Abstract
This study examines whether the relationship between traumatic brain injury (TBI) and post-deployment binge drinking is independent of screening positive for mental health problems among male and female service members. Data are from the Substance Use and Psychological Injury Combat Study of Army members returning from deployment to Afghanistan or Iraq in fiscal years 2008-2011. The sample consists of 240,694 male and 26,406 female active duty members who completed initial and follow-up questionnaires. The initial questionnaire, completed at the end of deployment, included screens for TBI and mental health problems (post-traumatic stress disorder, depression, harmful thoughts). The dependent variable, frequent binge drinking (six or more drinks on one occasion, at least monthly), was assessed on the follow-up questionnaire on average 3-9 months post-deployment. More than 21% of males and 7% of females reported frequent binge drinking. Male members were more likely to screen positive for TBI, compared with females (7.5% vs. 4.4%). Females with both TBI and mental health positive screens had more than double the risk of frequent binge drinking, compared with those without either problem (15.8% vs. 6.6%), and males with both problems had almost double the risk, compared with males with neither problem (33.6% vs. 19.7%). In multivariable logistic regression models, having a TBI and a comorbid positive mental health screen was associated with increased odds of frequent binge drinking among both males and females (adjusted odds ratio [AOR] = 1.59, CI: 1.50-1.69, and AOR = 2.11, CI: 1.57-2.83, respectively), compared with those with neither condition. More research is needed on the interaction of gender and binge drinking, especially when TBI and mental health problems co-exist.