Noncombat Veterans Research Articles

Posttraumatic growth among Israeli female combat veterans: The mediating roles of posttraumatic stress symptoms and self-efficacy.

Posttraumatic growth (PTG) is a possible common reaction to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about correlates of PTG among female combat veterans is sparse. This study examines associations between combat exposure, posttraumatic stress symptoms (PTSS), general self-efficacy (GSE), and PTG among Israeli female veterans. This is a cross-sectional studyA volunteer sample of female Israeli combat veterans (n=616) and non-combat veterans (n=484) responded to self-report questionnaires. Combat veterans reported higher levels of combat exposure, PTSS, GSE, and PTG, as compared to non-combat veterans. Among combat veterans, combat exposure and GSE were associated with greater PTG. Importantly, PTSS and GSE mediated the link between combat exposure and PTG. The study's findings are among the first to report about possible psychological growth outcomes among Israeli combat veterans. Clinicians treating female veterans coping with combat trauma should be aware of the heterogeneity of reactions to military service challenges and the importance of enhancing veterans' GSE to facilitate PTG.

The contribution of maladaptive personality traits to PTSD and depression symptoms among Israeli female veterans.

Exposure to potentially traumatic events during military service is associated with mental health problems such as posttraumatic stress disorder (PTSD) and depression symptoms. However, knowledge regarding the implications of maladaptive personality traits in psychopathology among female veterans is sparse. The present study aims to use the Diagnostic and Statistical Manual of Mental Disorders, fifth edition-an alternative model of personality disorder, to examine associations between maladaptive personality traits, PTSD and depression symptoms, among female Israeli veterans. A volunteer sample of female Israeli combat veterans (n = 616) and noncombat veterans (n = 484) responded to self-report questionnaires in a cross-sectional study. Combat veterans reported higher levels of combat exposure and PTSD symptoms, but not depressive symptoms, than noncombat veterans. Combat veterans also reported lower levels of negative affectivity but higher levels of disinhibition than noncombat veterans. All five traits were positive predictors of PTSD and depression symptoms, with psychoticism constituting the strongest predictor. A moderated-mediation analysis indicated four traits (negative affectivity, detachment, disinhibition, and psychoticism) that had a moderating effect on the relationship between combat exposure and PTSD symptoms, and two of the traits (antagonism and disinhibition) that had a moderate effect on the relationship between combat exposure and depressive symptoms. Maladaptive personality traits play an important role in psychological distress following female veterans' combat service. Future prospective research is necessary to determine the temporal associations between preenlistment maladaptive personality traits and postdeployment mental health of veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Emergency Department Use Among Combat and Non-Combat Post-9/11 Military Veterans.

Most post-9/11 Veterans have completed at least 1 combat deployment-a known factor associated with adverse health outcomes. Such Veterans are known to have unmet health care needs, and the emergency department (ED) may serve as a safety net, yet little is known about whether combat status is associated with more frequent ED use. We sought to evaluate the relationship between combat status and frequency of ED use among post-9/11 Veterans and assess the most common reasons for ED visits. This retrospective cohort study consisted of post-9/11 Veterans who enrolled in U.S. Department of Veterans Affairs (VA) care between fiscal years (FYs) 2005 and 2015. Data were obtained from the VA Corporate Data Warehouse. Incidence rates for ED visits for combat and non-combat Veterans were compared from FY 2010 to 2019 using zero-inflated negative binomial regression. The most frequent reasons for ED visits were determined using International Classification of Diseases codes. This study was approved by the Stanford Institutional Review Board. Among 1.3 million Veterans included in analyses, 70.4% had deployed to a combat zone. The mean (SD) age of our cohort was 32.6 (5.0) years and 83.5% of Veterans were male. After controlling for other factors, combat Veterans had 1.84 times the rate of ED visits compared to non-combat Veterans (95% CI, 1.83-1.85). Only combat Veterans had a mental health-related ED visit (suicidal ideations) among the top 3 reasons for ED presentation. Those who deployed to a combat zone had a significantly higher rate of ED use compared to those who did not. Further, mental health-related ED diagnoses appeared to be more prevalent in combat Veterans. These findings highlight the unique health care needs faced by combat Veterans and emphasize the importance of tailored interventions and support services for this specific population.

