Department of Family Medicine, University at Buffalo, Buffalo, New York, USA.
Department of Community Health and Health Behavior, University at Buffalo, Buffalo, New York, USA.
J Trauma Stress. 2022 Dec;35(6):1642-1655. doi: 10.1002/jts.22867. Epub 2022 Jul 28.
Although trauma exposure is a recognized risk factor for alcohol use, research on military populations has emphasized combat exposure, with minimal consideration of exposure to other potentially traumatic events (PTEs). We aimed to (a) identify, characterize, and quantify subgroups of service members based on PTE patterns; (b) examine associations between trauma exposure subgroups and alcohol use; and (c) examine these associations longitudinally. Data were drawn from Operation: SAFETY, a longitudinal study of health and well-being among U.S. Army Reserve/National Guard soldiers (N = 478). Exposure to 15 PTEs, including childhood maltreatment, noninterpersonal events (e.g., natural disasters, accidents), interpersonal trauma, and military-related exposures, was assessed at baseline. Latent profile analysis was conducted to characterize mutually exclusive trauma profiles; profile membership was used to longitudinally predict alcohol use in generalized estimating equation models. Four exposure profiles were identified: intimate partner violence (IPV)/combat trauma (8.4%, n = 40), combat trauma (24.7%, n = 118), childhood trauma (8.4%, n = 40), and low trauma (58.6%, n = 280). In adjusted models, compared to the low trauma profile, IPV/combat profile membership was longitudinally associated with alcohol problems, OR = 2.44, p =.005. Membership in other trauma profiles was not associated with alcohol use. Within the IPV/combat profile, men had a higher risk of frequent heavy drinking than women. Results suggest a need to comprehensively screen for lifetime PTE exposure, particularly IPV, in military populations. Given the high prevalence of nonmilitary PTEs, an inclusive, trauma-informed approach to health care and service provision is warranted.
虽然创伤暴露是饮酒的公认风险因素，但针对军事人群的研究强调了战斗暴露，而对其他潜在创伤事件（PTEs）的关注较少。我们旨在：（a）根据 PTE 模式识别、描述和量化服务成员的亚组；（b）研究创伤暴露亚组与饮酒之间的关联；（c）纵向研究这些关联。数据来自 Operation: SAFETY，这是一项针对美国陆军预备役/国民警卫队士兵健康和福祉的纵向研究（N=478）。在基线时评估了 15 种 PTE 的暴露情况，包括儿童期虐待、非人际事件（如自然灾害、事故）、人际创伤和与军事相关的暴露。使用潜在剖面分析来描述相互排斥的创伤特征；使用特征成员身份在广义估计方程模型中对酒精使用进行纵向预测。确定了四个暴露特征：亲密伴侣暴力（IPV）/战斗创伤（8.4%，n=40）、战斗创伤（24.7%，n=118）、儿童期创伤（8.4%，n=40）和低创伤（58.6%，n=280）。在调整后的模型中，与低创伤特征相比，IPV/战斗特征成员与酒精问题呈纵向相关，OR=2.44，p=.005。其他创伤特征的成员与饮酒无关。在 IPV/战斗特征中，男性比女性更频繁地发生重度饮酒。结果表明，有必要在军事人群中全面筛查终生 PTE 暴露情况，特别是 IPV。鉴于非军事性 PTE 的高患病率，需要采用包容、以创伤为中心的方法来提供医疗保健和服务。
