Mental health stigma has been identified as a barrier to help-seeking in the United States. This may be particularly salient for military personnel who tend to report higher mental health stigma than the general population. Evidence suggests that both supportive and destructive military leadership are related to service members’ attitudes toward seeking help. In the current study, a sample of military service members and Veterans (N = 232) completed an online survey regarding mental health stigma, previous experiences with military leaders, and mental health help-seeking behaviors. Findings indicated that destructive and supportive leadership experiences were significantly related to self stigma, public stigma, and help-seeking. Military members and Veterans who experienced destructive leadership were more likely to report internalized mental health stigma, which decreased the likelihood of seeking help. Supportive leadership, on the other hand, was associated with greater likelihood of seeking help for mental health concerns, and was indirectly related to help-seeking through lower self-stigma. Findings suggest that the military leadership style plays a significant role in service members’ and Veterans’ willingness to seek assistance for mental health concerns.
Search Results
Library (17)
Showing library results for: August 2022
1 - 17 of 17
1 Military and veteran help-seeking behaviors: Role of mental health stigma and leadership
Military and veteran help-seeking behaviors: Role of mental health stigma and leadership
APA Citation:
McGuffin, J. J., Riggs, S. A., Raiche, E. M., & Romero, D. H. (2021). Military and veteran help-seeking behaviors: Role of mental health stigma and leadership. Military Psychology, 33(5), 332-340. https://doi.org/10.1080/08995605.2021.1962181
Focus:
Mental health
Trauma
Veterans
Branch of Service:
Army
Air Force
Marine Corps
Navy
Multiple branches
Military Affiliation:
Active Duty
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
McGuffin, James J.; Riggs, Shelley A.; Raiche, Emily M.; Romero, Daniel H.
2021
2 Barriers to licensure for military spouse registered nurses
Barriers to licensure for military spouse registered nurses
APA Citation:
Brannock, M. K., & Bradford, N. A. (2021). Barriers to licensure for military spouse registered nurses. Journal of Nursing Regulation, 11(4), 4-14. https://doi.org/10.1016/S2155-8256(20)30170-8
Focus:
Programming
Other
Branch of Service:
Air Force
Army
Coast Guard
Marine Corps
Navy
Multiple branches
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Brannock, Mary K.; Bradford, Nicole A.
2021
Background : By 2030, one million registered nurses (RNs) in the United States are projected to retire, which will exacerbate an existing U.S. nurse shortage. Reasons for the shortage include retiring RNs, an aging population, nurse burnout, and fewer nurse educators. Interestingly, military spouse RNs face unique hurdles to employment. Nursing is among the most common professions for military spouses, yet 89% of spouses did not relicense after a military move (Bradbard et al., 2016). Purpose The aim of this study was to better understand the military spouse RN landscape as it relates to barriers and facilitators to employment and the feasibility of licensure innovation. Methods A mixed methods feasibility review of 191 completed surveys and 14 semi-structured in-depth interviews were completed with military spouse RNs. Additionally, 5 stakeholder in-depth interviews were conducted and represent voices from hospitals, government, patient safety, and non-profit organizations. Results Multiple challenges with licensing were noted. More than 35% of the surveyed RN sample indicated they considered leaving the field of nursing due to constant licensing issues. Stakeholders and nurses aligned on the need for a unified platform that could assist with licensing, and preliminary feasibility was obtained for license innovation. Conclusion Differing state licensure requirements are a significant barrier to military spouses staying in the nursing workforce. Enhancing compacts or allowing special regulation for this population is critical not only to improve patient health outcomes, but also to support military families and the unique challenges they face as a result of frequent relocations.
3 COVID‐19 and the relationships and involvement of nonresident fathers
COVID‐19 and the relationships and involvement of nonresident fathers
APA Citation:
Adamsons, K. (2022). COVID-19 and the relationships and involvement of nonresident fathers. Family Relations, 71(3), 827-848. https://doi.org/10.1111/fare.12663
Focus:
Parents
Children
Mental health
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Adamsons, Kari
2022
Objective Background Method Results Conclusion and Implications To support nonresident fathers in maintaining involvement and relationships with their children during the COVID‐19 pandemic, we must understand how such fathers have been impacted thus far by the pandemic.All families have been impacted by the pandemic, but fathers who do not reside with their children are particularly likely to be negatively impacted. Social distancing, restrictions on travel, job loss/economic downturn, family court closures, and numerous other effects of the COVID‐19 crisis impact the ability of nonresident fathers to maintain relationships and involvement with their children.The current study analyzed retrospective data from 373 nonresident U.S. fathers to assess perceived parenting and coparenting changes during the pandemic, as well as whether coparenting relationships and mental health were associated with their involvement and relationships with their children.On average, fathers' involvement, father–child relationship quality, and coparenting support declined, but wide variability also existed, with a substantial minority of fathers reporting increased involvement. Coparenting support was positively associated with current levels of involvement and relationship quality as well as changes to both since the pandemic, but mental health was inconsistently associated with outcomes.To keep these average declines from becoming permanent, future research should investigate what factors foster higher involvement and improved relationships. Practitioners should offer additional support to nonresident fathers to promote their involvement and relationships in ways compatible with evolving restrictions.