The Contribution of Maladaptive Personality Traits to Psychological Distress Among Israeli Women Veterans

IntroductionExposure to potentially traumatic events (PTEs) during military service is associated with mental health problems such as posttraumatic stress disorder (PTSD) and depression symptoms. However, knowledge regarding the implications of maladaptive personality traits in psychopathology among female veterans is sparse.ObjectivesThe present study aims to use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) -- an alternative model of personality disorder, to examine associations between maladaptive personality traits, PTSD and depression symptoms, among female Israeli veterans.MethodsA volunteer sample of female Israeli combat veterans (n=616) and non-combat veterans (n=484) responded to self-report questionnaires in a cross-sectional study.ResultsCombat veterans reported higher levels of combat exposure and PTSD symptoms, but not depressive symptoms, than non-combat veterans. Combat veterans also reported lower levels of negative affectivity but higher levels of disinhibition than non-combat veterans. All five traits were positive predictors of psychological distress, with psychoticism constituting the strongest predictor. A moderated-mediation analysis indicated four traits (negative affectivity, detachment, disinhibition, and psychoticism) that had a moderating effect on the relationship between combat exposure and PTSD symptoms, and two of the traits (antagonism and disinhibition) that had a moderate effect on the relationship between combat exposure and depressive symptoms.ConclusionsMaladaptive personality traits play an important role in psychological distress following female veterans’ combat service. Future prospective research is necessary to determine the temporal associations between pre-enlistment maladaptive personality traits and post-deployment mental health of veterans.Disclosure of InterestNone Declared

Hypertension at the nexus of veteran status, psychiatric disorders, and traumatic brain injury: Insights from the 2011 Behavioral Risk Factor Surveillance System.

Compare the odds of self-reported hypertension among non-combat and combat veterans with and without PD/TBI to non-veterans and each other. We used data from men from the 2011 Behavioral Risk Factor Surveillance System and distinguished: non-veterans (n = 21,076); non-combat veterans with no PD/TBI (n = 3,150); combat veterans with no PD/TBI (n = 1,979); and veterans (combat and non-combat) with PD and/or TBI (n = 805). Multivariable, hierarchical logistic regression models included exogenous demographic, socioeconomic attainment and family structure, health behavior and conditions, and methodological control variables. One-third of men reported having been told at least once by a medical professional that they had high blood pressure. Bivariate analyses indicated that each veteran group had a higher prevalence of self-reported hypertension than non-veterans (design-based F = 45.2, p<0.001). In the fully adjusted model, no statistically significant differences in the odds of self-reported hypertension were observed between non-veterans and: non-combat veterans without PD/TBI (odds ratio [OR] = 0.92); combat veterans without PD/TBI (OR = 0.87); veterans with PD and/or TBI (OR = 1.35). However, veterans with PD and/or TBI had greater odds of reporting hypertension than both combat and non-combat veterans without PD/TBI (p<0.05). Military service-related experiences were differentially associated with a survey-based measure of hypertension. Specifically, veterans self-reporting PD and/or TBI had significantly higher odds of self-reporting hypertension (i.e., medical provider-identified high blood pressure).

