Prevalence and predictors of alcohol use disorder among Canadian Armed Forces members and veterans with military sexual trauma

Abstract

Military sexual trauma (MST) is a pervasive issue that is associated with adverse psychological and physical health sequelae (e.g., chronic health conditions, mental health disorders, suicidal ideation). Alcohol use disorder (AUD) is positively associated with MST and may exacerbate physical and mental health conditions. An elevated lifetime prevalence of MST was recently reported among Canadian Armed Forces (CAF) Members and Veterans. Still, research examining the relationship between MST and AUD within a Canadian context is lacking. Risk factors for AUD among CAF Members and Veterans with MST have also yet to be identified. The current thesis used the 2018 CAF Members and Veterans Mental Health Survey (n = 2,941) to assess the prevalence and predictors of AUD since 2002 among participants with lifetime MST, non-military sexual trauma (NMST), and no sexual trauma. Findings from cross tabulations revealed greater prevalence estimates of AUD among participants with any sexual trauma (MST = 21.6%, NMST = 29.2%) compared to those without sexual trauma (14.68%). Disproportionately greater prevalence estimates of AUD were found among males relative to females across all sexual trauma groups. Results of logistic regression analyses indicated that individuals with MST and NMST had significantly greater odds of AUD than those without sexual trauma. Younger age, male sex, and greater moral injury significantly predicted increased odds of AUD among all three groups. Few unique predictors of AUD were observed across the sexual trauma groups. Deployment history predicted AUD among those with MST and no sexual trauma. Lower rank predicted AUD among those with NMST and no sexual trauma. Military environment, lifetime other mental health disorders, and childhood maltreatment history were associated with significantly increased odds of AUD only among participants without sexual trauma. The current thesis determined that AUD represents a substantial issue among CAF Members and Veterans, particularly among those with military and civilian sexual trauma. This investigation contributes to the advancement of the current understanding of AUD among CAF Members and Veterans by identifying prevalence estimates of AUD and elucidating factors that enhance vulnerability to AUD among those with and without sexual trauma. These findings highlight the importance of supporting initiatives designed to prevent civilian and military sexual trauma. Additionally, the current findings suggest that screening for AUD among individuals with MST and NMST may be especially important. Keywords: military sexual trauma, alcohol use disorder, Canadian Armed Forces, Veterans