Substance Use in Reservists: Social and Environmental Influences

摘要 此续订申请将建立在当前资助的R01的成功基础上，重点放在两个高度 普遍但研究不足的经历：从未部署过的士兵和正在分离的士兵 来自军方的。药物滥用是军人最常见的健康问题之一。 总体而言，与现役相比，预备役人员的比例更高。2，3关于军事的研究 关注于部署和战斗的影响，但相当大比例的预备役士兵从未 部署。4、5部署是士兵身份的重要组成部分；因此，不部署可能有助于 负罪感和与自己单位的联系减少，这反过来会增加消极的风险 结果。6例如，在一项对130万名退伍军人的研究中，有 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量的增加。8，9我们发现了横截面证据表明，前者 与目前的预备役军人相比，现役军人的物质使用率和依赖率更高，10和 无论是带着负面健康问题离开军队的预备役军人，还是他们的配偶都更赞同 11鉴于我们目前的项目，我们处于独特的地位，可以检查 在我们的样本中，士兵及其配偶在药物使用和心理健康方面的变化 分离过渡期。我们建议使用基于Web的加密技术额外进行三次年度评估 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和 利用经过调整的社会生态框架，专门针对军事背景而设计。 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 分析证明了高度的严谨性。我们建议实现以下具体目标：1. 检查药物使用的纵向变化(酒精、烟草、非法药物、非医疗使用处方 毒品(NMUPD)与审查不足的军事经历有关：a)从未部署和b)过渡 从军队分离后的平民生活。2.检查个人-、关系-和 社区层面的因素与这些未得到充分审查的军事经验相互作用，以影响 随着时间的推移物质的使用。3.审查可能的机制(例如，物质使用规范和与 士兵身份)将这些未被审查的经历与随着时间的推移而使用的物质联系起来。4.研究如何 物质使用的变化与这些未被研究的经历相互作用，从而影响亲密伴侣 关系运作(言语、身体和性亲密伴侣的暴力，以及婚姻满意度)。vt.给出 作为坚实的基础，这些新目标将以节约成本和节省时间的方式产生 丰富的新知识推动该领域向前发展，从而改善士兵、合作伙伴和他们的成果 家人。

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.