Publications

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

Title Publication Date/Location
Sexual trauma and adverse health and occupational outcomes among men serving in the US Military Journal of Traumatic Stress 2016 Apr;29(1):132-40

Millegan J, Wang L, LeardMann CA, Miletich D, Street AE

This study examined the association of recent sexual trauma with health and occupational outcomes among US Service men using longitudinal Millennium Cohort data (2004-2013). Findings from this study indicated that recent sexual trauma, sexual harassment or sexual assault, is associated with adverse physical health and mental health among Service men, after adjustment for relevant covariates. Men who reported sexual trauma were more likely to have left military service and experience post-service disability or unemployment. Results demonstrate that, among Service men, sexual trauma is significantly associated with adverse health and functionality extending to post-military life. Findings support the need for developing more effective prevention strategies and services to reduce the burden of sexual trauma of Service men.

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Deployment, combat, and risk of multiple physical symptoms in the US Military: A prospective cohort study Annals of Epidemiology 2016 Feb;26(2):122-8

McCutchan PK, Liu X, LeardMann CA, Smith TC, Boyko EJ, Gore KL, Freed MC, Engel CC

This study examined longitudinal trends in multiple physical symptoms and its relationship to deployment among US military service members and veterans. Those who had deployed and experienced combat were significantly more likely to report multiple physical symptoms at each time point compared with those not deployed and those who deployed without combat, after adjustment for demographic, military, and health characteristics. Longitudinal trends indicate that the probability of reporting multiple physical symptoms has increased consistently over time only for those deployed, regardless of combat experience.

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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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