Spirituality and Substance Misuse in Combat Veterans With PTSD

Publication Date



This study examined the role of spirituality in substance misuse among two independent samples of combat Veterans seeking residential treatment for posttraumatic stress disorder (PTSD), including 477 Veterans predominantly from the Vietnam era and 209 Veterans from Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) conflicts. Veterans in both samples provided basic demographic information (e.g., age, race, marital status) and completed measures of combat exposure, PTSD symptom severity, and problematic substance use, as well as a multidimensional measure of spirituality. Among Veterans from the Vietnam era sample, spirituality dimensions were not associated with substance use outcomes. Instead, demographic risk factors (age, race, and marital status), combat exposure, and PTSD symptom severity were differentially related to problematic substance use for these Veterans. In contrast, spirituality dimensions as a whole contributed uniquely to variance in endorsement of alcohol-related problems among OIF/OEF Veterans, even when controlling for demographic risk factors, PTSD symptom severity, and level of combat exposure. Several aspects of spirituality were also uniquely associated with less problematic substance use, including private religious practices, positive religious coping, and forgiveness. Contrary to study hypotheses, increases in daily spiritual experiences were associated with greater likelihood of alcohol or drug-related problems. As such, study findings point to the complex association between aspects of spirituality and substance misuse and highlight the need for a more nuanced understanding of these associations for the purpose of proper assessment and treatment of substance misuse among Veterans with PTSD.

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

First Advisor

Currier, Joseph M.

Document Type





Veterans, Substance abuse, Post-traumatic stress disorder




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