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
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

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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Sexual Health Difficulties Among Service Women: The Influence of Posttraumatic Stress Disorder Journal of Affective Disorders 2021 Sep 1;292:678-686

Kolaja CA, Schuyler AC, Armenta RF, Orman JA, Stander VA, LeardMann CA

Sexual health of service women was found to be negatively impacted by recent combat deployment and sexual assault. Post-traumatic stress disorder(PTSD) mediated the associations of recent combat deployment and sexual assault with sexual health difficulties. Some military factors (i.e., service branch, component, paygrade) were associated with sexual health difficulties among service women. Findings indicate that effective treatment of PTSD may mitigate sexual health issues.

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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

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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Multiple imputation validation study: Addressing unmeasured survey data in a longitudinal design BMC Medical Research Methodology 2021 Jan 6;21(1):5

Kolaja CA, Porter B, Powell TM, Rull RP, Millennium Cohort Study Team

This study examined the efficiency and feasibility of multiple imputation (MI) to recover data from a question completely missing at a follow-up survey assessment. Specifically, the suicidal ideation item on the depression module of the Patient Health Questionnaire was set to missing on a follow-up survey and then filled in using different MI models. Imputed and self-reported suicidal ideation were similarly associated with the related constructs of sleep duration and smoking status, suggesting that MI allowed for the inclusion of an otherwise missing item as a covariate in statistical models.

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Sexual Health Problems among Service Men: The Influence of Posttraumatic Stress Disorder Journal of Sex Research 2021 Jan 11:1-13

Kolaja CA, Roenfeldt K, Armenta RF, Schuyler AC, Orman JA, Stander VA, LeardMann CA

Among service men, numerous factors (e.g. older age, lower education, enlisted paygrade, disabling injury, BMI) were associated with sexual health problems. PTSD mediated the associations between stressors (combat deployment and sexual assault) and sexual health outcomes. These findings indicate that sexual health is negatively affected by military-related stressors and comprehensive treatment options are warranted.

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Longitudinal associations of military-related factors on self-reported sleep among U.S. service members Sleep 2021 Dec 10;44(12):zsab168

Cooper AD, Kolaja CA, Markwald RR, Jacobson IG, Chinoy ED

This study examined military factors in relation to the development and reoccurrence of short sleep duration (≤5 hours or 6 hours) and insomnia symptoms (i.e., trouble falling asleep or staying asleep in the past month)over a 3-15 year follow-up period. Military factors consistently associated with an increased risk for development and/or reoccurrence of short sleep duration and insomnia symptoms included active duty service, Army or Marine Corps service, combat deployment, and longer than average deployment lengths. Officers and noncombat deployers had decreased risk for either poor sleep characteristic. Length of service and separation from the military were complex factors; each lowered risk for ≤5 hours sleep but increased risk for insomnia symptoms. Findings suggest that efforts to improve sleep prioritization and implement interventions targeting at-risk military populations, behaviors, and other significant factors are warranted.

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Health of Army Veterinarians and Veterinary Technicians in the Millennium Cohort Study Journal of the American Veterinary Medical Association 2021 Apr 1;258(7):767-775

Rivera AC, Geronimo-Hara TR, LeardMann CA, Penix EA, Phillips CJ, Faix DJ, Rull RP, Whitmer DL, Adler AB, for the Millennium Cohort Study Team

This analysis assessed the risk of mental health problems, suicidal ideation, psychotropic medication use, problem drinking, sleep quality, and lack of social support among 101 Army veterinarians and 334 veterinary technicians compared with other Army medical professionals (856 physicians and dentists and 6,453 medics, respectively) enrolled in the Millennium Cohort Study. Compared with physicians and dentists, veterinarians had elevated risks for mental health problems, trouble sleeping, and lack of social support after adjusting for important factors such as age, sex, race/ethnicity, financial problems, and deployment status. Veterinary technicians had no significantly elevated risks for any of the adverse outcomes of interest compared with medics.

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Magnitude of Problematic Anger and its Predictors in the Millennium Cohort BMC Public Health 2020;20(1):1168

Adler AB, LeardMann CA, Roenfeldt KA, Jacobson IG, Forbes D

Among sample of service members and Veterans (N= 90,266), 17% screened positive for problematic anger. Numerous independent factors were associated with an increased risk of problematic anger (e.g., PTSD, depression, financial problems, problem drinking) and decreased risk of problem anger (e.g., positive perspective, self-mastery). Developing interventions that target problematic anger in the military is critical given its high prevalence, distinction from other mental disorders, role in impeding effective PTSD treatment, and impact on vocational and interpersonal functioning.

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The effect of combat exposure on veteran homelessness Journal of Housing Economics Information 2020 Sept; 49,101711

Ackerman A, Porter B, Sullivan R

Homelessness is a serious problem among veterans, but how military service contributes to the risk of homelessness is unclear. This study examined the impact of witnessing another's death (a proxy for combat) on likelihood of reporting homelessness. One exposure was associated with a 0.6% increase in homelessness. Extrapolated to the overall population, combat exposure is expected to contribute to 4,600 instances of homeless veterans.

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Posttraumatic Stress Disorder Symptom Clusters in Service Members Predict New-Onset Depression Among Military Spouses Journal of Traumatic Stress 2020 Sep 3. doi: 10.1002/jts.22575

Walter KH, LeardMann CA, Carballo CE, McMaster HM, Donoho CJ, & Stander VA

Among spouses of service members with probable posttraumatic stress disorder (PTSD), 14% met criteria for new-onset depression over a 3-year period. The service member’s PTSD symptom cluster of effortful avoidance was associated with an increased risk of new-onset depression in spouses, underscoring the impact of service member psychological symptoms on the spouse.

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