Association of gonadotropin-releasing hormone analogue use with subsequent use of gender-affirming hormones among transgender adolescents
APA Citation:
Nos, A. L., Klein, D. A., Adirim, T. A., Schvey, N. A., Hisle-Gorman, E., Susi, A., & Roberts, C. M. (2022). Association of gonadotropin-releasing hormone analogue use with subsequent use of gender-affirming hormones among transgender adolescents. JAMA Network Open, 5(11), Article e2239758. https://doi.org/10.1001/jamanetworkopen.2022.39758
Focus:
Physical health
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Share the article
Research
Nos, Andrea L.; Klein, David A.; Adirim, Terry A.; Schvey, Natasha A.; Hisle-Gorman, Elizabeth; Susi, Apryl; Roberts, Christina M.
2022
Gonadotropin-releasing hormone analogue (GnRHa) use during puberty improves mental health among transgender and gender-diverse (TGD) adolescents. In previous studies, most (96.5%-98.1%) TGD adolescents who started GnRHa subsequently started gender-affirming hormones (GAH), raising concerns that GnRHa use promotes later use of GAH.To determine whether GnRHa use among TGD adolescents is associated with increased subsequent GAH use.This is a retrospective cohort study of administrative records collected between 2009 and 2018. The current analysis was completed in August 2022. Participants were enrolled in the US Military Healthcare System (MHS) with an initial TGD-related encounter occurring between ages 10 and 17 years.GnRHa use.Initiation of GAH.The 434 patients were a mean (SD) of 15.4 (1.6) years old at the time of their first TGD-related encounter; 312 (71.9%) were assigned female at birth, and 300 (69.1%) had an enlisted insurance sponsor. GnRHa use was more common among patients who were assigned male at birth (28 patients [23.0%]) than those assigned female (42 patients [13.5%]), but GAH use was not. Socioeconomic status was not associated with GnRHa or GAH use. Compared with older patients (aged 14-17 years), those who were younger (aged 10-13 years) at the time of the initial TGD-related encounter had a higher rate of GnRHa use (32 patients [57.1%] vs 38 patients [10.1%]) and a longer median time to starting GAH. The median interval from the date of the initial encounter to starting GAH decreased over time, from 2.3 years (95% CI, 1.7-2.8 years) between October 2009 and December 2014 to 0.6 years (95% CI, 0.5-0.6 years) between September 2016 and April 2018. Patients who were prescribed GnRHa had a longer median time to starting GAH (1.8 years; 95% CI, 1.1-2.4 years) than patients who were not (1.0 years; 95% CI, 0.8-1.2 years) and were less likely to start GAH during the 6 years after their first TGD-related encounter (hazard ratio, 0.52; 95% CI, 0.37-0.71). Among 54 younger (aged 10-13 years) patients who were not eligible to start GAH at their first encounter, GnRHa use was associated with a longer median time to starting GAH, but age at the first TGD-related visit was not.In this cohort study of TGD adolescents, GnRHa use was not associated with increased subsequent GAH use. These findings suggest that clinicians can offer the benefits of GnRHa treatment without concern for increasing rates of future GAH use.
5 Suicide Ideation, Plans, and Attempts Among Military Veterans vs Nonveterans With Disability
Suicide Ideation, Plans, and Attempts Among Military Veterans vs Nonveterans With Disability
APA Citation:
Blais, R. K., Xie, Z., Kirby, A. V., & Marlow, N. M. (2023). Suicide ideation, plans, and attempts among military veterans vs nonveterans with disability. JAMA Network Open, 6(10), Article e2337679. https://doi.org/10.1001/jamanetworkopen.2023.37679
Focus:
Veterans
Physical health
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research
Blais, Rebecca K.; Xie, Zhigang; Kirby, Anne V.; Marlow, Nicole M.
