Examining Alcohol Use after Combat-Acquired Traumatic Brain Injury

检查战斗获得性脑外伤后的饮酒情况

• 批准号: 8253160
• 负责人: Rachel Sayko Adams
• 金额: $ 2.66万
• 依托单位: BRANDEIS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8253160
• 关键词: Address; Affect; Age; Alcohol abuse; Alcohol consumption; Alcohol dependence; Alcohols; Attention; Behavior; Conflict (Psychology); Dangerous Behavior; Department of Defense; Diagnosis; Ensure; Experimental Designs; Freedom; General Population; Goals; Health; Health Surveys; Health system; Hospitalization; Impairment; Injury; Intervention; Knowledge; Lead; Linear Regressions; Logistic Regressions; Measures; Mediating; Mental Health; Methods; Military Personnel; Modeling; Observational Study; Outcome; Performance at work; Policies; Post-Traumatic Stress Disorders; Public Health; Readiness; Recovery; Rehabilitation therapy; Research; Research Design; Respondent; Risk; Running; Sampling; Sampling Studies; Self Medication; Self-Administered; Services; Stress; Substance abuse problem; Surveys; Symptoms; Techniques; Traumatic Brain Injury; acute traumatic stress disorder; alcohol misuse; cohort; combat; coping; design; drinking; drinking behavior; experience; fighting; impaired driving performance; improved; injury stressor; innovation; intervention program; member; operation; peer; population based; research study; response; theories

DESCRIPTION (provided by applicant): Military service members engage in unhealthy drinking at higher rates than the general public, causing health consequences and affecting force readiness. For those returning from combat deployment to Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), unhealthy drinking may be exacerbated by acute stress reactions and injury, including traumatic brain injury (TBI), which is common among service members in OEF/OIF. Although civilian research suggests that impairments due to TBI may lead to an increased risk for unhealthy drinking, scant military research exists to examine whether TBI influences drinking behaviors among service members and evidence to date has been mixed. Further, TBI and posttraumatic stress disorder (PTSD) have overlapping symptoms and may co-occur, thus complicating assessment for both conditions. The three research aims of this application are to: 1) compare the post-deployment drinking behaviors for service members who experienced a TBI to those who did not, 2) to examine the relationship between experiencing a TBI and post-deployment drinking-related negative consequences, and 3) to examine the possible mediational effect of PTSD on the relationship between having experienced a TBI and the two outcome variables (drinking behaviors and negative post-deployment consequences). To analyze these research aims, this study will use the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, a worldwide population-based assessment. The survey was self-administered and anonymous with a response rate of 71.6 percent. The proposed study is a quasi-experimental design. The study sample includes a cohort of service members with a recent combat deployment (past year) and at least six months post-deployment before completing the survey (over 4,000 respondents), allowing the study to examine post-deployment drinking behaviors and consequences. The study will use multivariate linear and logistic regressions to assess the relationship between experiencing a TBI and 1) drinking behaviors and 2) negative consequences, as well as path analysis to examine whether PTSD mediates the relationship between TBI and drinking behaviors and negative consequences. This study is significant because it will use a population-based assessment of the military to examine the gap in knowledge regarding the association between combat-acquired TBI and post-deployment drinking and consequences, with attention to impacts on younger service members. The study is strengthened by improving upon methods for measuring combat-related TBI and addressing the controversy in the field about potential confounding between TBI and PTSD by using path analysis techniques. This innovative research application will inform future research, thus providing the Department of Defense (DOD) with information to design targeted early and secondary intervention practices to address unhealthy drinking and its consequences, helping to reduce the negative impacts to military personnel and the DOD.

描述（由申请人提供）：军人从事不健康饮酒的比例高于普通公众，造成健康后果并影响部队的战备状态。对于那些从战斗部署返回持久自由行动 (OEF) 和伊拉克自由行动 (OIF) 的人来说，急性应激反应和伤害可能会加剧不健康的饮酒，包括创伤性脑损伤 (TBI)，这在 OEF/伊拉克自由行动的军人中很常见。奥伊夫。尽管民间研究表明，TBI 造成的损害可能会导致不健康饮酒的风险增加，但很少有军事研究来检验 TBI 是否影响军人的饮酒行为，而且迄今为止的证据好坏参半。此外，TBI 和创伤后应激障碍 (PTSD) 具有重叠的症状，并且可能同时发生，因此对这两种情况的评估变得复杂。 此应用程序的三个研究目的是：1) 比较经历过 TBI 的服役人员与未经历过 TBI 的服役人员的部署后饮酒行为，2) 检查经历 TBI 与部署后饮酒相关的负面影响之间的关系后果，3) 检查 PTSD 对经历 TBI 和两个结果变量（饮酒行为和部署后负面后果）之间的关系可能产生的中介作用。 为了分析这些研究目标，本研究将使用 2008 年国防部现役军人健康相关行为调查，这是一项基于全球人口的评估。该调查是自我管理且匿名的，回应率为 71.6%。拟议的研究是一项准实验设计。研究样本包括最近参加过战斗部署（去年）和部署后至少六个月才完成调查的服役人员（超过 4,000 名受访者），从而使研究能够检查部署后的饮酒行为和后果。该研究将使用多元线性和逻辑回归来评估经历 TBI 与 1）饮酒行为和 2）负面后果之间的关系，并使用路径分析来检查 PTSD 是否介导 TBI 与饮酒行为和负面后果之间的关系。 这项研究意义重大，因为它将利用基于人群的军队评估来检查有关战后创伤性脑损伤与部署后饮酒及其后果之间关系的知识差距，并关注对年轻军人的影响。通过改进测量与战斗相关的 TBI 的方法，并使用路径分析技术解决该领域关于 TBI 和 PTSD 之间潜在混淆的争议，该研究得到了加强。这项创新的研究应用将为未来的研究提供信息，从而为国防部 (DOD) 提供信息，以设计有针对性的早期和二级干预措施，以解决不健康饮酒及其后果，帮助减少对军事人员和国防部的负面影响。