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Probable post-traumatic stress disorder and harmful alcohol use among male members of the British Police Forces and the British Armed Forces: a comparative study

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posted on 2021-03-26, 00:00 authored by Patricia Irizar, Sharon A.M. Stevelink, David Pernet, Suzanne H. Gage, Neil Greenberg, Simon Wessely, Laura Goodwin, Nicola T. Fear

Background: British Armed Forces’ and Police Forces’ personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress disorder (PTSD), which is often comorbid with harmful alcohol use.

Objective: We aimed to assess the proportions, and associations, of probable PTSD and harmful alcohol use among a covariate-balanced sample of male military personnel and police employees.

Methods: Proportions of probable PTSD, harmful alcohol use, and daily binge drinking, were explored using data from the police Airwave Health Monitoring Study (2007–2015) (N = 23,826) and the military Health and Wellbeing Cohort Study (phase 2: 2007–2009, phase 3: 2014–2016) (N = 7,399). Entropy balancing weights were applied to the larger police sample to make them comparable to the military sample on a range of pre-specified variables (i.e. year of data collection, age and education attainment). Multinomial and logistic regression analyses determined sample differences in outcome variables, and associated factors (stratified by sample).

Results: Proportions of probable PTSD were similar in military personnel and police employees (3.67% vs 3.95%), although the large sample size made these borderline significant (Adjusted Odds Ratio (AOR): 0.84; 95% Confidence Intervals (CI): 0.72 to 0.99). Clear differences were found in harmful alcohol use among military personnel, compared to police employees (9.59% vs 2.87%; AOR: 2.79; 95% CI: 2.42 to 3.21). Current smoking, which was more prevalent in military personnel, was associated with harmful drinking and binge drinking in both samples but was associated with PTSD in military personnel only. Conclusions: It is generally assumed that both groups have high rates of PTSD from traumatic exposures, however, low proportions of PTSD were observed in both samples, possibly reflecting protective effects of unit cohesion or resilience. The higher level of harmful drinking in military personnel may relate to more prominent drinking cultures or unique operational experiences.

Probable PTSD and harmful drinking were compared in military personnel and police employees.

Proportions of probable PTSD were comparable in military personnel and police employees.

Military personnel were three times more likely to drink harmfully than police employees.

Probable PTSD and harmful drinking were compared in military personnel and police employees.

Proportions of probable PTSD were comparable in military personnel and police employees.

Military personnel were three times more likely to drink harmfully than police employees.

Funding

SAMS, SW, NTF, MH and NG are based at King’s College London. This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London Maudsley Foundation Trust and King’s College London. SAMS and NTF salaries are part funded by the UK Ministry of Defence (MoD). NTF reports grants from the US Department of Defence and the UK MoD, is a trustee (unpaid) of The Warrior Programme, is Chair of the Emergency Responders Senior Leaders Board and is an independent advisor to the Independent Group Advising on the Release of Data (IGARD) for NHS Digital. The research was partially funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with Public Health England (PHE), in collaboration with the University of East Anglia and Newcastle University. The Airwave Health Monitoring Study was funded by the UK Home Office (780- TETRA, 2003-2018) and is currently funded by the MRC and ESRC (MR/R023484/1). This research was conducted as part of PI’s PhD studentship which is funded by the Economic and Social Research Council (ESRC) and partly funded by the charity, Alcohol Change UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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