2023
People with disability are at heightened risk for suicide ideation, planning, and attempt, with risk growing as the number of disabling limitations increases. Military veterans have higher rates of suicide deaths and disability relative to nonveterans.To evaluate whether veteran status is associated with greater risk for suicide in those with disability.This survey study used cross-sectional self-reported data from US adults who participated in the 2015-2020 National Survey on Drug Use and Health. Data were weighted to represent the population. Data analysis was conducted from July to August 2022.Suicide ideation, planning, and attempt served as primary outcomes. Disability status (present or absent) and number of disabling limitations (1, 2, or ≥3) served as factors. Veteran status was determined based on self-report (veteran or nonveteran). Multivariable logistic regression examined suicide ideation, planning, and attempt as a function of veteran status and disability variables.Participants included 231 099 US veterans and nonveterans, representing 236 551 727 US adults, of whom 20.03% (weighted n = 47 397 876) reported a disabling limitation, 8.92% were veterans (weighted n = 21 111 727; 16.0% aged 35-49 years; 91.0% men; 6.7% Hispanic; 10.9% non-Hispanic Black; and 78.4% non-Hispanic White) and 91.08% were nonveterans (weighted n = 215 440 000; 25.4% aged 35-49 years; 44.0% male; 16.5% Hispanic; 11.7% non-Hispanic Black; and 63.3% non-Hispanic White). Overall, 4.39% reported suicide ideation, planning, or attempt (weighted n = 10 401 065). Among those with no disability, veteran status was associated with higher risk of suicide planning (adjusted odds ratio [AOR], 1.71; 95% CI, 1.17-2.49). Among those with 1 or 2 disabling limitations, being a veteran was associated with a lower risk of suicide planning (AOR, 0.57; 95% CI, 0.34-0.95) and history of attempt (AOR, 0.46; 95% CI, 0.24-0.88).In this study of how suicide risk differs as a function of disability and veteran status, risk for death by suicide was lower among veterans with disability relative to nonveterans with disability. Veteran status may mitigate risk for suicide given increased receipt of more disability-related care through the Department of Veterans Affairs. Further research would extend this line of inquiry by examining the cause and type of disability as well as perceptions of disability on self-worth. It is possible that physical wounds of war are protective because of the meaning and value of service to one’s country.
Evaluation of the NHS England ‘Op COURAGE’ high intensity service for military veterans with significant mental health problems
APA Citation:
Finnegan, A., Salem, K., Green, N., Ainsworth-Moore, L., & Ghomi, M. (2023). Evaluation of the NHS England ‘Op COURAGE’ high intensity service for military veterans with significant mental health problems. BMJ Mil Health. Advance online publication. https://doi.org/10.1136/military-2023-002385
Focus:
Mental health
Veterans
Branch of Service:
International Military
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research
Finnegan, Alan; Salem, K.; Green, N.; Ainsworth-Moore, L.; Ghomi, M.
2023
Introduction In November 2020, The NHS for England launched a pilot High Intensity Service (HIS) programme for treating military veterans complex mental health problems. Seven regional grants were awarded to manage the HIS, including NHS Solent, in South East England. This paper details an evaluation of the HIS, which was conducted from February 2021 to August 2022. Methods This mixed-methods study gained quantitative data from a specifically designed questionnaire that included a number of validated psychometric questionnaires. These were completed by either HIS staff or beneficiaries at entry and exit from the HIS, and qualitative data were gained from semi-structured interviews with the HIS staff. Results Data were sourced from 45 pre-questionnaires, 25 post programme questionnaires and 11 interviews. This evaluation identified reductions in situational stressors, symptoms and reported illnesses for veterans in crisis. There were reductions in depression, anxiety and post-traumatic stress disorder following programme exit. Staff reported that there was no notable changes in stress levels which appeared to remain high at programme exit. Staff interviews highlighted the importance of simultaneously understanding the social and psychological needs of veterans in mental health crisis. The benefits of integrating veteran staff members into military veteran health services were identified, demonstrating improvements in education around military culture in civilian services. Conclusions The importance of collaboration between clinical and veteran staff members in veteran health services was noted, demonstrating the positive impact social care provision has on veteran’s overall health and well-being. Veteran engagement with the service was advocated as a result of veterans accessing the service feeling understood. This first independent evaluation of the HIS provides a positive reflection, and adds to the limited empirical evidence exploring veteran engagement in health services.
