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
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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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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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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