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 2018 May;60(5):e261-e267

Porter B, Long K, Rull RP, Dursa EK for the Millennium Cohort Study Team

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.

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New-Onset Asthma and Combat Deployment: Findings from the Millennium Cohort Study American Journal of Epidemiology 2018 Oct 1;187(10):2136-2144

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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Posttraumatic Stress Disorder Symptom Association With Subsequent Risky and Problem Drinking Initiation Journal of Addiction Medicine 2018 Sep/Oct;12(5):353-362

Bensley KM, Seelig AD, Armenta RF, Rivera AC, Peterson AV, Jacobson IG, Littman AJ, Maynard C, Bricker JB, Boyko EJ, Rull RP, and Williams EC

This study investigated the association between PTSD symptoms and symptom clusters and the initiation of risky and problem drinking. One PTSD symptom (irritability/anger) was associated with a higher risk of risky drinking initiation. Five PTSD symptoms (restricted affect, sense of foreshortened future, exaggerated startle response, sleep disturbance, and irritability/anger) and two symptom clusters (dysphoric arousal and emotional numbing) were associated with an increased risk of problem drinking initiation.

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Respiratory Health after Military Service in Southwest Asia and Afghanistan. An Official American Thoracic Society Workshop Report Annals of the American Thoracic Society 2019 Aug;16(8):e1-e16

Garshick E, Abraham JH, Baird CP, Ciminera P, Downey GP, Falvo MJ, Hart JE, Jackson DA, Jerrett M, Kuschner W, Helmer DA, Jones KD, Krefft SD, Mallon T, Miller RF, Morris MJ, Proctor SP, Redlich CA, Rose CS, Rull RP, Saers J, Schneiderman AI, Smith NL, Yiallouros P, Blanc PD

This workshop report identified key studies, including the Millennium Cohort Study, for assessing post-deployment and long-term respiratory health as well as emerging research and current knowledge gaps.

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Longitudinal Trajectories of Comorbid PTSD and Depression Symptoms Among U.S. Service Members and Veterans BMC Psychiatry 2019 Dec 13;19(1):396

Armenta RF, Walter KH, Geronimo-Hara TR, Porter B, Stander V, LeardMann CA, for the Millennium Cohort Study Team

This study examined the patterns of PTSD and depression symptoms over time among those with probable comorbid PTSD and depression at baseline. We found that PTSD and depression symptoms tended to move in tandem. Although many service members and veterans experienced a reduction of symptoms over time, one quarter of individuals reported high levels of PTSD and depression symptoms during the almost 12 years of follow-up. Notable factors associated with elevated comorbid PTSD/depression symptoms included older age, combat experiences, and having other co-occurring health problems. Results highlight the need for comprehensive assessment and treatment of comorbid PTSD/depression.

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Comparing Self-Reported Physical Activity and Sedentary Time to Objective Fitness Measures in a Military Cohort Journal of Science and Medicine in Sport 2019 Jan;22(1):59-64

de la Motte SJ, Welsh MM, Castle V, Burnett D, Gackstetter GD, Littman AJ, Boyko EJ, and Hooper TI

This was a cross-sectional study of 10,105 Air Force Millennium Cohort participants who completed a physical fitness assessment (PFA) in 2007-2008. Linear regression was used to relate objective PFA measures to self-reported physical activity (PA) and sedentary behavior, and logistic regression was used to examine the risk of PFA failure associated with these self-reported measures. After controlling for demographic characteristics, BMI, and smoking status, we found self-reported PA and screen time were associated with some objective PFA measures, including VO2Max and abdominal circumference. However, screen time alone was associated with odds of PFA failure.

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Combat and Trajectories of Physical Health Functioning in U.S. Service Members American Journal of Preventative Medicine 2019 Nov;57(5):637-644

Porter B, Bonanno GA, Bliese PD, Phillips CJ, Proctor SP for the Millennium Cohort Study Team

Combat is detrimental to long-term physical health functioning among deployed service members, but other pre-deployment modifiable factors like body size and smoking status had stronger associations with subsequent trajectories. This indicates the negative impact of combat may be mitigated through pre-deployment healthy behaviors.

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Healthy Behaviors and Incidence of Overweight and Obesity in Military Veterans Annals of Epidemiology 2019;39:26–32.e1

Bookwalter DB, Porter B, Jacobson IG, Kong SY, Littman AJ, Rull RP, Boyko EJ

This study looked at how several healthy behaviors of veterans (including moderate-to-high physical activity, low sedentary time, eating little fast-food, appropriate nightly sleep duration, non-smoking, and moderate alcohol use) were associated with weight changes. Veterans who reported more healthy behaviors were less likely to become overweight and/or obese. For example, if all veterans of a healthy weight followed all six healthy behaviors, the number of veterans becoming overweight is estimated to go down by 23% and the number of veterans becoming obese is estimated to go down by 68%.

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Posttraumatic Stress Disorder and Risk of Selected Autoimmune Diseases among US Military Personnel BMC Psychiatry 2020 Jan 15; 20 (1):23

Bookwalter DB, Roenfeldt KA, LeardMann CA, Kong SY, Riddle MS,Rull RP

This study investigated the association between PTSD and risk of developing selected autoimmune diseases among US active duty service members. Among 120,572 participants followed for an average of 5 years, risk of any of the selected new-onset autoimmune diseases was 58% higher for those with a history of PTSD compared to those with no history. Observed associations did not differ by specific types of trauma experienced. Future research is needed to understand the physiological pathways that may link PTSD with increased risk of immune-mediated inflammatory diseases.

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Smoking Among U.S. Service Members Following Transition From Military to Veteran Status Health Promotion Practice 2020 Jan;21(1_suppl):165S-175S

Nieh C, Powell TM, Gackstetter GD, Hooper TI

This study examined whether the time period just prior to military separation or the reasons for separation were associated with smoking among veterans. We found that service members are more likely to smoke when closer to their military separation date. The smoking prevalence among service members separating within 3 months was 23%, whereas 17% was observed among those separating in 2+ years. We also found that veterans who were heavy drinkers were 50% more likely to smoke and those with a standards/judicial-related separation reason were 69% more likely to smoke.

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