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
Smokeless Tobacco Use Related to Military Deployment, Cigarettes, and Mental Health Symptoms in a Large, Prospective Cohort Study Among US Service Members Addiction 2012 May;107(5):983-994

Hermes ED, Wells TS, Smith B, Boyko EJ, Gackstetter GD, Miller SC, Smith TC, for the Millennium Cohort Study Team

Chronic use of smokeless tobacco has been linked to poor military training performance, early discharge, and a host of medical problems from cancer to heart disease. Smokeless tobacco initiation occurred in 1.9% and persistent use in 8.9% of Millennium Cohort participants. The study showed that deployment, combat exposure, smoking, and symptoms of posttraumatic stress disorder increased the risk for smokeless tobacco initiation, while deployment and combat exposure increased the risk for persistent use.

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Epidemiology of Inflammatory Bowel Disease Among Participants of the Millennium Cohort: Incidence, Deployment-Related Risk Factors, and Antecedent Episodes of Infectious Gastroenteritis Alimentary Pharmacology & Therapeutics 2017 Apr;45(8):1115-1127

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

This study describes the incidence of and risk factors for two pathotypes of inflammable bowel disease (IBD), Crohn’s Disease (CD) and ulcerative colitis (UC) among Millennium Cohort Study participants using survey responses as well as data from post-deployment health assessments and medical encounters in the Military Health System. We observed that CD risk predictors included current smoking, two life stressors (vs. none), and prior irritable bowel syndrome. For UC, a dose-response relationship between the risk of UC and an increasing number of life stressors was observed. Antecedent infectious gastroenteritis was associated with an almost three-fold increase in risk in UC, but was not associated with CD. Stressful conditions along with infectious gastroenteritis are usual features of any deployment operation and may play a role in the development of IBD. However, observed differences in risk factors for UC and CD warrant further investigation.

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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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Longitudinal Associations Among PTSD, Disordered Eating, and Weight Gain in Military Men and Women American Journal of Epidemiology 2016 Jul 1;184(1):33-47

Mitchell KS, Porter B, Boyko EJ, Field AE

This study examined longitudinal associations between PTSD, disordered eating, and weight change in Millennium Cohort data from U.S. military Service members who completed the baseline survey and first and second follow-up surveys. The association between PTSD and weight change from time 2 to time 3 was partially mediated by disordered eating symptoms measured at time 2, specifically compensatory behaviors (vomiting, laxative use, fasting, over-exercise). In stratified models, the association between PTSD and weight gain via compensatory behaviors was significant for men and for non-Hispanic white participants only. Results highlight potentially important demographic differences in these associations and emphasize the need for further investigation of eating disorders in military Service members.

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A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure American Journal of Epidemiology 15 December 2017;186(12):1310–1318.

Donoho CJ, Bonanno GA, Porter B, Kearney L, Powell TM

Using survey data collected at four different time points over a 10-year study period, four distinct patterns of PTSD symptoms were observed among deployed personnel. More than 85% of participants were found to be resilient with almost no PTSD symptoms. Despite similarity in pre-deployment symptoms, those experiencing combat-related trauma had higher PTSD symptom levels following deployment across every trajectory compared with those not exposed to combat-related trauma. These findings suggest the clinical course of PTSD symptoms has a heterogeneous pattern of development, but that combat exposure is uniformly associated with poorer mental health.

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New-Onset Asthma and Combat Deployment: Findings from the Millennium Cohort Study American Journal of Epidemiology In Press

Rivera AC, Powell TM, Boyko EJ, Lee RU, Faix DJ, Luxton DD, and Rull RP

New-onset asthma developed in 2.7% of men and 4.6% of women during the follow-up period, among participants without a prior diagnosis of asthma at baseline. Compared with those who did not deploy, those who deployed with combat experience were 24-30% more likely to develop asthma, even after controlling for smoking status and other covariates. No elevated risk was observed for deployers who did not experience combat. Additional risk factors for asthma among both men and women included Hispanic ethnicity, overweight or obesity, Army service, stressful life events, PTSD, and health care or other technical occupations.

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When Epidemiology Meets the Internet: Web-Based Surveys in the Millennium Cohort Study American Journal of Epidemiology 2007 Nov;166(11):1345-54

Smith B, Smith TC, Gray GC, Ryan MAK, for the Millennium Cohort Study Team

Optimal use of the Internet - with minimal response bias, maximum cost-savings, and improved data - is highlighted.

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Disordered Eating and Weight Changes After Deployment: Longitudinal Assessment of a Large US Military Cohort American Journal of Epidemiology 2009 Feb;169(4):415-27

Jacobson IG, Smith TC, Smith B, Keel PK, Amoroso PJ, Wells TS, Bathalon GP, Boyko EJ, Ryan MAK for the Millennium Cohort Study Team

Deployed women who reported combat exposures represent a subgroup at higher risk for developing eating problems and weight loss postdeployment compared with deployed women who did not report combat exposures.

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Newly Reported Respiratory Symptoms and Conditions Among Military Personnel Deployed to Iraq and Afghanistan: A Prospective Population-Based Study American Journal of Epidemiology 2009 Dec;170(11):1433-42

Smith B, Wong CA, Smith TC, Boyko EJ, Gackstetter GD, Ryan MAK, for the Millennium Cohort Study Team

Elevated risk for self-reported respiratory symptoms was found among Army and Marine Corps personnel deployed in support of operations in Iraq and Afghanistan. No increased risk for self-reported asthma, bronchitis, or emphysema was found.

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Prospective Evaluation of Mental Health and Deployment Experience Among Women in the US Military American Journal of Epidemiology 2012;176(2):135-45

Seelig AD, Jacobson IG, Smith B, Hooper TI, Gackstetter GG, Ryan MAK, Wells TS, MacDermid Wadsworth S, Smith TC, for the Millennium Cohort Study Team

Women with reported combat exposures were more likely to have mental health symptoms than women who deployed without combat associated exposures and women who never deployed.

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