17 Neural networks connecting these areas of the prefrontal cortex to the basal ganglia and midbrain constitute the so-called “reward circuit,” which is implicated in substance abuse. 9 It is well-established that a TBI of sufficient force will damage the frontal lobes, ventral medial prefrontal cortex, and orbital frontal cortex regardless of the location of head impact. Studies suggest that experiencing a traumatic brain injury (TBI) while deployed increases the risk for post-deployment frequent (at least monthly) binge drinking, 8, 15 alcohol misuse, 16 and negative drinking-related consequences. Understanding deployment-related risk factors for post-deployment binge drinking is important for targeted prevention strategies. 13 DoD population-based surveys show that females binge drink less frequently than males, yet these studies have not analyzed differences in binge drinking by gender with a post-deployment cohort. 9–12 Female members represent approximately 10% of OEF/OIF deployments. 8 Binge drinking is associated with negative drinking-related consequences among military members, including drinking-related injuries and job-performance problems. 7 Prevalence of binge drinking is higher when assessed on DoD anonymous surveys, with 54% of active duty members returning from a combat deployment in 2007–2008 reporting binge drinking. ![]() Department of Defense (DoD) questionnaire at the end of their deployment. 5–7 A study of more than 300,000 Army active duty members returning from OEF/OIF deployments in fiscal years (FYs) 2008–2011 found that 38% reported binge drinking, using a higher and non–gender specific definition of six or more (6+) drinks on one occasion for males and females, when completing a U.S. 1–4 With more than a decade of deployments supporting Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom (OEF/OIF), studies have found that those who have been on a combat deployment or have experienced combat are at increased risk for binge drinking and problem alcohol use. More research is needed on the interaction of gender and binge drinking, especially when TBI and mental health problems co-exist.ī inge drinking, frequently defined as consuming five or more (5+) drinks on one occasion for males, and four or more (4+) drinks for females, has been common historically among military service members. In multivariable logistic regression models, having a TBI and a comorbid positive mental health screen was associated with increased odds of frequent binge drinking among both males and females (adjusted odds ratio = 1.59, CI: 1.50-1.69, and AOR = 2.11, CI: 1.57-2.83, respectively), compared with those with neither condition. 6.6%), and males with both problems had almost double the risk, compared with males with neither problem (33.6% vs. Females with both TBI and mental health positive screens had more than double the risk of frequent binge drinking, compared with those without either problem (15.8% vs. Male members were more likely to screen positive for TBI, compared with females (7.5% vs. More than 21% of males and 7% of females reported frequent binge drinking. ![]() The dependent variable, frequent binge drinking (six or more drinks on one occasion, at least monthly), was assessed on the follow-up questionnaire on average 3–9 months post-deployment. The initial questionnaire, completed at the end of deployment, included screens for TBI and mental health problems (post-traumatic stress disorder, depression, harmful thoughts). The sample consists of 240,694 male and 26,406 female active duty members who completed initial and follow-up questionnaires. Data are from the Substance Use and Psychological Injury Combat Study of Army members returning from deployment to Afghanistan or Iraq in fiscal years 2008–2011. ![]() This study examines whether the relationship between traumatic brain injury (TBI) and post-deployment binge drinking is independent of screening positive for mental health problems among male and female service members.
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