Risk factors for pathological cannabis use among Israeli combat veterans: empirical and narrative findings

Substance use is common among military personnel and war veterans, especially combat veterans. Despite substantially high prevalence of cannabis use consistently reported among veterans, little is known on psychological factors which may underline pathological cannabis use among this population. In this talk, I will present findings from two studies which focused on psychosocial risk factors for pathological cannabis use among veterans, employing quantitative and qualitative methodology. The first study focused on moral injury, a shame and guilt-based trauma-related syndrome which may emerge among war veterans engaging in potentially morally injurious events. 191 Israeli combat veterans (85.4% men, mean age=25.39) completed a set of validated self-report questionnaires. A serial mediation analysis indicated that perceived betrayal was associated with increased frequency of cannabis use and that levels of psychological distress mediated this association. In addition, the association between levels of perceived perpetration and frequency of cannabis was mediated by levels of distress and perceived social support. The second study included a narrative analysis of retrospective in-depth interviews of combat veterans (N=40) who reported pathological cannabis use within five years since their release from military duty. Preliminary results indicate that themes associated with traumatic experiences during the service, post-release disintegration into civil life and post-service back-packing tourism emerge as possible risk factors for transition to pathological cannabis use among combat veterans. Findings from these studies are discussed in light of the growing global prevalence of cannabis use and its possible harmful effect on heavy users.