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
The effect of combat exposure on veteran homelessness Journal of Housing Economics Information In press

Ackerman A, Porter B, Sullivan R

Homelessness is a serious problem among veterans, but now military service contributes to the risk of homelessness is unclear. This study examined the impact of witnessing another's death (a proxy for combat) on likelihood of reporting homelessness. One exposure was associated with a 0.6% increase in homelessness. Extrapolated to the overall population, combat exposure is expected to contribute to 4,600 instances of homeless veterans.

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Health of Army Veterinarians and Veterinary Technicians in the Millennium Cohort Study Journal of the American Veterinary Medical Association In press

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.
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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Sexual Health Problems among Service Men: The Influence of Posttraumatic Stress Disorder Journal of Sex Research 2021 Jan 11:1-13

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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Multiple imputation validation study: Addressing unmeasured survey data in a longitudinal design BMC Medical Research Methodology 2021 Jan 6;21(1):5

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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Posttraumatic Stress Disorder Symptom Clusters in Service Members Predict New-Onset Depression Among Military Spouses Journal of Traumatic Stress 2020 Sep 3. doi: 10.1002/jts.22575

Walter KH, LeardMann CA, Carballo CE, McMaster HM, Donoho CJ, & Stander VA

Among spouses of service members with probable posttraumatic stress disorder (PTSD), 14% met criteria for new-onset depression over a 3-year period. The service member’s PTSD symptom cluster of effortful avoidance was associated with an increased risk of new-onset depression in spouses, underscoring the impact of service member psychological symptoms on the spouse.

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Longitudinal Investigation of Military-Specific Factors Associated with Continued Unhealthy Alcohol Use Among a Large US Military Cohort Journal of Addiction Medicine 2020 Jul-Aug; 14(4): e53–e63

Jacobson IG, Williams EC, Seelig AD, Littman AJ, Maynard CC, Bricker JB, Rull RR, Boyko EJ, for the Millennium Cohort Study Team

This study examined military-specific risk factors for continued unhealthy alcohol use (e.g. heavy weekly, heavy episodic, and problem drinking) among service members screening positive on two consecutive surveys. Service members in the Reserve/Guard (compared with Active Duty) and those who separated from military service during follow-up (compared with those remaining on active service) had an elevated risk for continuing unhealthy drinking across all three dimensions of unhealthy alcohol use.

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Hypertension in Military Veterans Is Associated With Combat Exposure and Combat Injury Journal of Hypertension 2020 Jul;38(7):1293-1301

Howard JT, Stewart IJ, Kolaja C, Sosnov JA, Rull R, Torres I, Janak JC, Walker LE, Trone DW, Armenta RF

This study examined the association between combat injury and incident hypertension. We found that those who were injured during combat were more likely to develop hypertension. Further, inadequate sleep, having PTSD, and being overweight or obese were associated with developing hypertension. Results highlight the importance of hypertension prevention among those who are injured during their time in service.

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Magnitude of Problematic Anger and its Predictors in the Millennium Cohort BMC Public Health 2020;20(1):1168

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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Cervical Screening among U.S. Military Servicewomen in the Millennium Cohort Study, 2003–2015 Medical Surveillance Monthly Report 2020 Jul;27(7):15

Matsuno RK, Porter B, Warner SG, Wells N for the Millennium Cohort Study Team

Across a 13 year period (2003-2015), the percentage of U.S. service women who were up-to-date with cervical cancer screening peaked in 2010, then declined. Screening was generally highest among Air Force personnel and lowest among Navy personnel. Being up-to-date was higher for servicewomen who had initiated the HPV vaccine than for women who had not.

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