NONCOMBAT AND COMBAT MILITARY SERVICE EXPERIENCES, HEARING DIFFICULTY, AND DIFFICULTY REMEMBERING/CONCENTRATING

Abstract Hearing difficulty is widespread among U.S. veterans. Research documents a strong association between hearing difficulty and a range of cognitive outcomes. Most research that examines cognitive outcomes in older adults does not distinguish veterans from non-veterans or non-combat from combat veterans. We use data on Sample Adults aged 50+ from the 2021 National Health Interview Survey to examine: the associations between military service experiences (non-veteran, non-combat veteran, combat veteran) and difficulty remembering/concentrating (none, some, a lot/cannot do at all) net of sociodemographic controls; the extent to which observed associations are mediated by hearing difficulty (none, some, a lot/cannot do at all); whether military service experiences moderate the association between hearing loss and difficulty remembering and concentrating. This latter hypothesis is motivated by the notion that service-related hearing loss may occur earlier in the life course and therefore be more detrimental to cognitive outcomes. Analyses are weighted; standard errors are adjusted for the complex sampling design. Preliminary results from multivariable ordinal logistic regression models that include sociodemographic controls indicate that: non-combat and combat veterans have significantly more difficulty remembering/concentrating than non-veterans; the associations between non-combat and combat military service experiences and increased difficulty remembering/concentrating are reduced 20% when hearing difficulty is added to the model, but remain statistically significant; hearing difficulty is strongly associated with difficulty remembering/concentrating; and military service experiences moderate the associations between hearing difficulty and difficulty remembering/concentrating. For example, the highest level of hearing difficulty is more strongly associated with difficulty remembering/concentrating among combat veterans than non-combat veterans.

The contribution of childhood adversity and potentially traumatic events during military service to PTSD and complex PTSD symptoms among Israeli women veterans.

Adverse childhood experiences (ACEs) and exposure to potentially traumatic events (PTEs) during military service are associated with mental health problems. However, knowledge about relative contributions of these factors to non-U.S. women combat veterans' posttraumatic sequelae is sparse. This study examines associations between ACEs, combat exposure (CES), military sexual trauma (MST), potentially morally injurious events (PMIEs), posttraumatic stress disorder (PTSD), and complex PTSD (CPTSD) symptoms among women veterans. A volunteer sample of Israeli women combat veterans (n = 885) and noncombat veterans (n = 728) responded to self-report questionnaires in a cross-sectional design study. Combat veterans reported higher total average ACEs and were more likely to experience three or more ACEs and specific ACEs of physical abuse and emotional neglect, as compared to noncombat veterans. Combat veterans also reported higher levels of CES, PMIEs, higher prevalence of MST, and higher levels of PTSD symptoms, but not CPTSD symptoms, as compared to noncombat veterans. Importantly, ACEs, CES, MST-assault, and PMIEs of betrayal predicted PTSD symptoms, while only ACEs and PMIEs of betrayal predicted CPTSD symptoms. This study emphasized the relatively high exposure to PTEs and PTSD symptoms of women combat veterans as compared to noncombat veterans. Our findings also confirm prior studies demonstrating associations between ACEs, CES, MST, and mental health problems. Importantly, we demonstrated the unique contribution of betrayal-based PMIEs and the differential associations of PTEs with PTSD and CPTSD symptoms among combat veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Age differences in long-term mortality among male nonveterans, noncombat veterans, and combat veterans.

Research documenting differences in mortality risk across the life course between veterans and nonveterans has not accounted for combat status. To address this gap in the literature, the current study examined differences in long-term mortality among midlife and older-adult male nonveterans, noncombat veterans, and combat veterans. Data were drawn from Wave 2 (2004/2005) of the Midlife Development in the United States survey and linked to 2020 mortality data (N = 2,024). Based on interpretation of a veteran-combat status by age interaction term, compared to nonveterans, noncombat veterans experienced a mortality advantage at younger ages, ORmain effect = 0.12, 95% CI [0.03, 0.54], p = .006, and a mortality disadvantage at older ages, ORinteraction term = 1.06, 95% CI [1.01, 1.05], p = .004, with the crossover occurring at 73.4 years. A similar pattern was present among combat veterans, with the mortality advantage at younger ages not reaching significance, ORmain effect = 0.16; 95% CI [0.02, 1.18], p = .072; a mortality advantage at older ages, ORinteraction term = 1.03, 95% CI [1.00, 1.05], p = .040; and the crossover occurring 4.2 years earlier at 69.2 years. The findings suggest that combat status may accelerate the age-related mortality disadvantage among veterans. Studies of health and mortality outcomes among veterans should, therefore, account for combat status. When data allow, future studies should confirm whether this pattern is present in nationally representative samples.

