Publications
Research Publication 2
Title Publication Date/Location
Posttraumatic stress disorder symptom clusters in service members predict new-onset depression among military spouses Journal of Traumatic Stress Epub ahead of print

Walter KH, LeardMann CA, Carballo CE, McMaster HM, Donoho CJ, Stander VA

Among spouses of service members with probable posttraumatic stress disorder (PTSD), 14% met criteria for new-onset depression over a 3-year period. The service member’s PTSD symptom cluster of effortful avoidance was associated with an increased risk of new-onset depression in spouses, underscoring the impact of service member psychological symptoms on the spouse.

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High-risk and long-term opioid prescribing to military spouses in the Millennium Cohort Family Study Military Medicine 2020 Sep;185(9-10):e1759-e1769

McDonald DC, Radakrishnan S, Sparks AC, Corry NH, Carballo CE, Carlson K, Stander VA

The use and misuse of opioids by active service members has been examined in several studies, but little is known about their spouses' opioid use. This study estimates the number of military spouses who received high-risk or long-term opioid prescriptions between 2010 and 2014, and addresses how the Military Health System can help prevent risky prescribing in order to improve military force readiness. Using data from the Millennium Cohort Family Study and the Pharmacy Data Transaction Service, this study found that nearly 1 in 10 military spouses received an opioid prescription that put their health at risk. Spouses with physical pain, a lack of social support, and adverse childhood experiences were all associated with receiving higher risk opioid prescriptions.

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Reducing the length of the Multidimensional Scale of Perceived Social Support European Journal of Psychological Assessment 2020 Sep;36(5):829-838

Porter B, Kolaja CA, Powell TM, Pflieger JC, Stander VA, Armenta RA

This study establishes the utility and validity of a shortened version of the Multidimensional Scale of Perceived Social Support (MSPSS). Using data from the first follow-up survey of the Millennium Cohort Family Study and a sample of university undergraduate students, results demonstrated that a scale half the length of the original measure (six items) assessed perceived social support about equally well as the full length MSPSS. Therefore, future Millennium Cohort and Millennium Cohort Family Study questionnaires will contain the reduced measure, saving participants time without sacrificing data quality.

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Association of military life experiences and health indicators among military spouses BMC Public Health 2019 Nov;19(1):1517

Corry NH, Radakrishnan S, Williams CS, Sparks AC, Woodall KA, Fairbank JA, Stander VA

The purpose of this study was to assess the extent to which military spouses' health behaviors met national physical health goals (Healthy People 2020), and to assess associations between health behaviors and sociodemographic characteristics, military experiences, and psychosocial factors. Attainment of national health goals was measured using six indicators of health: 1) healthy weight (body mass index), 2) aerobic exercise, 3) strength training, 4) sleep, 5) alcohol use (risky drinking), and 6) tobacco use. Overall, the majority of military spouses and service members met most of the HP2020 goals analyzed in the study, and the behaviors of each member of the couple were moderately correlated. Greater social support and perceived support from the military, in addition to several demographic variables, were associated with a greater likelihood of meeting the Healthy People 2020 goals among military spouses.

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Patterns of strengths in U.S. military couples Journal of Child and Family Studies 2019 Sep;29:1249–1263

Pflieger JC, Porter B, Carballo CE, Stander VA, Corry NH

This study examined patterns of strengths among military couples in the Millennium Cohort Family Study (n = 9,642), including beliefs (self-mastery, positive outlook, spirituality), social support, and family communication. Results supported five patterns of strengths, with 58.4% of couples exhibiting a pattern of high strengths; 33.6% of couples exhibiting two patterns in which one member of the couple was higher on strengths than the other member; 5.1% of couples exhibiting a pattern of low strengths; and 2.9% of couples exhibiting a pattern of moderately high beliefs and social support, yet very low family communication. Higher spouse education level and service member officer rank consistently distinguished patterns of high strengths, whereas couples with lower mental health, marital quality, and military satisfaction were more likely to exhibit patterns of low strengths. These results provide a snapshot of couples early in the military career cycle and highlight the need to adopt a family-centered perspective in military resilience programs and policies.

