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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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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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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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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Newly Reported Hypertension After Military Combat Deployment in a Large Population-Based Study Hypertension 2009 Nov;54(5):966-73

Granado NS, Smith TC, Swanson GM, Harris RB, Shahar E, Smith B, Boyko EJ, Wells TS, Ryan MAK, for the Millennium Cohort Study Team

Findings suggest that deployers who report multiple combat exposures, especially those who personally witnessed a death due to war or disaster, are at higher risk for newly-reported hypertension, possibly indicating a stress-induced hypertensive effect.

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Newly Reported Lupus and Rheumatoid Arthritis in Relation to Deployment Within Proximity to a Documented Open-Air Burn Pit in Iraq Journal of Occupational and Environmental Medicine 2012 June;54(6):698-707

Jones KA, Smith B, Granado NS, Boyko EJ, Gackstetter GD, Ryan MAK, Phillips CJ, Smith TC, for the Millennium Cohort Study Team

This study examined the incidence lupus and rheumatoid arthritis in relation to Army and Air Force personnel deployed within a 3- and 5-mile radius of documented open-air burn pits located in Iraq at Joint Base Balad, Camp Speicher, and Camp Taji. Overall, the results indicate no elevated risk of newly reported lupus or rheumatoid arthritis in the combined three-camp analysis. However, possible exposure at Balad was individually associated with newly reported lupus, although only two cases were at this site. Additional studies, including individual exposure data, are needed to further investigate these associations.

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Newly Reported Respiratory Symptoms and Conditions Among Military Personnel Deployed to Iraq and Afghanistan: A Prospective Population-Based Study American Journal of Epidemiology 2009 Dec;170(11):1433-42

Smith B, Wong CA, Smith TC, Boyko EJ, Gackstetter GD, Ryan MAK, for the Millennium Cohort Study Team

Elevated risk for self-reported respiratory symptoms was found among Army and Marine Corps personnel deployed in support of operations in Iraq and Afghanistan. No increased risk for self-reported asthma, bronchitis, or emphysema was found.

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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

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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