Exposure to combat experiences: PTSD, somatization and aggression amongst combat and non-combat veterans.

To this date, the prevalence of posttraumatic stress disorder (PTSD) and associated psychological symptom profiles amongst non-combatant community-based veterans in Israel has not been studied. Data were analysed from a web-based survey of veterans via a market research platform during September 2021 and included 522 non-combat (e.g. intelligence, office-based or education corps) veterans and 534 combat (e.g. front-line infantry) veterans. The survey assessed PTSD, depression, anxiety and somatic symptoms in addition to the prevalence of self-reported aggression. A two-way multivariate analysis of covariance indicated that higher PTSD and somatic symptoms were prevalent for those exposed to combat experiences even when not in a combatant role. A logistic regression indicated that of those who did not self-define as aggressive prior to service, those exposed to combat were three times more likely to be aggressive following their service than veterans not exposed to combat. This effect was not demonstrated for combat soldiers compared to non-combat soldiers. Results indicate that mental health outreach would be better targeted towards those who have been exposed to combat-type experiences during their service even in non-combat units. The current study highlights the effect of combat exposure on secondary PTSD symptoms; aggression and somatization.

The Contribution of Childhood Adversity and Potentially Traumatic Events During Military Service to PTSD and Complex PTSD Symptoms Among Israeli Women Veterans

IntroductionAdverse childhood experiences (ACEs) and exposure to potentially traumatic events (PTEs) during military service are associated with mental health problems. However, knowledge about relative contributions of these factors to non-U.S women combat veterans’ posttraumatic sequalae is sparse.ObjectivesTo examine associations between ACEs, combat exposure, military sexual trauma (MST), potentially morally injurious events (PMIEs), posttraumatic stress disorder (PTSD) and complex PTSD symptoms among women veterans.MethodsA volunteer sample of Israeli women combat veterans (n=885) and non-combat veterans (n=728) responded to self-report questionnaires in a cross-sectional design study.ResultsCombat veterans reported more total average ACEs, were more likely to experience 3 or more ACEs and specific ACEs of physical abuse and emotional neglect, as compared to non-combat veterans. Combat veterans also reported higher levels of combat exposure, PMIEs, higher prevalence of MST and higher levels of PTSD symptoms, but not CPTSD symptoms, as compared to non-combat veterans. Importantly, ACEs, combat exposure, MST-assault and PMIEs of betrayal predicted PTSD symptoms, while only ACEs and PMIEs of betrayal predicted complex PTSD symptoms.ConclusionsThis study emphasized the relatively high exposure to PTEs and PTSD symptoms of women combat veterans as compared to non-combat veterans. Our findings also confirm prior studies demonstrating associations between ACEs, combat exposure, MST and mental health problems. Importantly, we demonstrated the unique contribution of betrayal based PMIEs and the differential associations of PTEs with PTSD and Complex PTSD symptoms among combat veterans.Disclosure of InterestNone Declared

Exposure to potentially morally injurious events, disruption in assumptive world, moral injury symptoms, and psychological distress among Israeli female veterans.

