Department of Family Medicine, University at Buffalo, 77 Goodell Street, Suite 220, Buffalo, NY, 14203, USA.
Department of Community Health and Health Behavior, University at Buffalo, 325 Kimball Tower, 3435 Main Street, Buffalo, NY, 14214, USA.
Soc Psychiatry Psychiatr Epidemiol. 2018 Apr;53(4):413-420. doi: 10.1007/s00127-017-1477-7. Epub 2017 Dec 27.
While the relationship between combat exposure and alcohol problems is well-established, the role of perceptions of trauma is less understood. The goal of this study was to explore associations between National Guard (NG) and reserve soldiers' perceptions of combat experiences as traumatic and alcohol problems, and to examine marital satisfaction as a possible protective factor.
The Operation: SAFETY study recruited US Army Reserve and NG soldiers and their partners to complete a questionnaire covering many physical and mental health, military service, and substance use topics. Negative binomial regression models examined the impact of perceived trauma of combat experiences on alcohol problems (N = 198). The potential role of marital satisfaction as a resiliency factor was also examined.
The perception of combat experiences as traumatic was associated with increased risk of alcohol problems (risk ratio [RR] = 1.06, 95% confidence interval [CI] 1.01, 1.12; p = 0.024). Combat exposure itself showed no relationship. Marital satisfaction had a significant interaction with perceived combat trauma on alcohol problems (RR = 0.90, 95% CI 0.81, 0.99, p = 0.046), such that soldiers who perceived combat exposure as moderately-highly traumatic were less likely to have alcohol problems when they rated their marital satisfaction highly.
Our results demonstrate that the perception of combat experiences as traumatic may be a greater contributor to adverse outcomes, such as alcohol problems, than mere combat exposure. They also demonstrate the importance of marital satisfaction as a resiliency factor, particularly at the highest levels of trauma.
虽然战斗暴露与酒精问题之间的关系已得到充分证实，但对创伤认知的作用了解较少。本研究的目的是探讨国民警卫队（NG）和预备役士兵对战斗经历的创伤认知与酒精问题之间的关联，并研究婚姻满意度作为一种可能的保护因素。
“安全行动”研究招募了美国陆军预备役和国民警卫队的士兵及其配偶，让他们填写一份涵盖许多身心健康、兵役和药物使用话题的问卷。负二项回归模型检验了对战斗经历的创伤认知对酒精问题的影响（N=198）。还检验了婚姻满意度作为弹性因素的潜在作用。
对战斗经历的创伤认知与酒精问题的风险增加相关（风险比[RR]=1.06，95%置信区间[CI]为 1.01，1.12；p=0.024）。战斗暴露本身与酒精问题无关。婚姻满意度与对战斗创伤的认知对酒精问题有显著的交互作用（RR=0.90，95%CI 为 0.81，0.99，p=0.046），即当士兵认为战斗暴露为中度至高度创伤时，如果他们对婚姻满意度评价较高，则发生酒精问题的可能性较低。
我们的结果表明，对战斗经历的创伤认知可能比单纯的战斗暴露更能导致不良后果，如酒精问题。它们还表明婚姻满意度作为一种弹性因素的重要性，尤其是在创伤程度最高时。
