Publications
The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.
| Title | Publication | Date/Location |
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| Sleep Characteristics, Mental Health, and Diabetes Risk: A Prospective Study of US Military Service Members in the Millennium Cohort Study | Diabetes Care | 2013 Oct;36(10):3154-61 |
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Boyko EJ, Seelig AD, Jacobson IG, Hooper TI, Smith B, Smith TC, Crum-Cianflone NF We investigated whether poor sleep and mental health symptoms were independently related to diabetes risk. During 6 years of follow-up, the annual incidence rate for type 2 diabetes was 3.6/1,000 person years. After adjusting for covariates including mental health disorders like posttraumatic stress disorder and depression, both trouble sleeping and sleep apnea significantly predicted diabetes risk independent of these mental health conditions and other diabetes risk factors. |
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| The Impact of Prior Deployment Experience on Civilian Employment After Military Service | Occupational and Environmental Medicine | 2013; 70: 408-417 |
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Horton JL, Jacobson IG, Wong CA, Wells TS, Boyko EJ, Smith B, Ryan MA, and Smith TC Employment after military service, in particular after stressful deployment experiences, is a concern for many veterans and policymakers. Among this large cohort of veterans, we found that prior deployment and PTSD were not significantly associated with job status post-service; in contrast, depression, panic/anxiety disorder, and poor physical health increased the risk of unemployment among certain groups. These findings may guide policy for veterans most in need of post-military employment support. |
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| The Association of Predeployment and Deployment-Related Factors on Dimensions of Postdeployment Wellness in US Military Service Members | The American Journal of Health Promotion | 2013;28:2, 56-66 |
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Bagnell ME, LeardMann CA, McMaster HS, Boyko EJ, Smith B, Granado, NS, and Smith TC This study found that the majority of participants were well post-deployment, and military factors associated with post-deployment wellness included not experiencing combat and being trained as a combat specialist. Modifiable factors significantly associated with post-deployment wellness were also detected, including normal BMI, not smoking, and being physically active. |
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| Risk Factors Associated with Suicide in Current and Former US Military Personnel | Journal of the American Medical Association | 2013;310(5):496-506 |
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LeardMann CA, Powell TM, Smith TC, Bell MR, Smith B, Boyko EJ, Hooper TI, Gackstetter GD, Ghamsary M, Hoge CW Based on data from over 150,000 current and former service members from all service branches, 83 suicide deaths occurred in 707,493 person-years from 2001 through 2008 (11.73/100,000 person-years). Suicide risk was independently associated with depression, manic-depressive disorder, alcohol-related problems, and male gender. None of the deployment or military-related factors were associated with an increased risk for suicide. Assessing service members' prior psychiatric history as well as screening for and treating mental and substance abuse disorders may provide the best potential for mitigating suicide risk. |
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| Longitudinal Assessment of Mental Disorders, Smoking, and Hazardous Drinking Among a Population-Based Cohort of US Service Members | Journal of Addiction Medicine | 2014 Jul-Aug;8(4):271-281 |
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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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| Deployment-Related Depression Screening Results, 2001-2008: Comparing Clinical vs. Research Surveys | American Journal of Preventative Medicine | 2014 Nov;47(5):531-540 |
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Welsh MM, PhD, Federinko SP, Burnett DG, Gackstetter GD, Boyko EJ, Seelig AD, Wells TS, and Hooper TI This study compared depression symptoms reported on military-linked surveys, post-deployment health assessments, with responses from confidential surveys of the Millennium Cohort Study and then evaluated whether any factors were associated with discrepant responses. Moderate agreement was observed between paired survey responses. A higher proportion of active duty members, unmarried participants, and new accessions into military service endorsed depression symptoms on the confidential survey but not the military-linked survey. This study identifies potential subgroups to target for improving follow-up care for optimal mental health. |
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| Impact of Combat Deployment and Posttraumatic Stress Disorder on Newly Reported Coronary Heart Disease Among US Active Duty and Reserve Forces | Circulation | 2014;129:1813-1820 |
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Crum-Cianflone NF, Bagnell ME, Schaller E, Boyko EJ, Smith B, Maynard C, Ulmer CS, Vernalis M and Smith TC This study evaluated the association of combat deployments and posttraumatic stress disorder (PTSD) on coronary heart disease among a young cohort of US service members. Experiencing combat deployment was associated with an increased odds of coronary heart disease by both self-report and medical record diagnosis after adjustment for demographic, military, and mental health characteristics. Screening positive for PTSD was not associated with CHD after adjustment. This study demonstrates that intense and acute stressful life experiences may increase the risk for coronary heart disease over a relatively short period among young adults. |
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| Chronic Multisymptom Illness: A Comparison of Iraq and Afghanistan Deployers with 1991 Gulf War Veterans | American Journal of Epidemiology | 2014;180(12):1176-1187 |
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Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD These data highlight a difference in CMI reporting when comparing deployed to non-deployed military members. While symptom reporting in this contemporary Cohort occurred less frequently than in the historical 1991 GW cohort, increased CMI reporting was noted among deployed compared to non-deployed contemporary Cohort members. |
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| A Longitudinal Comparison of Posttraumatic Stress Disorder and Depression Among Military Service Components | Military Psychology | 2014;26(2): 77–87 |
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Schaller EK, Woodall KA, Lemus H, Proctor SP, Russell DW, Crum-Cianflone NF This study investigated PTSD and depression between Reserve, National Guard and active duty continuously and dichotomously, while adjusting for deployment-related characteristics and other relevant covariates. The findings from this study suggest that Reservists and National Guardsmen do not have significantly higher mean PTSD or depression severity scores nor increased odds of screening positive for PTSD or depression compared with active-duty members over approximately 6 years of follow-up. |
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| US Naval and Marine Corps Occupations, PTSD and Depression Risk and Absenteeism | Journal of Workplace Behavioral Health | 2014;29(2):91–112 |
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Wells TS, Bagnell ME, Miller SC, Smith TC, Gackstetter GD and Boyko EJ for the Millennium Cohort Study Team This study investigated whether military occupation was associated with PTSD or depression, and if PTSD or depression was associated with lost workdays among US Navy and US Marine personnel. Navy personnel in service and supply occupations were 85% more likely to screen positive for new-onset PTSD, while those serving in health care were 58% more likely to screen positive for new-onset depression compared to other occupations. In addition, those with new-onset and persistent PTSD were twice as likely to miss one or more days of work. This suggests that early identification and management of these conditions may improve force readiness. |
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