This article reviews process and performance of an innovative effort leveraging virtual health to manage unmet demand for behavioral health and substance use disorder services across a large military region. This effort began in June 2022 and included nearly all of the Defense Health Agency Region—Europe’s military behavioral health and substance abuse clinics participating. The two goals of improving access to behavioral health and substance use services for active duty service members and improving utilization of the military clinics were employed. Operational and remote locations with known care gaps could access services as well. Connecting services to the point of need is an established strength of virtual health delivery systems of care.A team consisting of clinical leaders and Virtual Medical Center—Europe staff developed a centralized screening process and simple business rules. When a clinic was unable to meet its access-to-care standard of 28 days, the patient requesting or referral from a remote location, was offered a virtual video option with a provider from another clinic with availability. Centralized screening was created and staffed by three technicians. The Behavioral Health Integrated Support Network (BHISN) screening clinic assessed appropriateness of virtual care using established exclusion criteria. Once screened, the patient was scheduled for an appointment with one of the 31 therapists in 14 participating clinics in a 3- to 5-day window. The military health system’s video connect platform was used.Between June 2022 and November 2023, 131 patients who were unable to find routine care in their home clinic were screened, scheduled, and completed a virtual visit with one of the 31 participating therapists from 14 behavioral health and substance use clinics. Seventy-eight (59%) participants were active duty empaneled to military treatment facilities in Europe and 53 (39%) were active duty enrolled in Tricare Prime Remote and deployed to remote locations with limited care. Forty-four percent of patients were recommended for continued virtual therapy or counseling kept their first follow-up demonstrating good follow-up care using a virtual option. The overall no-show rate was low at 7%. Care and consultation were successfully delivered using video visits to location in 18 countries in three geographic Europe, the Middle East and, Africa.The Virtual Medical Center—Europe, Army Europe Behavioral Health, and Substance Use leadership work collaboratively to plan and optimize program performance. For BHISN to function as intended requires key dedicated support staff, such as mental health and social services assistants to screen and coordinate virtual care. Scheduling can be performed by a central cell requiring clinics to relinquish some local control in the interest of meeting patient demand in large and diverse area that covers three continents. BHISN shows promising initial success by providing a process of managing demand and connecting requests for behavioral health and substance use care leveraging capacity from all clinics using a virtual video service in a diverse operating environment.
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Showing library results for: June 2022
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1 Behavioral Health Integrated Support Network (BHISN)
Behavioral Health Integrated Support Network (BHISN)
APA Citation:
Cain, S. M., Bennetts, S., Riddoch, G., Pratt, D., Stock, A., Isidron, V., Lopez, M., & Orchowsky, M. (2023). Behavioral Health Integrated Support Network (BHISN). Military Medicine, Article-usad351. https://doi.org/10.1093/milmed/usad351
Focus:
Programming
Mental health
Substance use
Branch of Service:
International Military
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research
Cain, Steven M.; Bennetts, Sara; Riddoch, Gage; Pratt, Damon; Stock, Audra; Isidron, Veronica; Lopez, Maria; Orchowsky, Matthew
2023
Suicide bereavement and loneliness among UK Armed Forces veterans under the care of mental health services: Prevalence and associations
APA Citation:
Abrantes, M. L., & Pitman, A. (2023). Suicide bereavement and loneliness among UK Armed Forces veterans under the care of mental health services: Prevalence and associations. Current Research in Behavioral Sciences, 5, Article 100126. https://doi.org/10.1016/j.crbeha.2023.100126
Focus:
Veterans
Mental health
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)
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Research
Abrantes, Marta Lages; Pitman, Alexandra
2023
Suicide bereavement is a risk factor for suicide and psychiatric illness. Its lifetime prevalence in the general population is estimated at 22%, and in one (US) veteran sample as 47%, but no estimates exist for a UK veteran sample. We aimed to measure the lifetime prevalence of suicide bereavement in a clinical sample of UK veterans to inform service provision for this group. Our secondary aim was to measure the prevalence of loneliness and investigate the association between suicide bereavement and loneliness. We searched the routine electronic clinical records of all veterans treated in a London veterans’ crisis care service over the period September 2021 to June 2022 (n=69), capturing data on their sociodemographic and clinical characteristics, including the proportions recorded as having experienced the suicide of a friend or relative and as experiencing loneliness. We used multivariable logistic regression models to test for an association with loneliness. The lifetime prevalence of suicide bereavement was 30% (predominantly of friends) and the period prevalence of loneliness was 57%. There was no association of suicide bereavement with loneliness. This work highlights the high proportion of veterans in this clinical sample with a specific suicide risk factor, and their likely needs for specific support to address the psychological consequences of suicide loss.
