Substance Use and Psychological Distress Before and After the Military to Civilian Transition
Substance Use and Psychological Distress Before and After the Military to Civilian Transition
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DOI：
10.1093/milmed/usx082
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发表时间：
2018-05-01
影响因子：
1.2
通讯作者：
Klesges, Robert C.
中科院分区：
文献类型：
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作者：
Derefinko, Karen J.;Hallsell, Troy A.;Klesges, Robert C.
背景：目前在军队服役的人是一个弱势群体，因为他们的物质使用处于高风险状态，人口数据表明，退伍军人在服兵役结束后很长一段时间内仍在继续大量使用物质。最近的研究表明，从现役到平民生活的分离过渡可能对退伍军人的未来功能至关重要。方法：我们试图通过回顾性评估现役期间和离职后的物质使用情况来探讨退伍军人的物质使用情况，以及潜在的情绪困扰，以检查这段时间内使用情况可能发生的变化。本研究评估了退伍军人（N = 80, 90%为男性）在军民过渡期间的物质使用和情绪困扰。结果：重复测量测试表明，在服役期间和离职后，对酒精使用、吸烟使用和处方药滥用的认可相似，在离职后6个月期间，大麻和硬性药物使用的认可显著增加。此外，不同药物的合并症使用很常见。从现役到离职后，焦虑/抑郁和攻击性情绪维持在现役水平，孤独感和军事创伤症状显著增加。最后，参与者表示，他们认识的退伍军人中只有少数人情绪良好或没有酒精/物质使用问题。讨论：这些发现表明，为了使退伍军人有效地过渡到平民生活，在过渡前后明显需要物质使用和心理干预的可用性。基于转型过程中存在的诸多问题，项目最好更具体地关注问题的识别和提高认识，而不是等待未来出现更严重的问题。确认分离过渡的困难，退伍军人的孤立感以及退伍军人社区支持的重要性可能有助于新过渡的退伍军人找到可以帮助他们导航现有援助计划的倡导者。
Background: Those currently serving in the military constitute a vulnerable population given their high-risk status for substance use, and population data suggest that veterans continue to engage in significant substance use long after their military service ends. Recent research suggests that the separation transition from active duty to civilian life may be critical in terms of the future functioning of the veteran. Methods: We sought to explore substance use prevalence, as well as potential emotional distress among veterans by retrospectively assessing substance use during active duty and following separation to examine possible changes in use over this period. This study assessed substance use and emotional distress in veterans (N = 80; 90% male) across the military to civilian transition. Findings: Repeated measures tests indicated that endorsement of alcohol use, cigarette use, and prescription drug misuse was similar during active duty and post-separation, and marijuana and hard drug use endorsement increased significantly in the 6-mo period post-separation. Further, comorbid use of different substances was common. Active duty levels of anxiety/depression and aggressive feelings were maintained from active duty to post-separation, and feeling alone and military-based trauma symptoms increased significantly. Finally, participants indicated that only a minority of the veterans they knew were doing emotionally well or did not have alcohol/substance use issues. Discussion: These findings indicate a clear need for substance use and psychological intervention availability before and after transition to enable veterans to transition to civilian life effectively. Based on the many issues at work during the transition process, programs may do well to focus more specifically on identification of problems and raising awareness, rather than awaiting more severe issues in the future. Validation of the difficulties of the separation transition, veterans' feelings of isolation, and the importance of veteran community support may help newly transitioning veterans find advocates who may help them navigate existing assistance programs.