‘Whether it’s your weapon or not, it’s your home’: US military spouse perspectives on personal firearm storage
APA Citation:
Betz, M. E., Meza, K., Friedman, K., Moceri-Brooks, J., Johnson, M. L., Simonetti, J., Baker, J. C., Bryan, C. J., & Anestis, M. D. (2023). ‘Whether it’s your weapon or not, it’s your home’: US military spouse perspectives on personal firearm storage. BMJ Mil Health. Advance online publication. https://doi.org/10.1136/military-2023-002591
Focus:
Couples
Other
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Guard
Reserve
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research
Betz, Marian E.; Meza, K.; Friedman, K.; Moceri-Brooks, J.; Johnson, M. L.; Simonetti, J.; Baker, J. C.; Bryan, C. J.; Anestis, M. D.
2023
Introduction In the USA, an estimated 45% of veterans personally own firearms. Firearm access increases the risk of suicide, so suicide prevention efforts in the US Department of Defense (DoD) focus on lethal means safety, including reducing firearm access. Spouse input may enhance effective messaging and intervention delivery of lethal means safety. This study used qualitative methods to explore the perspectives of military spouses or partners on personal firearm storage, including at-home decisions, on-base storage and existing messaging from the DoD. Materials and methods Qualitative data were obtained using 1:1 interviews and focus groups with spouses/partners of US military service members (active duty, Reserve, National Guard, recently separated from the military) and representatives from military support organisations. Sessions focused on personal firearm storage (at home or on military installations) and military messaging around secure firearm storage and firearm suicide prevention. Data were analysed using a team-based, mixed deductive–inductive approach. Results Across 56 participants (August 2022–March 2023), the themes were variability in current home firearm storage and spousal participation in decision-making; uncertainty about firearm storage protocols on military installations; mixed awareness of secure firearm storage messaging from the military; and uncertainty about procedures or protocols for removing firearm access for an at-risk person. Conclusion US military spouses are important messengers for firearm safety and suicide prevention, but they are currently underutilised. Tailored prevention campaigns should consider spousal dynamics and incorporate education about installation procedures.
Designing a knowledge translation tool for women’s health research in the U.S. Military Health System
APA Citation:
Janvrin, M. L., Korona-Bailey, J., & Koehlmoos, T. P. (2023). Designing a knowledge translation tool for women’s health research in the U.S. Military Health System. Health Research Policy and Systems, 21, Article 47. https://doi.org/10.1186/s12961-023-01002-9
Focus:
Physical health
Programming
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research
Janvrin, Miranda Lynn; Korona-Bailey, Jessica; Koehlmoos, Tracey Perez
2023
Background Current United States Department of Defense (DoD) estimates indicate that women comprise 17% of the total active duty component. Despite this, the specific health needs of service women have often been neglected. The Center for Health Services Research (CHSR) at the Uniformed Services University (USU) has been working to create a portfolio of rapid research synthesis briefs on topics including, but not limited to reproductive health, infertility, pregnancy loss, and contraceptive use among active duty service women. The goal of these briefs is to condense and translate the existing research literature for a non-academic audience. The aim of this study is to evaluate the utility of the research briefs to inform decision making around service women’s health issues and impart an overall understanding of the current literature surrounding these topics to a non-academic audience. Methods Adopting a previously tested knowledge translation evaluation tool, we conducted a series of key informant interviews in July–August 2022 with decision makers in the Military Health System and the US DoD to elicit feedback regarding the overall utility of the research brief, as well as its ability to meet standards of usefulness, usability, desirability, credibility, and value. Results We interviewed a total of 17 participants of a diverse range of healthcare occupations and educational backgrounds, but all currently were working within the Department of Defense in support of the Military Health System. User feedback on the research brief was thematically evaluated based on the predetermined themes of usefulness, desirability, credibility, value, and two emergent themes—findability and language. Conclusions This study allowed us to gather key insights from decision makers to better tailor future iterations of our research brief toward rapidly disseminating information for improving the healthcare and policy of active duty service women. The key themes ascertained from this study may help others when adapting their own knowledge translation tools.
