Durham VA Health Care System.
VA Mid-Atlantic Mental Illness Research, Education and Clinical Center.
Psychol Trauma. 2022 Mar;14(3):421-430. doi: 10.1037/tra0001018. Epub 2021 Mar 4.
Concurrent posttraumatic stress disorder and substance use disorder (PTSD/SUD) in U.S. military veterans represents an urgent public health issue associated with significant clinical challenges. Although previous research has shown that veterans with PTSD/SUD endorse more psychosocial risk factors and fewer protective factors than veterans with neither or only one of these disorders, no study has applied a comprehensive framework to characterize the vocational, financial, and social well-being of veterans with PTSD/SUD. Furthermore, it is not fully known how well-being among veterans with PTSD/SUD compares to that of veterans with posttraumatic stress disorder (PTSD) only, substance use disorder (SUD) only, or neither disorder.
This cross-sectional observational study analyzed data from the National Post-Deployment Adjustment Survey, which recruited a random national sample of U.S. veterans who served on/after September 11, 2001. Participants (weighted N = 1,102) self-reported sociodemographic, clinical, and military background information in addition to aspects of their vocational, financial, and social well-being.
Veterans with PTSD/SUD were particularly likely to report lifetime experiences of homelessness, violent behavior, suicidal ideation, and suicide attempts. Veterans with PTSD/SUD reported worse social well-being than the PTSD-only, SUD-only, and neither-disorder groups. They also reported worse vocational and financial well-being than veterans with SUD only or with neither disorder but did not significantly differ from the PTSD-only group on vocational or financial well-being.
The findings underscore the importance of assessing multiple aspects of well-being in veterans with PTSD and/or SUD. The findings also point to promising treatment targets to improve psychosocial functioning and overall quality of life among veterans with PTSD and/or SUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
美国退伍军人并发创伤后应激障碍和物质使用障碍(PTSD/SUD)是一个紧迫的公共卫生问题,与重大的临床挑战有关。尽管先前的研究表明,并发 PTSD/SUD 的退伍军人比没有或只有一种障碍的退伍军人更认同更多的心理社会风险因素,更少的保护因素,但没有研究应用综合框架来描述 PTSD/SUD 退伍军人的职业、财务和社会福利。此外,并发 PTSD/SUD 的退伍军人的幸福感与仅 PTSD、仅 SUD 或没有障碍的退伍军人相比如何,目前还不完全清楚。
本横断面观察性研究分析了国家部署后调整调查的数据,该调查招募了 2001 年 9 月 11 日之后在役的美国退伍军人的随机全国样本。参与者(加权 N=1102)报告了社会人口统计学、临床和军事背景信息,以及职业、财务和社会福利方面的信息。
并发 PTSD/SUD 的退伍军人特别可能报告终身经历无家可归、暴力行为、自杀意念和自杀企图。并发 PTSD/SUD 的退伍军人报告的社会福利较差,比仅 PTSD、仅 SUD 和无障碍组差。他们报告的职业和财务福利也比仅 SUD 或无障碍组差,但在职业或财务福利方面与仅 PTSD 组没有显著差异。
这些发现强调了在 PTSD 和/或 SUD 退伍军人中评估幸福感多个方面的重要性。这些发现还指出了有希望的治疗目标,以改善 PTSD 和/或 SUD 退伍军人的心理社会功能和整体生活质量。