Psychosocial Well-Being Among Veterans With Posttraumatic Stress Disorder and Substance Use Disorder

• Published in: Psychological trauma 2022-03, Vol.14 (3), p.421-430
• Main Authors: Blakey, Shannon M., Dillon, Kirsten H., Wagner, H. Ryan, Simpson, Tracy L., Beckham, Jean C., Calhoun, Patrick S., Elbogen, Eric B.
• Format: Article
• Language: English
• Subjects: Alcoholism; Comorbidity; Cross-Sectional Studies; Female; Human; Humans; Male; Military Veterans; Posttraumatic Stress Disorder; Protective Factors; Psychosocial Factors; Public Health; Quality of Life; Stress Disorders, Post-Traumatic - psychology; Substance Use Disorder; Substance-Related Disorders - psychology; Veterans - psychology; Well Being
• ISSN: 1942-9681; 1942-969X
• DOI: 10.1037/tra0001018

Objective: Concurrent posttraumatic stress disorder and substance use disorder (PTSD/SUD) in U.S. military veterans represents an urgent public health issue associated with significant clinical challenges. Although previous research has shown that veterans with PTSD/SUD endorse more psychosocial risk factors and fewer protective factors than veterans with neither or only one of these disorders, no study has applied a comprehensive framework to characterize the vocational, financial, and social well-being of veterans with PTSD/SUD. Furthermore, it is not fully known how well-being among veterans with PTSD/SUD compares to that of veterans with posttraumatic stress disorder (PTSD) only, substance use disorder (SUD) only, or neither disorder. Method: This cross-sectional observational study analyzed data from the National Post-Deployment Adjustment Survey, which recruited a random national sample of U.S. veterans who served on/after September 11, 2001. Participants (weighted N = 1,102) self-reported sociodemographic, clinical, and military background information in addition to aspects of their vocational, financial, and social well-being. Results: Veterans with PTSD/SUD were particularly likely to report lifetime experiences of homelessness, violent behavior, suicidal ideation, and suicide attempts. Veterans with PTSD/SUD reported worse social well-being than the PTSD-only, SUD-only, and neither-disorder groups. They also reported worse vocational and financial well-being than veterans with SUD only or with neither disorder but did not significantly differ from the PTSD-only group on vocational or financial well-being. Conclusions: The findings underscore the importance of assessing multiple aspects of well-being in veterans with PTSD and/or SUD. The findings also point to promising treatment targets to improve psychosocial functioning and overall quality of life among veterans with PTSD and/or SUD. Clinical Impact Statement This study suggests that veterans who served on/after September 11, 2001 (i.e., post-9/11 veterans) with comorbid posttraumatic stress disorder and substance use disorder (PTSD/SUD) are at high risk for adverse experiences such as lifetime homelessness, violent behavior, and suicide. Moreover, post-9/11 veterans with comorbid PTSD/SUD appear to have worse psychosocial well-being in key aspects of their vocational, financial, and social lives relative to post-9/11 veterans with only one or neither of these disorders. Findings suggest that h