Skip to main content
SpringerLink
Log in

Hazardous Alcohol Use and Treatment Outcome in Male Combat Veterans with Posttraumatic Stress Disorder

  • Published:
Journal of Traumatic Stress

Abstract

The relationship between alcohol problems and posttraumatic stress disorder (PTSD) remains unclear. Six hundred and eight combat veterans diagnosed with PTSD were assessed for PTSD symptoms and alcohol problems prior to group cognitive–behavioral treatment. They were reassessed 3 and 9 months after treatment. Participants were classified into low-risk and hazardous drinkers at each time point. Drinking status at intake did not predict PTSD symptoms at intake or follow-up. However, drinking status was associated with PTSD symptoms when both were assessed at follow-up. PTSD arousal symptoms were the only symptom cluster to differentiate drinking groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Asmundson, G. J., Frombach, I., McQuaid, J., Pedrelli, P., Lenox, R., & Stein, M. B. (2000). Dimensionality of posttraumatic stress symptoms: A confirmatory factor analysis of DSM-IV symptom clusters and other symptom models. Behaviour Research and Therapy, 38, 203–214.

    Google Scholar 

  • Babor, T. F., Fuente, J., Saunders, J., & Grant, M. (1989). The Alcohol Use Disorder Identification Test: Guidelines for use in primary health care. Geneva: World Health Organisation.

    Google Scholar 

  • Babor, T. F., & Higgins-Biddle, J. C. (2000). Alcohol screening and brief intervention: Dissemination strategies for medical practice and public health. Addiction, 95, 677–686.

    Google Scholar 

  • Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: Guilford Press.

    Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Google Scholar 

  • Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., et al. (1995). The development of a Clinician-Administered PTSD Scale. Journal of Traumatic Stress, 8, 75–90.

    Google Scholar 

  • Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34, 669–673.

    Google Scholar 

  • Boudewyns, P. A., Woods, M. G., Hyer, L., & Albrecht, J. W. (1991). Chronic combat-related PTSD and concurrent substance abuse: Implications for treatment of this frequent “dual diagnosis.” Journal of Traumatic Stress, 4, 549–560.

    Google Scholar 

  • Bremner, J. D., Southwick, S. M., Darnell, A., & Charney, D. S. (1996). Chronic PTSD in Vietnam combat veterans: Course of illness and substance abuse. American Journal of Psychiatry, 153, 369–375.

    Google Scholar 

  • Brinson, T., & Treanor, V. (1989). Alcoholism and post traumatic stress disorder among combat Vietnam veterans. Alcoholism Treatment Quarterly, 5, 65–82.

    Google Scholar 

  • Conigrave, K. M., Hall, W. D., & Saunders, J. B. (1995). The AUDIT questionnaire: Choosing a cut-off score. Addiction, 90, 1349–1356.

    Google Scholar 

  • Creamer, M., Morris, P., Biddle, D., & Elliot, P. (1999). Treatment outcome in Australian veterans with combat-related posttraumatic stress disorder: A cause for cautious optimism? Journal of Traumatic Stress, 12, 545–558.

    Google Scholar 

  • Crowe, A. (1999). The battle after the war: The story of Australia's Vietnam veterans. St Leonards, NSW: Allen & Unwin.

    Google Scholar 

  • Davidson, J. R. T., Kudler, H. S., Saunders, W. B., & Smith, R. D. (1990). Symptom and comorbidity patterns in World War II and Vietnam veterans with posttraumatic stress disorder. Comprehensive Psychiatry, 31, 162–170.

    Google Scholar 

  • Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.

    Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). Structured Clinical Interview for DSM-IV Axis I Disorders—Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459–473.

    Google Scholar 

  • Greeley, J., & Oei, T. (1999). Alcohol and tension reduction. In K. E. Leonard & H. T. Blane (Eds.), Psychological theories of drinking and alcoholism (2nd ed.), pp. 14–53). New York: Guilford Press.

    Google Scholar 

  • Hyer, L., Woods, M. G., Summers, M. N., Boudewyns, P., & Harrison, W. R. (1990). Alexithymia among Vietnam veterans with posttraumatic stress disorder. Journal of Clinical Psychiatry, 51, 243–247.

    Google Scholar 

  • Keane, T. M., Caddell, J. M., & Taylor, K. L. (1988). Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85–90.

    Google Scholar 

  • Keane, T. M., Gerardi, R. J., Lyons, J. A., & Wolfe, J. (1988). The interrelationship of substance abuse and posttraumatic stress disorder: Epidemiological and clinical considerations. In M. Galanter (Ed.), Recent developments in alcoholism (Vol. 6, pp. 27–48). New York: Plenum.

    Google Scholar 

  • Keane, T. M., Fairbank, J. A., Caddell, J. M., & Zimering, R. T. (1989). Clinical evaluation of a measure to assess combat exposure. Psychological Assessment, 1, 53–55.

    Google Scholar 

  • Keane, T. M., & Wolfe, J. (1990). Comorbidity in posttraumatic stress disorder: An analysis of community and clinical studies. Journal of Applied Social Psychology, 20, 1776–1788.

    Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.

    Google Scholar 

  • Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., et al. (1990). Trauma and the Vietnam War generation: Report of findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel.

