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
Millennium Cohort: Enrollment Begins a 21-year Contribution to Understanding the Impact of Military Service Journal of Clinical Epidemiology 2007 Feb;60(2):181-91

Ryan MA, Smith TC, Smith B, Amoroso P, Boyko EJ, Gray GC, Gackstetter GD, Riddle JR, Wells TS, Gumbs G, Corbeil TE, Hooper TI, for the Millennium Cohort Study Team

A foundation report, this describes original enrollment methods and challenges of the Millennium Cohort Study. Characteristics of the first 77,047 participants are detailed and shown to strongly represent the population-based sample of the US military from which they were drawn.

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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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Problematic Anger and Economic Difficulties: Findings from the Millennium Cohort Study Journal of Affective Disorders 2022 Jan 15;297:679-68

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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A Comparison of the PRIME-MD PHQ-9 and PHQ-8 in a Large Military Prospective Study, The Millennium Cohort Study Journal of Affective Disorders May 2013; 148(1): 77-83

Wells TS, Horton JL, LeardMann CA, Jacobson IG, and Boyko EJ

The PHQ-9 is a validated tool for depression screening, however recently an abbreviated version (PHQ-8) is increasingly being used in survey research that excludes the last and most sensitive item. This study compared the performance of the PHQ-8 with the PHQ-9 in a large, population-based sample of current and former military service members. Excellent agreement was detected between the two instruments, suggesting that the PHQ-8 performs well when screening for depression in similar 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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Posttraumatic Stress Disorder Symptom Association With Subsequent Risky and Problem Drinking Initiation Journal of Addiction Medicine 2018 Sep/Oct;12(5):353-362

Bensley KM, Seelig AD, Armenta RF, Rivera AC, Peterson AV, Jacobson IG, Littman AJ, Maynard C, Bricker JB, Boyko EJ, Rull RP, and Williams EC

This study investigated the association between PTSD symptoms and symptom clusters and the initiation of risky and problem drinking. One PTSD symptom (irritability/anger) was associated with a higher risk of risky drinking initiation. Five PTSD symptoms (restricted affect, sense of foreshortened future, exaggerated startle response, sleep disturbance, and irritability/anger) and two symptom clusters (dysphoric arousal and emotional numbing) were associated with an increased risk of problem drinking initiation.

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Longitudinal Investigation of Military-Specific Factors Associated with Continued Unhealthy Alcohol Use Among a Large US Military Cohort Journal of Addiction Medicine 2020 Jul-Aug; 14(4): e53–e63

Jacobson IG, Williams EC, Seelig AD, Littman AJ, Maynard CC, Bricker JB, Rull RR, Boyko EJ, for the Millennium Cohort Study Team

This study examined military-specific risk factors for continued unhealthy alcohol use (e.g. heavy weekly, heavy episodic, and problem drinking) among service members screening positive on two consecutive surveys. Service members in the Reserve/Guard (compared with Active Duty) and those who separated from military service during follow-up (compared with those remaining on active service) had an elevated risk for continuing unhealthy drinking across all three dimensions of unhealthy alcohol use.

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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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