Effect of adverse childhood experiences on alcohol misuse among soldiers who deployed to Iraq or Afghanistan

While the relationship between adverse childhood experiences (ACEs) and alcohol use has been studied extensively, it is unclear if these experiences contribute to alcohol misuse independently of traumatic experiences and mental health problems in both civilian and military populations. Soldiers experience a number of traumatic combat experiences while deployed, which research has shown to contribute to the development of mental health problems and alcohol misuse. We hypothesize that having ACEs increases the likelihood that soldiers will misuse alcohol, even after adjusting for mental health problems (posttraumatic stress disorder, depression, or anxiety) and combat experiences. Of the 8,298 soldiers anonymously surveyed 3-6 months upon return from Iraq or Afghanistan in our sample, 2,440 soldiers (29.4%) screened positive for alcohol misuse. Among those screening positive, the most frequently reported ACE item was the presence of a problem drinker in the childhood household (40.9%). All six ACE items were significantly associated with screening positive for alcohol misuse except for experiencing physical abuse. Experiencing sexual abuse was the most strongly associated ACE item, with an almost 2-fold increase in risk of alcohol misuse even after adjusting for mental health problems and combat experience. Findings suggest that ACEs are a substantial risk factor for alcohol misuse among soldiers returning from deployments, and should be considered in the development of interventions designed to reduce this risk behavior.