Hanson Karen L, Schiehser Dawn M, Clark Alexandra L, Sorg Scott F, Kim Russell T, Jacobson Mark W, Werhane Madeleine L, Jak Amy J, Twamley Elizabeth W, Delano-Wood Lisa
a VA San Diego Healthcare System (VASDHS) , San Diego , CA , USA.
c Veterans Medical Research Foundation , San Diego , CA , USA.
J Clin Exp Neuropsychol. 2016 Dec;38(10):1115-30. doi: 10.1080/13803395.2016.1198468. Epub 2016 Jul 19.
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.
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.
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 (R(2) = .04, ns) and posttraumatic stress disorder (PTSD) symptoms (ΔR(2) = .08, p = .05), we found that higher AUDIT scores were associated with poorer attention/processing speed, F(9, 37) = 2.55, p = .022; ΔR(2) = .26, p = .03.
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.
鉴于对于有轻度创伤性脑损伤（mTBI）病史的退伍军人，酒精使用、认知和精神症状之间的关联了解甚少，我们旨在：（a）在问题饮酒测量方面，描述他们与退伍军人对照组的差异；（b）调查问题饮酒是否与人口统计学特征或mTBI特征相关；（c）研究酒精使用、mTBI病史、精神功能和认知之间的关联。
我们评估了59名退伍军人（n = 32有mTBI病史；n = 27为军事对照组）的问题酒精使用情况（酒精使用障碍识别测试：AUDIT）、精神症状和神经心理功能。
与对照组相比，有mTBI病史的退伍军人更有可能得分高于AUDIT的临界分数8分（p = 0.016），表明问题饮酒率更高。有mTBI病史的参与者还表现出精神症状升高（p < 0.001）和认知分数降低（p < 0.05至< 0.001）。AUDIT分数较高的退伍军人更年轻（p = 0.05），受教育程度较低（p < 0.01），精神症状更多（p < 0.01），但mTBI特征无差异。在控制了战斗经历和mTBI病史（R² = 0.04，无显著性差异）以及创伤后应激障碍（PTSD）症状（ΔR² = 0.08，p = 0.05）后，我们发现较高的AUDIT分数与较差的注意力/处理速度相关，F(9, 37) = 2.55，p = 0.022；ΔR² = 0.26，p = 0.03。
这项初步研究表明，有mTBI病史的退伍军人可能有更高的问题饮酒风险。问题酒精使用主要与更严重的PTSD症状和较差的注意力/处理速度相关，而与战斗经历或mTBI特征本身无关。重要的是，研究结果强调了评估和治疗退伍军人中存在问题的酒精使用和共病精神症状的重要性，包括那些有神经创伤病史的退伍军人。
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