Animal-assisted interventions and post-traumatic stress disorder of military workers and veterans: A systematic review
APA Citation:
Chirico, F., Capitanelli, I., Nowrouzi-Kia, B., Howe, A., Batra, K., Sharma, M., Szarpak, Ł., Pruc, M., Nucera, G., Ferrari, G., Cortese, C., Gianino, M., & Acquadro Maran, D. (2022). Animal-assisted interventions and post-traumatic stress disorder of military workers and veterans: A systematic review. Journal of Health and Social Sciences, 7, 152–180. https://doi.org/10.19204/2022/NMLS4
Focus:
Trauma
Mental health
Veterans
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research
Chirico, Francesco; Capitanelli, Ilaria; Nowrouzi-Kia, Behdin; Howe, Aaron; Batra, Kavita; Sharma, Manoj; Szarpak, Łukasz; Pruc, Michał; Nucera, Gabriella; Ferrari, Giuseppe; Cortese, Claudio; Gianino, Mariola; Acquadro Maran, Daniela
2022
Introduction: Animal-Assisted Interventions (AAIs) have been increasingly used in the workplace to mitigate the effect of work-related stress and improve psychological well-being among employees. Military workers returning home from combat and veterans face a high burden of post-traumatic stress disorders (PTSD). This systematic review aimed to investigate the potential benefits of AAIs on military workers and veterans affected by PTSD. Methods: A systematic review was conducted across Scopus, PubMed Central/Medline, Web of Science, and Google Scholar in December 2021 and June 2022 using predefined search criteria. All types of studies published in the English language were included except editorials, commentaries, and narrative reviews. Studied published from January 2001 to December 2021 were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines for this systematic review. The assessment of study quality was carried out with a 16-item Quality Assessment Tool for Studies with Diverse Designs (QATSDD) Results: Overall, 25 studies were finally included in this systematic review. Most of the AAIs were canine-assisted programs (n=12) and therapeutic horseback riding or equine-assisted psychotherapy (n=11). There was only one intervention study utilizing a pinnipeds-based program (n=1), while one study was based on several types of animals (n=1). Out of 25 studies focusing on the effects of AAIs on PTSD in the military (n=3) and veterans (n=21), the majority of them (n=18) observed significantly lower PTSD symptomatology following AAIs. Three studies observed no statistically significant difference in PTSD symptomatology. Discussion: Our findings indicated that implementing AAI programs among military workers and veterans may improve their psychological well-being and reduce the severity of PTSD symptoms. Policymakers and occupational health services should consider adopting AAIs during military service and after military discharge to support the mental health of military workers.
Propensity of US military personnel to seek mental health care when community psychiatric capacity changes
APA Citation:
Shen, Y.-C., Bacolod, M., & Heissel, J. A. (2023). Propensity of us military personnel to seek mental health care when community psychiatric capacity changes. JAMA Health Forum, 4(10), Article e233330. https://doi.org/10.1001/jamahealthforum.2023.3330
Focus:
Mental 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)
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Research
Shen, Yu-Chu; Bacolod, Marigee; Heissel, Jennifer A.
2023
Importance Understanding how the active duty military population’s mental health care use is associated with local military and civilian psychiatrist capacity is critical in designing the optimal allocation of mental health resources from both sectors to improve the mental health of military personnel. Objective To evaluate whether the probability of mental health care visits by military personnel changes when psychiatrist capacity changes in their communities, when capacity is measured separately for military treatment facilities and civilian sectors. Design, Setting, and Participants This cohort study of active duty US military service members between January 1, 2016, and September 30, 2020, combines data from the Defense Health Agency, the National Plan and Provider Enumeration System, and the US Census. Data were collected and analyzed from June 2022 to July 2023. Main Outcomes and Measures The main outcome was the probability of making at least 1 mental health care visit in a given quarter at military treatment facilities and in civilian settings. Linear probability models with 2-dimensional fixed effects at individual and community levels were implemented to estimate changes in individual outcomes when community psychiatrist capacity changed. Results This study includes 1 958 421 US service members (83% men; mean [SD] age at baseline, 28.4 [8.0] years). Thirteen percent of service members did not have military treatment facility psychiatrists available within a 30-minute driving time, and 66% lived in communities with a psychiatrist shortage (3 psychiatrists per 20 000 relevant population) military treatment facility psychiatrist capacity. Five percent of service members lived in communities with no civilian psychiatrists within a 30-minute driving time, while 66% lived in communities with high civilian psychiatrist capacity. The mean quarterly mental health care visit rates to military treatment facilities and civilian settings were 7% and 2%, respectively. The probability of a mental health care visit to a military treatment facility increased by 0.95 percentage points (95% CI, 0.79-1.10 percentage points; equivalent to 14%) when the individual experienced a change in military treatment facility capacity from no psychiatrist to high capacity. The probability of a mental health care visit to a civilian setting increased by 0.57 percentage points (95% CI, 0.38-0.76 percentage points; equivalent to 32%) when civilian capacity changed from no psychiatrist to high capacity. The magnitude of responses to military treatment facility capacity changes remained similar in communities that already had high civilian capacity. Conclusions and Relevance This cohort study of the US military population suggests that active duty military personnel rely largely on military treatment facilities for their mental health care and that there are meaningful responses to military treatment facility psychiatrist capacity changes even in communities with high civilian psychiatric capacity. Realigning military treatment facility psychiatrists across communities with shortages and high-capacity military treatment facilities, as well as addressing nongeographical barriers in the civilian sector, remain critical to achieve the optimal balance between military and civilian care provision.
