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
The Epidemiology of Irritable Bowel Syndrome in the US Military: Findings from the Millennium Cohort Study American Journal of Gastroenterology 2016;111:93-104

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

This study describes the incidence of irritable bowel syndrome (IBS) and its association with antecedent infectious gastroenteritis among Millennium Cohort Study participants using survey data and post-deployment health assessments and medical encounter data in the military health system. Consistent with other studies, the risk of IBS increased after acute enteric infection. Novel findings included increased risk of incident IBS among those with post-traumatic stress disorder (PTSD) and preceding life stressors, as well as stronger associations between infectious gastroenteritis and IBS among those with antecedent depression or anxiety. These results reinforce the need to prevent acute gastrointestinal infections and their chronic consequences among our Service members. Additional studies on the underlying biopsychosocial mechanisms of IBS may help to explain these findings.

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The Impact of Deployment Experience and Prior Healthcare Utilization on Enrollment in a Large Military Cohort Study BMC Medical Research Methodology 2013 Jul 11;13:90

Horton JL, Jacobson IJ, Littman AJ, Alcaraz JE, Smith B, and Crum-Cianflone NF

This study compared the characteristics of invited subjects (responders and nonresponders) prior to the enrollment cycle. Military personnel who deployed in support of OIF/OEF and those who presented for routine outpatient care were significantly more likely to enroll in a longitudinal cohort study examining their health and military experiences, while those with baseline mental disorders or longer hospital stays were less likely to enroll. These findings, which controlled for demographic and other potential confounders, suggest differential enrollment by deployment experience and health status, and may help guide recruitment efforts in future studies.

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The Impact of Prior Deployment Experience on Civilian Employment After Military Service Occupational and Environmental Medicine 2013; 70: 408-417

Horton JL, Jacobson IG, Wong CA, Wells TS, Boyko EJ, Smith B, Ryan MA, and Smith TC

Employment after military service, in particular after stressful deployment experiences, is a concern for many veterans and policymakers. Among this large cohort of veterans, we found that prior deployment and PTSD were not significantly associated with job status post-service; in contrast, depression, panic/anxiety disorder, and poor physical health increased the risk of unemployment among certain groups. These findings may guide policy for veterans most in need of post-military employment support.

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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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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.
The Occupational Role of Women in Military Service: Validation of Occupation and Prevalence of Exposures in the Millennium Cohort Study International Journal of Environmental Health Research 2007 Aug;17(4):271-84

Smith TC, Jacobson IG, Smith B, Hooper TI, Ryan MAK, for the Millennium Cohort Study Team

Data on women's occupations are reliable, and occupational codes can be well correlated with exposures of concern. This was an award-winning presentation at a Navy conference in 2006.

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The Physical and Mental Health of a Large Military Cohort: Baseline Functional Health Status of the Millennium Cohort BMC Public Health 2007 Nov;7(147):340

Smith TC, Zamorski M, Smith B, Riddle JR, LeardMann CA, Wells TS, Engel CC, Hoge CW, Adkins J, Blazer D, for the Millennium Cohort Study Team

The functional health of service members in this 22-year longitudinal study compares favorably at baseline with other civilian and military populations.

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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 US Department of Defense Millennium Cohort Study: Career Span and Beyond Longitudinal Follow-Up Journal of Occupational and Environmental Medicine 2009 Oct;51(10):1193-1201

Smith TS, for the Millennium Cohort Study Team

Describes the Millennium Cohort Study, a large longitudinal occupational health study designed and initiated prior to the combat deployments in Iraq and Afghanistan specifically to assess any short or long-term health outcomes during and after military service and career.

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Trajectories of Trauma Symptoms and Resilience in Deployed US Military Service Members: A Prospective Cohort Study British Journal of Psychiatry 2012 Apr;200(4):317-23

Bonanno GA, Mancini AD, Horton JL, Powell TM, LeardMann CA, Boyko EJ, Wells TS, Hooper TI, Gackstetter GD, Smith TC, for the Millennium Cohort Study Team

Symptoms of posttraumatic stress (PTS) were examined over time in relation to deployment. Four classes of PTS trajectories were identified for both single and multiple deployers, with over 80% of the deployers exhibiting a stable trajectory of low symptoms (i.e., resilience) pre- to post-deployment. Several factors predicting PTS trajectories were identified, which may direct future research aimed at decreasing the risk of posttraumatic stress disorder among deployers

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