Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

Figures & data

Figure 1. Flow diagram showing the allocation of participants to phase 2 and phase 3

^aParticipants with data for both phases were included in phase 3 to create a more equal distribution, which reflects the distribution of the Airwave data.^bParticipants who completed the Airwave Health Monitoring Study survey in 2006 were not asked the PTSD items, and so, were dropped. The phase 1 KCMHR data were also dropped as this was the same timeframe.

Table 1. Demographic (age, marital status, education, income), occupational (role, rank, deployment, service) and health (smoking status) characteristics from police (N = 23,826) and military personnel (N = 7,399)

		Police				Military
Characteristic		Total	N	%	95% CI	Total	N	%	95% CI
Age (years)		23,651				7,399
	< 29		2,469	35.71	34.64 to 36.79		2,896	39.18	38.06 to 40.31
	30 to 39		7,394	40.55	39.66 to 41.45		2,694	36.35	35.25 to 37.46
	40 to 49		10,193	21.09	20.56 to 21.63		1,428	19.26	18.37 to 20.18
	≥ 50		3,770	2.66	2.55 to 2.76		381	5.21	4.72 to 5.75
Marital status		23,240				7,298
	Married/Cohabiting		19,747	79.06	78.19 to 79.92		5,764	79.00	78.04 to 79.93
	Divorced/Separated		1,619	5.18	4.83 to 5.55		395	5.32	4.82 to 5.86
	Single		1,874	15.76	14.94 to 16.61		1,139	15.68	14.86 to 16.54
Education		23,651				7,233
	Low (GSCE/O level or below)		8,167	42.77	41.77 to 43.77		3,094	42.78	41.64 to 43.92
	High (Vocational/A levels or higher)		15,484	57.23	56.22 to 58.23		4,139	57.22	56.08 to 58.36
Smoking status		23,617				7,113
	Non-smoker		21,681	89.98	89.36 to 90.56		5,481	75.48	74.47 to 76.47
	Current smoker		2,111	10.02	9.44 to 10.64		1,791	24.52	23.53 to 25.53
Income (police only)		23,651
	Less than £25,999		2,096	15.49	14.62 to 16.41		-	-	-
	£26,000 – £37,999		9,655	48.47	47.49 to 49.44		-	-	-
	£38,000 – £59,999		10,832	34.09	33.25 to 34.95		-	-	-
	More than £60,000		1,068	1.94	1.79 to 2.12		-	-	-
Role (police only)		21,290
	Police staff		3,627	15.28	14.53 to 16.07		-	-	-
	Police constable/sergeant		15,645	79.81	79.00 to 80.60		-	-	-
	Inspector or above		2,182	4.91	4.62 to 5.21		-	-	-
Rank (military only)						7,233
	Other		-	-	-		1,717	21.47	20.54 to 22.43
	Non-commissioned officer		-	-	-		4,108	55.23	54.08 to 56.38
	Commissioned officer		-	-	-		1,574	23.30	22.34 to 24.28
Deployed (military only)						7,195
	Not deployed		-	-	-		1,128	15.44	14.62 to 16.29
	Deployed		-	-	-		6,233	84.56	83.70 to 85.38
Service (military only)						7,399
	Naval Services		-	-	-		1,197	16.18	15.47 to 17.17
	Army		-	-	-		4,751	64.21	62.70 to 64.92
	Royal Air Force		-	-	-		1,451	19.61	19.88 to 20.82

Percentages are weighted with entropy balancing (e.g. year of data collection, age and educational attainment).

Table 2. Logistic and multinomial regression analyses showing the differences in PTSD and alcohol consumption characteristics stratified among police and military personnel. The police sample is the reference group ^a.

Outcome variable		Police N (%)	Military N (%)	OR (95% CI)	AOR (95% CI) ^b
PTSD
	Non-case	22,721 (96.05)	7,009 (96.33)	1.00	1.00
	Case	944 (3.95)	266 (3.67)	0.93 (0.79 to 1.09)	0.84 (0.72 to 0.99)*
				N = 30,749	N = 30,217
Alcohol use (UK government guidelines)
	Non-drinker	1,810 (8.52)	294 (3.93)	0.46 (0.40 to 0.54)***	0.46 (0.40 to 0.53)***
	Low risk (0 to 14 units)	11,656 (52.03)	3,754 (51.63)	1.00	1.00
	Hazardous (15 to 50 units)	9,429 (36.57)	2,524 (34.84)	0.96 (0.90 to 1.02)	0.90 (0.84 to 0.96)**
	Harmful (above 50 units)	767 (2.87)	683 (9.59)	3.37 (2.94 to 3.88)***	2.79 (2.42 to 3.21)***
				N = 30,656	N = 30,143
Binge drinking ^c
	No	23,169 (98.50)	7,075 (96.96)	1.00	1.00
	Yes	493 (1.50)	216 (3.04)	2.06 (1.71 to 2.48)***	1.67 (1.37 to 2.03)***
				N = 30,672	N = 30,160
Comorbidity
	PTSD non-case and non-case harmful alcohol use	21,924 (93.41)	6,327 (87.58)	1.00	1.00
	PTSD case only	888 (3.71)	199 (2.77)	0.79 (0.67 to 0.95)*	0.75 (0.63 to 0.89)**
	Harmful alcohol use only	709 (2.62)	614 (8.69)	3.52 (3.07 to 4.04)***	3.02 (2.62 to 3.48)***
	PTSD case and harmful alcohol use case	55 (0.25)	61 (0.87)	3.76 (2.20 to 6.43)***	2.84 (1.67 to 4.84)***
				N = 30,590	N = 30,083

