Publications

The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.

Title Publication Date/Location
The Epidemiology of Irritable Bowel Syndrome in the US Military: Findings from the Millennium Cohort Study American Journal of Gastroenterology 2016;111:93-104

Riddle MS, Welsh M, Porter CK, Nieh C, Boyko EJ, Gackstetter GD, Hooper TI

This study describes the incidence of irritable bowel syndrome (IBS) and its association with antecedent infectious gastroenteritis among Millennium Cohort Study participants using survey data and post-deployment health assessments and medical encounter data in the military health system. Consistent with other studies, the risk of IBS increased after acute enteric infection. Novel findings included increased risk of incident IBS among those with post-traumatic stress disorder (PTSD) and preceding life stressors, as well as stronger associations between infectious gastroenteritis and IBS among those with antecedent depression or anxiety. These results reinforce the need to prevent acute gastrointestinal infections and their chronic consequences among our Service members. Additional studies on the underlying biopsychosocial mechanisms of IBS may help to explain these findings.

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Prescription stimulants and Post-Traumatic Stress Disorder among U.S. Military Service Members Journal of Traumatic Stress 2015 Dec;28(6):585-589

Crum-Cianflone NF, Frasco M, Armenta RF, Phillips CJ, Horton J, Ryan MAK, Russell DW, LeardMann CA

Millennium Cohort data from U.S. military members who completed the baseline survey, and two follow-up surveys were evaluated to determine associations between receipt of prescription stimulants and PTSD. Prescription stimulants were significantly associated with incident PTSD after adjustment for attention-deficit/hyperactivity disorder, baseline mental and physical health status, deployment experiences, and other known confounders. Findings from this study may inform the underlying pathogenesis of and preventive strategies for PTSD.

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Longitudinal assessment of gender differences in the development of PTSD among US military personnel deployed in support of the operations in Iraq and Afghanistan Journal of Psychiatric Research 2015;68:30-36

Jacobson IG, Donoho CJ, Crum-Cianflone NF, Maguen S

Using prospective data from Millennium Cohort Study participants, a propensity score matching technique was used to match 1 male with each female using demographic, military, and behavioral factors including baseline sexual assault. After stratifying by combat experience and adjusting for sexual assault at follow-up, findings revealed no significant gender differences for new-onset postdeployment PTSD among men and women including among those who experienced combat.

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Recent sexual trauma and adverse health and occupational outcomes among U.S. Service women Journal of Traumatic Stress 2015 Aug;28(4):298-306

Millegan J, Schaller EK, LeardMann CA, Street AE, Williams D, Trone DW, Crum-Cianflone NF

Findings from this study indicate that recent sexual trauma is associated with potential adverse physical health, mental health, and occupational outcomes among women serving in the US armed forces, after adjustment for demographics, prior sexual trauma, mental health, and military factors. Given these findings and the increasing role of women in the military, prevention and mitigation of sexual trauma should remain a high priority and more effective strategies should be developed to prevent sexual trauma.

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Associations of military divorce with mental, behavioral, and physical health outcomes BMC Psychiatry 2015; 15:128

Wang L, Seelig AD, MacDermid Wadsworth S, McMaster HS, Alcarez J, Crum-Cianflone NF

This prospective study investigated the associations of recent divorce with health outcomes among US Service members. Findings indicate that recent divorce is associated with adverse mental health outcomes, including new-onset PTSD and depression, and risky behaviors, such as smoking initiation and new-onset alcohol-related problems, after adjusting for relevant demographics and covariates. Given these findings, it is important to make sure resources are available to support recently divorced Service members, since divorce may not only affect personal quality of life, but also military force readiness.

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A longitudinal investigation of smoking initiation and relapse among younger and older US military personnel American Journal of Public Health 2015 Jun;105(6):1220-1229

Boyko EJ, Trone DW, Peterson AV, Jacobson IG, Littman AJ, Maynard C, Seelig AD, Crum-Cianflone NF, Bricker JB

Smoking initiation and relapse were examined among current and former military Service members. Deployment with combat experience predicted higher initiation and relapse rates. Additionally, depending on the panel, prior mental health disorders, life stressors, and other military and nonmilitary characteristics independently predicted initiation and relapse.

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Changes in meeting physical activity guidelines after discharge from the military Journal of Physical Activity Health 2015 May;12(5):666-674

Littman AJ, Jacobson IG, Boyko EJ, Smith TC

Using data from Millennium Cohort Study participants, we investigated changes in meeting federal Physical Activity Guidelines for moderate-to-vigorous activity (MVPA) following military discharge. MVPA declined more in those who were discharged than those who were not (-17.8 percentage points vs. -2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14-25 years of service, and had been discharged more recently (<1 year prior). Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in physical activity will help prevent excess weight gain and physical inactivity-associated health consequences.

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Post-traumatic stress disorder predicts future weight change in the Millennium Cohort Study Obesity 2015 Apr;23(4):886-92

LeardMann CA, Woodall KA, Littman AJ, Jacobson IG, Boyko EJ, Smith B, Wells TS, Crum-Cianflone NF

Data from Millennium Cohort Study participants (2001-2008), consisting of US Service members and Veterans, were used to prospectively examine the association between posttraumatic stress disorder (PTSD) and weight change. A significant and consistent association of PTSD with subsequent three-year weight gain and the development of obesity was found in adjusted models. Given these findings, weight gain and development of obesity should be considered important comorbidities for PTSD; existing screening and treatment programs should make sure to address these associated conditions.

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Hearing loss associated with US military combat deployment Noise and Health 2015 Jan-Feb; 74(17): 34-42

Wells TS, Seelig AD, Ryan MAK, Jones JM, Hooper TI, Jacobson IG, Boyko EJ

This study investigated hearing loss among Service members and Veterans. New-onset hearing loss was associated with combat deployment. Among those who had deployed, new-onset hearing loss was also associated with proximity to improvised explosive devices and experiencing a combat-related head injury. These findings have implications for health care and disability planning, as well as for prevention programs.

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Risk factors for relapse to problem drinking among current and former US military personnel: A prospective study of the Millennium Cohort. Drug and Alcohol Dependence 2015; 148:93-101.

Williams EC, Frasco MA, Jacobson IG, Maynard C, Littman AJ, Seelig AD, Crum-Cianflone NF, Nagel A, Boyko EJ.

This study investigated demographic, military, behavioral, and health characteristics associated with relapse among current and former military members with remittent problem drinking. The findings from this study suggest 16% of this population relapse. Several military and non-military characteristics were found to predict relapse, including being in the Reserve/National Guard compared to Active-duty and screening positive for mental health conditions. Targeted intervention to prevent relapse may be indicated for particular subgroups.

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