Publications
The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.
| Title | Publication | Date/Location |
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| Comparison of Posttraumatic Stress Disorder Checklist Instruments from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition vs Fifth Edition in a Large Cohort of US Military Service Members and Veterans | JAMA Network Open | 2021; 4(4): e218072 |
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LeardMann, CA, McMaster HS, Warner S, Esquivel AP, Porter B, Powell TM, Tu XM, Lee WW, Rull RP, Hoge CW, for the Millennium Cohort Study Team To assist in the longitudinal assessment of PTSD spanning the transition between the DSM-IV and DSM-V, we compared the PTSD Checklist-Civilian version (PCL-C) with the PCL for DSM-5 (PCL-5) in a sample of 1,921 servicemembers. There was substantial to excellent agreement when comparing individual items, frequency of probable PTSD, and sum scores; and nearly identical associations with comorbid conditions. Our results provide support that PTSD can be successfully assessed and compared over time with either PCL instrument in veteran and military populations. |
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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 |
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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 exposure and behavioral health in U.S. Army Special Forces | PLoS One | 2022 Jun 28;17(6):e0270515 |
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Rivera AC, LeardMann CA, Rull RP, Cooper A, Warner S, Faix D, Deagle E, Neff R, Caserta R, Adler AB, Millennium Cohort Study Team In this cross-sectional study using Millennium Cohort Study data, various types of combat, such as combat severity, fighting, threat to oneself, and killing noncombatants, were consistently associated with mental health disorders, trouble sleeping, and problem drinking among all three Army occupational specialization investigated (General Purpose Forces infantrymen, Ranger Qualified infantrymen, and Special Forces personnel). However, with few exceptions, Special Forces personnel and Ranger Qualified infantrymen had lower prevalence of these adverse outcomes. Findings suggest that even elite personnel may be negatively impacted by experiencing combat, thus trainings and interventions focused on moral conflict reasoning and resolution may help to mitigate some of these adverse behavioral outcomes. |
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| Combat Experience, New-Onset Mental Health Conditions, and Posttraumatic Growth in U.S. Service Members | Psychiatry | Fall 2021;84(3):276-290 |
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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. |
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| Combat Deployment is Associated with Sexual Harassment or Sexual Assault in a Large, Female Military Cohort | Women's Health Issues | 2013 Jul-Aug;23(4):e215-23 |
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LeardMann CA, Pietrucha A, Magruder KM, Smith B, Murdoch M, Jacobson IG, Ryan MAK, Gackstetter G, Smith TC, for the Millennium Cohort Study Team Among female service members, the 3-year cumulative incidence of sexual harassment was 9.4% and sexual assault was 2.1%. Significant risk factors for sexual trauma included prior deployment with combat experience, serving as a Marine, younger age, recent marital separation or divorce, positive screen for a prior mental health condition, moderate/severe life stress, and prior sexual trauma experiences. Understanding the factors associated with sexual harassment and assault can inform future policy and prevention efforts in order to eliminate sexual trauma. |
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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 |
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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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| Cigarette smoking patterns among U.S. military service members before and after separation from the military | PLoS One | 2021 Oct 4;16(10):e0257539 |
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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. |
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| Cigarette Smoking and Military Deployment: A Prospective Evaluation | American Journal of Preventive Medicine | 2008 Dec;35(6):539-46 |
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Smith B, Ryan MAK, Wingard DL, Patterson TL, Slymen DJ, Macera CA, for the Millennium Cohort Study Team Findings suggest an increase in smoking initiation and recidivism among deployers and highlight the importance of prevention strategies pre, during, and post deployment. |
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| Chronic Multisymptom Illness: A Comparison of Iraq and Afghanistan Deployers with 1991 Gulf War Veterans | American Journal of Epidemiology | 2014;180(12):1176-1187 |
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Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD These data highlight a difference in CMI reporting when comparing deployed to non-deployed military members. While symptom reporting in this contemporary Cohort occurred less frequently than in the historical 1991 GW cohort, increased CMI reporting was noted among deployed compared to non-deployed contemporary Cohort members. |
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| Changes in Meeting Physical Activity Guidelines After Discharge from the Military | Journal of Physical Activity Health | 2015 May;12(5):666-674 |
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Littman AJ, Jacobson IG, Boyko EJ, Smith TC Using data from Millennium Cohort Study participants, we investigated changes in meeting federal Physical Activity Guidelines for moderate-to-vigorous activity (MVPA) following military discharge. MVPA declined more in those who were discharged than those who were not (-17.8 percentage points vs. -2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14-25 years of service, and had been discharged more recently (<1 year prior). Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in physical activity will help prevent excess weight gain and physical inactivity-associated health consequences. |
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