The role of military identity in substance use and mental health outcomes among U.S. Army Reserve and National Guard Soldiers

ABSTRACT We investigated how military identity (i.e., veteran identity centrality—the extent to which military service is central to an individual’s sense of self) relates to substance use and mental health among U.S. Army Reserve and National Guard (USAR/NG) soldiers. Data were drawn from Operation: SAFETY, a longitudinal survey study of USAR/NG soldiers. Regression models (n = 413 soldiers) examined relationships between military identity and substance use (i.e., alcohol problems, past 3-months non-medical use of prescription drugs (NMUPD), illicit drug use, tobacco use), and mental health (i.e., generalized anxiety, anger, depression, and PTSD), controlling for sex, race, age, education, years of military service, military status (current/former), and deployment (ever/never). In adjusted models, stronger military identity was not related to alcohol, illicit drug, or tobacco use, but was associated with past 3-months NMUPD (OR: 1.40, 95% CI: 1.12, 1.75, p < .01) and greater symptoms of anger (IRR: 1.02, 95% CI: 1.01, 1.03, p < .01), generalized anxiety (IRR: 1.05, 95% CI: 1.01, 1.10, p < .01), depression (IRR: 1.06, 95% CI: 1.02, 1.10, p < .01), and PTSD (IRR: 1.07, 95% CI: 1.02, 1.12, p < .01). The findings demonstrate the importance of military identity for health-related outcomes. NMUPD suggests potential self-medication and avoidance of help-seeking, as admitting difficulties may conflict with military identity.