Publications

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

Research Publication 2
Title Publication Date/Location
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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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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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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Patterns of smoking and unhealthy alcohol use following sexual trauma among U.S. Service Members Journal of Traumatic Stress 2017 Sep; Epub ahead of print

Seelig AD, Rivera AC, Powell TM, Williams EC, Peterson AV, Littman AJ, Maynard C, Street AE, Bricker JB, Boyko EJ

Following sexual assault while serving in the military, women had double the risk for unhealthy alcohol use relapse while men had 6 times the risk for smoking relapse compared with women and men who did not experience sexual assault, respectively. No other associations between sexual trauma (assault or harassment) and subsequent smoking or unhealthy alcohol use were observed. Substance use prevention measures are recommended for those who experience sexual assault and have a history of smoking and unhealthy alcohol use.

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A comparison of mental health outcomes in persons entering U.S. Military Service before and after September 11, 2001 Journal of Traumatic Stress 2012 Feb;25: 17-24

Wells TS, Ryan MAK, Jones KA, Hooper TI, Boyko EJ, Jacobson IG, Smith TC, Gackstetter GD, for the Millennium Cohort Study Team

It is hypothesized that those who entered military service prior to September 11, 2001 might have had expectations of experiencing a regular operational tempo and less combat compared with those entering service after this date, therefore an increased risk for mental disorders. Although measuring the direct reason for entering the military was not possible for this study, the findings showed that those entering pre-September 11 did not have a higher odds of mental disorders, suggesting that mental disorders resulting from the experience of war are common across the pre- and post-September 11 accession eras.

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Posttraumatic stress disorder and depression among US military health care professionals deployed in support of the operations in Iraq and Afghanistan Journal of Traumatic Stress 2012 Dec;25(6):616-23

Jacobson IG, Horton JL, LeardMann CA, Ryan MAK, Boyko EJ, Wells TS, Smith B, Smith TC, for the Millennium Cohort Study Team

Among military personnel deployed with combat experience, health care professionals did not have increased odds for new-onset PTSD or depression over time compared to individuals in other occupations. Combat experience significantly increased the odds for new-onset PTSD or depression among deployed health care professionals, suggesting that combat experience, not features specific to being a health care professional, was the key exposure explaining development of these outcomes.

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Is Military Deployment a Risk Factor for Maternal Depression? Journal of Women's Health 2013 Jan; 22(1):9-18

Nguyen S, LeardMann CA, Smith B, Conlin AMS, Slymen DJ, Hooper TI, Ryan MAK, Smith TC, for the Millennium Cohort Study Team

This study found that military women who recently gave birth and then deployed with combat experience had an increased risk for depression. Combat experience primarily increased the risk for depression, rather than childbirth itself. In addition, deployment without combat experience was not significantly associated with maternal depression among women who recently gave birth.

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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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The Millennium Cohort Study: answering long-term health concerns of US military service members by integrating longitudinal survey data with military health system records Military Health Care From predeployment to post-separation 1st ed. New York, NY: Routledge;2013: 55-77

Crum-Cianflone N

In: Amara J, Hendricks A, eds

This textbook chapter provides a detailed summary of the first decade of the Millennium Cohort Study. The chapter includes an overview of the study methodology and key publications including a review of foundational papers and epidemiologic studies examining the associations of military service experiences with mental, behavioral, and physical health outcomes.
Mental Health and Comorbidities in U.S. Military Members Military Medicine 2016 June;181(6):537-45

Crum-Cianflone NF, Powell TM, LeardMann CA, Russell DR, Boyko EJ

This study examined incidence rates of mental and behavioral disorders using self-reported and electronic medical record data from US Servicemembers who joined the military after September 11th, 2001. Combat deployers had the highest incidence rates of PTSD, panic/anxiety disorder, and any mental disorder. Of those with recent PTSD, 73% concurrently developed at least one other incident mental or behavioral conditions. Most diagnoses were not represented in the medical records. Findings indicate the high burden of these conditions that are greatly underestimated using medical data alone, demonstrating the value of survey data and screening tools among this population.

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