Problem alcohol use in veterans with mild traumatic brain injury: Associations with cognitive performance and psychiatric symptoms

ABSTRACT

Introduction: Given that little is known about the associations between alcohol use, cognition, and psychiatric symptoms among veterans with a history of mild traumatic brain injury (mTBI), we aimed to (a) characterize how they differ from veteran controls on a measure of problem drinking; (b) investigate whether problem drinking is associated with demographic or mTBI characteristics; and (c) examine the associations between alcohol use, mTBI history, psychiatric functioning, and cognition. Method: We assessed 59 veterans (n = 32 with mTBI history; n = 27 military controls) for problem alcohol use (Alcohol Use Disorders Identification Test: AUDIT), psychiatric symptoms, and neuropsychological functioning. Results: Compared to controls, veterans with mTBI history were more likely to score above the AUDIT cutoff score of 8 (p = .016), suggesting a higher rate of problem drinking. Participants with mTBI history also showed elevated psychiatric symptoms (ps < .001) and lower cognitive scores (ps < .05 to < .001). Veterans with higher AUDIT scores were younger (p = .05) and had less education (p < .01) and more psychiatric symptoms (ps < .01), but mTBI characteristics did not differ. After controlling for combat and mTBI history (R² = .04, ns) and posttraumatic stress disorder (PTSD) symptoms (ΔR² = .08, p = .05), we found that higher AUDIT scores were associated with poorer attention/processing speed, F(9, 37) = 2.55, p = .022; ΔR² = .26, p = .03. Conclusions: This preliminary study suggested that veterans with mTBI history may be at increased risk for problem drinking. Problem alcohol use was primarily associated with more severe PTSD symptoms and poorer attention/processing speed, though not with combat or mTBI characteristics per se. Importantly, findings emphasize the importance of assessing for and treating problematic alcohol use and comorbid psychiatric symptoms among veterans, including those with a history of neurotrauma.

KEYWORDS:

• Alcohol
• Cognition
• Posttraumatic stress disorder
• Traumatic brain injury
• Veterans

Acknowledgements

The authors would like to sincerely thank the veterans who volunteered to participate in this study, those who could not, and those who continue to serve at home and abroad. In addition, we would like to gratefully acknowledge the Veterans Affairs San Diego Healthcare System for their organizational assistance.

Disclosure statement

No conflicts of interest were declared.

Additional information

Funding

This project was the result of research conducted at the VA San Diego Healthcare System (VASDHS) and the Veterans Medical Research Foundation, San Diego. This research was supported by grants from the Veterans Affairs (Merit and Career Development Awards) awarded to L. Delano-Wood [grant number CDA-2-034-07F], [grant number CX000842-01A2] and D. M. Schiehser [grant number CDA-2-065-10S]; and the Department of Defense (Investigator-Initiated Research Grant, IIRG) to L. Delano-Wood [grant number W81XWH-10-2-0169]. This material is the result of work supported with resources of the VA San Diego Healthcare System (VA Center of Excellence for Stress and Mental Health).