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.

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Combat exposure and behavioral health in U.S. Army Special Forces PLoS One 2022 Jun 28;17(6):e0270515

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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The relative impact of injury and deployment on mental and physical quality of life among military service members PLoS One 2022 Sep 29;17(9):e0274973

Kolaja CA, Castañeda SF, Woodruff SI, Rull RP, Armenta RF

Deployment and injury status was associated with poorer mental and physical quality of life (QOL) with clinically significant decreases in physical QOL observed for those who deployed and were injured, either in battle or nonbattle settings, compared with uninjured deployers.

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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.

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Cervical cancer screening compliance among active duty service members in the US military Preventive Medicine Reports 2022 Apr; 26: 101746

Seay J, Matsuno RK, Porter B, Tannenbaum K, Warner S, Wells N

Previous research suggests active duty service members (ADSM) experience higher rates of human papilloma virus infection and cervical dysplasia, which puts them at greater risk for cervical cancer. The current study examined crude rates and correlates of cervical cancer screening compliance in 2003–2015 among screening-eligible ADSM in the Millennium Cohort Study (MCS). Most participants were 21–29 years old (79.4%), non-Hispanic White (60.6%), and enlisted (82.2%). Crude rates of cervical cancer screening compliance increased from 2003 (61.2%) to 2010 (83.1%), and then declined in 2015 (59.8%). Older ADSM and those who had a history of deployment had lower odds of screening compliance. ADSM in the Air Force and those in healthcare occupations had higher odds of screening compliance. Study findings suggest that cervical cancer screening compliance is declining among ADSM. Interventions to improve screening should target groups with lower screening compliance.

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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

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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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.

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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.

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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.

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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.

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