Publications
The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.
| Title | Publication | Date/Location |
|---|---|---|
| Association of Combat Experiences With Suicide Attempts Among Active-Duty US Service Members | JAMA Network Open | 2021;4(2):e2036065 |
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LeardMann CA, Matsuno R, Boyko EJ, Powell TM, Reger MA, Hoge CW, for the Millennium Cohort Study Team Among 57,841 active-duty service members who had deployed, high combat severity and certain specific combat experiences were associated with suicide attempts. However, these associations were mostly accounted for by mental disorders, especially PTSD. Findings suggest that service members who experience high levels of combat or are exposed to certain types of combat experiences, involving unexpected events or those that challenge moral or ethical norms, may have an increased risk of a suicide attempt, either directly or indirectly through mental disorders. |
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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;9(4):442–462 |
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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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| Cervical cancer screening compliance among active duty service members in the US military | Preventive Medicine Reports | 2022 Apr; 26: 101746 |
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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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| A temporal analysis of mental health symptoms relative to separation from the military | Depression and Anxiety | 2022 Apr;39(4):334- 343 |
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Porter B, Carey FR, Roenfeldt KA, Rull RP, Castro CA This paper examined mental health symptoms among 23,887 active duty Millennium Cohort Study participants who completed a survey within one year of their separation from the military. While significant, timing prior to or after separation did not have a practical impact on mental health among all study participants, accounting for less than 0.2% of variance in mental health symptoms. However, among participants with Other Than Honorable (i.e., “bad paperâ€) or General discharges, timing to separation accounted for 5.1% and 3.6% of the variance in posttraumatic stress disorder and depression symptoms, respectively; mental health symptoms increased among these participants around the time of separation and remained elevated in the period following separation. Increased outreach at the time of separation and post-separation is needed for service members with bad paper discharges. |
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| Association of deployment with maintenance of healthy weight among active duty service members in the Millennium Cohort Study | Obesity Science and Practice | 2022 Apr;8(2):247-253 |
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Carey FR, Jacobson IG, Roenfeldt KA, Rull RP Understanding changes in weight in relation to deployment readiness can inform Department of Defense fitness policies. This study examined longitudinal associations between deployment and service branch-specific changes in body mass index (BMI) among active duty participants without obesity (BMI< 30kg/m2) at baseline (n=22,995). Service members, particularly Army and Marine Corps personnel, with longer deployments were less likely to maintain a healthy weight (BMI < 30) than those with shorter deployment lengths. Conversely, each additional deployment increased the likelihood of maintaining a healthy weight post-deployment for personnel in the Army, Marine Corps, and within the pooled population. These results indicate that multiple deployments may support healthy weight maintenance and longer deployments may adversely impact weight maintenance. Fitness policies designed to optimize service member readiness should consider modifiable behaviors related to weight gain among those who are deployed for long periods of time. |
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| The bi-directional relationship between post-traumatic stress disorder and obstructive sleep apnea and/or insomnia in a large U.S. military cohort | Sleep Health | 2022 December | doi: 10.1016/j.sleh.2022.07.005 |
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Chinoy ED, Carey FR, Kolaja CA, Jacobson IG, Cooper AD, Markwald RR Study findings indicate a bi-directional relationship between the development of sleep disorders and PTSD. Military-related factors associated with new onset PTSD or sleep disorders, such as combat deployment, recent military separation, and rank, should be considered in prevention efforts for sleep disorders and PTSD. |
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| Occupation and Risk of Traumatic Brain Injury in the Millennium Cohort Study | Military Medicine | 2022 Feb 27;usac035 |
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Jannace KC, Pompeii L, Gimeno Ruiz de Porras D, Perkison WB, Yamal JM, Trone DW, Rull RP Using 2014-16 survey data from active duty 33,646 Millennium Cohort Study participants, we assessed the association between their primary military occupational categories (MOC) and self-reported traumatic brain injury (TBI) sustained during military service. Adjusting for military and demographic characteristics and pre-service TBI, all MOCs except for health care MOCs were statistically significantly more likely to experience service-related TBI compared with “Administration & Executive†MOCs, while those in “Infantry/Tactical Operations†had the highest odds of service-related TBI. Enlisted (28%) personnel were more likely than officers (24%) to experience a service-related TBI. Results highlight the importance of targeting specific occupational categories for TBI risk reduction and a quantification of risk among enlisted MOCs suggests a need for further research into the causes of TBI. |
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| Problematic Anger and Economic Difficulties: Findings from the Millennium Cohort Study | Journal of Affective Disorders | 2022 Jan 15;297:679-68 |
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Adler AB, LeardMann CA, Yun S, Jacobson IG, Forbes D; Millennium Cohort Study Team Of 95,895 participants, 17.4% screened positive for problematic anger. Problematic anger was significantly associated with involuntary job loss and financial problems, adjusting for demographics, military characteristics, disabling injury, and behavioral health factors. Among veterans, problematic anger was associated with unemployment and homelessness after adjustment for covariates. These findings suggest it may be useful for military leaders, veteran organizations, and policy makers to support the adjustment and financial health of military personnel and veterans by proactively addressing problematic anger. |
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| Factors associated with human papillomavirus vaccine initiation and compliance among U.S. military service members | Military Medicine | 2022 Jan 25:usab562 |
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Matsuno RK, Seay J, Porter B, Tannenbaum K, Warner S, Wells N The goal of this study was to assess factors associated with human papillomavirus (HPV) vaccine initiation and compliance in a cohort of active duty US military service members (SM). We included active-duty participants aged 18-26 years from the Millennium Cohort Study, a longitudinal cohort study of over 200,000 military SMs. The eligible study population included 22,387 female SMs and 31,705 male SMs. Vaccination was assessed over the period 2006-2017. Among female SMs, 37.8% initiated the vaccine and 40.2% of initiators completed the series within a year. Among male SMs, 3.9% initiated the vaccine and 22.1% of initiators completed the series within a year. Differences were observed by sociodemographic factors, deployment status, branch of service, occupation, and smoking status, but not by selected mental health conditions. These results indicated that HPV vaccination uptake may be subpar across all military service branches. Certain subgroups of SMs could be targeted to increase overall HPV vaccine coverage in the US military population. |
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| Military service experiences and reasons for service separation among lesbian, gay, and bisexual individuals in a large military cohort | BMC Public Health | 2022 Jan 6;22(1):39 |
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Carey FR, Jacobson IG, Lehavot K, LeardMann CA, Kolaja CA, Stander VA, Rull RP The goal of this study was to examine differences in military and service separation experiences by sexual orientation among a large representative sample of United States service members and veterans. Survey data from the 2016 Millennium Cohort Study follow-up questionnaire were used to assess sexual orientation (lesbian, gay, and bisexual [LGB] versus heterosexual) and military experiences and service separation experiences. Of the 99,599 participants, 3.4% identified as LGB. Those service members were more likely than their heterosexual peers to report feeling unimpressed by the quality of unit leadership, unsupported by the military, and negative about the military overall. LGB veterans were more likely than heterosexual peers of the same sex to separate from service for a variety of reasons (e.g., administrative, dissatisfaction with promotions/pay, disability/medical reasons, dissatisfaction with leadership and incompatibility with the military). Less positive military- and separation-specific experiences disproportionately affected LGB service members in this study. Promoting inclusion and increasing support for LGB service members may improve satisfaction with military service and retention. |
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