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
Linking exposures and health outcomes to a large population-based longitudinal study: the Millennium Cohort Study Military Medicine 2011 Jul;176(7 Suppl):56-63

Smith TC, for the Millennium Cohort Study Team

Linking Millennium Cohort prospective data to individual-level exposure data is critical for understanding and quantifying any long-term health outcomes potentially associated with unique military occupational exposures.

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Longitudinal assessment of gender differences in the development of PTSD among US military personnel deployed in support of the operations in Iraq and Afghanistan Journal of Psychiatric Research 2015;68:30-36

Jacobson IG, Donoho CJ, Crum-Cianflone NF, Maguen S

Using prospective data from Millennium Cohort Study participants, a propensity score matching technique was used to match 1 male with each female using demographic, military, and behavioral factors including baseline sexual assault. After stratifying by combat experience and adjusting for sexual assault at follow-up, findings revealed no significant gender differences for new-onset postdeployment PTSD among men and women including among those who experienced combat.

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Longitudinal assessment of mental disorders, smoking, and hazardous drinking among a population-based cohort of U.S. service members Journal of Addiction Medicine 2014 Jul-Aug;8(4):271-281

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 assessment of self-reported recent back pain and combat deployment in the Millennium Cohort Study Spine 2016;41:1754–1763

Granado NS, Pietrucha A, Ryan M, Boyko EJ, Hooper TI, Smith B, Smith TC

Among military personnel, back pain is among the most frequent reasons for medical visits and lost duty time, and has been associated with pain-related disability. This study found that 15.5% of participants reported recent back pain at follow-up. Our study confirmed the high burden of this condition in the military, showing that deployers with combat experiences had a 38% higher odds of reporting back pain at follow-up, and 27% higher odds of repeated back pain, compared with deployers without combat experiences. Additionally, exposures associated with a physically demanding work environment were related to a higher risk of back pain. This well-defined group of military personnel would potentially benefit from integrated prevention efforts focused on mitigating and eliminating back pain over time.

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Longitudinal associations among PTSD, disordered eating, and weight gain in military men and women American Journal of Epidemiology 2016 Jul 1;184(1):33-47

Mitchell KS, Porter B, Boyko EJ, Field AE

This study examined longitudinal associations between PTSD, disordered eating, and weight change in Millennium Cohort data from U.S. military Service members who completed the baseline survey and first and second follow-up surveys. The association between PTSD and weight change from time 2 to time 3 was partially mediated by disordered eating symptoms measured at time 2, specifically compensatory behaviors (vomiting, laxative use, fasting, over-exercise). In stratified models, the association between PTSD and weight gain via compensatory behaviors was significant for men and for non-Hispanic white participants only. Results highlight potentially important demographic differences in these associations and emphasize the need for further investigation of eating disorders in military Service members.

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Measuring aggregated and specific combat exposures: associations with posttraumatic stress disorders, depression, and alcohol-related problems Journal of Traumatic Stress In Press

Porter B, Hoge CH, Tobin LE, Donoho CJ, Castro CA, Luxton DD, Faix DJ

This study compared two measures of combat exposure and showed that both measures were similarly predictive of poor mental health. The unique contributions of specific exposures to poor mental health were also examined. While all combat exposure items were related to poor mental health, relatively stronger independent associations were observed for certain exposures (e.g., witnessing instances of physical abuse).
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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