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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| Multiple imputation validation study: Addressing unmeasured survey data in a longitudinal design | BMC Medical Research Methodology | 2021 Jan 6;21(1):5 |
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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 |
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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 |
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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 (less than 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 less than 5 hours of sleep but increased the 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 |
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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 |
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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 |
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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 |
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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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| Mental Health, Physical Health, and Health-Related Behaviors of U.S. Army Special Forces | PLOS One | 2020 Jun 3;15(6):e023356 |
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Cooper AD, Warner SG, Rivera AC, Rull RP, Adler AB, Faix DJ, Neff RR, Deagle EA, Caserta RJ, LeardMann CA, for the Millennium Cohort Study Team Using prospective data, Army Special Forces personnel and Ranger Qualified infantrymen reported fewer mental health problems, multiple somatic symptoms, and unhealthy behaviors than General Purpose Forces infantrymen. Findings indicate that the adoption of healthy behaviors, such as adequate sleep and physical activity, may be an efficient and cost-effective approach for preventing adverse health outcomes, regardless of occupational specialization or prior health status. |
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| Surveillance Snapshot: Cervical Screening among U.S. Military Servicewomen in the Millennium Cohort Study, 2003 to 2015 | Medical Surveillance Monthly Report | 2020 Jul;27(7):15 |
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Matsuno RK, Porter B, Warner SG, Wells N for the Millennium Cohort Study Team Across a 13 year period (2003-2015), the percentage of U.S. service women who were up-to-date with cervical cancer screening peaked in 2010, then declined. Screening was generally highest among Air Force personnel and lowest among Navy personnel. Being up-to-date was higher for servicewomen who had initiated the HPV vaccine than for women who had not. |
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| Prevalence of Chronic Multisymptom Illness/Gulf War Illness Over Time Among Millennium Cohort Participants, 2001 to 2016 | Journal of Occupational and Environmental Medicine | 2020 Jan;62(1):4-10 |
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Porter B, Long K, Rull RP, Dursa EK for the Millennium Cohort Study Team Chronic multisymptom illness/Gulf War illness (CMI/GWI) is a signature illness of the 1990-1991 Gulf War. Using a modified CMI/GWI definition, this study estimated the prevalence of CMI/GWI from 2001-2016 among Gulf War veterans and two other non-deployed groups enrolled in the Millennium Cohort Study. Overall, Gulf War veterans had the highest prevalence of CMI/GWI across the study period. The prevalence among all three groups increased substantially at approximately the same rate from 2001 to 2016. |
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