***p < .001, **p < .01, *p < .05. Percentages are weighted with entropy balancing (e.g. year of data collection, age and educational attainment).

^aAge and education were not adjusted for as these variables were used in the entropy balancing to match the samples.

^bAdjusted for marital status and smoking status.

^cBinge drinking defined as drinking 6 or more units daily or almost daily.

Table 3. Demographic, occupational and health associations with PTSD caseness (PTSD non-case is the reference group) stratified by police and military personnel. Row percentages are shown representing the number of participants with probable PTSD

		PTSD Case
		Police		Military
Explanatory variable		N caseness (%)	OR (95% CI)	N caseness (%)	OR (95% CI)
Age (years)
	< 29	85 (3.64)	0.87 (0.66 to 1.15)	120 (4.27)	1.23 (0.93 to 1.63)
	30 to 39	281 (4.15)	1.00	92 (3.50)	1.00
	40 to 49	463 (4.20)	1.01 (0.86 to 1.20)	46 (3.19)	0.91 (0.63 to 1.31)
	≥ 50	115 (2.95)	0.70 (0.55 to 0.89)**	8 (2.14)	0.60 (0.29 to 1.25)
Marital status
	Married/Cohabiting	771 (3.91)	1.00	185 (3.23)	1.00
	Divorced/Separated	77 (3.79)	0.97 (0.68 to 1.37)	43 (3.90)	3.05 (2.08 to 4.44)***
	Single	73 (4.42)	1.14 (0.83 to 1.56)	35 (9.23)	1.22 (0.87 to 1.71)
Education
	Low (GSCE/O level or below)	324 (4.44)	1.00	134 (4.42)	1.00
	High (Vocational/A levels or higher)	617 (3.57)	0.80 (0.65 to 0.98)*	127 (3.11)	0.69 (0.54 to 0.89)***
Smoking status
	Non-smoker	871 (3.97)	1.00	161 (2.96)	1.00
	Current smoker	73 (3.75)	0.94 (0.64 to 1.38)	99 (5.62)	1.95 (1.51 to 2.53)***
Income (police only)
	Less than £25,999	76 (3.75)	1.00	-	-
	£26,000 – £37,999	406 (4.16)	1.11 (0.78 to 1.59)	-	-
	£38,000 – £59,999	428 (3.74)	1.00 (0.71 to 1.42)	-	-
	More than £60,000	31 (3.40)	0.90 (0.49 to 1.68)	-	-
Role (police only)
	Police constable/sergeants	661 (4.08)	1.00	-	-
	Police staff	104 (3.90)	0.95 (0.67 to 1.36)	-	-
	Inspector or above	94 (4.31)	1.06 (0.78 to 1.44)	-	-
Rank (military only)
	Other	-	-	98 (5.87)	1.00
	Non-commissioned officer	-	-	140 (3.48)	0.58 (0.44 to 0.75)***
	Commissioned officer	-	-	28 (1.82)	0.30 (0.19 to 0.46)***
Deployed (military only)
	Not deployed	-	-	52 (4.74)	1.00
	Deployed	-	-	213 (3.48)	0.72 (0.53 to 0.99)*
Service (military only)
	Naval Services	-	-	33 (2.77)	0.45 (0.43 to 0.92)*
	Army	-	-	199 (4.30)	1.00
	Royal Air Force	-	-	34 (2.38)	0.54 (0.37 to 0.78)**

***p < .001, **p < .01, *p < .05. Percentages are weighted with entropy balancing (e.g. year of data collection, age and educational attainment).