    Google Scholar 

  • LaCoursiere, R. B., Godfrey, K. E., & Ruby, L. M. (1980). Traumatic neurosis in the etiology of alcoholism: Vietnam combat and other trauma. American Journal of Psychiatry, 137, 966–968.

    Google Scholar 

  • Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford Press.

    Google Scholar 

  • McFall, M. E., Mackay, P. W., & Donovan, D. M. (1992). Combat-related posttraumatic stress disorder and severity of substance abuse in Vietnam veterans. Journal of Studies on Alcohol, 53, 357–363.

    Google Scholar 

  • McFall, M. E., Wright, P. W., Donovan, D. M., & Raskind, M. (1999). Multidimensional assessment of anger in Vietnam veterans with posttraumatic stress disorder. Comprehensive Psychiatry, 40, 216–220.

    Google Scholar 

  • Miller, W. R., & Marlatt, G. A. (1984). Manual for the Comprehensive Drinker Profile. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press.

    Google Scholar 

  • Monti, P. M., Rohsenow, D. J., Colby, S. M., & Abrams, D. B. (1995). Coping and social skills training. In R. K. Hester & W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: Effective alternatives (2nd ed.), pp. 221–241). Boston, MA: Allyn and Bacon.

    Google Scholar 

  • Ouimette, P. C., Ahrens, C., Moos, R. H., & Finney, J. W. (1998). During treatment changes in substance abuse patients with posttraumatic stress disorder: The influence of specific interventions and program environments. Journal of Substance Abuse Treatment, 15, 555–564.

    Google Scholar 

  • Ouimette, P. C., Finney, J. W., & Moos, R. H. (1999). Two-year posttreatment functioning and coping of substance abuse patients with posttraumatic stress disorder. Psychology of Addictive Behaviors, 13, 105–114.

    Google Scholar 

  • Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E., Burke, J. D., et al. (1984). Lifetime prevalence or specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949–958.

    Google Scholar 

  • Saladin, M. E., Brady, K. T., Dansky, B. S., & Kilpatrick, D. G. (1995). Understanding comorbidity between PTSD and substance abuse disorders: Two preliminary investigations. Addictive Behaviors, 20, 643–655.

    Google Scholar 

  • Saunders, J. B., Aasland, O. G., Babor, T. F., de-la-Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption: II. Addiction, 88, 791–804.

    Google Scholar 

  • Selzer, M. (1971). The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 1653–1658.

    Google Scholar 

  • Sobell, M. B., & Sobell, L. B. (1978). Behavioral treatment of alcohol problems: Individualized therapy and controlled drinking. New York: Plenum.

    Google Scholar 

  • Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1990). User's guide for the Structured Clinical Interview for DSM-III-R: SCID. Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Steele, C. M., & Josephs, R. A. (1988). Drinking your troubles away: II. An attention–allocation model of alcohol's effect on psychological stress. Journal of Abnormal Psychology, 97, 196–205.

    Google Scholar 

  • Stewart, S. H. (1996). Alcohol abuse in individuals exposed to trauma: A critical review. Psychological Bulletin, 120, 83–112.

    Google Scholar 

  • Stewart, S. H., Conrod, P. J., Pihl, R. O., & Dongier, M. (1999). Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women. Psychology of Addictive Behaviors, 13, 78–88.

    Google Scholar 

  • Stewart, S. H., Pihl, R. O., Conrod, P. J., & Dongier, M. (1998). Functional associations among trauma, PTSD, and substance-related disorders. Addictive Behaviors, 23, 797–812.

    Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics. Boston, MA: Allyn and Bacon.

    Google Scholar 

  • Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993, October). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the 9th annual conference of the ISTSS, San Antonio, TX.

  • Weathers, F. W., Ruscio, A. M., & Keane, T. M. (1999). Psychometric properties of nine scoring rules for the Clinician-Administered Posttraumatic Stress Disorder Scale. Psychological Assessment, 11, 124–133.

    Google Scholar 

  • Young, R. McD., & Oei, T. P. S. (2000). The predictive utility of drinking refusal self-efficacy and alcohol expectancy: A diary-based study of tension reduction. Addictive Behavior, 25, 415–421.

    Google Scholar 

  • Young, R. McD., Oei, T. P. S., & Knight, R. G. (1990). The Tension Reduction Hypothesis revisited: An alcohol expectancy perspective. British Journal of Addiction, 85, 31–40.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, The University of Queensland, Brisbane, Australia

    Stanley R. Steindl

  2. School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia

    Ross McD. Young

  3. Department of Psychiatry, University of Melbourne, Melbourne, Australia

    Mark Creamer

  4. The Australian Centre for Posttraumatic Mental Health, Melbourne, Australia

    Mark Creamer

  5. Trauma Treatment Program, Toowong Private Hospital, Brisbane, Australia

    David Crompton

Authors
  1. Stanley R. Steindl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ross McD. Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark Creamer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David Crompton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ross McD. Young.

About this article

Cite this article

Steindl, S.R., Young, R.M., Creamer, M. et al. Hazardous Alcohol Use and Treatment Outcome in Male Combat Veterans with Posttraumatic Stress Disorder. J Trauma Stress 16, 27–34 (2003). https://doi.org/10.1023/A:1022055110238

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1022055110238

Search

Navigation