Publications
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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| The Role of Posttraumatic Stress Symptoms and Negative Affect in Predicting Substantiated Intimate Partner Violence Incidents Among Military Personnel | Military Behavioral Health | 2021;9(4):442–462 |
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Stander, VA, Woodall KA, Richardson SM, Thomsen CJ, Milner JS, McCarroll JE, Riggs DS, Cozza SJ, for the Millennium Cohort Study Team Increasing rates of posttraumatic stress disorder (PTSD) in military populations may indicate heightened risk for aggression, including aggression among domestic partners. Using longitudinal data from the Millennium Cohort Study, we evaluated the association of PTSD symptom clusters and comorbid conditions as predictors of incidents of met criteria incidents of domestic abuse (physical and psychological) from DoD Family Advocacy Program (FAP) Central Registry data. Among 54,667 active-duty personnel who responded to the 2011 survey, FAP records documented 501 participants (1%) with incidents of emotional or physical met criteria incidents of aggression in the data collection period. Results showed that certain aspects of PTSD and behavioral health problems predicted incidents. In particular, general PTSD symptoms (e.g., anger/irritability, sleep disruption) and comorbid alcohol dependence were stronger predictors than trauma-specific PTSD symptomology (e.g., reexperiencing, hypervigilance). These results indicate that clinicians should consider the interpersonal consequences of PTSD and related behavioral problems. |
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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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| Sexual Health Difficulties Among Service Women: The Influence of Posttraumatic Stress Disorder | Journal of Affective Disorders | 2021 Sep 1;292:678-686 |
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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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| Cigarette smoking patterns among U.S. military service members before and after separation from the military | PLoS One | 2021 Oct 4;16(10):e0257539 |
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Nieh C, Mancuso JD, Powell TM, Welsh MM, Gackstetter GD, Hooper TI. Millennium Cohort Study data were used to examine smoking behavior at enrollment into the study and through their first follow-up survey, approximately 3 years later. Time remaining in service from baseline until separation or the first follow-up survey was the main exposure of interest. The baseline prevalence of smoking in the Cohort was higher among those who eventually separated (20.1%) than among those who remained on active service (17.4%), but the overall prevalence of current smokers significantly declined over the observation period. Factors significantly associated with greater likelihood of smoking at follow- up were baseline smoking, non-White Hispanic individuals, being non-married, enlisted rank, underweight or healthy BMI, active duty component, any alcohol consumption, experiencing two or more stressful life events, and screening positive for either PTSD or depression. Including smoking prevention and/or cessation programs in pre-separation counseling sessions and developing smoking screening and cessation programs targeting high-risk subgroups may reduce smoking among Service members and veterans. |
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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 |
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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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| Sexual Health Problems among Service Men: The Influence of Posttraumatic Stress Disorder | Journal of Sex Research | 2021 Jan 11:1-13 |
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Kolaja CA, Roenfeldt K, Armenta RF, Schuyler AC, Orman JA, Stander VA, LeardMann CA Among service men, numerous factors (e.g. older age, lower education, enlisted paygrade, disabling injury, BMI) were associated with sexual health problems. PTSD mediated the associations between stressors (combat deployment and sexual assault) and sexual health outcomes. These findings indicate that sexual health is negatively affected by military-related stressors and comprehensive treatment options are warranted. |
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| Longitudinal associations of military-related factors on self-reported sleep among U.S. service members | Sleep | 2021 Dec 10;44(12):zsab168 |
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Cooper AD, Kolaja CA, Markwald RR, Jacobson IG, Chinoy ED This study examined military factors in relation to the development and reoccurrence of short sleep duration (≤5 hours or 6 hours) and insomnia symptoms (i.e., trouble falling asleep or staying asleep in the past month)over a 3-15 year follow-up period. Military factors consistently associated with an increased risk for development and/or reoccurrence of short sleep duration and insomnia symptoms included active duty service, Army or Marine Corps service, combat deployment, and longer than average deployment lengths. Officers and noncombat deployers had decreased risk for either poor sleep characteristic. Length of service and separation from the military were complex factors; each lowered risk for ≤5 hours sleep but increased risk for insomnia symptoms. Findings suggest that efforts to improve sleep prioritization and implement interventions targeting at-risk military populations, behaviors, and other significant factors are warranted. |
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| Health of Army Veterinarians and Veterinary Technicians in the Millennium Cohort Study | Journal of the American Veterinary Medical Association | 2021 Apr 1;258(7):767-775 |
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Rivera AC, Geronimo-Hara TR, LeardMann CA, Penix EA, Phillips CJ, Faix DJ, Rull RP, Whitmer DL, Adler AB, for the Millennium Cohort Study Team This analysis assessed the risk of mental health problems, suicidal ideation, psychotropic medication use, problem drinking, sleep quality, and lack of social support among 101 Army veterinarians and 334 veterinary technicians compared with other Army medical professionals (856 physicians and dentists and 6,453 medics, respectively) enrolled in the Millennium Cohort Study. Compared with physicians and dentists, veterinarians had elevated risks for mental health problems, trouble sleeping, and lack of social support after adjusting for important factors such as age, sex, race/ethnicity, financial problems, and deployment status. Veterinary technicians had no significantly elevated risks for any of the adverse outcomes of interest compared with medics. |
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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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