5 Firearm suicide prevention in the U.S. military: Recommendations from a national summit
Firearm suicide prevention in the U.S. military: Recommendations from a national summit
APA Citation:
Betz, M. E., Stanley, I. H., Anestis, M. D., Bryan, C. J., Buck-Atkinson, J., Carey, N., Ghahramanlou-Holloway, M., Morrissey, B. H., Holloway, K., Houtsma, C., Kennedy, R., Paine, C. M., Ramchand, R., Simonetti, J., Walsh, A., & Wright-Kelly, E. (2022). Firearm suicide prevention in the U.S. military: Recommendations from a national summit. Military Medicine, usac371. https://doi.org/10.1093/milmed/usac371
Focus:
Mental health
Branch of Service:
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)
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Research
Betz, Marian E.; Stanley, Ian H.; Anestis, Michael D.; Bryan, Craig J.; Buck-Atkinson, Jessica; Carey, Neil; Ghahramanlou-Holloway, Marjan; Morrissey, Brooke Heintz; Holloway, Kathryn; Houtsma, Claire; Kennedy, Rachel; Paine, Christopher M.; Ramchand, Rajeev; Simonetti, Joseph; Walsh, Adam; Wright-Kelly, Erin
2022
The U.S. DoD has identified firearm suicide prevention as a key operational priority. One vital approach to addressing firearm suicides is through promoting lethal means safety, which involves the voluntary use of secure storage for personally owned firearms and/or temporarily moving firearms out of the home during risk periods. Despite promising approaches to lethal means safety, critical gaps remain in research, programming, and communication among and across scientists, DoD programmatic leaders, front-line commanders, and service members. To address these gaps, the first-ever national “Firearm Suicide Prevention in the Military: Messaging and Interventions Summit” was convened in June 2022, bringing together DoD personnel and researchers with expertise in firearm suicide prevention and lethal means safety. The Summit identified 10 recommendations to enhance firearm suicide prevention messaging and interventions in the U.S. military, including (1) repeal or amend prohibitions on questioning service members about personal firearms; (2) develop, examine, and use common language for firearm injury prevention; (3) implement a universal approach to training on comprehensive firearm injury prevention; (4) encourage leadership across disciplines and levels; (5) aim for broad culture change; (6) support innovative research; (7) consider various outcome measures; (8) promote “cultural competence” for better communication; (9) reduce territorialism; and (10) develop creative partnerships. Ultimately, these recommendations can facilitate productive partnerships with a shared goal: to develop, test, and implement strategies that standardize lethal means safety and reduce firearm suicides and other firearm injuries or harm among service members.
6 Black women in the military: Prevalence, characteristics, & correlates of sexual harassment
Black women in the military: Prevalence, characteristics, & correlates of sexual harassment
APA Citation:
Breslin, R.A., Daniel, S., & Hylton, K. (2022). Black women in the military: Prevalence, characteristics, and correlates of sexual harassment. Public Administration Review, 82(3), 410-419. https://doi.org/10.1111/puar.13464
Focus:
Physical health
Trauma
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Breslin, Rachel A.; Daniel, Samantha; Hylton, Kimberly
2022
Sexual harassment is a persistent problem in the workplace that warrants further attention in public administration research. Despite the fact that Black women are one of the largest subpopulations in the military, most studies of sexual harassment treat women as a homogenous group and results generally reflect the experiences of White women given their overrepresentation in samples. Using data from a large-scale and representative survey of military members, we find that nearly one in five Black women in the military (17.9%) experienced sexual harassment in 2018. Our findings further detail Black women's sexual harassment experiences and advance the discourse on the need to address sexual harassment in the workplace through an intersectional lens in order to design more inclusive prevention and response programs and policies. For example, inclusive programs should proactively account for the experiences of Black women in the design and evaluation of prevention and response efforts.