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Military life stressors, family communication and satisfaction: Associations with children’s psychosocial outcomes Journal of Child & Adolescent Trauma 2019 May;13(1):75-87

Briggs EC, Fairbank JA, Tunno AM, Lee RC, Corry NH, Pflieger JC, Stander VA, Murphy RA

The purpose of this study was to examine facets of military life and family factors that may impact child psychosocial and mental health functioning. Using baseline data from the Millennium Cohort Family Study, this study examined family demographics and composition (age, number of children), military life stressors (injury, family, and deployment stressors), family communication and satisfaction, parental social functioning, and child mental health and behavioral functioning. Injury- and family-related military stressors were significant indicators of heightened risk for child mental health conditions, whereas greater levels of parental social functioning and family satisfaction were associated with lower risk of child mental health conditions. Differential associations were found in child functioning when military-related variables (e.g., service component), sociodemographic, and family composition factors (number and age of the children in the home) were examined. These findings underscore the importance of examining the “whole child” within the broader ecological and military family context to understand factors associated with children’s mental and behavioral health. The results have considerable implications for the development of policies to support children and families encountering multiple stressors related to a parent’s military service.

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Guidance for use of weights: An analysis of different types of weights and their implications when using SAS PROCs. General Psychiatry 2019 Feb 20;32(1):e100038

Richardson, S., Lin, T., Li, Y., Niu, X., Xu, M., Stander, V., & Tu, X.

SAS and other popular statistical packages provide support for survey data with sampling weights. For example, PROC MEANS and PROC LOGISTIC in SAS have their counterparts PROC SURVEYMEANS and PROC SURVEYLOGISTIC to facilitate analysis of data from complex survey studies. On the other hand, PROC MEANS and many other classic SAS procedures also provide an option for including weights and yield identical point estimates, but different standard errors (SEs), as their corresponding survey procedures. This paper takes an in-depth look at different types of weights and provides guidance on use of different SAS procedures.

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Depression among military spouses: Demographic, military, and service member psychological health risk factors Depression and Anxiety 2018 Dec;35(12):1137-1144

Donoho CJ, LeardMann CA, O’Malley CA, Walter KH, Riviere LA, Curry JF, Adler AB

In this study, 4.9% of military spouses had a probable diagnosis of major depression disorder (MDD). Spouses married to enlisted service members or those with PTSD had increased risk for MDD, after adjustment for demographic and military factors. Less education, unemployment, and prior military service among spouses, as well as having more than three children, were also associated with increased risk for MDD. These findings imply that deployment alone may not negatively impact military spouses, but rather adverse mental health of the service member, especially PTSD, may increase the risk for MDD among military spouses.

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Mental health of children of deployed and non-deployed US military service members: The Millennium Cohort Family Study Journal of Developmental & Behavioral Pediatrics 2018 Dec;39(9):683-692

Fairbank JA, Briggs EC, Lee RC, Corry NH, Pflieger JC, Gerrity ET, Amaya-Jackson LM, Stander VA, Murphy RA

Prior research has found that youth in military families were significantly more likely to report higher rates of major depression and use of illicit drugs in comparison to their non-military counterparts. The present study investigated the associations between service member deployment experiences and family demographic factors and children’s mental health and psychological functioning, utilizing data collected from 9,872 Service members/military spouses through both online and mail survey options. The results from the Family Study indicated that while most spouses did not report that their children had mental health, emotional, or behavioral difficulties regardless of parental deployment status, a significant minority of children whose parents had been combat deployed were more likely to have been diagnosed with ADD/ADHD and depression by a doctor or health professional in comparison to youth without a deployed parent. Children with a non-combat deployed service member parent were also more likely to have been assigned a diagnosis of depression in comparison to youth without a deployed parent.

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Engaging military couples in marital research: Does requesting referrals from service members to recruit their spouses introduce sample bias? BMC Medical Research Methodology 2018 Oct;18(1):114

McMaster HS, Stander VA, Williams CS, Woodall KA, O'Malley CA, Bauer LM, Davila EP

Enrolling couples in research studies is not uncommon; however, most research reports fail to provide details about recruitment strategies or have the ability to examine selection biases. This paper examined two recruitment strategies used to enroll military couples in a longitudinal study, assessing the impact of both strategies on the representativeness of the final study sample. Using data from the Millennium Cohort Program, results suggest that requesting referrals from service members to recruit their spouses introduced minimal bias compared to contacting spouses directly. Service members appeared to be more likely to refer their spouses if they perceived the research topic as relevant to their spouse, and these spouses were more likely to respond for similar reasons. Even though referred spouses were more likely to respond, the overall success rate of using a referral strategy was less than that of recruiting spouses directly.

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