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
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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Survey response over 15 years of follow-up in the Millennium Cohort Study BMC Medical Research Methodology 2023 Sep 9; 23(1):205 | doi: 10.1186/s12874-023-02018-z

Kolaja CA, Belding JN, Boparai SK, Castañeda SF, Geronimo-Hara TR, Powell TM, Tu XM, Walstrom JL, Sheppard BD, Rull RP; Millennium Cohort Study Team

Across a 3-15 year follow-up period, the average response rate among almost 198,833 Millennium Cohort Study participants was 60%. Factors associated with follow-up survey response over time included increased educational attainment, married status, female sex, older age, military deployment, greater life stress, and poorer mental/physical health status.

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Associations of Military Divorce with Mental, Behavioral, and Physical Health Outcomes BMC Psychiatry 2015; 15:128

Wang L, Seelig AD, MacDermid Wadsworth S, McMaster HS, Alcarez J, Crum-Cianflone NF

This prospective study investigated the associations of recent divorce with health outcomes among US Service members. Findings indicate that recent divorce is associated with adverse mental health outcomes, including new-onset PTSD and depression, and risky behaviors, such as smoking initiation and new-onset alcohol-related problems, after adjusting for relevant demographics and covariates. Given these findings, it is important to make sure resources are available to support recently divorced Service members, since divorce may not only affect personal quality of life, but also military force readiness.

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Factors Associated With Persistent Posttraumatic Stress Disorder Among U.S. Military Service Members and Veterans BMC Psychiatry 2018 Feb 17;18(1):48

Armenta RF, Rush T, LeardMann CA, Millegan J, Cooper AD, Hoge, CW

Among service members and veterans who screened positive for PTSD at baseline, 47% met the criteria for persistent PTSD. Combat experiences and PTSD severity were found to be the most salient factors associated with persistent PTSD; other associated factors included co-morbid conditions, sleep problems, and somatic symptoms. These findings corroborate the need for more comprehensive and accessible treatment to address both PTSD symptoms and comorbid conditions.

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Longitudinal Trajectories of Comorbid PTSD and Depression Symptoms Among U.S. Service Members and Veterans BMC Psychiatry 2019 Dec 13;19(1):396

Armenta RF, Walter KH, Geronimo-Hara TR, Porter B, Stander V, LeardMann CA, for the Millennium Cohort Study Team

This study examined the patterns of PTSD and depression symptoms over time among those with probable comorbid PTSD and depression at baseline. We found that PTSD and depression symptoms tended to move in tandem. Although many service members and veterans experienced a reduction of symptoms over time, one quarter of individuals reported high levels of PTSD and depression symptoms during the almost 12 years of follow-up. Notable factors associated with elevated comorbid PTSD/depression symptoms included older age, combat experiences, and having other co-occurring health problems. Results highlight the need for comprehensive assessment and treatment of comorbid PTSD/depression.

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Posttraumatic Stress Disorder and Risk of Selected Autoimmune Diseases among US Military Personnel BMC Psychiatry 2020 Jan 15; 20 (1):23

Bookwalter DB, Roenfeldt KA, LeardMann CA, Kong SY, Riddle MS,Rull RP

This study investigated the association between PTSD and risk of developing selected autoimmune diseases among US active duty service members. Among 120,572 participants followed for an average of 5 years, risk of any of the selected new-onset autoimmune diseases was 58% higher for those with a history of PTSD compared to those with no history. Observed associations did not differ by specific types of trauma experienced. Future research is needed to understand the physiological pathways that may link PTSD with increased risk of immune-mediated inflammatory diseases.

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The Physical and Mental Health of a Large Military Cohort: Baseline Functional Health Status of the Millennium Cohort BMC Public Health 2007 Nov;7(147):340

Smith TC, Zamorski M, Smith B, Riddle JR, LeardMann CA, Wells TS, Engel CC, Hoge CW, Adkins J, Blazer D, for the Millennium Cohort Study Team

The functional health of service members in this 22-year longitudinal study compares favorably at baseline with other civilian and military populations.

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Health Impact of US Military Service in a Large Population-Based Military Cohort: Findings of the Millennium Cohort Study, 2001-2008 BMC Public Health 2011 Jan;11(1):69

Smith TC, Jacobson IG, Hooper TI, LeardMann CA, Boyko EJ, Smith B, Gackstetter GD, Wells TS, Amoroso PJ, Gray GC, Riddle JR, Ryan MAK, for the Millennium Cohort Study Team

This report summarizes findings from the Millennium Cohort Study through 2008 that have addressed health concerns related to military service. Conducting strategic studies aimed to identify, reduce, and prevent adverse health outcomes in military members have guided public health policy and will continue to affect policy for years to come.

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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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Military service experiences and reasons for service separation among lesbian, gay, and bisexual individuals in a large military cohort BMC Public Health 2022 Jan 6;22(1):39

Carey FR, Jacobson IG, Lehavot K, LeardMann CA, Kolaja CA, Stander VA, Rull RP

The goal of this study was to examine differences in military and service separation experiences by sexual orientation among a large representative sample of United States service members and veterans. Survey data from the 2016 Millennium Cohort Study follow-up questionnaire were used to assess sexual orientation (lesbian, gay, and bisexual [LGB] versus heterosexual) and military experiences and service separation experiences. Of the 99,599 participants, 3.4% identified as LGB. Those service members were more likely than their heterosexual peers to report feeling unimpressed by the quality of unit leadership, unsupported by the military, and negative about the military overall. LGB veterans were more likely than heterosexual peers of the same sex to separate from service for a variety of reasons (e.g., administrative, dissatisfaction with promotions/pay, disability/medical reasons, dissatisfaction with leadership and incompatibility with the military). Less positive military- and separation-specific experiences disproportionately affected LGB service members in this study. Promoting inclusion and increasing support for LGB service members may improve satisfaction with military service and retention.

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