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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| Combat exposure and behavioral health in U.S. Army Special Forces | PLoS One | 2022 Jun 28 | doi: 10.1371/journal.pone.0270515 |
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Rivera AC, LeardMann CA, Rull RP, Cooper A, Warner S, Faix D, Deagle E, Neff R, Caserta R, Adler AB, Millennium Cohort Study Team In this cross-sectional study using Millennium Cohort Study data, various types of combat, such as combat severity, fighting, threat to oneself, and killing noncombatants, were consistently associated with mental health disorders, trouble sleeping, and problem drinking among all three Army occupational specialization investigated (General Purpose Forces infantrymen, Ranger Qualified infantrymen, and Special Forces personnel). However, with few exceptions, Special Forces personnel and Ranger Qualified infantrymen had lower prevalence of these adverse outcomes. Findings suggest that even elite personnel may be negatively impacted by experiencing combat, thus trainings and interventions focused on moral conflict reasoning and resolution may help to mitigate some of these adverse behavioral outcomes. |
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| The relative impact of injury and deployment on mental and physical quality of life among military service members | PLoS One | 2022 Sep 29 | doi: 10.1371/journal.pone.0274973 |
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Kolaja CA, Castañeda SF, Woodruff SI, Rull RP, Armenta RF Deployment and injury status was associated with poorer mental and physical quality of life (QOL) with clinically significant decreases in physical QOL observed for those who deployed and were injured, either in battle or nonbattle settings, compared with uninjured deployers. |
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| The Impact of Prior Deployment Experience on Civilian Employment After Military Service | Occupational and Environmental Medicine | 2013; 70: 408-417 |
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Horton JL, Jacobson IG, Wong CA, Wells TS, Boyko EJ, Smith B, Ryan MA, and Smith TC Employment after military service, in particular after stressful deployment experiences, is a concern for many veterans and policymakers. Among this large cohort of veterans, we found that prior deployment and PTSD were not significantly associated with job status post-service; in contrast, depression, panic/anxiety disorder, and poor physical health increased the risk of unemployment among certain groups. These findings may guide policy for veterans most in need of post-military employment support. |
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| Association of deployment with maintenance of healthy weight among active duty service members in the Millennium Cohort Study | Obesity Science and Practice | 2022 Apr;8(2):247-253 |
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Carey FR, Jacobson IG, Roenfeldt KA, Rull RP Understanding changes in weight in relation to deployment readiness can inform Department of Defense fitness policies. This study examined longitudinal associations between deployment and service branch-specific changes in body mass index (BMI) among active duty participants without obesity (BMI< 30kg/m2) at baseline (n=22,995). Service members, particularly Army and Marine Corps personnel, with longer deployments were less likely to maintain a healthy weight (BMI < 30) than those with shorter deployment lengths. Conversely, each additional deployment increased the likelihood of maintaining a healthy weight post-deployment for personnel in the Army, Marine Corps, and within the pooled population. These results indicate that multiple deployments may support healthy weight maintenance and longer deployments may adversely impact weight maintenance. Fitness policies designed to optimize service member readiness should consider modifiable behaviors related to weight gain among those who are deployed for long periods of time. |
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| Post-Traumatic Stress Disorder Predicts Future Weight Change in the Millennium Cohort Study | Obesity | 2015 Apr;23(4):886-92 |
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LeardMann CA, Woodall KA, Littman AJ, Jacobson IG, Boyko EJ, Smith B, Wells TS, Crum-Cianflone NF Data from Millennium Cohort Study participants (2001-2008), consisting of US Service members and Veterans, were used to prospectively examine the association between posttraumatic stress disorder (PTSD) and weight change. A significant and consistent association of PTSD with subsequent three-year weight gain and the development of obesity was found in adjusted models. Given these findings, weight gain and development of obesity should be considered important comorbidities for PTSD; existing screening and treatment programs should make sure to address these associated conditions. |
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| Obesity and Associated Adverse Health Outcomes Among US Military Members: Findings from the Millennium Cohort Study | Obesity | 2016 Jul;24(7):1582-1589 |
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Rush T, LeardMann CA, Crum-Cianflone NF This study examined body weight among Service members and Veterans over time (2001-2007), finding a doubling of the prevalence of obesity. Obesity rates were significantly higher among veterans, including among those recently discharged from service. The study found that military personnel, even during service time, experienced weight gain and the development of obesity. Individuals with obesity had higher rates of adverse physical, mental, and functional health, suggesting that weight control should be a DoD and national priority. |
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| Hearing Loss Associated with US Military Combat Deployment | Noise and Health | 2015 Jan-Feb; 74(17): 34-42 |
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Wells TS, Seelig AD, Ryan MAK, Jones JM, Hooper TI, Jacobson IG, Boyko EJ This study investigated hearing loss among Service members and Veterans. New-onset hearing loss was associated with combat deployment. Among those who had deployed, new-onset hearing loss was also associated with proximity to improvised explosive devices and experiencing a combat-related head injury. These findings have implications for health care and disability planning, as well as for prevention programs. |
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| A Longitudinal Comparison of Posttraumatic Stress Disorder and Depression Among Military Service Components | Military Psychology | 2014;26(2): 77–87 |
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Schaller EK, Woodall KA, Lemus H, Proctor SP, Russell DW, Crum-Cianflone NF This study investigated PTSD and depression between Reserve, National Guard and active duty continuously and dichotomously, while adjusting for deployment-related characteristics and other relevant covariates. The findings from this study suggest that Reservists and National Guardsmen do not have significantly higher mean PTSD or depression severity scores nor increased odds of screening positive for PTSD or depression compared with active-duty members over approximately 6 years of follow-up. |
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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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| The Millennium Cohort Study: A 21-Year Prospective Cohort Study of 140,000 Military Personnel | Military Medicine | 2002 Jun;167(6):483-8. |
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Gray GC, Chesbrough KB, Ryan MAK, Amoroso P, Boyko EJ, Gackstetter GD, Hooper TI, Riddle JR, for the Millennium Cohort Study Group The origins and development of the Millennium Cohort Study are described. The largest prospective study in military history was established to answer the most difficult questions about long-term health after military service. |
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