Mechanisms of the association between PTSD and sexual arousal and lubrication functioning among trauma-exposed female service members/veterans
APA Citation:
Blais, R. K., Bird, E., Sartin-Tarm, A., Campbell, S. B., & Lorenz, T. (2022). Mechanisms of the association between PTSD and sexual arousal and lubrication functioning among trauma-exposed female service members/veterans. Journal of Affective Disorders, 301, 352-359. https://doi.org/10.1016/j.jad.2021.12.106
Focus:
Mental health
Physical health
Trauma
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Veteran
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Blais, Rebecca K.; Bird, Elizabeth; Sartin-Tarm, Annaliis; Campbell, Sarah B.; Lorenz, Tierney
2021
Background The presence of a post-traumatic stress disorder (PTSD) diagnosis or higher PTSD severity is associated with higher overall sexual dysfunction in female service members/veterans. However, the mechanisms linking PTSD to specific components of women's sexual arousal function, like lubrication and mental arousal, are unknown. Methods We conducted a survey among 464 women who reported probable Criterion A exposure for PTSD. Path analysis examined (1) the association of PTSD with sexual arousal, (2) whether specific PTSD symptom clusters were uniquely associated with sexual arousal, and (3) whether this association is indirect, through the effects of higher depression severity and lower romantic relationship satisfaction. Arousal was operationalized to measure both mental (subjective arousal) and physical (lubrication) experiences. Results Higher PTSD severity was associated with lower lubrication and arousal function. The association of PTSD severity with arousal was indirect, through lower romantic relationship satisfaction (estimate: -0.12; 95% CI: [-0.014, -0.007]) and higher depression (estimate: -0.08, 95% CI: [-0.012, -0.002]). The association of PTSD severity with lubrication was also indirect, but only through lower relationship satisfaction (estimate: -0.10, 95% CI: [-0.013, -0.006]). PTSD symptom clusters were not uniquely associated with arousal and lubrication through mediated pathways. Limitations Data were from a cross-sectional study using a convenience sample. Criterion A exposure could not be confirmed. Conclusions PTSD may lead to arousal and lubrication dysfunction by contributing to higher depression severity and strained romantic relationships. Interventions targeting reductions in depressive symptoms and bolstering relationship satisfaction may minimize the burden of PTSD on sexual arousal concerns.
Emotionally focused couple therapy within VA healthcare: Reductions in relationship distress, PTSD, and depressive symptoms as a function of attachment-based couple treatment
APA Citation:
Ganz, M. B., Rasmussen, H. F., McDougall, T. V., Corner, G. W., Black, T. T., & De Los Santos, H. F. (2022). Emotionally focused couple therapy within VA healthcare: Reductions in relationship distress, PTSD, and depressive symptoms as a function of attachment-based couple treatment. Couple and Family Psychology: Research and Practice, 11(1), 15–32. https://doi.org/10.1037/cfp0000210
Focus:
Couples
Veterans
Branch of Service:
Army
Navy
Marine Corps
Air Force
Coast Guard
Multiple branches
Military Affiliation:
Veteran
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Ganz, Michael B.; Rasmussen, Hannah F.; McDougall, Tatiana V.; Corner, Geoffrey W.; Black, Tabitha T.; De Los Santos, Hector F.
2021
Emotionally Focused Couple Therapy (EFT) is a well-established, attachment-based treatment for relationship distress. This study seeks to further previous research by examining the impact of EFT on veterans’ and their partners’ symptoms of posttraumatic stress disorder (PTSD), depression, and relationship distress, in a real-life clinical setting. The present study uses dyadic data analyses to test three hypotheses: from pre to posttherapy veterans and their partners would report (a) increases in relationship satisfaction and decreases in (b) PTSD and (c) depression symptoms. In addition, we tested whether diagnostic status at the start of therapy, that is, meeting clinical criteria for that outcome, moderated the changes. Data were collected as part of routine care at an outpatient clinic at a Veterans Affairs (VA) Hospital. The sample consisted of 29 couples. Pre and postmeasures were obtained at the first and final sessions (Msessions = 15.52 SD = 7.19). Multilevel models examining changes across time for all partners found that the difference between pre and posttherapy scores for relationship satisfaction (b = 10.85, p b = −1.61, p b = 13.93, p b = −12.39, p b = −7.64, p < .001). Although PTSD and depression are not the focus of treatment, results indicate EFT is effective at reducing relationship distress and individual symptomatology in veterans and their partners.
