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
Contribution of Post-Trauma Insomnia to Depression and Posttraumatic Stress Disorder in Women Service Members: Findings from the Millennium Cohort Study Sleep 2023 Mar 9; 46(3):zsac313 | doi: 10.1093/sleep/zsac313

Carlson GC, Sharifian N, Jacobson IG, LeardMann CA, Rull RP, Martin JL

Post-trauma insomnia contributed to the development of depression and PTSD among women service members and veterans; screening for insomnia may help mitigate the development of posttraumatic mental health conditions.

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Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation Frontiers in Neurology 2023 Mar 21; 14:1110717 | doi: 10.3389/fneur.20

Belding JN, Kolaja CA, Rull RP, Trone DW for the Millennium Cohort Study Team

This study examined whether single and repeated high-level blast exposure (e.g., from incoming munitions) and low-level blast exposure (e.g., from outgoing munitions) were associated with 45 different self-reported diagnoses of illness and injury. Outcomes examined included PTSD, depression, hearing loss, tinnitus, chronic fatigue syndrome, and migraines. Findings suggest that blast exposure elevated risks for more than 20 different diagnoses and that repeated exposure was associated with worse outcomes.

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Pre-incentive Efficacy in Survey Response Rates in a Large Prospective Military Cohort Field Methods 2023 Mar 17; 35(4), 392-408 | doi: 10.1177/1525822X231163668

Powell TM, Geronimo-Hara TR, Tobin LE, Donoho CJ, Sheppard BD, Walstrom JL, Rull RP, Faix DJ

U.S. military and veteran populations are challenging to retain in longitudinal studies as they span the globe, frequently move, and are heavily surveyed. This study tested the effectiveness of multiple pre-incentives ($2 bill, $5 gift card, magnet, and Apple iPad® lottery entry) on increasing the response rate to the 2014 survey of the Millennium Cohort Study. Findings suggest that providing participants a monetary pre-incentive was an effective way to increase response rates and participant retention as well as re-engage participants who did not respond to a previous follow-up survey.

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Identifying at-risk marines: A person-centered approach to adverse childhood experiences, mental health, and social support Journal of Affective Disorders 2023 Mar 15; 325:721-731 | doi: 10.1016/j.jad.2023.01.020

Reed-Fitzke K, LeardMann CA, Wojciak AS, Ferraro AJ, Hamilton A, Duncan JM, Rull RP

In a sample of male Marines (n=3,881), five subgroups based on adverse childhood experiences were identified. One in five Marines reported moderate to elevated levels of childhood adversity. A history of varying types of childhood adversity characterized by parental absence was associated with greater PTSD and depression symptomology and lower levels of social support. When attempting to identify Marines most at-risk for mental health concerns, the identification of specific patterns of childhood adversity, particularly regarding parental absence, may be more valuable.

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Cohort Profile Update: The US Millennium Cohort Study—evaluating the impact of military experiences on service members and veteran health International Journal of Epidemiology 2023 Aug 2; 52(4):e222-e231 | doi: 10.1093/ije/dyad088

Castañeda SF, Belding JN, Kolaja CA, LeardMann CA, Jacobson IG, Rivera AC, Carey FR, Boparai S, Walstrom JL, Sheppard BD, Boyko EJ, Ryan MAK, Rull RP

This paper provides an update to the original cohort profile paper published a decade ago. The Study includes 260,228 military personnel enrolled across 5 panels between 2001 and 2021 (baseline age range: 25-35 years), where participants are surveyed every 3-5 years through 2068. Longitudinal survey data are linked to administrative and medical data from DoD, VA, and external sources. The breadth of research topics has expanded over the past decade with the continued aim of contributing to policies and programs that improve service member and Veteran health and wellbeing.

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Brief Report: Menstrual Suppression Among U.S. Female Service Members in the Millennium Cohort Study Medical Surveillance Monthly Report 2022 Sept 29(9), 19-22

Zhu Y, Kolaja CA, Stamas N, Matsuno RK, Rull RP; Millennium Cohort Study Team

This study examined the prevalence of self-reported menstrual suppression among U.S. female active duty personnel (N=22,920) at two time points (2008, 2013) by demographic and military characteristics. Menstrual suppression increased significantly overall from 2008 (2.5%) to 2013 (3.8%) and among younger age groups (aged 18-34), non-Hispanic White individuals, Army, Navy, or Air Force personnel. The highest prevalence of menstrual suppression was reported in 2013 among those who deployed in the past year (4.7%) or worked in health care (5.1%) or combat specialties (4.7%). Increased health education is needed to support the health care needs and readiness of female service members.

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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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Health Disparities Among Lesbian, Gay, and Bisexual Service Members and Veterans American Journal of Preventive Medicine 2022 Oct; 63(4):521-531 | doi: 10.1016/j.amepre.2022.04.034

Carey FR, LeardMann CA, Lehavot K, Jacobson IG, Kolaja CA, Stander VA, Rull RP, Millennium Cohort Study Team

This study examined whether differences in mental, physical, and behavioral health exist by sexual orientation among active duty and Reserve/National Guard service members and veterans (N=96,930). Lesbian, gay, and bisexual (LGB) individuals (3.6% of the sample) were more likely to screen positive for post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger, multiple somatic symptoms, and insomnia than heterosexual individuals. LGB women reported more adverse health outcomes (overweight and obesity, smoking, problem/risky drinking) than heterosexual women. Gay and bisexual men reported some adverse health outcomes (e.g., smoking and problem drinking) but better physical health (e.g., less overweight/obesity) than heterosexual men. These results suggest that LGB service members experience health disparities, despite many having equal eligibility for health care, highlighting the need for improved equity initiatives that promote cultural responsiveness, acceptance, and approaches to support the healthcare needs of LGB military members.

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The effect of combat exposure on financial problems International Review of Economics and Finance 2022 May;79:241-257

Ackerman A, Porter, B

This paper examined whether combat exposure led to new-onset financial problems and financial stress among 64,508 veterans using 2001-2016 data from the Millennium Cohort Study. The average predicted probability of developing a new major financial problem (such as bankruptcy) and greater financial stress increased 0.44% (21% relative to the mean probability) following a single combat exposure and increased 0.90% (43% relative to the mean probability) following multiple combat exposures. The likelihood of financial decline resulting from combat exposure were greater for veterans with poorer pre-deployment mental or physical health, veterans in enlisted ranks, and younger veterans between the ages of 26 and 36. These results translate to a crude cost estimate of lost productivity of at least $41 million and up to 3,629 bankruptcies for the 2.7 million veterans (1.34 per 1,000) deployed from 2001 through 2016.

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The Millennium Cohort Study: The First 20 Years of Research Dedicated to Understanding the Long-Term Health of US Service Members and Veterans Annals of Epidemiology 2022 Mar;67:61-72

Belding JN, Castañeda SF, Jacobson IG, LeardMann CA, Porter B, Powell TM, Kolaja CA, Seelig AD, Matsuno RK, Carey FR, Rivera AC, Trone DW, Sheppard B, Walstrom J, Boyko EJ, Rull RP, For The Millennium Cohort Study Team

In commemoration of the 20th anniversary of the Millennium Cohort Study, this paper provides a summary of the study design, key findings, and future directions. Published findings are summarized and categorized into 3 core areas (psychological health, physical health, and health-related behaviors) and several crosscutting areas culminating in more than 120 publications to date. The Study will continue to foster stakeholder relationships such that research findings inform and guide policy initiatives and health promotion efforts.

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