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
Cigarette smoking patterns among U.S. military service members before and after separation from the military. PLoS One. 2021 Oct 4;16(10):e0257539

Nieh C, Mancuso JD, Powell TM, Welsh MM, Gackstetter GD, Hooper TI.

Millennium Cohort Study data were used to examine smoking behavior at enrollment into the study and through their first follow-up survey, approximately 3 years later. Time remaining in service from baseline until separation or the first follow-up survey was the main exposure of interest. The baseline prevalence of smoking in the Cohort was higher among those who eventually separated (20.1%) than among those who remained on active service (17.4%), but the overall prevalence of current smokers significantly declined over the observation period. Factors significantly associated with greater likelihood of smoking at follow- up were baseline smoking, non-White Hispanic individuals, being non-married, enlisted rank, underweight or healthy BMI, active duty component, any alcohol consumption, experiencing two or more stressful life events, and screening positive for either PTSD or depression. Including smoking prevention and/or cessation programs in pre-separation counseling sessions and developing smoking screening and cessation programs targeting high-risk subgroups may reduce smoking among Service members and veterans.

View full text

Early Mortality Experience in a Large Military Cohort and a Comparison of Data Sources Used for Mortality Ascertainment Population Health Metrics 2010 May;8(1):15

Hooper TI, Gackstetter GD, LeardMann CA, Boyko EJ, Pearse LA, Smith B, Amoroso PA, Smith TC, for the Millennium Cohort Study Team

This study assessed the ability of four different mortality data sources to document the early mortality experience of the Cohort. The strengths and limitations of each data source are described and support continued use of multiple sources for future mortality assessment.

View full text

Combat Experience, New-Onset Mental Health Conditions, and Posttraumatic Growth in U.S. Service Members Psychiatry In press

Jacobson IG, Adler AB, Roenfeldt KA, Porter,B., LeardMann CA, Rull RP, Hoge CW

Research on posttraumatic growth (PTG) after traumatic experiences has raised questions on measurement, validity, and clinical utility. We longitudinally examined PTG among Millennium Cohort Study deployers (n=8,732), who screened negative for PTSD and depression at time 1, using a measure that improved upon previous psychometric issues. A strong inverse correlation was found between PTG scores at time 2 and new onset mental health problems (PTSD, depression), where lower growth scores correlated with worse mental health (i.e. higher PTSD or depression screening scores). Only 5% of participants who screened positive for a mental health problem at time 2 experienced positive growth. Results suggest that measurement of PTG is not independent from mental health problems following combat experiences and thus challenge the clinical utility of the PTG construct.

View full text

PTSD Prevalence, Associated Exposures, and Functional Health Outcomes in a Large, Population-Based Military Cohort Public Health Report 2009 Jan;124:90-102

Smith TC, Wingard DL, Ryan MAK, Kritz-Silverstein D, Slymen DJ, Sallis JF, for the Millennium Cohort Study Team

Findings suggest a 2% prevalence of current PTSD symptoms in the US Military that are associated with increased reporting of exposures and decrements in functional health.

View full text

Prospectively Assessed Posttraumatic Stress Disorder and Associated Physical Activity Public Health Reports 2011 May/Jun;126(3):371-83

LeardMann CA, Kelton ML, Smith B, Littman AJ, Boyko EJ, Wells TS, Smith TC, for the Millennium Cohort Study Team

Nearly 90% of the Cohort participate in some level of physical activity. Engagement in physical activity, specifically vigorous activity, was associated with decreased odds of PTSD symptoms. While further research is needed, a physical activity component may be valuable to treat and/or prevent PTSD among service members.

View abstract

Predeployment Sleep Duration and Insomnia Symptoms as Risk Factors for New-Onset Mental Health Disorders Following Military Deployment Sleep 2013 Jul 1;36(7):1009-1018

Gehrman P, Seelig AD, Jacobson IG, Boyko EJ, Hooper TI, Gackstetter GD, Ulmer CS, Smith TC

This study showed that combat-related trauma and predeployment insomnia symptoms were significantly associated with developing posttraumatic stress disorder, depression, and anxiety following deployment. Assessment of insomnia symptoms predeployment may help to better identify those at highest risk for subsequent adverse mental health outcomes.

View abstract

Sleep and Health Resilience Metrics in a Large Military Cohort Sleep 2016 May;39(5):1111-1120

Seelig AD, Jacobson IG, Donoho CJ, Trone DW, Crum-Cianflone NF, Balkin TJ

The presence of insomnia symptoms was significantly associated with worse self-rated health, more lost work days, lower odds of deployment, higher odds of leaving military service early, and more health care utilization, after adjustment for demographic, military, behavioral and other health covariates. Findings were similar for those reporting less than 6 hours of sleep per night. Future research should focus on the efficacy of interventions to promote healthy sleep in military populations.

View abstract

Sleep Patterns Before, During, and After Deployment to Iraq and Afghanistan Sleep 2010 Dec;33(12):1615-22

Seelig AD, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD, Gehrman PR, Macera CA, Smith TC, for the Millennium Cohort Study Team

Participants reported having trouble sleeping and getting less sleep either during deployment or after returning home from deployment more than nondeployed participants. Self-reported combat exposures and mental health symptoms were independently associated with increased reporting of trouble sleeping.

View abstract

Longitudinal associations of military-related factors on self-reported sleep among U.S. service members Sleep In press

Cooper AD, Kolaja CA, Markwald RR, Jacobson IG, Chinoy ED

This study examined military factors in relation to the development and reoccurrence of short sleep duration (≤5 hours or 6 hours) and insomnia symptoms (i.e., trouble falling asleep or staying asleep in the past month)over a 3-15 year follow-up period. Military factors consistently associated with an increased risk for development and/or reoccurrence of short sleep duration and insomnia symptoms included active duty service, Army or Marine Corps service, combat deployment, and longer than average deployment lengths. Officers and noncombat deployers had decreased risk for either poor sleep characteristic. Length of service and separation from the military were complex factors; each lowered risk for ≤5 hours sleep but increased risk for insomnia symptoms. Findings suggest that efforts to improve sleep prioritization and implement interventions targeting at-risk military populations, behaviors, and other significant factors are warranted.

View abstract

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.

View abstract

The appearance of hyperlinks does not constitute endorsement by the Department of Defense of non-U.S. Government sites or the information, products, or services contained therein. Although the Department of Defense may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Such links are provided consistent with the stated purpose of this website.

Publication badge scores are provided by Altmetric.