Transgenerational factors associated with military service: Comparison of children of veterans and nonveterans in a nationally representative sample
APA Citation:
Bommersbach, T. J., Rosenheck, R., & Rhee, T. G. (2022). Transgenerational factors associated with military service: Comparison of children of veterans and nonveterans in a nationally representative sample. Journal of the American Academy of Child and Adolescent Psychiatry, 61, 1141-1154. https://doi.org/10.1016/j.jaac.2022.03.024
Focus:
Children
Mental health
Physical health
Veterans
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Reserve
Guard
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
School age (6 - 12 yrs)
Share the article
Research & Summary
Bommersbach, Tanner J.; Rosenheck, Robert; Rhee, Greg
2022
Objective While the psychological effects of military service on the children of active-duty personnel have been studied extensively, little is known about the potential effects of military service for children of veterans after service has ended. Method Using nationally-representative data from the 2018-2019 National Survey of Children’s Health (NSCH), we compare the school-age children of veteran families (n=4,028) to those of non-veteran families (n=38,228). Due to large sample sizes, effect sizes (relative risk and Cohen’s d), rather than p values, were used to identify substantial differences in caregiver-reported sociodemographic, clinical, and school performance factors between children and caregivers in families with and without a veteran caregiver. Multivariate analyses were used to adjust for socio-economic factors that could increase health service use. Results Children of veteran families were more likely to have higher family incomes, health insurance, and married caregivers but are also reported to have higher rates of clinically-recognized externalizing behavioral conditions (ADD/ADHD or conduct) (17.6% vs. 12.7%, relative risk, 1.42; 95% confidence intervals (CI), 1.21-1.66) and adverse childhood experiences; but no substantial differences in clinically-recognized anxiety or depression. After adjustment for potentially confounding factors, children in veteran families were still more likely to be reported to have externalizing problems (odds ratio, 1.34; 95% CI, 1.02-1.77). Conclusion After adjustment for socio-economic advantages that may increase health service use, children of veteran families demonstrate substantially higher rates of clinically-recognized externalizing problems. While explanations for this require further study, service systems working with veterans may consider integrating child-focused screening/services.
Quantifying the emotional experiences of partners of veterans with PTSD service dogs using ecological momentary assessment
APA Citation:
Nieforth, L. O., Abdul Wahab, A. H., Sabbaghi, A., MacDermid Wadsworth, S., Foti, D., & O’Haire, M. E. (2022). Quantifying the emotional experiences of partners of veterans with PTSD service dogs using ecological momentary assessment. Complementary Therapies in Clinical Practice, 48, Article 101590. https://doi.org/10.1016/j.ctcp.2022.101590
Focus:
Couples
Mental health
Veterans
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Nieforth, Leanne O.; Abdul Wahab, Ahmad Hakeem; Sabbaghi, Arman; MacDermid Wadsworth, Shelley; Foti, Daniel; O'Haire, Marguerite E.
2022
The objective of this study was to investigate the day-to-day experiences of positive and negative emotions among partners of veterans assigned service dogs for posttraumatic stress disorder (PTSD). As part of a larger clinical trial, a total of N = 87 partners of post-9/11 veterans with PTSD were recruited from a nonprofit service dog provider and participated in an ecological momentary assessment (EMA) protocol. The sample included partners of veterans who received a PTSD service dog after baseline (n = 48, treatment group) and partners of veterans on the waitlist for a service dog (n = 39, control group). Data were collected twice daily for two weeks at baseline and again at follow-up three months later, for approximately 56 assessments per participant (28 at baseline, 28 at follow up). Participants completed an average of 84% of questionnaires at baseline (n = 23.6) and 86% (n = 24.1) at follow-up. A total of 3780 EMA questionnaires were collected among partners for this analysis. Data were analyzed using a generalized linear mixed model. Three months following baseline, partners of veterans with service dogs reported statistically significant higher levels of positive emotions than the control partners (p = .01, d = 0.39) with small-to-medium effect sizes for each individual positive emotion. No statistically significant differences were reported for negative emotions (p = .77, d = 0.21). This study quantitatively identifies higher levels of positive emotion in partners who are cohabitating with a PTSD service dog compared to those partners who remained on the waitlist. Given the influence that positive emotions have on well-being and coping, findings suggest that the influence of service dogs may go beyond veterans to influence their cohabitating partners.
New mental health diagnoses in parents of infants admitted to a neonatal intensive care unit—A retrospective review of the Military Health System database
APA Citation:
Farr, B. J., Evans, A. M., Rush, T. M., Grabill, C. M., Ricca, R. L., & Rice-Townsend, S. E. (2022). New mental health diagnoses in parents of infants admitted to a neonatal intensive care unit—A retrospective review of the Military Health System database. Journal of Perinatology, 42, 738-744. https://doi.org/10.1038/s41372-022-01331-7
Focus:
Parents
Mental health
Substance use
Branch of Service:
Multiple branches
Navy
Air Force
Marine Corps
Coast Guard
Military Affiliation:
Guard
Reserve
Veteran
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Farr, Bethany J.; Evans, Amber M.; Rush, Toni M.; Grabill, Colette M.; Ricca, Robert L.; Rice-Townsend, Samuel E.