Exposure to potentially morally injurious events (PMIEs) during military service is associated with mental health problems. However, knowledge about these associations and possible mechanisms of effect among female combat veterans is sparse. This study examines associations between PMIEs, posttraumatic stress disorder (PTSD), complex PTSD, depression and anxiety symptoms among female veterans, as well as the mediating role of disruption in assumptive world and moral injury (MI) symptoms. A volunteer sample of Israeli female combat veterans (n=885) and non-combat veterans (n=728) responded to self-report questionnaires in a cross-sectional design study. Results show that combat veterans reported higher levels of PMIEs, PTSD and MI symptoms, but not CPTSD, depression and anxiety symptoms, as compared to non-combat veterans. Importantly, PMIEs was indirectly associated with PTSD, complex PTSD, depression and anxiety symptoms through serial mediators of disruption in assumptive world and MI symptoms. This study emphasized the exposure to PMIEs and its posttraumatic sequelae among female combat veterans as compared to non-combat veterans. Our findings also suggest that future longitudinal studies should examine the mediating role of disruption in assumptive world and MI symptoms for the deleterious effects of exposure to PMIEs during military service.

MORTALITY RISK AMONG OLDER VETERANS AND NONVETERANS: THE IMPORTANCE OF COMBAT STATUS

Abstract Over 17.4 million Americans have served in the U.S. armed forces. Although long-term mortality risk is reported to be higher among older veterans than nonveterans, research does differentiate whether there is variation by combat status. This study examined later-life mortality rates among nonveterans, noncombat veterans, and combat veterans. Data were from Wave 2 of the Midlife Development in the United States Survey (N = 4,633). Participants included 3832 nonveterans, 584 noncombat veterans, and 217 combat veterans. Mortality rates did not differ when comparing nonveterans and noncombat veterans. Combat veterans, however, had a higher risk of mortality than did than nonveterans. Combat experience is a determinant of long-term mortality risk among veterans. Future studies should account for combat status when comparing health and mortality between veterans and nonveterans. Because of their heightened mortality risk, combat veterans should be provided with additional services during and after their time in the armed forces.

Comparing Two Distinct Miliary Samples on Traumatic Events, Positive Coping Styles and Post Traumatic Growth

This study collected complete data traumatic event-related information, positive coping styles, and post traumatic growth variables from two different United States (US) military veteran samples: non-combat military veterans (n = 54) and combat military veterans (n = 84). Although both samples represent military veterans, only one sample experienced actual combat, i.e., active fighting in a war against an enemy. All data were collected via online survey. Demographically, both samples were predominately White male, with a four-year college degree being the highest education level frequency. The average participant age was 29 years and there was no significant mean age difference between the samples. In addition, there were no significant sample differences in the total number of traumatic events experienced or time since the most powerful traumatic event was experienced. The purposes of this study were to: (1) test if four positive coping strategies were related to Post Traumatic Growh (PTG), and (2) to determine if there were differences in the use of these four coping strategies or experienced PTG for non-combat versus combat military veterans. The four positive coping styles were measured, instrumental support, emotional support, religion, and acceptance. For the combined sample, two coping styles, instrumental support and religion were each significant positively related to post traumatic growth (PTG). Significant sample differences were found on instrumental support and religion such that the non-combat veterans perceived higher mean levels on both coping styles versus the combat veterans. No sample difference was found for PTG. Future research directions and study limitations are discussed.

Age differences in allostatic load among veterans: The importance of combat exposure.

The current study examinedage differences in allostatic load among nonveterans, noncombat veterans, and combat veterans. Participants included 280 individuals from the Midlife Development in the United States (MIDUS) survey, including 164 veterans (n=48 combat veterans; n=116 noncombat veterans) and 116 nonveterans. Age differences in allostatic load were similar among nonveterans and noncombat veterans, B=0.002, SE=.011, p=.878, with older adults showing higher levels of allostatic load than their comparatively younger counterparts. Among combat veterans, however, a different pattern emerged. In this group, levels of allostatic load were similar across age, seemingly due to higher levels of allostatic load among younger combat veterans, B=-0.029, SE=.014, p=.031, ƞp 2 = .022. Results reveal the importance of considering combat exposure when examining health outcomes of military veterans, particularly in the context of age.

Mindfulness as a mediator between trauma exposure and mental health outcomes: Results from the National Health and Resilience in Veterans Study.

