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Alcohol and stress in the military.

Schumm JA, Chard KM - Alcohol Res (2012)

Bottom Line: Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members.This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models.It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Psychiatry, University of Cincinnati, Cincinnati, OH, USA.

ABSTRACT
Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members. This overlap seems to be most understood in individuals who have experienced combat or military sexual trauma. This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models. It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders.

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Self-medication model explaining the link between traumatic stress and alcohol use disorder.
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f1-arcr-34-4-401: Self-medication model explaining the link between traumatic stress and alcohol use disorder.

Mentions: Although the self-medication hypothesis proposes that the initial development of an alcohol use disorder is reactionary to PTSD or other post-traumatic psychiatric disorders, an important corollary is that alcohol abuse impedes recovery and even worsens symptoms of posttraumatic mental health disorders. Within a cognitive–behavioral paradigm that attempts to understand the necessary conditions to recover from PTSD, it is hypothesized that the individual must be able to eliminate avoidance of stressful situations—i.e., they must put themselves into contact with people, places, or things that are objectively safe but that continue to cause distress, such as being in crowds, thinking about the trauma, or experiencing emotions related to the trauma (Foa and Kozak 1986). Alcohol misuse can interfere with this necessary precondition for recovery by leading individuals to continue to engage in unhelpful avoidance behaviors. In fact, within the self-medication framework, alcohol use can in itself be conceptualized as an avoidance behavior (e.g., using alcohol to avoid thinking about the traumas). In addition, alcohol withdrawal symptoms can mirror or exacerbate the symptoms of PTSD (Jacobson et al. 2001). For example, people experiencing post–acute withdrawal may have increased irritability, sleep problems, difficulty concentrating, and anxious and depressed mood, all of which overlap with symptoms of PTSD or depression. Thus, alcohol misuse feeds back into the posttraumatic mental health symptoms, in a bidirectional manner (see the figure).


Alcohol and stress in the military.

Schumm JA, Chard KM - Alcohol Res (2012)

Self-medication model explaining the link between traumatic stress and alcohol use disorder.
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860389&req=5

f1-arcr-34-4-401: Self-medication model explaining the link between traumatic stress and alcohol use disorder.
Mentions: Although the self-medication hypothesis proposes that the initial development of an alcohol use disorder is reactionary to PTSD or other post-traumatic psychiatric disorders, an important corollary is that alcohol abuse impedes recovery and even worsens symptoms of posttraumatic mental health disorders. Within a cognitive–behavioral paradigm that attempts to understand the necessary conditions to recover from PTSD, it is hypothesized that the individual must be able to eliminate avoidance of stressful situations—i.e., they must put themselves into contact with people, places, or things that are objectively safe but that continue to cause distress, such as being in crowds, thinking about the trauma, or experiencing emotions related to the trauma (Foa and Kozak 1986). Alcohol misuse can interfere with this necessary precondition for recovery by leading individuals to continue to engage in unhelpful avoidance behaviors. In fact, within the self-medication framework, alcohol use can in itself be conceptualized as an avoidance behavior (e.g., using alcohol to avoid thinking about the traumas). In addition, alcohol withdrawal symptoms can mirror or exacerbate the symptoms of PTSD (Jacobson et al. 2001). For example, people experiencing post–acute withdrawal may have increased irritability, sleep problems, difficulty concentrating, and anxious and depressed mood, all of which overlap with symptoms of PTSD or depression. Thus, alcohol misuse feeds back into the posttraumatic mental health symptoms, in a bidirectional manner (see the figure).

Bottom Line: Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members.This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models.It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Psychiatry, University of Cincinnati, Cincinnati, OH, USA.

ABSTRACT
Although research has independently linked stress experienced by military personnel to both alcohol use and posttraumatic stress disorder, more recently researchers have noted that there also is a significant overlap between stress reactions and alcohol use in veterans and active-duty service members. This overlap seems to be most understood in individuals who have experienced combat or military sexual trauma. This article will provide a brief review of some potential causal mechanisms underlying this relationship, including self-medication and genetic vulnerability models. It also addresses the possible implications for assessment and treatment of military personnel with co-occurring disorders.

Show MeSH
Related in: MedlinePlus