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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| Identifying at-risk marines: A person-centered approach to adverse childhood experiences, mental health, and social support | Journal of Affective Disorders | 2023 Mar 15 | doi: 10.1016/j.jad.2023.01.020 |
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Reed-Fitzke K, LeardMann CA, Wojciak AS, Ferraro AJ, Hamilton A, Duncan JM, Rull RP In a sample of male Marines (n=3,881), five subgroups based on adverse childhood experiences were identified. One in five Marines reported moderate to elevated levels of childhood adversity. A history of varying types of childhood adversity characterized by parental absence was associated with greater PTSD and depression symptomology and lower levels of social support. When attempting to identify Marines most at-risk for mental health concerns, the identification of specific patterns of childhood adversity, particularly regarding parental absence, may be more valuable. |
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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 |
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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 |
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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 |
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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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| Posttraumatic Stress Disorder Symptom Association With Subsequent Risky and Problem Drinking Initiation | Journal of Addiction Medicine | 2018 Sep/Oct;12(5):353-362 |
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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 |
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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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| Association of Combat Experiences With Suicide Attempts Among Active-Duty US Service Members | JAMA Network Open | 2021;4(2):e2036065 |
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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 |
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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 | doi: 10.1001/jamanetworkopen.2022.23236 |
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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 | doi: 10.1001/jamanetworkopen.2023.54741 |
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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 scales reliability, validity, and cut-off score. The DAR-3 has practical utility for military and veteran populations. |
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