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Military and Veterans Psychology

Veteran perspectives on recovery from co-occurring hazardous drinking and anxiety and posttraumatic stress disorder

(PS6-D79) Veteran Perspectives on Recovery from Co-occurring Hazardous Drinking and Anxiety and Posttraumatic Stress Disorder

Friday, November 17, 2023
4:00 PM – 5:00 PM PST
Location: Regency Ballroom, Level 7
US military veterans experience high rates of alcohol use, anxiety disorders, and post-traumatic stress disorder (PTSD). Nearly 42% of veterans meet criteria for a lifetime alcohol use disorder (AUD) and approximately 15% meet diagnostic criteria for a past-year AUD (Fuehrlein et al., 2016). Further, rates of PTSD and anxiety disorders (PTSD) ranges from 12-41% among veterans (Milanak et al., 2013; Sayer et al., 2010; Seal et al., 2009; Stecker et al., 2010). Moreover, veterans also report high rates of comorbidity between substance use, PTSD, and anxiety disorders which contributes to greater risk for suicide, increased severity of mental health symptoms, higher rates of functional impairment, and occupational and housing problems (Bowe & Rosenheck, 2014; Erbes et al., 2011; Kashdan et al., 2005; Milanak et al., 2013; Stecker et al., 2010). Emerging data supports the efficacy of transdiagnostic cognitive behavioral treatments for co-occurring anxiety and substance use disorders (e.g., Buckner et al., 2021), but little is known about veterans’ needs and preferences related to recovery from co-occurring mental health disorders. This information is critical to the successful implementation of interventions to address this care gap. The current study used qualitative methods to examine veterans’ needs, preferences and perspectives on recovery from co-occurring anxiety and PTSD and AUD. We interviewed 20 veterans with anxiety disorders and/or PTSD and AUD recruited from a large southwestern VA medical center. Most (80%) participants identified with underrepresented racial and ethnic groups, mean age was 59 and 20% were women. Participants completed a semi-structured interview by phone which was recorded and transcribed. The interview guide was informed by the dual-diagnosis recovery model (Davidson & White, 2007). Rapid analysis (Hamilton, 2013) was used to organize and summarize data into domains. Veterans reported several factor that are important to recovery from co-occurring disorders, including learning new coping skills in therapy (e.g., managing triggers), therapists helping to challenge thoughts of hopelessness, actively participating in care planning, and connecting with important relationships. Veterans also provided their impressions of how a transdiagnostic cognitive behavior therapy to address hazardous drinking in concert with anxiety or PTSD. Veterans were largely supportive of such a treatment, with a key strength being that a single therapist could address multiple concerns simultaneously and learn about the connections between anxiety/PTSD and drinking and coping skills to address them. Veterans also noted that such a treatment may not be the best fit for all and that the provider would need to have training in both alcohol use and anxiety/PTSD. Findings from this diverse sample of veterans with co-occurring conditions were incorporated into treatment manual that will be tested for feasibility and acceptability. Specifically, in light of veteran feedback more discussion of building social support and relationships and managing anxiety related triggers were included based on the feedback from participants.