7 Some parents survive and some don't: The Army and the family as “greedy institutions”
Some parents survive and some don't: The Army and the family as “greedy institutions”
APA Citation:
Strader, E. & Smith, M. (2022). Some parents survive and some don't: The Army and the family as "greedy institutions". Public Administration Review, 82(3), 446-458. https://doi.org/10.1111/puar.13467
Focus:
Parents
Other
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)
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Research & Summary
Strader, Eiko; Smith, Capt Margaret
2022
The military and the family are “greedy institutions” that require the full attention of their members. Being aware of the tension between work and family, the United States military has developed family support policies that are more generous than legally required to ensure personnel readiness. However, family formation remains a major obstacle for recruitment, retention, and integration of women. Using administrative data, this research shows that fathers were more likely to leave prematurely for family reasons than childless men, particularly among non-Hispanic Black and American Indian/Alaska Native men. However, women who gave birth while in service were much less likely to leave for work-family reasons than childless women, while the same could not be said for women who joined as mothers and had no additional children. The results reflect the gendered logic of the organization and the narrow conceptualization of work–family conflict, both of which perpetuate gender-role stereotypes.
The buffering role of higher romantic relationship satisfaction on the association of hazardous drinking with PTSD and depression symptoms among female military service members/veterans
APA Citation:
Blais, R. K., Hess, R. A., & Serang, S. (2021). The buffering role of higher romantic relationship satisfaction on the association of hazardous drinking with PTSD and depression symptoms among female military service members/veterans. Addictive Behaviors, 123, 107081. https://doi.org/10.1016/j.addbeh.2021.107081
Focus:
Couples
Substance use
Trauma
Mental health
Branch of Service:
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)
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Research & Summary
Blais, Rebecca K.; Hess, Ryan A.; Serang, Sarfaraz
2021
Studies show that more positive relationship satisfaction can mitigate the effects of posttraumatic stress disorder (PTSD) and depression severity on hazardous drinking in military samples. However, past studies were not circumscribed to female service members/veterans (SM/V), who represent the fastest growing demographic in the military. Moreover, studies did not examine moderators of specific symptom clusters of PTSD and depression with hazardous drinking. Indeed, recent studies have shown that the more depressive and cognitive clusters are associated with greater dysfunction. The current study extended this literature in a convenience sample of 584 female SM/V who completed self-report measures of hazardous drinking, PTSD, depression, and relationship satisfaction. PTSD or depression severity, relationship satisfaction, and their interaction, were examined as correlates of hazardous drinking after accounting for relationship, demographic, and military characteristics. For both overall PTSD and depression severity, higher relationship satisfaction weakened their association with hazardous drinking. Such results were consistent when global scores were replaced with PTSD-related negative alterations in cognitions and mood and somatic depression symptom clusters, but not for PTSD-related dysphoric arousal, anhedonia, or non-somatic depression symptom clusters. Findings suggest that to lessen the association of PTSD or depressive symptoms with problematic drinking, interventions aimed at improving relationship satisfaction may be worth considering among women in relationships. Moreover, symptom cluster analyses show that the cognitive and depressive components of PTSD, as well as the physical symptoms of depression, are most problematic, pinpointing specific areas of function on which to intervene.
Safety planning for intimate partner violence: Practical and contextual considerations for service providers
APA Citation:
Frye-Cox, N., Short, K., O’Neal, C. W., & Lucier-Greer, M. (2022). Safety planning for intimate partner violence: Practical and contextual considerations for service providers. Auburn, AL: Military REACH
Focus:
Couples
Programming
Trauma
Branch of Service:
Multiple branches
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research Report
Frye-Cox, Nick; Short, Kaylee; O'Neal, Catherine W.; Lucier-Greer, Mallory
2022
Interpersonal trauma histories and relationship functioning among LGB veteran couples seeking PTSD treatment
APA Citation:
Rashkovsky, K., Solano, I., Khalifian, C., Morland, L. A., & Knopp, K. (2022). Interpersonal trauma histories and relationship functioning among LGB veteran couples seeking PTSD treatment. Military Psychology, 34(4), 494-501. https://doi.org/10.1080/08 995605.2021.2016308
Focus:
Veterans
Couples
Trauma
Branch of Service:
Navy
Army
Marine Corps
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Rashkovsky, Katerine; Solano, Ingrid; Khalifian, Chandra; Morland, Leslie A.; Knopp, Kayla
2022
Lesbian, gay, and bisexual (LGB) Veterans report greater emotional distress, trauma exposure, and PTSD rates than both LGB civilians and non-LGB Veterans. Traumatic experiences impact intimate relationships, potentially placing LGB Veterans at higher risk of relationship dysfunction secondary to trauma and PTSD. However, limited research has examined links between relationship functioning and trauma histories among couples with one or more LGB-identifying partners. In this exploratory study, participants include 21 couples from a larger treatment study comprising a PTSD-diagnosed Veteran and their significant other in which at least one partner identified as LGB. Variables included trauma experiences, PTSD symptom severity, and relationship satisfaction. A descriptive analysis revealed high relationship satisfaction despite high interpersonal trauma rates among both PTSD-diagnosed Veterans and their partners. Further, we found different patterns of relationship functioning depending on whether a participant had experienced sexual assault. These initial analyses present novel data on trauma in treatment-seeking LGB veteran couples and provide an important basis for future research on couple-based mental health treatments for this population.
