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
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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Surveillance Snapshot: Cervical Screening among U.S. Military Servicewomen in the Millennium Cohort Study, 2003–2015 Medical Surveillance Monthly Report 2020 Jul;27(7):15

Matsuno RK, Porter B, Warner SG, Wells N for the Millennium Cohort Study Team

Across a 13 year period (2003-2015), the percentage of U.S. service women who were up-to-date with cervical cancer screening peaked in 2010, then declined. Screening was generally highest among Air Force personnel and lowest among Navy personnel. Being up-to-date was higher for servicewomen who had initiated the HPV vaccine than for women who had not.

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Surveillance Snapshot: Human Papillomavirus Vaccination Among U.S. Active Component Service Members in the Millennium Cohort Study, 2006–2017 Medical Surveillance Monthly Report 2019 Jun;26(6):18

Matsuno RK, Porter B, Warner SG, Wells N

Among a sample of active component members under the age of 26, (22,387 service women and 31,705 service men), service more women (37.8%) were more likely than service men (3.9%) to initiate receiving the HPV vaccine. Among those who initiated the vaccine, 40.2% of women and 23.1% of men were adherent to receiving all 3 doses within 1 year. Members of the Air Force and those in healthcare occupations had higher percentages of HPV vaccine initiation and adherence.

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Brief Report: Menstrual Suppression Among U.S. Female Service Members in the Millennium Cohort Study Medical Surveillance Monthly Report 2022 September 29(9), 19-22

Zhu Y, Kolaja CA, Stamas N, Matsuno RK, Rull RP; Millennium Cohort Study Team

This study examined the prevalence of self-reported menstrual suppression among U.S. female active duty personnel (N=22,920) at two time points (2008, 2013) by demographic and military characteristics. Menstrual suppression increased significantly overall from 2008 (2.5%) to 2013 (3.8%) and among younger age groups (aged 18-34), non-Hispanic White individuals, Army, Navy, or Air Force personnel. The highest prevalence of menstrual suppression was reported in 2013 among those who deployed in the past year (4.7%) or worked in health care (5.1%) or combat specialties (4.7%). Increased health education is needed to support the health care needs and readiness of female service members.

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The Role of Posttraumatic Stress Symptoms and Negative Affect in Predicting Substantiated Intimate Partner Violence Incidents Among Military Personnel Military Behavioral Health 2021 Aug 2. doi:10.1080/21635781.2021.1953644

Stander, VA, Woodall KA, Richardson SM, Thomsen CJ, Milner JS, McCarroll JE, Riggs DS, Cozza SJ, for the Millennium Cohort Study Team

Increasing rates of posttraumatic stress disorder (PTSD) in military populations may indicate heightened risk for aggression, including aggression among domestic partners. Using longitudinal data from the Millennium Cohort Study, we evaluated the association of PTSD symptom clusters and comorbid conditions as predictors of incidents of met criteria incidents of domestic abuse (physical and psychological) from DoD Family Advocacy Program (FAP) Central Registry data. Among 54,667 active-duty personnel who responded to the 2011 survey, FAP records documented 501 participants (1%) with incidents of emotional or physical met criteria incidents of aggression in the data collection period. Results showed that certain aspects of PTSD and behavioral health problems predicted incidents. In particular, general PTSD symptoms (e.g., anger/irritability, sleep disruption) and comorbid alcohol dependence were stronger predictors than trauma-specific PTSD symptomology (e.g., reexperiencing, hypervigilance). These results indicate that clinicians should consider the interpersonal consequences of PTSD and related behavioral problems.

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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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The Millennium Cohort Study: A 21-Year Prospective Cohort Study of 140,000 Military Personnel Military Medicine 2002 Jun;167(6):483-8.

Gray GC, Chesbrough KB, Ryan MAK, Amoroso P, Boyko EJ, Gackstetter GD, Hooper TI, Riddle JR, for the Millennium Cohort Study Group

The origins and development of the Millennium Cohort Study are described. The largest prospective study in military history was established to answer the most difficult questions about long-term health after military service.

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