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
Weight Change Following US Military Service Int J Obes (Lond) 2013 Feb;37(2):244-53

Littman AJ, Jacobson IG, Boyko EJ, Powell TM, Smith TC, for the Millennium Cohort Study Team

This study provides the first prospectively collected evidence for an increased rate of weight gain around the time of military discharge that may explain previously reported higher rates of obesity in veterans, and identifies characteristics of higher-risk groups. Discharge from military service presents a window of risk and opportunity to prevent unhealthy weight gain in military personnel and veterans.

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The Occupational Role of Women in Military Service: Validation of Occupation and Prevalence of Exposures in the Millennium Cohort Study International Journal of Environmental Health Research 2007 Aug;17(4):271-84

Smith TC, Jacobson IG, Smith B, Hooper TI, Ryan MAK, for the Millennium Cohort Study Team

Data on women's occupations are reliable, and occupational codes can be well correlated with exposures of concern. This was an award-winning presentation at a Navy conference in 2006.

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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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Profile of Two Cohorts: UK and US Prospective Studies of Military Health International Journal of Epidemiology 2012 Oct;41(5):1272-82

Pinder RJ, Greenberg N, Boyko EJ, Gackstetter GD, Hooper TI, Murphy D, Ryan MA, Smith B, Smith TC, Wells TS, Wessely S, for the Millennium Cohort Study Team

Despite differences and limitations in methodologies, analyses of these two cohorts provide the prospect of driving improvement and innovation in military health and extending findings to other occupational populations.

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Association of Combat Experiences With Suicide Attempts Among Active-Duty US Service Members JAMA Network Open 2021;4(2):e2036065

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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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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Association of Problematic Anger With Long-term Adjustment Following the Military-to-Civilian Transition JAMA Network Open 2022 Jul 1;5(7):e2223236

Adler AB, LeardMann CA, Villalobos J, Jacobson IG, Forbes D, for the Millennium Cohort Study Team

In the Millennium Cohort Study’s third paper documenting the risks associated with problematic anger, 15.9% of active duty service members reported problematic anger two years before military separation. This prevalence essentially doubled to 31.2% two years following separation. Problematic anger around the time of military separation was associated with PTSD, depression, low relationship quality, difficulties coping with parental demands, low social support, and economic difficulties approximately 5 years later, after adjustment for demographics and baseline health. Findings suggest that training in emotion regulation may improve the military-to-civilian transition.

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Three-Item Dimensions of Anger Reactions Scale JAMA Network Open 2024 Feb 5;7(2):e2354741

Forbes D, LeardMann CA, Lawrence-Wood E, Villalobos J, Madden K, Gutierrez IA, Cowlishaw S, Baur J, Adler AB

Given the prevalence of problematic anger and its association with adverse outcomes, it is vital to develop a very brief measure that can be easily included in research and clinical contexts. Using data from two large military samples with current and former service members in Australia and the US, this study reported on a newly developed 3-item Dimensions of Anger Reactions (DAR-3) scale. The DAR-3 assesses anger intensity, frequency, and duration. Results were consistent across the samples in terms of the scale’s reliability, validity, and cut-off score. The DAR-3 has practical utility for military and veteran populations.

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Longitudinal Assessment of Mental Disorders, Smoking, and Hazardous Drinking Among a Population-Based Cohort of US Service Members Journal of Addiction Medicine 2014 Jul-Aug;8(4):271-281

Smith TC, LeardMann CA, Smith B, Jacobson IG, Miller SC, Wells TS, Boyko EJ, Ryan MAK

This study investigated mental disorders in association with hazardous drinking and cigarette smoking. These prospective data highlight the inter-related nature of these symptoms and behaviors and the potentially complex bi-directional causal pathway. Military health professionals should consider the constellation of potential behaviors and symptoms during the treatment of specific mental health illnesses and negative health behaviors.

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Longitudinal Examination of the Influence of Individual Posttraumatic Stress Disorder Symptoms and Clusters of Symptoms on the Initiation of Cigarette Smoking Journal of Addiction Medicine Sep/Oct;12(5):363-372

Seelig AD, Bensley KM, Williams EC, Armenta RF, Rivera AC, Peterson AV, Jacobson IG, Littman AJ, Maynard C, Bricker JB, Rull RP, Boyko EJ for the Millennium Cohort Study Team

This study examined the risk for smoking initiation by each of the 17 PTSD symptoms that characterize the disorder. No significant associations between specific PTSD symptoms and subsequent smoking initiation were observed in this study population. Among the subsample who screened positive for PTSD, "feeling irritable or having angry outbursts" and "feeling as though your future will somehow be cut short" were associated with a higher risk of subsequent smoking initiation.

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