• Chapter

Substance use and mental health wounds of war Findings from U.S. Department of Defense health related behavior surveys

This paper examines the prevalence of substance use and mental health issues among active-duty military personnel, and provides a preliminary assessment of several risk and protective factors associated with the development of common mental health conditions in military personnel. Data were drawn from large-scale population-based U.S. Department of Defense Surveys of Health Related Behaviors Among Active Duty Military Personnel. Assessment of trends showed large reductions in cigarette use and illicit drug use, but less change in heavy alcohol use. The most important risk factors predicting negative mental health outcomes were avoidance coping behaviors, lack of adequate sleep and high levels of work stress. The most important protective factor against negative mental health outcomes was implementation of active coping strategies. Military personnel who reported avoidant coping strategies were most likely to suffer from a range of negative mental health consequences, whereas those who implemented active coping strategies, including both problem-focused and emotion-focused strategies, were least likely to report mental health problems. Findings suggest that active coping strategies may buffer military personnel from the development of a range of negative mental health outcomes. Further study is needed to determine the key elements of active coping strategies and the conditions under which they are most effective for active-duty military personnel. Additional research is also needed to develop and implement targeted interventions that promote active coping strategies to help prevent negative mental health outcomes during stressful situations including combat.


Bray, R., McLean, A., & Hourani, L. (2010). Substance use and mental health wounds of war: Findings from U.S. Department of Defense health related behavior surveys. In BK. Wiederhold (Ed.), Coping with Posttraumatic Stress Disorder in Returning Troops Fairfax, VA: IOS Press.