Depression, Posttraumatic Stress & Alcohol Misuse in Young Adult Veterans: The Transdiagnostic Role of Distress Tolerance

BACKGROUND:

Alcohol misuse is common among young adult veterans, and is commonly associated with depression and posttraumatic stress disorder (PTSD). In fact, rates of comorbid depression, PTSD, and problem drinking are high in this population. Although distress tolerance, the capacity to experience and withstand negative psychological states, has been examined as a potential transdiagnostic factor that accounts for the development of mental health disorders, problem drinking, and the comorbidity between these presenting concerns, its role has not been evaluated in a veteran population.

METHODS:

Young adult veterans were recruited for an online survey related to alcohol use. Participants (n=783) completed self-report measures of alcohol use, depression and PTSD symptoms, and distress tolerance. Mediation models were conducted to examine whether distress tolerance mediated the relationship between (1) probable PTSD, (2) probable depression, and (3) comorbid probable PTSD and depression with alcohol misuse. Moderated mediation models were conducted to examine gender as a moderator.

RESULTS:

Significant bivariate associations were observed among mental health symptoms, distress tolerance, and alcohol misuse. Distress tolerance significantly mediated the relationship between probable depression and PTSD (both alone and in combination) and alcohol misuse. Evidence of moderated mediation was present for probable PTSD and probable comorbid PTSD and depression, such that the indirect effect was stronger among males.

CONCLUSIONS:

These results suggest that distress tolerance may be a transdiagnostic factor explaining the comorbidity of depression and PTSD with alcohol misuse in young adult veterans. These findings may inform screening and intervention efforts with this high-risk population.

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By:  Brooks Holliday S1, Pedersen ER2, Leventhal AM3.

• 1RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States. Electronic address: holliday@rand.org.
• 2RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States.
• 3University of Southern California, Los Angeles, CA 90089, United States. 
• Drug Alcohol Depend. 2016 Apr 1;161:348-55. doi: 10.1016/j.drugalcdep.2016.02.030. Epub 2016 Feb 27.

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The Whole Family Serves: Supporting Sexual Minority Youth in Military Families

Sexual minority youth in military families have a unique set of stressors that affect their mental, emotional, and physical health. There is a pronounced gap in data addressing the specific stressors of this population and how they interact to impact the health of the adolescent. 

The culture of the United States military has historically been heterosexist and homophobic, propelled primarily by policies that restricted the recruitment and service of lesbian, gay, bisexual, or transgender individuals, leading to a continued secrecy around sexual orientation that may affect how sexual minority youth within the community view themselves. 

Homophobia, social stigma, and victimization lead to significant health disparities among sexual minority youth, and youth connected to the military have additional stressors as a result of frequent moves, parental deployment, and general military culture. 

Primary care providers must be aware of these stressors to provide a safe environment, thorough screening, and competent care for these adolescents.

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By:  Gyura AN, McCauley SO.

Correspondence: Ashley N. Gyura, BSN, RN, School of Nursing, Columbia University, New York, NY.

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