Exposure to traumatic life events is associated with increased risk of posttraumatic stress disorder (PTSD) and other mental health problems such as suicidal ideation (SI), alcohol use disorder (AUD), and decreased quality of life (QOL). Mindfulness, which involves attending to the present moment, may help individuals cope with traumatic events by increasing acceptance of trauma-related experiences and decreasing trauma-related negative affect and avoidance of trauma reminders. The current study evaluated whether mindful attention to the present moment mediated the association between number of lifetime traumas and mental health. The sample consisted of 1,268 trauma-exposed U.S. veterans who participated in the National Health and Resilience in Veterans Study, a nationally representative study of U.S. veterans. On average, the sample was 60.6 years of age (SD = 15.2, range = 20-94), predominantly male (89.8%), Caucasian (75.0%), and noncombat veterans (59.2%). Path analyses revealed that mindfulness partially mediated the relation between number of lifetime traumas and PTSD symptoms (β = -.55), AUD (β = -.17), and QOL (β = .38), and fully mediated the relation between number of lifetime traumas and SI (β = -.36). The relationship between lifetime trauma burden and various mental health issues of relevance to U.S. veterans may be mediated by mindfulness, or the ability to pay attention to the present moment. Interventions that bolster mindfulness may help mitigate the negative impact of cumulative traumas in this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Comparing Three Distinct Samples on Traumatic Events, Post Traumatic Stress Disorder and Dysfunctional Coping Styles

The purpose of this study was to compare three distinct United States (US) samples on traumatic events, dysfunctional coping styles and Post Traumatic Stress Disorder (PTSD). The samples were: civilian (n = 97); non-combat military veterans (n=61) and combat military veterans (n = 91). An online survey was used to collect all the data. The average age across all participants was 29 years old. For the overall combined sample, three avoidance coping styles, venting, denial, and dark humor, were each positively related to Post Traumatic Stress Disorder (PTSD). Looking at differences between the three samples, the combat veteran sample had more traumatic events (TEs), with the most recent TE being longer ago, then the non-combat veteran and civilian samples. There were no sample differences in PTSD. However, the non-combat veteran sample had higher levels of denial, venting and dark humor in dealing with their most recent TE, than the other two samples. This research draws needed attention to helping non-combat military veterans cope in a more positive way with their most recent TE. Future research directions and study limitations are discussed.

Veteran Status Matters! Life Course Perspectives on the Health and Well-Being of Aging Veterans

Military service during early life can result in exposure to traumatic events that can reverberate throughout life. Although much attention is focused on the negative effects of military service, many veterans report positive effects. These papers explore life course effects of military service on veterans’ health and well-being. Three used national US longitudinal cohorts (HRS, MIDUS); two sampled veterans from Oregon or from Korea. Three compared veterans to non-veterans; two examined veterans only. Cheng and colleagues found that veterans in HRS are more likely to be risk-averse than non-veterans. Risk aversion matters because it determines how people make decisions and predicts a wide array of health and economic outcomes. Kurth and colleagues examined Oregon veterans from several wars, finding PTSD symptoms were highest among Vietnam combat veterans, the oldest cohort; there were no differences among non-combat veterans. Piazza and colleagues examined in MIDUS the impact of veteran status on cortisol, a stress biomarker, finding older veterans more likely had non-normative patterns than did younger or non-veterans. Lee and colleagues studied patterns of mental health among Korean Vietnam veterans, identifying two patterns as ‘normal’ and ‘resilient’ encompassing half the sample; these veterans demonstrated positive outcomes of military service. Frochen and colleagues compared depression trajectories between veterans and non-veterans in HRS, finding veterans had less depression than non-veterans, but among veterans, trajectories varied based on extent of service. in sum, these papers demonstrate that military service can have positive as well as negative effects on veterans’ health and well-being in later life. Aging Veterans: Effects of Military Service across the Life Course Interest Group Sponsored Symposium.

