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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| 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 |
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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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| 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 |
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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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| Longitudinal Trajectories of Comorbid PTSD and Depression Symptoms Among U.S. Service Members and Veterans | BMC Psychiatry | 2019 Dec 13;19(1):396 |
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Armenta RF, Walter KH, Geronimo-Hara TR, Porter B, Stander V, LeardMann CA, for the Millennium Cohort Study Team This study examined the patterns of PTSD and depression symptoms over time among those with probable comorbid PTSD and depression at baseline. We found that PTSD and depression symptoms tended to move in tandem. Although many service members and veterans experienced a reduction of symptoms over time, one quarter of individuals reported high levels of PTSD and depression symptoms during the almost 12 years of follow-up. Notable factors associated with elevated comorbid PTSD/depression symptoms included older age, combat experiences, and having other co-occurring health problems. Results highlight the need for comprehensive assessment and treatment of comorbid PTSD/depression. |
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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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| Measuring Aggregated and Specific Combat Exposures: Associations Between Combat Exposure Measures and Posttraumatic Stress Disorder, Depression, and Alcohol-Related Problems | Journal of Traumatic Stress | 2018 Apr;31:296-306 |
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Porter B, Hoge CW, Tobin LE, Donoho CJ, Castro CA, Luxton DD, Faix D This study compared two measures of combat exposure and showed that both measures were similarly predictive of poor mental health. The unique contributions of specific exposures to poor mental health were also examined. While all combat exposure items were related to poor mental health, relatively stronger independent associations were observed for certain exposures (e.g., witnessing instances of physical abuse). |
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| Mental Health and Comorbidities in U.S. Military Members | Military Medicine | 2016 June;181(6):537-45 |
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Crum-Cianflone NF, Powell TM, LeardMann CA, Russell DR, Boyko EJ This study examined incidence rates of mental and behavioral disorders using self-reported and electronic medical record data from US Servicemembers who joined the military after September 11th, 2001. Combat deployers had the highest incidence rates of PTSD, panic/anxiety disorder, and any mental disorder. Of those with recent PTSD, 73% concurrently developed at least one other incident mental or behavioral conditions. Most diagnoses were not represented in the medical records. Findings indicate the high burden of these conditions that are greatly underestimated using medical data alone, demonstrating the value of survey data and screening tools among this population. |
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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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| Military Combat Deployment and Alcohol Use Reply | Journal of the American Medical Association | 2008 Dec;300(22):2607 |
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Jacobson IG, Smith TC, Bell NS Highlights the utility of CAGE screening questions for use as controlling factors for those with potential problems using alcohol at baseline. |
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| Military service experiences and reasons for service separation among lesbian, gay, and bisexual individuals in a large military cohort | BMC Public Health | 2022 Jan 6;22(1):39 |
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Carey FR, Jacobson IG, Lehavot K, LeardMann CA, Kolaja CA, Stander VA, Rull RP The goal of this study was to examine differences in military and service separation experiences by sexual orientation among a large representative sample of United States service members and veterans. Survey data from the 2016 Millennium Cohort Study follow-up questionnaire were used to assess sexual orientation (lesbian, gay, and bisexual [LGB] versus heterosexual) and military experiences and service separation experiences. Of the 99,599 participants, 3.4% identified as LGB. Those service members were more likely than their heterosexual peers to report feeling unimpressed by the quality of unit leadership, unsupported by the military, and negative about the military overall. LGB veterans were more likely than heterosexual peers of the same sex to separate from service for a variety of reasons (e.g., administrative, dissatisfaction with promotions/pay, disability/medical reasons, dissatisfaction with leadership and incompatibility with the military). Less positive military- and separation-specific experiences disproportionately affected LGB service members in this study. Promoting inclusion and increasing support for LGB service members may improve satisfaction with military service and retention. |
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| 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 |
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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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