Alcohol use has been linked to family violence, assaults, and suicides. Some studies suggest that all these forms of intentional injury may result from a similar constellation of risk factors, such as alcohol abuse, depression, impulsivity, and aggression. The factors that may mediate the role of alcohol and those that may determine whether the endpoint is violence against others versus violence against self are less clear. Long-term health and occupational experiences of perpetrators and victims of violence are not clear, nor have potential modifying factors for these outcomes been elucidated.
Specific Aims : This study uses a large linked database to identify fixed and time-varying factors that modify the relationship between alcohol use and perpetrating or experiencing violence or suicide. Factors can be measured prior to the event as well as during the event. In addition, we will follow perpetrators and victims of violence subsequent to the violent episode to document long-term health and occupational experiences of these individuals. Methods: This study uses data from the Total Army Injury and Health Outcomes Database (TAIHOD). Data are available on almost 3 million unique soldiers who were on active duty 1980-1998, including personnel records (occupation, hazardous duty pay, gender, age, rank, education, marital status, dependents, overseas assignments-all updated every 6 months), hospitalization (including ICD-9-CM codes, cause of injury codes indicating mechanism and intentionality), disability evaluations, health habit surveys (including typical alcohol use, the CAGE, drinking and driving, and, other health behaviors, and satisfaction with one's life and family), occupational surveys (job satisfaction, harassment on the job) and outpatient data. In addition, Spouse Abuse Registry Data have recently been added to the TAIHOD, which include information on victims and perpetrators as well as severity of the assault. Most questions will be addressed using a retrospective cohort design. Standard time-to-event statistical techniques will be employed (e.g., Cox Proportional Hazards Models). MIMIC models (i.e., confirmatory factor analyses with background variables) will be used to investigate more complex relationships where there may be multiple possible outcomes (e.g., different levels of severity of assault; or violence against self versus others). Conclusions: This study offers a number of advantages over prior research. This population is fully employed and has full access to healthcare and housing, controlling many potential socioeconomic confounders. Data are very complete with little lost information. Data for both victims and perpetrators regarding the incident of violence, precursors to the event, and long-range health and occupational outcomes are available. This study will allow us to cost-effectively assess the role of alcohol in intentional injuries, for a large diverse population encompassing a wide range of occupational, racial, and gender groups.
| Bell, Nicole S; Harford, Thomas C; Amoroso, Paul J et al. (2010) Prior health care utilization patterns and suicide among U.S. Army soldiers. Suicide Life Threat Behav 40:407-15 |
| Bell, Nicole S (2009) Health and occupational consequences of spouse abuse victimization among male U.S. Army soldiers. J Interpers Violence 24:751-69 |
| McCarroll, James E; Fan, ZiZhong; Bell, Nicole S (2009) Alcohol use in nonmutual and mutual domestic violence in the U.S. Army: 1998-2004. Violence Vict 24:364-79 |
| Jacobson, Isabel G; Ryan, Margaret A K; Hooper, Tomoko I et al. (2008) Alcohol use and alcohol-related problems before and after military combat deployment. JAMA 300:663-75 |
| Benjamin, Katy L; Bell, Nicole S; Hollander, Ilyssa E (2007) A historical look at alcohol abuse trends in army and civilian populations, 1980-1995. Mil Med 172:950-5 |
| Howland, Jonathan; Bell, Nicole S; Hollander, Ilyssa E (2007) Causes, types and severity of injury among army soldiers hospitalized with alcohol comorbidity. Addiction 102:1411-20 |
| Bell, Nicole S; Harford, Thomas C; Fuchs, Cara H et al. (2006) Spouse abuse and alcohol problems among white, African American, and Hispanic U.S. Army soldiers. Alcohol Clin Exp Res 30:1721-33 |
| Smith, Gordon S; Lincoln, Andrew E; Wong, Tien Y et al. (2005) Does occupation explain gender and other differences in work-related eye injury hospitalization rates? J Occup Environ Med 47:640-8 |
| Bell, Nicole S; Harford, Thomas; McCarroll, James E et al. (2004) Drinking and spouse abuse among U.S. Army soldiers. Alcohol Clin Exp Res 28:1890-7 |
