Changes in Anhedonic Symptoms are Related to Transformational Leadership Styles Experienced During Military Service in Veterans With Alcohol Use Disorder

Aims: At least 60% of U.S. Armed Services Veterans will resume hazardous alcohol consumption levels within 6 months of completion of treatment for alcohol use disorder (AUD). This high frequency of resumption requires a more complete assessment of the factors associated with the persistence of AUD in Veterans. This study examined the associations of perceived transformational leadership styles (TLS) experienced during military service and changes in anhedonic depression and self-efficacy related to confidence to abstain or reduce alcohol consumption in Veterans in clinical trials evaluating intermittent theta burst (iTBS) for AUD treatment. Design and Methods: Veterans with AUD ( n = 55; 50 ± 14 years of age) were recruited from residential treatment at the Palo Alto Veterans Administration Health Care System. The Multifactor Leadership Questionnaire assessed participants’ perceived TLS exhibited by supervisor(s) during military service (average across leadership dimensions [TLS average]) and was administered before initiation of iTBS sessions (Baseline). Results: Higher baseline TLS average was related to decreased anhedonic depressive symptoms over the 2-week iTBS treatment interval. Higher baseline TLS average was also significantly related to lower anhedonic depressive symptoms after iTBS sessions. The association of TLS average with anhedonic symptoms was not mediated by service branch, duration of service, time since military separation, concurrent posttraumatic stress disorder symptomatology, psychiatric diagnoses, or assignment to active or sham iTBS. Conclusions: Results indicated that perceived TLS, experienced during military service, had an enduring association with postservice anhedonic symptomatology, which is a core component of major depressive disorder. Results also have implications for leadership training across the U.S. Armed Forces branches.