Substance Use in Reservists: Social and Environmental Influences

摘要 此更新应用程序将建立在目前资助的R 01的成功基础上，重点关注两个高度 普遍存在但研究不足的经验：从未部署过的士兵和正在分离的士兵 从军队。药物滥用是军人最常见的健康问题之一 总的来说，1与现役相比，预备役人员的死亡率甚至更高。 一直专注于部署和战斗的影响，但很大一部分预备役士兵从来没有 部署是士兵身份的重要组成部分;因此，不部署可能会导致 内疚感和与单位的联系减少，这反过来会增加消极的风险。 6例如，在一项对130万退伍军人的研究中，自杀风险在那些有自杀倾向的退伍军人中较高。 7与军队分离也会给军人及其配偶带来压力， 并可能导致物质使用的增加。8，9我们发现了横截面证据， 与目前的预备役人员相比，服务人员的物质使用和依赖率更高， 那些因健康问题离开军队的预备役军人和他们的配偶都更赞成 11鉴于我们目前的项目，我们处于独特的地位，可以审查 在我们的样本中，士兵及其配偶在2005年期间的物质使用和心理健康的变化 分离过渡期。我们建议增加三个年度评估，使用加密的基于网络的 调查.这项工作的科学前提是强有力的，建立在正在进行的成功项目的基础上， 利用一个经过调整的社会生态框架，专门针对军事背景。 使用经过验证和可靠的测量方法、经过验证的调查方法和复杂的纵向数据 分析显示了高度的严谨性。我们建议实现以下具体目标：1.到 检查物质使用的纵向变化（酒精，烟草，非法药物，非医疗使用处方 毒品（NMUPD））与未得到充分审查的军事经验有关：a）从未部署和B）过渡 脱离军队后的平民生活。2.为了研究个人，关系， 社区层面的因素与这些未被充分研究的军事经历相互作用，影响着 随着时间的推移，物质的使用。3.研究可能的机制（例如，物质使用规范和冲突 士兵身份）将这些未经审查的经历与长期使用药物联系起来。4.审查如何 物质使用的变化与这些未被充分研究的经历相互作用，影响亲密伴侣 关系功能（亲密伴侣的言语、身体和性暴力，以及婚姻满意度）。给定 这些新目标将以具有成本效益和时间效益的方式， 大量的新知识，以推动该领域的发展，从而改善士兵，合作伙伴， 家庭

ABSTRACT This renewal application will build off of the success of the currently funded R01 by focusing on two highly prevalent, yet understudied, experiences: soldiers who have never deployed and those who are separating from the military. Substance abuse is one of the most common health problems among military personnel overall1 and tends to be even higher among reservists compared to active duty.2, 3 Research on the military has focused on the effects of deployment and combat, yet a significant proportion of reserve soldiers are never deployed.4, 5 Deployment is an important part of soldier identity; therefore, non-deployment may contribute to feelings of guilt and decreased connectedness with one's unit, which, in turn, can increase risk for negative outcomes.6 For example, in a study of 1.3 million veterans, suicide risk was higher among veterans who had never deployed.7 Separation from the military can also be stressful for service members and their spouses, and may contribute to increased substance use.8, 9 We have found cross-sectional evidence that former service members, compared to current reservists, have higher rates of substance use and dependence,10 and that both reservists who have left the military with negative health issues and their spouses are more approving of substance use than current reservists.11 Given our current project, we are uniquely positioned to examine changes in substance use and mental health among both soldiers and their spouses in our sample during the separation transition period. We propose three additional yearly assessments using an encrypted web-based survey. The scientific premise for this work is strong, building off of the on-going successful project and utilizing an adapted social ecological framework, specifically designed to address the military context.12 The use of validated and reliable measures, a proven survey methodology, and sophisticated longitudinal data analysis demonstrate a high level of rigor. We propose to accomplish the following specific aims: 1. To examine longitudinal changes in substance use (alcohol, tobacco, illicit drugs, nonmedical use of prescription drugs (NMUPD)) related to under-examined military experiences: a) never being deployed and b) the transition to civilian life following separation from the military. 2. To examine how individual-, relationship-, and community-level factors interact with these under-examined military experiences to influence changes in substance use over time. 3. To examine possible mechanisms (e.g., substance use norms and conflicts with soldier identity) linking these under-examined experiences with substance use over time. 4. To examine how changes in substance use interact with these under-examined experiences to influence intimate partner relationship functioning (verbal, physical and sexual intimate partner violence, and marital satisfaction). Given a strong foundation to build from, these new aims will, in a cost- and time-efficient manner, generate substantial new knowledge to move the field forward, thus improving outcomes for soldiers, partners, and their families.