11 Prescriptions of psychotropic medications by providers treating children of military service members
Prescriptions of psychotropic medications by providers treating children of military service members
APA Citation:
Kucera, A., Koehlmoos, T., Grunwald, L., Banaag, A., Schvey, N. A., Quinlan, J., & Tanofsky-Kraff, M. (2022). Prescriptions of psychotropic medications by providers treating children of military service members. Military Medicine, Article usac048. https://doi.org/10.1093/ milmed/usac048
Focus:
Mental health
Youth
Children
Branch of Service:
Multiple branches
Army
Navy
Air Force
Marine Corps
Military Affiliation:
Active Duty
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
School age (6 - 12 yrs)
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Research & Summary
Kucera, Alexandria; Koehlmoos, Tracey; Grunwald, Lindsay; Banaag, Amanda; Schvey, Natasha A.; Quinlan, Jeffrey; Tanofsky-Kraff, Marian
2022
There are approximately 1.5 million U.S. military-dependent children. However, little is known about mental health referrals for these youths. This study sought to examine the type of mental health treatment referrals made by primary care providers for child military-dependent beneficiaries receiving care in the direct (within Military Treatment Facilities) and private care (civilian-fee-for service facilities) sectors of the Military Health System.A between-subjects, cross-sectional study was performed on children aged 5–18 years old in fiscal years 2011–2015 and enrolled in TRICARE Prime. Study analyses examined specialty (“talk therapy”) mental health care and psychotropic medication referrals from TRICARE Prime (the Defense Health Agency-managed health care program) providers for beneficiary children diagnosed with attention-, mood-, anxiety-, or behavior-related disorders in direct versus private sector care.Of 1,533,630 children enrolled in TRICARE Prime (50.03% female), 8.6% (n = 131,393) were diagnosed with a psychological disorder during FY 2011–2015. Most were attention-related (5.2%, n = 79,770), followed by mood (1.7%, n = 25,314), anxiety (1.1%, n = 16,155), and conduct-related diagnoses (0.7%, n = 10,154). Adjusting for age, sex, and sponsor rank, children within direct care diagnosed with attention-related disorders were 1.7 times more likely to receive a prescription for psychotropic medication than those in private sector care, odds ratio (OR) = 1.72, 95% confidence interval (CI): [1.66, 1.77]. Children diagnosed with mood-related disorders in direct care were 2.1 times more likely to receive a prescription for psychotropic medication than those in private sector care, OR = 2.08, 95% CI: [1.96, 2.21]. Across disorders, children who received private sector care were more likely to have a referral specialty mental health (“talk therapy”) follow-up (ps < 0.0001).For attention- and mood-related disorders, but not anxiety- or conduct-related disorders, direct care providers were more likely than private sector care providers to prescribe psychotropic medications. Inconsistencies of provider referrals within and outside of the Military Health System should be elucidated to determine the impact on outcomes.
The roles of stress, coping, and parental support in adolescent psychological well-being in the context of COVID-19: A daily-diary study
APA Citation:
Wang, M.T., Del Toro, J., Scanlon, C. L., Schall, J. D., Zhang, A. L.,...Plevniak, K. A. (2021). The roles of stress, coping, and parental support in adolescent psychological well-being in the context of COVID-19: A daily-diary study. Journal of Affective Disorders, 294, 245–253. https://doi.org/10.1016/j.jad.2021.06.082
Focus:
Mental health
Youth
Parents
Population:
Adolescence (13 - 17 yrs)
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Research & Summary
Wang, Ming-Te; Toro, Juan Del; Scanlon, Christina L.; Schall, Jacqueline D.; Zhang, Angela L.; Belmont, Allison M.; Voltin, Sarah E.; Plevniak, Keri A.