2022
Objective Studies suggest that parents of NICU infants are at increased risk of mental health disorders. We sought to characterize this risk using a large database. Study design The Military Health System was used to retrospectively link records between parents and infants admitted to a NICU over 5 years and were matched to similar families without NICU exposure. The total study population included 35,012 infants. Logistic regression was used to estimate the association between NICU exposure and parental mental health diagnoses within 5 years of infant birth. Results Maternal NICU exposure was associated with incident diagnoses of depression (OR: 1.18–1.27, p < 0.0001), anxiety (OR: 1.06–1.18, p = 0.0151), alcohol/opiate dependence (OR: 1.29–1.52, p = 0.0079), and adjustment disorder (OR: 0.97–1.18, p = 0.0224). Paternal NICU exposure was associated with alcohol/opiate dependence (OR: 0.78–1.42, p = 0.0339). Conclusion Parents of NICU infants are at risk of developing mental health disorders. Future work should identify characteristics that predict highest risk to develop effective interventions.
14 Gender differences in marital and military predictors of service member career satisfaction
Gender differences in marital and military predictors of service member career satisfaction
APA Citation:
Street, T., Lewin, A., Woodall, K., Cruz-Cano, R., Thoma, M., & Stander, V. A. (2022). Gender differences in marital and military predictors of service member career satisfaction. Family Relations, 71(4), 1515-1537. https://doi.org/10.1111/fare.12697
Focus:
Mental health
Couples
Deployment
Branch of Service:
Army
Navy
Coast Guard
Marine Corps
Air Force
Multiple branches
Military Affiliation:
Active Duty
Veteran
Reserve
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Street, Towanda; Lewin, Amy; Woodall, Kelly; Cruz-Cano, Raul; Thoma, Marie; Stander, Valerie A.
2022
Background U.S. servicewomen may face unique military experiences unlike those of servicemen, and stressors can affect their satisfaction with the military. Understanding factors influencing satisfaction among the increasing number of U.S. servicewomen in the U.S. military is important for retention. Methods Using family stress theory, data from service members and their spouses (N = 9325) enrolled in the Millennium Cohort Family Study were analyzed using cross-sectional linear regression to evaluate the relationship between military and family stressors and service members' military satisfaction, and how these relationships differ by gender. Results Service members with more deployment experience and better mental health were more satisfied with the military, while spouse employment outside the home and work–family conflict were associated with less satisfaction. Gender, marital quality, and social support moderated the relationships between stressors and military satisfaction, suggesting they may impact men and women differently. Overall, however, work–family conflict was associated with decrements in the career satisfaction of both men and women. Conclusion This study increases our understanding of the influence military and family stressors have on service members' satisfaction with the military. It also reveals gender differences in military satisfaction and recommends strategies to address the needs of diverse military families.
15 How work-related guilt informs parenting and adolescent psychological distress in military families
How work-related guilt informs parenting and adolescent psychological distress in military families
APA Citation:
Farnsworth, M. L., & O’Neal, C. W. (2022). How work-related guilt informs parenting and adolescent psychological distress in military families. Family Relations, 71(4), 1575-1592. https://doi. org/10.1111/fare.12685
Focus:
Parents
Children
Mental health
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Farnsworth, Meredith L.; O'Neal, Catherine W.
2022
Objective The current study examined inconsistent discipline as a linking mechanism connecting parental guilt about work to adolescent psychological distress in military families. Background Military families may face tensions connected to competing demands of family and the military career, which can produce a sense of parental guilt. This guilt may contribute to poor parenting behaviors, such as inconsistent discipline, which can be detrimental for adolescents (e.g., leading to depression and anxiety). Method A structural equation model with data from 223 military families (i.e., active duty father, civilian mother, and adolescent) examined the associations among parental guilt, inconsistent discipline, and adolescent psychological distress. Results Active duty fathers' guilt and inconsistent discipline were related to their perceptions of adolescent psychological distress, whereas civilian mothers' guilt was indirectly related to both their own and their partner's perceptions of adolescent psychological distress through their inconsistent discipline. Conclusion Inconsistent discipline is a parenting behavior related to parental guilt and adolescent psychological distress. More research is needed to better understand the nuances of military contexts for families. Implications Inconsistent discipline is a specific, malleable parenting behavior with implications for prevention and intervention programs designed for military families as well as family-related policies in the military.
A person-centered approach to identifying at-risk U.S. Army soldiers-in-training based on adverse childhood experiences
APA Citation:
Reed-Fitzke, K., Duncan, J. M., Wojciak, A. S., Ferraro, A J., Sánchez, J., & Smith, K. M. (2023). A person-centered approach to identifying at-risk U.S. Army soldiers-in-training based on adverse childhood experiences. Traumatology, 29(4), 481–492. https://doi.org/10.1037/trm0000395
Focus:
Child maltreatment
Mental health
Trauma
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Share the article
Research & Summary
Reed-Fitzke, Kayla; Duncan, James M.; Wojciak, Armeda S.; Ferraro, Anthony J.; Sánchez, Jennifer; Smith, Kevin M.
