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Randomized Controlled Trial
. 2017 Aug 1:177:221-227.
doi: 10.1016/j.drugalcdep.2017.03.031. Epub 2017 May 30.

Insomnia severity as a mediator of the association between mental health symptoms and alcohol use in young adult veterans

Mary Beth Miller  1 , Angelo M DiBello  2 , Kate B Carey  3 , Brian Borsari  4 , Eric R Pedersen  5
Affiliations
Randomized Controlled Trial

Insomnia severity as a mediator of the association between mental health symptoms and alcohol use in young adult veterans

Mary Beth Miller et al. Drug Alcohol Depend. .

Abstract

Purpose: Prior research has documented associations between mental health and alcohol use, mental health and insomnia, and insomnia and alcohol use. This study examined insomnia severity as a mediator of the association between mental health and alcohol-related outcomes in young adult veterans.

Procedures: Veterans aged 18-34 years (N=622, 83% male) who reported drinking in the past year completed assessments at baseline and one-month follow-up as part of a larger intervention trial. Participants reported symptoms of depression and posttraumatic stress disorder (PTSD) at baseline, insomnia severity at one month, and alcohol use and related consequences at baseline and one month. Mediation analyses using bootstrapped confidence intervals were used to examine the indirect effects of baseline mental health symptoms on alcohol-related outcomes at one month via insomnia severity.

Main findings: Insomnia severity was associated with both drinking quantity and alcohol-related consequences. Greater depressive (but not PTSD) symptoms were associated directly with more alcohol-related consequences. Neither depressive nor PTSD symptoms had direct effects on drinking quantity when controlling for the other mental health symptoms (e.g., depressive symptoms did not predict drinking quantity when controlling for symptoms of PTSD). However, symptoms of depression and PTSD predicted drinks per week and alcohol-related consequences indirectly through insomnia severity.

Conclusions: Symptoms of depression and PTSD increase risk for alcohol use and related consequences in part by increasing symptoms of insomnia. Findings suggest that insomnia may be an appropriate target for prevention and intervention efforts among heavy-drinking Veterans reporting symptoms of depression or PTSD.

Keywords: Alcohol consequences; Depression; Posttraumatic stress; Sleep.

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Conflict of interest statement

Conflict of Interest

The authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
a. Indirect effects of depression/PTSD symptoms on drinks per week. b. Indirect effects of depression/PTSD symptoms on alcohol-related consequences. Path coefficients for simple mediation analysis examining insomnia symptoms as a mediator of the association between depression/PTSD symptoms and alcohol-related outcomes. Lighter, dotted lines represent the effect of depression/PTSD symptoms on alcohol outcomes when mediators are not included in the model. All models include intervention condition, gender, age, combat severity, and the opposite mental health diagnosis as covariates (e.g., depressive symptom models include PTSD symptoms as a covariate). The model predicting alcohol-related consequences also controlled for drinks per week at baseline. *p < .05.
See this image and copyright information in PMC

References

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