2021
Background COVID-19 has introduced novel stressors into American adolescents’ lives. Studies have shown that adolescents adopt an array of coping mechanisms and social supports when contending with stress. It is unclear, though, which strategies are most effective in mitigating daily pandemic-related stress, as few micro-longitudinal studies have explored adolescents’ daily affect during COVID-19. Parental support may also be a critical component of adolescents’ pandemic-related coping, as adolescents’ peer networks have been limited by public health measures. Methods This longitudinal study examined links between stress, coping, parental support, and affect across 14 consecutive days and 6216 assessments from a national sample of adolescents (N=444; Mage=15.0; 60% female; 44% Black/African American, 39% White/Europen American, 9% Latinx, 6% Asian American, 2% Native American) during school closures and state-mandated stay-at-home orders between April 8 and April 21, 2021. Results Adolescents’ health and financial stress predicted increases in same-day (health stress’ effect size = .16; financial stress’ effect size = .11) and next-day negative affect (health stress’ effect size = .05; financial stress’ effect size = .08). Adolescents’ secondary control engagement coping predicted increases in same-day (effect size = .10) and next-day (effect size = .04) positive affect and moderated the link between health stress and negative affect. Parental social support predicted increases in same-day (effect size = .26) and next-day (effect size = .06) positive affect and decreases in same-day (effect size = .17) negative affect and moderated the link between financial stress and negative affect. Limitations Results are indicative of conditions at the immediate onset of COVID-19 and should be interpreted as such. Conclusions Findings provide information as to how health providers and parents can help adolescents mitigate the impact of COVID-19-related health and economic stressors on their psychological well-being. It remains critical to monitor the psychosocial impact of the pandemic on adolescents’ affect while continuing to identify personal and environmental protective factors for reducing harm and maximizing resilience.
Concerns of relationship mistreatment, emotional abuse, and physical abuse in deployed military medical personnel: Prevalence and risk factors
APA Citation:
McMahon, C. J., Zwetzig, S., Schumann, B., Straud, C. L., Baker, M. T., Young-McCaughan, S., Litz, B. T., Isler, W. C., McNally, R. J., Mintz, J., & Peterson, A. L. (2022). Concerns of relationship mistreatment, emotional abuse, and physical abuse in deployed military medical personnel: Prevalence and risk factors. Aggression and Violent Behavior, 66, Article 101735. https://doi.org/10.1016/j.avb.2022.101735
Focus:
Deployment
Couples
Mental health
Trauma
Branch of Service:
Air Force
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
McMahon, Chelsea J.; Zwetzig, Sarah; Schumann, Bailee; Straud, Casey L.; Baker, Monty T.; Young-McCaughan, Stacey; Litz, Brett T.; Isler, William C.; McNally, Richard J.; Mintz, Jim; Peterson, Alan L.
2022
The aims of this study were to identify self-reported point-prevalence rates of concerns about relationship mistreatment, emotional abuse, and physical abuse among military medical personnel and to evaluate demographic and military risk factors associated with these concerns. Participants (N = 721) were U.S. Air Force military medical personnel (61.4% male) deployed to Iraq between 2004 and 2011 who reported being either married or engaged. Most of the sample expressed at least some concern for mistreatment (79.0%), emotional abuse (70.8%), or physical abuse (66.3%) in their relationship. Caucasians were more likely to endorse emotional abuse concerns compared with other racial groups (p = .04). Men (p = .02) and service members who identified as Christians (p = .03) were more likely to endorse physical abuse concerns compared to their respective counterparts. Results suggest that relationship abuse concerns may be more common than expected among deployed military medical personnel. Demographic factors were associated with abuse concerns and military service characteristics and probable posttraumatic stress disorder diagnosis were not associated with abuse concerns. Future research should examine abuse concerns in population-based studies of military personnel and evaluate the longitudinal trajectory of outcomes associated with relationship abuse among active duty military personnel across the deployment cycle.
Factors influencing parental functioning and satisfaction for veteran mothers during civilian transition
APA Citation:
Morgan, N. R., Karre, J. K., Aronson, K. R., McCarthy, K. J., Bleser, J. A., & Perkins, D. F. (2022). Factors influencing parental functioning and satisfaction for veteran mothers during civilian transition. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 71(4), 1554-1574. https://doi.org/10.1111/fare.12669
Focus:
Veterans
Parents
Mental health
Physical health
Branch of Service:
Multiple branches
Army
Navy
Air Force
Marine Corps
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
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Research & Summary
Morgan, Nicole R.; Karre, Jennifer K.; Aronson, Keith R.; McCarthy, Kimberly J.; Bleser, Julia A.; Perkins, Daniel F.
