Decade of US Veteran Data Reveals AUD Risks, Protective Factors

A decade-long study of US veterans published in Drug and Alcohol Dependence indicates that youth, low agreeableness and conscientiousness scores, dysphoric arousal symptoms, and a lack of mental health treatment are all risk factors for developing chronic patterns of excessive alcohol consumption.  

Alcohol use disorder (AUD) is a significant global health issue more prevalent in US veterans than nonveterans. Researchers designed a study to examine 10-year alcohol consumption trajectories in a nationally representative sample of US veterans since there are limited existing longitudinal studies on alcohol use among veterans. The study aimed to identify associated risks, such as posttraumatic stress disorder, and protective factors, such as social support and secure attachment style.  

Researchers collected nationally representative, longitudinal data from 2309 US veterans from the 2011–2021 National Health and Resilience in Veterans Study. Four distinct trajectories of alcohol consumption were identified in the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) through latent growth mixture modeling analyses. The 4 groups were identified as:  

The excessive group (4.1% of participants) with a mean (standard deviation) AUDIT-C baseline score of 8.6 (2.0) and a negative slope of -0.33 (0.07); 

The at-risk group (22.1%) with a baseline score of 4.1 (1.6) and a positive slope of 0.02 (0.07); 

The rare group (71.7%) with a baseline score of 1.2 (1.3) and a negligible slope of -0.01 (0.03); and 

The recovering alcohol consumption group (2.1%) with a baseline score of 8.4 (1.9) and a steep negative slope of -0.70 (0.14). 

For the excessive vs rare alcohol consumption group, younger age (27.8% of relative variance explained [RVE]) and lower agreeableness (27.0% RVE) are significant predictors. Fewer medical comorbidities (82.3% RVE) were associated with the at-risk vs rare alcohol consumption group. Greater dysphoric arousal symptoms (46.1% RVE) and current mental health treatment (26.5% RVE) were predictive of belonging to the recovering vs rare alcohol consumption group. Younger age (25.9% RVE), greater dysphoric arousal symptoms of posttraumatic stress disorder (22.0% RVE), and lower conscientiousness (19.1% RVE) were significant predictors for the excessive vs at-risk alcohol consumption group. Lastly, current mental health treatment (61.1% RVE) and secure attachment style (12.4% RVE) were strong predictors for distinguishing the excessive vs recovering alcohol consumption group. 

“Over the past decade, more than 1 in 4 US veterans consumed alcohol at the at-risk-to-excessive level,” said researchers. “Veterans who are younger, score lower on agreeableness and conscientiousness, endorse greater dysphoric arousal symptoms, and currently not engaged in mental health treatment may require close monitoring and prevention efforts to mitigate the risk of a chronic course of at-risk-to-excessive alcohol consumption.” 

Reference  

Peter NJ, Montalvo-Ortiz J, Petrakis I, et all. Trajectories of alcohol consumption in U.S. military veterans: Results from a 10-year population-based longitudinal study. Drug and Alcohol Dependence. 2023;246:109833. ISSN 0376-8716. doi:10.1016/j.drugalcdep.2023.109833