IN THIS ISSUE
Student Research Grant recipient for 2011
"Post-deployment predictors of alcohol use among United States Service members with and without a history of inpatient psychiatric hospitalization"
Background: Psychiatric admissions are a leading reason for inpatient hospitalization in the U.S. military and are more likely to lead to separation than medical admissions. Service members returning from deployment are susceptible to increased alcohol use and a range of psychosocial risk factors strongly associated with poor mental health outcomes including psychopathology and/or suicide. However, high risk individuals are often not referred for mental health care, highlighting an urgent treatment gap in a vulnerable population. We hypothesize that prior psychiatric inpatient hospitalization and post-deployment psychosocial risk factors will be positively associated with post-deployment alcohol use and subsequent psychiatric hospitalizations.
Method: Post-deployment health assessment data including demographic information, alcohol use, combat exposure, and psychosocial risk factors will be collected for a sample of service members admitted to a psychiatric inpatient unit between 2001-2006 (N=5,000) and a control sample (N=10,000) with no such history. Follow-up data on psychiatric inpatient hospitalization will be obtained for all participants from the Defense Medical Surveillance System.
Data analytic plan: Hypotheses will be tested using logistic regression to predict post-deployment alcohol use and subsequent inpatient psychiatric hospitalizations.
Specific Aims and Hypotheses
Aim 1: To compare a sample of military Service members with and without a history of psychiatric inpatient hospitalization on alcohol use as reported on the Post-Deployment Health Assessment (PDHA) and Post-Deployment Health Re-Assessment (PDHRA). Research Question 1: Are military service members with a history of psychiatric inpatient hospitalization at greater risk for alcohol use post-deployment than those with no history of psychiatric inpatient hospitalization? Hypothesis 1: Military service members with a history of psychiatric inpatient hospitalization are significantly more likely than those without such a history to report a higher frequency and amount of alcohol use on the completed PDHRA.
Aim 2: To compare a sample of military service members with or without a history of psychiatric inpatient hospitalization on types of demographic and self-reported psychosocial factors most predictive of PDHRA-documented alcohol use. Research Question 2: Will the two samples differ on the types of demographic and self-reported psychosocial factors associated with PDHRA-documented alcohol use? Hypothesis 2: The following demographic and self-reported psychosocial factors will significantly predict alcohol use among the inpatient group only: younger age, male sex, lower rank, combat-related trauma exposure(s), impulsivity, irritability, sleep disturbance, depressive symptoms, suicide ideation, and interpersonal conflict.
Aim 3: To determine whether PDHRA-documented alcohol use is associated with subsequent psychiatric inpatient visits among the previously hospitalized sample. Research Question 3: Will PDHRA-documented alcohol use be associated with subsequent psychiatric inpatient visits among the sample previously hospitalized for psychiatric care? Hypothesis 3: PDHRA-documented alcohol use will demonstrate a significant positive association with the incidence of subsequent psychiatric inpatient visits.
Exploratory Hypothesis: PDHRA-documented self-appraisals associated with the extent of alcohol use will demonstrate a significant negative relationship with the incidence of subsequent psychiatric inpatient visits.