Table 4. Demographic, occupational and health associations with harmful alcohol use (low risk drinking is reference group) and daily or almost daily binge drink (not binge drinking daily or almost daily is the reference group) stratified by police and military personnel. Row percentages are shown representing the number of participants drinking alcohol at harmful levels or reporting daily or almost daily binge drinking

		Harmful alcohol use				Daily or almost daily binge drinking
		Police		Military		Police		Military
Explanatory variable		N caseness (%)	OR (95% CI)	N caseness (%)	OR (95% CI)	N caseness (%)	OR (95% CI)	N caseness (%)	OR (95% CI)
Age (years)
	< 29	61 (2.36)	0.95 (0.80 to 1.15)	383 (13.84)	1.25 (0.96 to 1.63)	13 (0.46)	0.25 (0.14 to 0.46)***	101 (3.64)	1.54 (1.12 to 2.13)**
	30 to 39	205 (2.93)	1.00	194 (7.46)	1.00	125 (1.83)	1.00	62 (2.39)	1.00
	40 to 49	357 (3.48)	1.16 (1.03 to 1.32)*	93 (6.77)	1.46 (1.03 to 2.07)*	245 (2.42)	1.33 (1.05 to 1.69)*	42 (3.05)	1.28 (0.86 to 1.91)
	≥ 50	144 (3.96)	1.20 (1.02 to 1.42)*	13 (3.46)	2.61 (1.21 to 5.63)*	110 (2.94)	1.63 (1.22 to 2.16)**	11 (2.93)	1.23 (0.64 to 2.36)
Marital status
	Married/Cohabiting	637 (2.79)	1.00	417 (7.44)	1.00	426 (1.67)	1.00	150 (2.70)	1.00
	Divorced/Separated	56 (3.66)	1.44 (0.97 to 2.14)	61 (16.31)	2.71 (1.99 to 3.70)***	40 (0.57)	1.46 (0.93 to 2.30)	22 (5.82)	2.24 (1.42 to 3.56)***
	Single	60 (3.26)	1.23 (0.85 to 1.77)	202 (18.35)	3.66 (3.00 to 4.45)***	19 (2.42)	0.34 (0.19 to 0.61)***	44 (3.99)	1.51 (1.07 to 2.12)**
Education
	Low (GSCE/O level or below)	311 (3.21)	1.00	395 (13.08)	1.00	223 (2.00)	1.00	124 (4.10)	1.00
	High (Vocational/A levels or higher)	451 (2.62)	0.79 (0.64 to 0.99)*	286 (7.01)	0.48 (0.41 to 0.57)***	267 (1.13)	0.56 (0.44 to 0.72)***	92 (2.25)	0.54 (0.41 to 0.71)***
Smoking status
	Non-smoker	631 (2.54)	1.00	382 (7.14)	1.00	404 (1.24)	1.00	119 (2.23)	1.00
	Current smoker	135 (5.83)	2.90 (2.17 to 3.87)***	295 (17.02)	3.27 (2.75 to 3.89)***	89 (3.79)	3.13 (2.26 to 4.34)***	95 (5.48)	2.54 (1.93 to 3.35)***
Income (police only)
	Less than £25,999	47 (1.83)	1.00	-	-	22 (0.06)	1.00	-	-
	£26,000 – £37,999	280 (2.62)	1.48 (0.97 to 2.24)	-	-	176 (1.22)	2.04 (1.11 to 3.74)**	-	-
	£38,000 – £59,999	403 (3.69)	2.31 (1.53 to 3.47)***	-	-	273 (2.27)	3.85 (2.13 to 6.96)***	-	-
	More than £60,000	32 (3.06)	2.07 (1.17 to 3.67)**	-	-	19 (1.98)	3.34 (1.44 to 7.74)***	-	-
Role (police only)
	Police constable/sergeants	539 (3.02)	1.00	-	-	341 (1.61)	1.00	-	-
	Police staff	59 (2.82)	0.90 (0.65 to 1.24)	-	-	47 (2.01)	0.82 (0.55 to 1.23)	-	-
	Inspector or above	108 (2.22)	0.82 (0.56 to 1.19)	-	-	67 (1.33)	1.25 (0.82 to 1.91)	-	-
Rank (military only)
	Other	-	-	240 (14.66)	1.00	-	-	69 (4.22)	1.00
	Non-commissioned officer	-	-	381 (9.66)	0.57 (0.47 to 0.68)***	-	-	111 (2.82)	0.66 (0.48 to 0.89)**
	Commissioned officer	-	-	62 (4.03)	0.23 (0.17 to 0.32)***	-	-	36 (2.34)	0.54 (0.36 to 0.82)**
Deployed (military only)
	Not deployed	-	-	65 (5.97)	1.00	-	-	21 (1.93)	1.00
	Deployed	-	-	615 (10.27)	2.14 (1.64 to 2.81)***	-	-	192 (3.21)	1.69 (1.07 to 2.66)*
Service (military only)
	Naval Services	-	-	130 (11.23)	1.25 (1.00 to 1.55)*	-	-	43 (3.70)	1.21 (0.86 to 1.72)
	Army	-	-	459 (10.12)	1.00	-	-	139 (3.07)	1.00
	Royal Air Force	-	-	94 (6.59)	0.61 (0.48 to 0.77)***	-	-	34 (2.39)	0.77 (0.53 to 1.13)

***p < .001, **p < .01, *p < .05. Percentages are weighted with entropy balancing (e.g. year of data collection, age and educational attainment).

Data availability statement

The data described in this article are openly available in the Open Science Framework at https://doi.org/10.17605/OSF.IO/TPA6U.