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
Health status of Gulf War and era veterans serving in the US military in 2000 Journal of Occupational and Environmental Medicine In Press

Porter B, Long K, Rull RP, Dursa EK

This paper describes Gulf War Veterans and non-deployed Gulf era personnel enrolled in the Millennium Cohort Study. Comparing distributions of survey responses with those from a population-based sample collected by the VA, we found that Millennium Cohort participants reported slightly better health, particularly regarding mental health. The Millennium Cohort Study is an important resource for investigating the health effects of Gulf War deployment.
Measuring aggregated and specific combat exposures: associations with posttraumatic stress disorders, depression, and alcohol-related problems Journal of Traumatic Stress In Press

Porter B, Hoge CH, Tobin LE, Donoho CJ, Castro CA, Luxton DD, Faix DJ

This study compared two measures of combat exposure and showed that both measures were similarly predictive of poor mental health. The unique contributions of specific exposures to poor mental health were also examined. While all combat exposure items were related to poor mental health, relatively stronger independent associations were observed for certain exposures (e.g., witnessing instances of physical abuse).
Factors Associated With Persistent Posttraumatic Stress Disorder Among U.S. Military Service Members and Veterans BMC Psychiatry 2018 Feb 17;18(1):48

Armenta RF, Rush T, LeardMann CA, Millegan J, Cooper AD, Hoge, CW

Among service members and veterans who screened positive for PTSD at baseline, 47% met the criteria for persistent PTSD. Combat experiences and PTSD severity were found to be the most salient factors associated with persistent PTSD; other associated factors included co-morbid conditions, sleep problems, and somatic symptoms. These findings corroborate the need for more comprehensive and accessible treatment to address both PTSD symptoms and comorbid conditions.

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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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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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Prospective post-traumatic stress disorder symptom trajectories in active duty and separated military personnel Journal of Psychiatric Research 2017 Jun;89:55-64

Porter B, Bonanno GA, Frasco MA, Dursa EK, Boyko EJ

This study compared trajectories of PTSD symptoms between separated and continuously serving Active Duty participants. Trajectories among both groups were highly similar and separated into four classes: resilient, delayed-onset, improving, and elevated-recovering. Resilient trajectories (i.e., having low PTSD symptoms throughout the study period) were the most common trajectory in both groups, although they were less common among separated (82%) compared with continuously serving (87%) personnel. Interventions targeted toward individuals with delayed-onset trajectories may prevent sub-clinical PTSD from worsening.

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Evaluation of a modified version of the Posttraumatic Growth Inventory-Short Form BMC Research Methodology 2017 Apr;17(1):69

Kaur N, Porter B, LeardMann CA, Tobin TE, Lemus H, Luxton DD

This study sought to validate a modified measure of posttraumatic growth, personal growth, and change that may occur following trauma. Results indicate that this modified measure may be used to assess well-being at one time point or growth over two time points. Furthermore, the two items assessing spirituality had a strong relationship with each other and may be used alone in future studies.

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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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Risk factors associated with miscarriage and impaired fecundity among United States servicewomen during the recent conflicts in Iraq and Afghanistan Women's Health Issues 2017 Feb;27(3):356-365

Ippolito AC, Seelig AD, Powell TM, Conlin AMS, Crum-Cianflone NF, Lemus H, Sevick CS, LeardMann CA

Among Servicewomen aged 18-45 years, 31% reported a miscarriage and 11% reported impaired fecundity (infertility) during a 3-year study period. Findings suggest that deployments in support of the operations in Iraq and Afghanistan do not increase the risk for miscarriage and infertility among U.S. Servicewomen. More research is needed to better understand whether specific combat experiences or environmental exposures encountered during deployments increase the risk for adverse reproductive health outcomes.

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Longitudinal assessment of self-reported recent back pain and combat deployment in the Millennium Cohort Study Spine 2016;41:1754–1763

Granado NS, Pietrucha A, Ryan M, Boyko EJ, Hooper TI, Smith B, Smith TC

Among military personnel, back pain is among the most frequent reasons for medical visits and lost duty time, and has been associated with pain-related disability. This study found that 15.5% of participants reported recent back pain at follow-up. Our study confirmed the high burden of this condition in the military, showing that deployers with combat experiences had a 38% higher odds of reporting back pain at follow-up, and 27% higher odds of repeated back pain, compared with deployers without combat experiences. Additionally, exposures associated with a physically demanding work environment were related to a higher risk of back pain. This well-defined group of military personnel would potentially benefit from integrated prevention efforts focused on mitigating and eliminating back pain over time.

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