2023
Military service members are confronted with numerous stressors as they progress through their career. Given the military’s desire to maintain mission readiness, it is imperative to identify areas of early intervention to promote optimal functioning and health. This study used the stress process framework and a person-centered approach to identify subgroups of soldiers-in-training based on adverse childhood experiences (ACEs). Specifically, two questions were addressed: (a) Are there distinct profiles of ACEs among soldiers-in-training, and (b) who are the most at-risk soldiers-in-training? The sample consisted of 30,836 soldiers-in-training from the Army study to Assess Risk and Resilience in Servicemembers. Five subgroups were identified using latent profile analysis: low adversity, moderate emotional adversity, elevated emotional adversity, moderate structural adversity, and high cumulative adversity. Results from a multivariate and univariate analyses of variance indicated significant small main effects of profile membership in anxiety, depression, posttraumatic stress disorder, and resilient mindset. Those with high cumulative adversity and elevated emotional adversity appeared to be the most at-risk regarding mental health, yet those with high cumulative adversity had similar levels of resilient mindset as the lower adversity groups. Those with elevated emotional adversity had the lowest levels of resilient mindset. Findings provide a more holistic understanding of unique combinations of ACEs among individuals’ as they enter military service. ACEs profiles may help providers identify those who may benefit from targeted supports (e.g., trauma-informed mental health providers) prior to or during service for those who may be most vulnerable to poor outcomes.
Unit cohesion during deployment and post-deployment mental health: Is cohesion an individual- or unit-level buffer for combat-exposed soldiers?
APA Citation:
Campbell-Sills, L., Flynn, P. J., Choi, K. W., Ng, T. H. H., Aliaga, P. A., Broshek, C., Jain, S…Bliese, P. D. (2022). Unit cohesion during deployment and post-deployment mental health: Is cohesion an individual- or unit-level buffer for combat-exposed soldiers? Psychological Medicine, 52, 121-131. https://doi.org/10.1017/S0033291720001786
Focus:
Deployment
Mental health
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Share the article
Research & Summary
Campbell-Sills, Laura; Flynn, Patrick J.; Choi, Karmel W.; Ng, Tsz Hin H.; Aliaga, Pablo A.; Broshek, Catherine; Jain, Sonia; Kessler, Ronald C.; Stein, Murray B.; Ursano, Robert J.; Bliese, Paul D.
2020
BACKGROUND: Unit cohesion may protect service member mental health by mitigating effects of combat exposure; however, questions remain about the origins of potential stress-buffering effects. We examined buffering effects associated with two forms of unit cohesion (peer-oriented horizontal cohesion and subordinate-leader vertical cohesion) defined as either individual-level or aggregated unit-level variables. METHODS: Longitudinal survey data from US Army soldiers who deployed to Afghanistan in 2012 were analyzed using mixed-effects regression. Models evaluated individual- and unit-level interaction effects of combat exposure and cohesion during deployment on symptoms of post-traumatic stress disorder (PTSD), depression, and suicidal ideation reported at 3 months post-deployment (model n's = 6684 to 6826). Given the small effective sample size (k = 89), the significance of unit-level interactions was evaluated at a 90% confidence level. RESULTS: At the individual-level, buffering effects of horizontal cohesion were found for PTSD symptoms [B = -0.11, 95% CI (-0.18 to -0.04), p < 0.01] and depressive symptoms [B = -0.06, 95% CI (-0.10 to -0.01), p < 0.05]; while a buffering effect of vertical cohesion was observed for PTSD symptoms only [B = -0.03, 95% CI (-0.06 to -0.0001), p < 0.05]. At the unit-level, buffering effects of horizontal (but not vertical) cohesion were observed for PTSD symptoms [B = -0.91, 90% CI (-1.70 to -0.11), p = 0.06], depressive symptoms [B = -0.83, 90% CI (-1.24 to -0.41), p < 0.01], and suicidal ideation [B = -0.32, 90% CI (-0.62 to -0.01), p = 0.08]. CONCLUSIONS: Policies and interventions that enhance horizontal cohesion may protect combat-exposed units against post-deployment mental health problems. Efforts to support individual soldiers who report low levels of horizontal or vertical cohesion may also yield mental health benefits.
