The associations between deployment experiences, PTSD, and alcohol use among male and female veterans

Abstract Overview Alcohol use is common following traumatic military deployment experiences. What is less clear is why, and for whom, particular deployment experiences lead to alcohol use. Method The current study explored associations between deployment stressors (Warfare, Military Sexual Trauma, and Concerns about Life and Family Disruptions—“Life Disruptions”), PTSD (PCL-5), and alcohol use (CAGE) post-deployment, stratified by gender among 2344 male and female veterans (1137 men; M age = 35). Conditional process analyses examined the indirect effect of traumatic deployment experiences on alcohol use, via PTSD symptom severity, with Life Disruptions as a moderator. Results More severe Warfare and military sexual trauma (MST) were associated with greater PTSD symptom severity, which was associated with higher problematic alcohol use. PTSD symptom severity accounted for the associations between trauma type (i.e., MST or Warfare) and alcohol use. Among women, but not men, Life Disruptions moderated the associations between trauma type (i.e., MST, Warfare) and PTSD symptom severity, such that elevated Life Disruptions amplified the associations between trauma type and PTSD symptom severity. Moderated mediation was significant for MST among women, indicating that the strength of the indirect effect (MST ➔ PTSD ➔ problematic alcohol use) was moderated by Life Disruptions; problematic alcohol use was highest for women with greater PTSD symptom severity following exposure to more severe Life Disruptions and MST ( Est . = 0.0007, SE  = 0.0001, CI = 0.0002 to 0.0013). Conclusions Taken together, alcohol use following potentially traumatic deployment experiences can be understood by considering PTSD symptom severity, gender, and Life Disruptions.