2022
Objective Risk and protective factors associated with parental functioning (i.e., meeting child's emotional needs) and satisfaction (i.e., closeness) were examined among post-9/11 veteran mothers during their civilian transition. Background Post–military-separation stressors (e.g., relocation, benefit changes) can strain well-being and familial relationships. Stress, particularly in the presence of unresolved trauma from military-specific risks, can impinge upon parental functioning and satisfaction, negatively influencing child outcomes (e.g., social–emotional, academic, behavioral). Method A prospective cohort was identified from all active duty service members who separated in May–September 2016. Logistic regression analyses of surveys completed by post-9/11 veteran mothers (n = 711) assessed effects of protective (i.e., resilience) and military-specific risk factors (i.e., deployments) on parental functioning and satisfaction. Interactions between protective factors and deployments and combat (patrols and corollaries) were explored. Results Coping characteristics (e.g., healthy behaviors), absence of mental health conditions, and social supports were positively associated with parental functioning and satisfaction. Household financial security was not. Mothers who had deployed reported higher parental functioning and satisfaction. Mothers experiencing combat patrols were less likely to report high parental functioning. Conclusion Malleable protective factors positively influence parenting but do not buffer against combat exposure. Implications Interventions bolstering protective factors for veteran mothers can foster coping, reintegration, and positive child outcomes.
15 Financial status and well-being in recently separated military veterans
Financial status and well-being in recently separated military veterans
APA Citation:
Elbogen, E. B., Zeber, J. E., Vogt, D., Perkins, D. F., Finley, E. P., & Copeland, L. A. (2022). Financial status and well-being in recently separated military veterans. Military Medicine, usac030. https://doi.org/10.1093/milmed/usac030
Focus:
Veterans
Mental health
Physical health
Other
Branch of Service:
Multiple branches
Army
Navy
Air Force
Marine Corps
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
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Research & Summary
Elbogen, Eric B.; Zeber, John E.; Vogt, Dawne; Perkins, Daniel F.; Finley, Erin P.; Copeland, Laurel A.
2022
Introduction Veterans transitioning from military service to civilian life manage numerous changes simultaneously, in health, employment, social relationships, and finances. Financial problems may impact financial well-being as well as adjustment to civilian life in general; yet, research on Veterans’ financial challenges remains limited. This study examined six indicators of perceived financial status among newly transitioned Veterans over a period of 3 years and then examined perceived financial well-being measured in two domains—satisfaction and functioning—and difficulty adjusting to civilian life as functions of financial status. Materials and Methods A sample representing 48,965 Veterans who separated from active duty/activated status in fall 2016 provided informed consent and survey data over their first 33 post-military months; data were analyzed in weighted regression models that included demographics, military characteristics, social support, resilience, life stress, and indicators of financial status. Results Financial status immediately post-separation included having stable housing (88%), being able to pay for necessities (83%), keeping up with creditors (88%), having insurance for catastrophic events such as disability (79%), saving for retirement (62%), and setting aside 3 months of salary (50%). Thirteen percent of Veterans disclosed troubled financial status, having achieved no more than two of these financial goals; 38% had moderate and 49% excellent financial status. Troubled or moderate financial status, Black race, enlisted, and higher levels of stress predicted lower financial functioning. Older age, college degree at baseline, employment, and social support predicted better financial satisfaction. Veterans with troubled financial status reported greater difficulty adjusting to civilian life (odds ratio 1.34); women were less likely to report difficulty adjusting to civilian life (odds ratio 0.85). Conclusions Findings indicate that financial satisfaction and functioning may be sensitive to psychosocial factors (social support and stress). Findings also underscore the value of assessing Veterans’ financial status (poor debt management and lack of future planning), providing encouragement and assistance to pursue a college degree, and improving household financial management, thus increasing the likelihood that Veterans will have the necessary tools to manage their finances after separation and achieve whole health well-being.
16 Physical health, behavioral and emotional functioning in children of gulf war veterans
Physical health, behavioral and emotional functioning in children of gulf war veterans
APA Citation:
Toomey, R., Alpern, R. E., White, A. J., Li, X., Reda, D. J., & Blanchard, M. S. (2021). Physical health, behavioral and emotional functioning in children of gulf war veterans. Life Sciences, 282, Article 119777. https://doi.org/10.1016/j.lfs.2021.119777
Focus:
Veterans
Children
Physical health
Mental health
Youth
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Preschool age (2 -5 yrs)
School age (6 - 12 yrs)
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Research & Summary
Toomey, R.; Alpern, R. E.; White, A. J.; Li, X.; Reda, D. J.; Blanchard, M. S.
