Prevalence of increased alcohol use and alcohol use disorders in adult victims of terrorist attacks: a systematic and meta-analytic review

ABSTRACT

Background: Previous studies have reviewed the evidence on the increase in alcohol consumption after a terrorist attack. However, an increase does not necessarily imply the presence of an alcohol use disorder.

Objectives: To conduct a systematic and meta-analytic review of the literature on the prevalence of increased alcohol consumption and alcohol use disorders in adult exposed to terrorism.

Methods: A search of PsycINFO, MEDLINE and PTSDpubs identified 29 studies published up to March 2023 in which 38 adult samples totaling 282,753 persons exposed to terrorism were assessed. Using inverse variance heterogeneity models, pooled prevalence rates of increased alcohol use and alcohol use disorders were calculated.

Results: 6% (95% CI [2.9, 9.5]) of the adults exposed to a terrorist attack increased their alcohol consumption. The prevalence of increased alcohol use varied depending on the degree of exposure (p = .006, R² = .18) and the procedure for measuring increases (p = .043, R² = .37). The prevalence of alcohol use disorders in adults exposed to a terrorist attack was 5.5% (95% CI [3.7, 7.5]), a rate that was not higher than that obtained in the general population and varied depending on the type of alcohol disorder (p = .015, R² = .30).

Conclusions: A relevant number of adults exposed to terrorist attacks will subsequently increase their alcohol consumption, but this increase is not associated with an increase in the prevalence of alcohol use disorders. Effects of terrorism on people’s health are potentially widespread, but concerns of excessive alcohol use after terrorist attacks may be unwarranted.

Resumen

Antecedentes: existen revisiones sobre el aumento del consumo de alcohol tras atentados terroristas. Sin embargo, un aumento no implica necesariamente la presencia de un trastorno por consumo de alcohol.

Objetivos: realizar una revisión sistemática y metaanalítica de la literatura sobre la prevalencia del aumento del consumo de alcohol y sus trastornos en adultos expuestos al terrorismo.

Métodos: una búsqueda en PsycInfo, MEDLINE y PTSDpubs identificó 29 estudios publicados hasta marzo de 2023 que evaluaron 38 muestras de adultos totalizando 282.753 personas expuestas al terrorismo. Usando modelos de heterogeneidad de la varianza inversa, se calcularon tasas de prevalencia conjunta del incremento en consumo de alcohol y sus trastornos.

Métodos: un 6% (IC al 95% [2,9, 9,5]) de los adultos expuestos a un atentado aumentarán su consumo de alcohol. La prevalencia del aumento varía según el procedimiento para medirlo (p = .043, R²= .37) y el grado de exposición (p =,006, R² =,18). La prevalencia de los trastornos por consumo de alcohol entre adultos expuestos a un atentado es 5,5% (IC al 95% [3,7, 7,5]), tasa que no es superior a la de la población general y varía dependiendo del tipo de trastorno (p =,015, R²=,30).

Conclusiones: un número relevante de adultos expuestos a un atentado aumentarán posteriormente su consumo de alcohol, pero este aumento no se asocia a una prevalencia incrementada de los trastornos por consumo de alcohol. Los efectos del terrorismo sobre la salud son potencialmente generalizados, pero la preocupación por un consumo excesivo de alcohol puede ser injustificada.

KEYWORDS:

• Alcohol
• alcohol use disorder
• terrorist attack
• terrorism
• review
• meta-analysis

PALABRAS CLAVE:

• alcohol
• trastorno por consumo de alcohol
• atentado terrorista
• terrorismo
• revisión
• metaanálisis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was possible thanks to a research grant from the Spanish Ministry of Science, Innovation and Universities (PGC2018-098387-B-I00) awarded to the first and last authors and a researcher contract from the INVESTIGO CM Program of the European Union, the Spanish Ministry of Labour and Social Economy and the Community of Madrid awarded to the penultimate author.