PTSD Symptoms Among Vietnam, Persian Gulf, and Post-9/11 Combat Veterans: Findings From VALOR

Much is known about the mental health of combat Vietnam Veterans, but less is known about Persian Gulf and post-9/11 veterans and how they compare to those from earlier eras. Using data from an online survey of Oregon veterans, we examine how PTSD symptoms differ by combat exposure across these three cohorts. The sample (N=167, Mage=57.86, SD=12.09), was largely composed of White (88%), male (69%) Veterans. Most served in the Persian Gulf (41%), followed by Vietnam (36%) and post-9/11 (23%) eras. ANCOVAs showed significant cohort differences in PTSD, after controlling for severity of combat exposure and demographics (age, gender, education, income) (F(2, 157) = 4.24, p < .05). Post-9/11 veterans had significantly lower PTSD symptom severity than Vietnam-era veterans but were comparable to Persian Gulf. There were no cohort differences for noncombat veterans. Future research should investigate why Vietnam veterans continue to have worse mental health than younger veteran cohorts. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.

Comparing Work-Related Correlates of Life Satisfaction for Combat Versus Non-Combat Military Veterans

Military veterans (n = 153) completed an on-line survey and were broken down into combat (n = 92) versus non-combat (n = 61) veterans. The combat veterans had higher life satisfaction, perceived occupational alternatives, and education level versus the non-combat veterans. Looking at correlates to life satisfaction, for both samples number of prior traumatic events (negative) and personal accomplishment (positive) were significantly related. In addition, for the combat veterans, highest education level and perceived occupational alternatives were significantly related to life satisfaction. A high percentage of both combat and non-combat veterans were currently going to school to further their education. Working with employed combat and non-combat veterans, those currently going to school to further their education had higher perceived occupational alternatives than veterans not going back. Working with a smaller group of combat versus non-combat respondents who did volunteer work, the non-combat veterans were higher on perceived meaningfulness of volunteer work than the combat veterans. Returning to school can be one way to help military veterans find rewarding meaningful work, through perceived occupational alternatives, which can help to increase their life satisfaction. If increased education is not an option, volunteer work may also lead to higher perceived meaningful work. As veterans transition from military to civilian life, military out-processing should continue to counsel/prepare transitioning veterans for: finding/interviewing for jobs as well as realistic new careers; identifying meaningful voluntary work opportunities; or finding resources for furthering one’s education.

The Influence of Military Service Experiences on Current and Daily Drinking

Background: An extensive public health literature associates military service with increased alcohol consumption and problematic drinking. However, few well-controlled population-based studies compare alcohol use among nonveterans and veterans with diverse military service experiences, and no such study examines everyday drinking. Methods: We use population-representative data from the 2010 and 2011 Behavioral Risk Factor Surveillance System and distinguish four groups of men: nonveterans; non-combat veterans without a psychiatric disorder (PD) or traumatic brain injury (TBI); combat veterans without a PD or TBI; and veterans (non-combat and combat combined) with a PD and/or TBI. We estimate hierarchical multivariate logistic regression models of current drinking (N = 21,947) and daily drinking (among current drinkers; N = 11,491). Results from supplemental analyses are discussed. Results: Relative to nonveterans, non-combat veterans with no PD or TBI and veterans with a PD and/or TBI, respectively, but not combat veterans with no PD or TBI, are more likely to be current drinkers. Among current drinkers, non-combat and combat veterans with no PD or TBI, respectively, are less likely than nonveterans to be daily drinkers. Conversely, among current drinkers, veterans with a PD and/or TBI are more likely to be daily drinkers than nonveterans, non-combat veterans with no PD or TBI, and combat veterans with no PD or TBI. Conclusion: We document heterogeneous and countervailing influences of military service experiences on current and daily drinking. Results indicate that harmful military service experience may be associated with an increased risk of current, moderate daily drinking, which may represent a form of self-medication.