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
A temporal analysis of mental health symptoms relative to separation from the military Depression and Anxiety 2022 Apr;39(4):334- 343

Porter B, Carey FR, Roenfeldt KA, Rull RP, Castro CA

This paper examined mental health symptoms among 23,887 active duty Millennium Cohort Study participants who completed a survey within one year of their separation from the military. While significant, timing prior to or after separation did not have a practical impact on mental health among all study participants, accounting for less than 0.2% of variance in mental health symptoms. However, among participants with Other Than Honorable (i.e., “bad paper”) or General discharges, timing to separation accounted for 5.1% and 3.6% of the variance in posttraumatic stress disorder and depression symptoms, respectively; mental health symptoms increased among these participants around the time of separation and remained elevated in the period following separation. Increased outreach at the time of separation and post-separation is needed for service members with bad paper discharges.

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Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment Journal of the American Medical Association 2008 Aug;300(6):663-75

Jacobson IG, Ryan MAK, Hooper TI, Smith TC, Amoroso PJ, Boyko EJ, Gackstetter GD, Wells TS, Bell NS, for the Millennium Cohort Study Team

Findings suggest that Reserve and National Guard personnel and younger service members who deploy with reported combat exposures are at increased risk of new-onset heavy weekly drinking, binge drinking, and other alcohol-related problems.

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Anthrax Vaccination in the Millennium Cohort: Validation and Measures of Health American Journal of Preventive Medicine 2007 Apr;32(4):347-53

Smith B, Leard CA, Smith TC, Reed RJ, Ryan MAK, for the Millennium Cohort Study Team

The largest ever evaluation of this topic revealed strong validity of self-reported vaccination, as well as unique health features of the small subset who may misreport vaccination. This work won awards at two research conferences in 2006.

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Application of Latent Semantic Analysis for Open-Ended Responses in a Large, Epidemiologic Study BMC Medical Research Methodology 2011 Oct;11:136

Leleu TD, Jacobson IG, LeardMann CA, Smith B, Foltz PW, Amoroso PJ, Derr M, Ryan MAK, Smith TC, for the Millennium Cohort Study Team

Using latent semantic analysis to analyze the final open-ended text field on the Millennium Cohort questionnaire helped identify important topic areas for future survey questions and also revealed the most common areas of concern for participants were illness and injuries, exposures, and exercise. Subjects with worse self-reported general health were more likely to provide a response in the open-ended text field than subjects with better general health.

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Assessing Nonresponse Bias at Follow-Up in a Large Prospective Cohort of Relatively Young and Mobile Military Service Members BMC Medical Research Methodology 2010 Oct;10(1):99

Littman AJ, Boyko EJ, Jacobson IG, Horton JL, Gackstetter GD, Smith B, Hooper TI, Amoroso PJ, Smith TC, for the Millennium Cohort Study Team

In this study population, nonresponse to the follow-up questionnaire did not result in appreciable bias as reflected by comparing measures of association for selected outcomes using complete case and inverse probability weighted methods.

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Association of Combat Experiences With Suicide Attempts Among Active-Duty US Service Members JAMA Network Open 2021;4(2):e2036065

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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Association of Problematic Anger With Long-term Adjustment Following the Military-to-Civilian Transition JAMA Network Open 2022 Jul 1;5(7):e2223236

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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Associations of Military Divorce with Mental, Behavioral, and Physical Health Outcomes BMC Psychiatry 2015; 15:128

Wang L, Seelig AD, MacDermid Wadsworth S, McMaster HS, Alcarez J, Crum-Cianflone NF

This prospective study investigated the associations of recent divorce with health outcomes among US Service members. Findings indicate that recent divorce is associated with adverse mental health outcomes, including new-onset PTSD and depression, and risky behaviors, such as smoking initiation and new-onset alcohol-related problems, after adjusting for relevant demographics and covariates. Given these findings, it is important to make sure resources are available to support recently divorced Service members, since divorce may not only affect personal quality of life, but also military force readiness.

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Baseline Self-Reported Functional Health Predicts Vulnerability to Posttraumatic Stress Disorder Following Combat Deployment: Prospective US Military Cohort Study British Medical Journal 2009 Apr;338:b1273

LeardMann CA, Smith TC, Smith B, Wells TS, Ryan MAK, for the Millennium Cohort Study Team

Military service members who screen in the lowest 15% of health prior to combat exposure are more vulnerable to developing postdeployment PTSD.

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Body Building, Energy, and Weight Loss Supplements are Associated with Deployment and Physical Activity in US Military Personnel Annals of Epidemiology 2012;22:318-330

Jacobson IG, Horton JL, Smith B, Wells TS, Boyko EJ, Lieberman HR, Ryan MAK, Smith TC, for the Millennium Cohort Study Team

Nearly half of the population studied reported use of energy, body building, or weight loss supplements, with energy supplements being the most highly endorsed (38%) supplement type. Deployment experience, physical activity, problem drinking, and suboptimal sleep emerged as important characteristics associated with supplement use, which may be of importance to medical planners and military policy makers in targeting adverse event monitoring and for future research determining how supplements affect performance and health over time.

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