Alcohol Misuse and Psychological Resilience among U.S. Iraq and Afghanistan Era Veteran Military Personnel

Objective—The present study sought to investigate the longitudinal effects of psychological resilience against alcohol misuse adjusting for socio-demographic factors, trauma-related variables, and self-reported history of alcohol abuse. Methodology—Data were from National Post-Deployment Adjustment Study (NPDAS) participants who completed both a baseline and one-year follow-up survey (N=1090). Survey questionnaires measured combat exposure, probable posttraumatic stress disorder (PTSD), psychological resilience, and alcohol misuse, all of which were measured at two discrete time periods (baseline and one-year follow-up). Baseline resilience and change in resilience (increased © 2013 Elsevier Ltd. All rights reserved. Correspondence concerning this article should be addressed to Kimberly Green, M.S., 508 Fulton Drive, Building #16, Room 62, Durham, North Carolina 27705, Phone: (919) 286-0411 x. 7093, kimberly.green@duke.edu. Kimberly T. Green, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center; Nagy Youssef, Department of Psychiatry and Behavioral Services, Duke University Medical Center, Durham, North Carolina, USA, University of South Alabama, Mobile, Alabama, USA; Jean C. Beckham, Department of Veterans Affairs Medical Center, Durham, North Carolina, USA, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA, VA MidAtlantic Mental Illness Research, Education and Clinical Center, Durham, NC USA; Eric B. Elbogen, Department of Psychiatry, University of North Carolina Chapel-Hill, Chapel-Hill, North Carolina, USA, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC USA Contributors Ms. Green wrote the first version of the manuscript. Dr. Youssef participated in edits of the manuscript. Dr. Beckham participated in the conceptualization and writing of the manuscript. Dr. Elbogen contributed to each aspect of this project from study design to edits of the manuscript. All authors have approved the final manuscript. Conflict of Interest My coauthors, Drs. Youssef, Beckham, and Elbogen and I do not have any interests that might be interpreted as influencing the research. APA ethical standards were followed in the conduct of this research. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript Addict Behav. Author manuscript; available in PMC 2015 February 01. Published in final edited form as: Addict Behav. 2014 February ; 39(2): 406–413. doi:10.1016/j.addbeh. 2013.08. 024. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript or decreased) were utilized as independent variables in separate models evaluating alcohol misuse at the one-year follow-up. Results—Multiple linear regression analyses controlled for age, gender, level of educational attainment, combat exposure, PTSD symptom severity, and self-reported alcohol abuse. Accounting for these covariates, findings revealed that lower baseline resilience, younger age, male gender, and self-reported alcohol abuse were related to alcohol misuse at the one-year follow-up. A separate regression analysis, adjusting for the same covariates, revealed a relationship between change in resilience (from baseline to the one-year follow-up) and alcohol misuse at the one-year follow-up. The regression model evaluating these variables in a subset of the sample in which all the participants had been deployed to Iraq and/or Afghanistan was consistent with findings involving the overall era sample. Finally, logistic regression analyses of the one-year follow-up data yielded similar results to the baseline and resilience change models. Conclusions—These findings suggest that increased psychological resilience is inversely related to alcohol misuse and is protective against alcohol misuse over time. Additionally, it supports the conceptualization of resilience as a process which evolves over time. Moreover, our results underscore the importance of assessing resilience as part of alcohol use screening for preventing alcohol misuse in Iraq and Afghanistan era military veterans.