Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


College of Psychology

First Advisor

Mark B. Sobell

Second Advisor

Linda C. Sobell

Third Advisor

Christian DeLucia


Afghanistan, alcohol use disorder, clinical psychology, deployment, healthcare, Iraq, military


Over 2.1 million United States military service members have deployed to support Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Nearly 40% of OEF/OIF service members meet criteria for an alcohol use disorder post-deployment. Minimal research has addressed alcohol misuse among military healthcare professionals despite the prevalence of alcohol abuse among civilian providers. This study explored whether military healthcare professionals involved with OIF/OEF operations have increased risk for alcohol misuse (i.e., problem drinking, heavy weekly drinking, heavy episodic drinking). Three evidence-based hypotheses were evaluated: (a) among OEF/OIF military personnel, healthcare professionals would have an increased likelihood of alcohol misuse compared to service members in other occupations; (b) personnel who screen positive for PTSD would be more likely to screen positive for alcohol misuse outcomes versus personnel who screen negative for PTSD; and (c) personnel with enlisted status would be more likely to endorse alcohol misuse compared to personnel with officer status. Participants were drawn from 81,247 military personnel enrolled in the Millennium Cohort Study, a prospective, longitudinal cohort study investigating health consequences of military service. Chi-square tests of independence identified significantly different demographic characteristics between participants in the first and second enrollment panels and resulted in participants being divided into subgroups based upon their enrollment panel and baseline alcohol use. Participants who had complete data at baseline and all follow-up waves were included in the primary multinomial logistic regression analyses used to identify variables associated with each alcohol use outcome over time. Results suggested that being a healthcare professional did not influence alcohol misuse outcomes. A positive screening for PTSD was associated with greater endorsement of alcohol misuse outcomes across most participant subgroups, and holding enlisted status was associated with problem drinking and heavy episodic drinking in some participant subgroups. Additional variables associated with alcohol misuse outcomes included being younger, male, using tobacco, and belonging to the National Guard/Reserve. The results of this study suggest that, while alcohol-related interventions may not need to be tailored to specific occupations, alcohol use screening and treatment should continue to be focused on at-risk groups to enhance troop health and functioning.

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