Childhood trauma, combat trauma, and substance use in National Guard and reserve soldiers

ABSTRACT

Background: The goal of this work was to examine associations among childhood trauma, combat trauma, and substance use (alcohol problems, frequent heavy drinking [FHD], current cigarette smoking, and current/lifetime drug use) and the interaction effects of childhood trauma and combat exposure on those associations among National Guard/reserve soldiers. Methods: Participants (N = 248) completed an electronic survey asking questions about their military experiences, physical and mental health, and substance use. Childhood trauma and combat exposure were examined jointly in regression models, controlling for age, marital satisfaction, and number of deployments. Results: Childhood trauma was associated with current drug use (trend level, odds ratio [OR] = 1.44, 95% confidence interval [CI]: 0.97, 2.14; P = .072) in the main effect model; however, there was not a significant interaction with combat. Combat exposure had a significant interaction with childhood trauma on alcohol problems (b = −0.56, 95% CI: −1.12, −0.01; P = .048), FHD (b = −0.27, 95% CI: −0.47, −0.08; P = .007), and lifetime drug use (OR = 1.78, 95% CI: 1.04, 3.04; P = .035). There were no associations with either of the trauma measures and current cigarette smoking. Conclusions: These results demonstrate that childhood and combat trauma have differential effects on alcohol use, such that combat trauma may not add to the effect on alcohol use in those with greater child maltreatment but may contribute to greater alcohol use among those with low child maltreatment. As expected, childhood and combat trauma had synergistic effects on lifetime drug use. Screening for multiple types of trauma prior to enlistment and/or deployment may help to identify at-risk individuals and allow time for early intervention to prevent future adverse outcomes.

KEYWORDS:

• Childhood trauma
• combat trauma
• military
• substance use

Author contributions

G.G.H. and D.L.H. conceived of, designed, and implemented the study. R.A.H. and D.L.H. conducted the statistical analysis. B.M.V. conducted the literature review, with support from R.C.D., and wrote the first draft of the manuscript. Sections of the manuscript were contributed by R.A.H., R.C.D., and D.L.H. All authors critically reviewed the manuscript for content. All authors contributed to and approved the final manuscript.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse of the National Institutes of Health (R01DA034072) to Gregory G. Homish. Research reported in this publication was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (UL1TR001412). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.