and 5 symptoms (restricted affect [RR 1.13, 95% CI 1.08–1.19], sense of foreshortened future [RR 1.12, 95% CI 1.06–1.18], exaggerated startle response [RR 1.07, 95% CI 1.01–1.13], sleep disturbance [RR 1.11, 95% CI 1.07–1.15], and irritability/anger [RR 1.12, 95% CI 1.07–1.17]) were associated with subsequent initiation of problem drinking.
Conclusions: Findings suggest that specific PTSD symptoms and symptom clusters are associated with subsequent initiation of unhealthy alcohol use.
It’s amazing how little alcohol is needed to keep anger flaming hot!