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
Mental Health and Comorbidities in U.S. Military Members Military Medicine 2016 June;181(6):537-45

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

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

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

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 Study Team. Contribution of Post-Trauma Insomnia to Depression and Posttraumatic Stress Disorder in Women Service Members: Findings from the Millennium Cohort Study Sleep In press

Carlson GC, Sharifian N, Jacobson IG, LeardMann CA, Rull RP, Martin JL

Post-trauma insomnia contributed to the development of depression and PTSD among women service members and veterans; screening for insomnia may help mitigate the development of posttraumatic mental health conditions.

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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

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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Millennium Cohort: The 2001-2003 Baseline Prevalence of Mental Disorders in the US Military Journal of Clinical Epidemiology 2007 Feb;60(2):192-201

Riddle JR, Smith TC, Smith B, Corbeil TE, Engel CC, Wells TS, Hoge CW, Adkins J, Zamorski M, Blazer D, for the Millennium Cohort Study Team

The baseline prevalence of mental disorders in this 22-year longitudinal study compares favorably with other civilian and military populations.

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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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New Onset and Persistent Symptoms of Posttraumatic Stress Disorder Self-Reported after Deployment and Combat Exposures: Prospective Population-Based US Military Cohort Study British Medical Journal 2008 Feb;336(7640):366-71

Smith TC, Ryan MAK, Wingard DL, Slymen DJ, Sallis JF, Kritz-Silverstein D, for the Millennium Cohort Study Team

Findings define the importance of PTSD in this population and emphasize that specific combat exposures, rather than deployment itself, significantly affect the onset of PTSD symptoms postdeployment.

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New-Onset Asthma and Combat Deployment: Findings from the Millennium Cohort Study American Journal of Epidemiology 2018 Oct 1;187(10):2136-2144

Rivera AC, Powell TM, Boyko EJ, Lee RU, Faix DJ, Luxton DD, and Rull RP

New-onset asthma developed in 2.7% of men and 4.6% of women during the follow-up period, among participants without a prior diagnosis of asthma at baseline. Compared with those who did not deploy, those who deployed with combat experience were 24-30% more likely to develop asthma, even after controlling for smoking status and other covariates. No elevated risk was observed for deployers who did not experience combat. Additional risk factors for asthma among both men and women included Hispanic ethnicity, overweight or obesity, Army service, stressful life events, PTSD, and health care or other technical occupations.

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