º£½ÇÉçÇø — Women veterans with alcohol use disorder (AUD) are drinking in similar quantities to their male peers and have more severe symptoms of co-occurring depression, anxiety, and PTSD, a new study suggests. Among veterans, the rates of AUD and related impairments in physical and mental functioning are higher than in the general population. The study in Alcohol: Clinical & Experimental Research implies that drinking trends among veterans are paralleling those in the general population.
Overall, the prevalence of AUD and alcohol-related deaths has increased substantially in recent years. Historically, men drink more alcohol than women and are more likely to die from alcohol-related causes (the alcohol gender gap). Women have traditionally experienced higher rates of many alcohol-related harms, including co-occurring mental health issues. In addition, women report more early life stressors and potentially traumatic events, increasing their vulnerability to alcohol misuse. While the alcohol gender gap is narrowing in the general population, as women’s alcohol use increases, investigators at Stanford University examined gender differences in AUD outcomes among veterans specifically.
Researchers worked with 126 veterans who were receiving AUD treatment in residential abstinence-based programs at a Veterans Affairs facility in California. The participants filled out questionnaires assessing the presence and severity of anxiety, depression, and PTSD, symptoms, early life stress, and their alcohol use in the previous 90 days. Following the study, they were assessed at 1, 3, and 6 months for alcohol use.
The participants were aged 23 to 91 (average 47). One in 4 were women; 8 in 10 were White. The men and women consumed alcohol at similar rates in the 90 days preceding the study and during the 6-month follow-up period. Consistent with the general population, however, women veterans bore a higher psychiatric burden than men. The women reported greater early-life stress and more symptoms of co-occurring depression, anxiety, and PTSD at baseline. Both men and women averaged clinically significant PTSD scores, consistent with a higher prevalence of the condition among veterans than the general population.
Women veterans report greater early life stress than civilians, and adverse childhood events are a known risk factor for AUD in adulthood; these early life exposures likely underlie the similarity in AUD rates between male and female veterans. The new study underscored the additional association between early life stressors and depression, anxiety, and PTSD. Gender and mental health status were not associated with AUD outcomes, such as relapse, perhaps because the severity of AUD across the sample blunted the effects of mental health issues.
The representation of women in the military is rapidly increasing. This study points to the importance of understanding how mental health affects AUD outcomes and women’s health broadly, potentially informing more effective prevention and treatment. The study findings may not apply to nonveterans. Additional research across longer timespans could illuminate the interplay of gender, mental health, and alcohol use.
Rethinking gender differences: An investigation of comorbid psychopathology and alcohol use disorder in veterans. W. H. Craft, C. Beatriz-Padula.
ACER-024-6179.R1