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
Combat Deployment is Associated with Sexual Harassment or Sexual Assault in a Large, Female Military Cohort Women's Health Issues 2013 Jul-Aug;23(4):e215-23

LeardMann CA, Pietrucha A, Magruder KM, Smith B, Murdoch M, Jacobson IG, Ryan MAK, Gackstetter G, Smith TC, for the Millennium Cohort Study Team

Among female service members, the 3-year cumulative incidence of sexual harassment was 9.4% and sexual assault was 2.1%. Significant risk factors for sexual trauma included prior deployment with combat experience, serving as a Marine, younger age, recent marital separation or divorce, positive screen for a prior mental health condition, moderate/severe life stress, and prior sexual trauma experiences. Understanding the factors associated with sexual harassment and assault can inform future policy and prevention efforts in order to eliminate sexual trauma.

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Combat Experience, New-Onset Mental Health Conditions, and Posttraumatic Growth in U.S. Service Members Psychiatry Fall 2021;84(3):276-290

Jacobson IG, Adler AB, Roenfeldt KA, Porter,B., LeardMann CA, Rull RP, Hoge CW

Research on posttraumatic growth (PTG) after traumatic experiences has raised questions on measurement, validity, and clinical utility. We longitudinally examined PTG among Millennium Cohort Study deployers (n=8,732), who screened negative for PTSD and depression at time 1, using a measure that improved upon previous psychometric issues. A strong inverse correlation was found between PTG scores at time 2 and new onset mental health problems (PTSD, depression), where lower growth scores correlated with worse mental health (i.e. higher PTSD or depression screening scores). Only 5% of participants who screened positive for a mental health problem at time 2 experienced positive growth. Results suggest that measurement of PTG is not independent from mental health problems following combat experiences and thus challenge the clinical utility of the PTG construct.

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Combat exposure and behavioral health in U.S. Army Special Forces PLoS One 2022 Jun 28 | doi: 10.1371/journal.pone.0270515

Rivera AC, LeardMann CA, Rull RP, Cooper A, Warner S, Faix D, Deagle E, Neff R, Caserta R, Adler AB, Millennium Cohort Study Team

In this cross-sectional study using Millennium Cohort Study data, various types of combat, such as combat severity, fighting, threat to oneself, and killing noncombatants, were consistently associated with mental health disorders, trouble sleeping, and problem drinking among all three Army occupational specialization investigated (General Purpose Forces infantrymen, Ranger Qualified infantrymen, and Special Forces personnel). However, with few exceptions, Special Forces personnel and Ranger Qualified infantrymen had lower prevalence of these adverse outcomes. Findings suggest that even elite personnel may be negatively impacted by experiencing combat, thus trainings and interventions focused on moral conflict reasoning and resolution may help to mitigate some of these adverse behavioral outcomes.

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Comparing Self-Reported Physical Activity and Sedentary Time to Objective Fitness Measures in a Military Cohort Journal of Science and Medicine in Sport 2019 Jan;22(1):59-64

de la Motte SJ, Welsh MM, Castle V, Burnett D, Gackstetter GD, Littman AJ, Boyko EJ, and Hooper TI

This was a cross-sectional study of 10,105 Air Force Millennium Cohort participants who completed a physical fitness assessment (PFA) in 2007-2008. Linear regression was used to relate objective PFA measures to self-reported physical activity (PA) and sedentary behavior, and logistic regression was used to examine the risk of PFA failure associated with these self-reported measures. After controlling for demographic characteristics, BMI, and smoking status, we found self-reported PA and screen time were associated with some objective PFA measures, including VO2Max and abdominal circumference. However, screen time alone was associated with odds of PFA failure.

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Comparison of Posttraumatic Stress Disorder Checklist Instruments from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition vs Fifth Edition in a Large Cohort of US Military Service Members and Veterans JAMA Network Open 2021; 4(4): e218072

LeardMann, CA, McMaster HS, Warner S, Esquivel AP, Porter B, Powell TM, Tu XM, Lee WW, Rull RP, Hoge CW, for the Millennium Cohort Study Team

To assist in the longitudinal assessment of PTSD spanning the transition between the DSM-IV and DSM-V, we compared the PTSD Checklist-Civilian version (PCL-C) with the PCL for DSM-5 (PCL-5) in a sample of 1,921 servicemembers. There was substantial to excellent agreement when comparing individual items, frequency of probable PTSD, and sum scores; and nearly identical associations with comorbid conditions. Our results provide support that PTSD can be successfully assessed and compared over time with either PCL instrument in veteran and military populations.

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Contribution of Post-Trauma Insomnia to Depression and Posttraumatic Stress Disorder in Women Service Members: Findings from the Millennium Cohort Study Sleep 2023 Mar 9 | doi: 10.1093/sleep/zsac313

Carlson GC, Sharifian N, Jacobson IG, LeardMann CA, Rull RP, Martin JL

Post-trauma insomnia contributed to the development of depression and PTSD among women service members and veterans; screening for insomnia may help mitigate the development of posttraumatic mental health conditions.

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Demographic and Occupational Predictors of Early Response to a Mailed Invitation to Enroll in a Longitudinal Health Study Biomed Central Medical Research Methodology 2007 Jan;7:6

Chretien JP, Chu LK, Smith TC, Smith B, Ryan MAK, for the Millennium Cohort Study Team

Those who respond first to study invitations, whether to participate or decline, have distinct characteristics within the study population. This information can help structure recruitment efforts.

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Deployment Experiences and Motor Vehicle Crashes Among US Service Members American Journal of Preventive Medicine 2014;46(4):350-358.

Woodall KA, Jacobson IG, Crum-Cianflone NF

Findings indicate experiencing combat during deployment and multiple deployments are strong predictors for a motor vehicle crash (MVC) within the first six months of returning home from deployments in support of Iraq and Afghanistan among U.S. military members. These data provide critical information for targeting prevention strategies to decrease MVCs among personnel postdeployment.

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Deployment, Combat, and Risk of Multiple Physical Symptoms in the US Military: A Prospective Cohort Study Annals of Epidemiology 2016 Feb;26(2):122-8

McCutchan PK, Liu X, LeardMann CA, Smith TC, Boyko EJ, Gore KL, Freed MC, Engel CC

This study examined longitudinal trends in multiple physical symptoms and its relationship to deployment among US military service members and veterans. Those who had deployed and experienced combat were significantly more likely to report multiple physical symptoms at each time point compared with those not deployed and those who deployed without combat, after adjustment for demographic, military, and health characteristics. Longitudinal trends indicate that the probability of reporting multiple physical symptoms has increased consistently over time only for those deployed, regardless of combat experience.

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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

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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