2021
Objective We examined whether the prevalence of medical and behavioral conditions is higher in children of deployed veterans (DVs) versus non-deployed veterans (NDVs) after the 1991 Gulf War. Methods We examined 1387 children of 737 veterans. Children ages 2-18 had physical exams and parental reports of physical history and behavior. Results Physical health was analyzed using GEE models. Behavioral health [total, internalizing, and externalizing behavior problems (TBP, IBP, EBP)] was analyzed with mixed-effects regression models. Analyses were conducted by age group (2-3, 4-11, 12-18), and gender (ages 4-11, 12-18). Children of DVs ages 2-3 had significantly worse dentition (13.9% vs. 4.8%, P = 0.03) and more EBP {least square means (lsmeans) 54.31 vs. 47.59, P = 0.02}. Children of DVs ages 4-11 had significantly more obesity (18.8% vs. 12.7%, P = 0.02). Among children 4-11, male children of DVs had significantly more TBP (lsmeans 70.68 vs. 57.34, P = 0.003), IBP (lsmeans 63.59 vs. 56.16, P = 0.002) and EBP (lsmeans 61.60 vs. 52.93, P = 0.03), but female children did not. For children ages 12-18, male children of DVs had more EBP (lsmeans 63.73 vs. 43.51, P = 0.008), while female children of DVs had fewer EBP (lsmeans 45.50 vs. 50.48, P = 0.02). Veteran military characteristics and mental health, and children's social status and health, including obesity, predicted children's TBP for one or more age groups. Conclusions Children of DVs experienced worse dentition, greater obesity, and more behavioral problems compared to NDV children, suggesting adverse health effects associated with parental deployment in need of further exploration.
Perceptions of family acceptance into the military community among U.S. LGBT service members: A mixed-methods study
APA Citation:
Sullivan, K. S., Dodge, J., McNamara, K., Gribble, R., Keeling, M., Taylor-Beirne, S., Kale, C., Goldbach, J., Fear, N. T., Castro, C. A. (2021). Perceptions of family acceptance into the military community among U.S. LGBT service members: A mixed-methods study. Journal of Military, Veteran and Family Health, 7(s1), 90-101. https://doi.org/10.3138/jmvfh-2021-0019
Focus:
Programming
Other
Branch of Service:
Air Force
Army
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)
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Research & Summary
Sullivan, Kathrine S.; Dodge, Jessica; McNamara, Kathleen; Gribble, Rachael; Keeling, Mary; Taylor-Beirne, Sean; Kale, Caroline; Goldbach, Jeremy; Fear, Nicola T.; Castro, Carl A.
2021
Lay Summary There are approximately 16,000 families of lesbian, gay, bisexual, or transgender (LGBT) service members in the U.S. military, but very little is known about how accepted they feel in the communities in which they live. This study begins to address this question by considering the perspectives of LGBT service members, which they shared both in response to an online survey and in interviews. Findings suggest that many service members believe their spouses and families are accepted by their chain of command. However, a smaller but important group continued to express concerns about their family being accepted in their military community. Many service members appear concerned that family services available to them through the military are not appropriate for LGBT families. Altogether, this article highlights the need for more research to understand the well-being and needs of this group.
18 Postdeployment mental health concerns and family functioning in veteran men and women
Postdeployment mental health concerns and family functioning in veteran men and women
APA Citation:
Zelkowitz, R. L., Archibald, E. A., Gradus, J. L., & Street, A. E. (2023). Postdeployment mental health concerns and family functioning in veteran men and women. Psychological Trauma: Theory, Research, Practice, and Policy, 15(4), 705-714. https://doi.org/10.1037/tra0001237
Focus:
Deployment
Mental health
Veterans
Parents
Trauma
Youth
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)
Aged (65 yrs & older)
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Research & Summary
Zelkowitz, Rachel L.; Archibald, Emma A.; Gradus, Jaimie L.; Street, Amy E.
2023
Objective: Despite growing numbers of veteran women, it is unclear whether the impact of common postdeployment mental health concerns on key aspects of family functioning varies by gender. We examined whether associations between PTSD, depression, and problematic alcohol use and intimate relationship quality and parenting self-efficacy differed among men and women in a large, gender-balanced sample of post-9/11 veterans. Method: Participants included 2,348 veterans (51.49% women) of the wars in Iraq and Afghanistan who were part of a larger study of gender differences in effects of wartime deployment. Veterans who were married or in a relationship (n = 1,536, 49.09% women) reported overall relationship quality. Veterans with children under age 18 (n = 1,049; 51.57% women) self-reported on their sense of efficacy as parents. All participants reported symptoms of PTSD, depression, and problematic alcohol use. We used a series of hierarchical linear regressions to test gender as a moderator of each postdeployment mental health concern and the family functioning constructs of interest. Results: Each postdeployment mental health concern was associated with reduced relationship quality and parenting self-efficacy, and these associations were largely consistent across gender. However, links between reduced parenting self-efficacy and increased PTSD and depressive symptoms were stronger in women compared with men. Conclusions: Postdeployment mental health concerns are associated with impairment in key family relationships for both veteran men and women. This impact may be particularly profound for parenting self-efficacy among female veterans, highlighting the potential importance of targeted interventions in this domain. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
