What drives the relationship between combat and alcohol problems in soldiers? The roles of perception and marriage

  • Bonnie M. Vest
  • D. Lynn Homish
  • Rachel A. Hoopsick
  • Gregory G. Homish
Original Paper



While the relationship between combat exposure and alcohol problems is well-established, the role of perceptions of trauma is less understood. The goal of this study was to explore associations between National Guard (NG) and reserve soldiers’ perceptions of combat experiences as traumatic and alcohol problems, and to examine marital satisfaction as a possible protective factor.


The Operation: SAFETY study recruited US Army Reserve and NG soldiers and their partners to complete a questionnaire covering many physical and mental health, military service, and substance use topics. Negative binomial regression models examined the impact of perceived trauma of combat experiences on alcohol problems (N = 198). The potential role of marital satisfaction as a resiliency factor was also examined.


The perception of combat experiences as traumatic was associated with increased risk of alcohol problems (risk ratio [RR] = 1.06, 95% confidence interval [CI] 1.01, 1.12; p = 0.024). Combat exposure itself showed no relationship. Marital satisfaction had a significant interaction with perceived combat trauma on alcohol problems (RR = 0.90, 95% CI 0.81, 0.99, p = 0.046), such that soldiers who perceived combat exposure as moderately-highly traumatic were less likely to have alcohol problems when they rated their marital satisfaction highly.


Our results demonstrate that the perception of combat experiences as traumatic may be a greater contributor to adverse outcomes, such as alcohol problems, than mere combat exposure. They also demonstrate the importance of marital satisfaction as a resiliency factor, particularly at the highest levels of trauma.


Reserve soldiers Combat exposure Alcohol problems Marital satisfaction Trauma perceptions 



Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number R01DA034072 (GGH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Portions of this work were presented at a symposium at the 39th Annual Meeting of the Research Society on Alcoholism, New Orleans, Louisiana, June 2016.

Compliance with ethical standards

Ethical standards

The State University of New York at Buffalo’s Institutional Review Board as well as the Army Human Research Protections Office, Office of the Chief, Army Reserve as well as the Adjutant General of the National Guard approved the study protocol. All participants provided informed consent.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Family MedicineUniversity at BuffaloBuffaloUSA
  2. 2.Department of Community Health and Health BehaviorUniversity at BuffaloBuffaloUSA

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