Publications

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

Title Publication Date/Location
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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A longitudinal comparison of posttraumatic stress disorder and depression among military service components Military Psychology 2014;26(2): 77–87

Schaller EK, Woodall KA, Lemus H, Proctor SP, Russell DW, Crum-Cianflone NF

This study investigated PTSD and depression between Reserve, National Guard and active duty continuously and dichotomously, while adjusting for deployment-related characteristics and other relevant covariates. The findings from this study suggest that Reservists and National Guardsmen do not have significantly higher mean PTSD or depression severity scores nor increased odds of screening positive for PTSD or depression compared with active-duty members over approximately 6 years of follow-up.

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Chronic multisymptom illness: A comparison of Iraq and Afghanistan deployers with 1991 Gulf War Veterans American Journal of Epidemiology 2014;180(12):1176-1187

Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD

These data highlight a difference in CMI reporting when comparing deployed to non-deployed military members. While symptom reporting in this contemporary Cohort occurred less frequently than in the historical 1991 GW cohort, increased CMI reporting was noted among deployed compared to non-deployed contemporary Cohort members.

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Deployment-related depression screening results, 2001-2008: comparing clinical vs. research surveys American Journal of Preventative Medicine 2014 Nov;47(5):531-540

Welsh MM, PhD, Federinko SP, Burnett DG, Gackstetter GD, Boyko EJ, Seelig AD, Wells TS, and Hooper TI

This study compared depression symptoms reported on military-linked surveys, post-deployment health assessments, with responses from confidential surveys of the Millennium Cohort Study and then evaluated whether any factors were associated with discrepant responses. Moderate agreement was observed between paired survey responses. A higher proportion of active duty members, unmarried participants, and new accessions into military service endorsed depression symptoms on the confidential survey but not the military-linked survey. This study identifies potential subgroups to target for improving follow-up care for optimal mental health.

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Longitudinal assessment of mental disorders, smoking, and hazardous drinking among a population-based cohort of U.S. service members Journal of Addiction Medicine 2014 Jul-Aug;8(4):271-281

Smith TC, LeardMann CA, Smith B, Jacobson IG, Miller SC, Wells TS, Boyko EJ, Ryan MAK

This study investigated mental disorders in association with hazardous drinking and cigarette smoking. These prospective data highlight the inter-related nature of these symptoms and behaviors and the potentially complex bi-directional causal pathway. Military health professionals should consider the constellation of potential behaviors and symptoms during the treatment of specific mental health illnesses and negative health behaviors.

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Impact of combat deployment and Posttraumatic Stress Disorder on newly reported coronary heart disease among US Active Duty and Reserve forces Circulation 2014;129:1813-1820

Crum-Cianflone NF, Bagnell ME, Schaller E, Boyko EJ, Smith B, Maynard C, Ulmer CS, Vernalis M and Smith TC

This study evaluated the association of combat deployments and posttraumatic stress disorder (PTSD) on coronary heart disease among a young cohort of US service members. Experiencing combat deployment was associated with an increased odds of coronary heart disease by both self-report and medical record diagnosis after adjustment for demographic, military, and mental health characteristics. Screening positive for PTSD was not associated with CHD after adjustment. This study demonstrates that intense and acute stressful life experiences may increase the risk for coronary heart disease over a relatively short period among young adults.

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US Naval and Marine Corps occupations, PTSD and depression risk and absenteeism Journal of Workplace Behavioral Health 2014;29(2):91–112

Wells TS, Bagnell ME, Miller SC, Smith TC, Gackstetter GD and Boyko EJ for the Millennium Cohort Study Team

This study investigated whether military occupation was associated with PTSD or depression, and if PTSD or depression was associated with lost workdays among US Navy and US Marine personnel. Navy personnel in service and supply occupations were 85% more likely to screen positive for new-onset PTSD, while those serving in health care were 58% more likely to screen positive for new-onset depression compared to other occupations. In addition, those with new-onset and persistent PTSD were twice as likely to miss one or more days of work. This suggests that early identification and management of these conditions may improve force readiness.

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Deployment experiences and motor vehicle crashes among U.S. service members American Journal of Preventive Medicine 2014;46(4):350-358.

Woodall KA, Jacobson IG, Crum-Cianflone NF

Findings indicate experiencing combat during deployment and multiple deployments are strong predictors for a motor vehicle crash (MVC) within the first six months of returning home from deployments in support of Iraq and Afghanistan among U.S. military members. These data provide critical information for targeting prevention strategies to decrease MVCs among personnel postdeployment.

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Suicides Among Military Personnel Reply Journal of the American Medical Association 2013 Dec;310(23):2565-2566

Hoge CW, LeardMann CA, Boyko EJ

Discusses the complexity of suicidal behaviors and some challenges related to this type of research, while highlighting the strengths of using data from the Millennium Cohort to study suicide.

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Risk factors associated with suicide in current and former US military personnel Journal of the American Medical Association 2013;310(5):496-506

LeardMann CA, Powell TM, Smith TC, Bell MR, Smith B, Boyko EJ, Hooper TI, Gackstetter GD, Ghamsary M, Hoge CW

Based on data from over 150,000 current and former service members from all service branches, 83 suicide deaths occurred in 707,493 person-years from 2001 through 2008 (11.73/100,000 person-years). Suicide risk was independently associated with depression, manic-depressive disorder, alcohol-related problems, and male gender. None of the deployment or military-related factors were associated with an increased risk for suicide. Assessing service members' prior psychiatric history as well as screening for and treating mental and substance abuse disorders may provide the best potential for mitigating suicide risk.

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