Alcohol misuse in the United Kingdom Armed Forces: A longitudinal study
Introduction
Recent studies from the US and UK have shown that high levels of alcohol misuse, alcohol related problems and binge drinking are common among military personnel (Fear et al., 2007, Jacobson et al., 2008, Pinder et al., 2012, Rona et al., 2010). Research investigating alcohol misuse and the associated risk factors in the military has largely been cross-sectional (Fear et al., 2007, Wilk et al., 2010) and longitudinal data examining the risk and protective factors associated with changes in alcohol misuse are limited (Schultz et al., 2014, Trautmann et al., 2015). Studies from the general population show that the psychological effects of negative life events include alcohol misuse whereas, positive life events, such as marriage, are associated with a decrease in alcohol misuse (Leonard and Rothbard, 1999, Perreira and Sloan, 2001, San José et al., 2000, Veenstra et al., 2006).
This longitudinal study aims to examine the effect of military factors such as operational deployment, life events and changes in mental health status on Alcohol Use Disorders Identification Test (AUDIT) scores over time among a large sample of UK military personnel.
Section snippets
Study design and sample
The data used in this study were collected as part of a longitudinal cohort study of UK Armed Forces personnel who were in service in March 2003 (Hotopf et al., 2006). A random sample was selected from personnel deployed to the first phase of the Iraq war in 2003 (the TELIC sample) and those who were in service but who did not deploy to Iraq at that time (the Era sample; Hotopf et al., 2006). This sample was stratified by: Service (Royal Navy [RN], Army/Royal Marines [Army/RM], Royal Air Force
Change in alcohol use
The overall mean AUDIT score at phase 1 was 10.15 and at phase 2 the mean AUDIT score was 9.14. There was a statistically significant decrease of around one point (Mean change = −1.01, 95% Confidence Interval −1.14, −0.88) in the mean AUDIT scores from phase 1 to phase 2 and this decrease was observed in all age groups, but was greater in young age groups (Table 1). At phase 1, 64.3% men and 49.4% women reported AUDIT scores greater than 8, i.e. hazardous use. The number of personnel reporting
Discussion
There was an overall decrease in AUDIT scores from phase 1 to phase 2. Despite this overall decrease, the mean AUDIT score among these military personnel remains high with 64.3% of men and 49.4% of women reporting hazardous drinking (AUDIT score 8+) compared to 33.2% of men, 15.7% of women in the UK general population (McManus et al., 2007). This study showed that a marginal change in AUDIT scores was associated with reporting new onset or persistent symptoms of probable PTSD and the breakdown
Role of funding source
The study was funded by the Ministry of Defence.
Contributions
GT, JS, NJ, MJ, LH, T-NK, NG, SW, and NTF experimental design, GT data analysis and writing up. All authors have read the paper and approve of this submission to DAD.
Conflict of interests
NJ is a full-time member of the reserves (part of the UK Armed Forces), and is currently seconded to King's College London. GT, JS, TN-K, NG, LH, MJ, RJR, NTF and SW are/were employed by King's College London, which receives funding from the UK Ministry of Defence. SW is also an honorary civilian consultant adviser in psychiatry to the British Army and a trustee of Combat Stress, a UK charity that provides service and support for veterans with mental health problems.
Ethical approval
The study received ethical approval from the Ministry of Defence's research ethics committee and the King's College Hospital local research ethics committee.
Acknowledgements
We would like to thank Major Mohammed Fertout for assisting in the design of the study.
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