Module 14: Co-Occurring Problems

Ch. 3: More About Post-traumatic Stress Disorder (PTSD)

This chapter introduces information about a population that we have not previously discussed in any specific way: the population of combat veterans. Although what we have discussed throughout the course applies to all types of individuals experiencing problems with substance misuse and substance use disorders, professionals are increasingly learning about some of the exceptional circumstances experienced by men and women who are combat veterans. Many, though by no means all, experience post-traumatic stress symptoms. Many experiences other than having been engaged in military combat also can lead to post-traumatic stress (e.g., being the victim of or witness to physical, sexual, or emotional forms of violence).

While post-traumatic stress disorder (PTSD) has very specific diagnostic criteria, individuals may experience a complex of post-traumatic stress symptoms without necessarily meeting the criteria for a diagnosis of PTSD. We do know that post-traumatic stress is highly prevalent in the personal histories of many individuals who use and misuse substances. The article that you will be reading for this chapter looks at alcohol misuse and two factors that might influence alcohol use disorders (AUDs) among combat veterans: (1) the use of alcohol as a coping strategy and (2) stigma around seeking help for post-traumatic stress symptoms. The most important sections to pay attention to include the introduction (all of section 1), Figure 1 (p. 92), and the discussion (all of section 4). The article you will be reading is: Miller, S.M., Pedersen, E.R., & Marshall, G.N. (2017). Combat experience and problem drinking in veterans: Exploring the role of PTSD, coping motives, and perceived stigma. Addictive Behaviors, 66, 90-95.

One other thing to keep in mind as you review this article: way back in the earliest modules of our course, we spent time thinking about the problem of casually using words like “addict” and “addicted.” It is equally important to address the overly casual use of the term “PTSD” that has crept into general conversation in our society. Like substance use disorders, PTSD is a very real (biopsychosocial) disorder with debilitating symptoms that can be effectively treated if properly diagnosed and managed.

In this chapter you will read about:

  • the nature of PTSD
  • the co-occurrence of alcohol use disorders and PTSD among combat veterans, and
  • key terms used in the fields of substance use disorders and veterans’ health.
PDF links icon

Click here for a link to our Carmen course where you can locate the assigned pdf file(s) for this chapter. You will need to be logged into our Carmen course, select Module 14, and proceed to the Coursework area. Under the Readings heading you will find a box with links to the readings for relevant coursebook chapters. Don’t forget to return here in your coursebook to complete the remaining chapters and interactive activities.


A Stop sign with "Stop, Think" written on it

  • What does the study conclusion about these young adult veterans possibly tell you about the relationship between PTSD symptoms and “drinking to cope” by people who have experienced trauma outside of combat?
  • What do the study conclusions about these young adult veterans also possibly indicate about the impact of perceived stigma about seeking help for alcohol (or other substance) problems?
  • What do you think are some other situations that might lead to a person have a trauma response like what was reported among these young adult veterans?
  • What did you learn about “the language that we use” related to addiction that might also apply to language about PTSD?


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