Publications
Research Publication 2
Title Publication Date/Location
Prevalence of psychiatric morbidity in the United States military spouses: The Millennium Cohort Family Study Depression and Anxiety 2018 Sep;35(9):815-829

Steenkamp MM, Corry NH, Qian M, Li M, McMaster HS, Fairbank JA, Stander VA, Hollahan L, Marmar CR

This cross-sectional study assesses the prevalence of eight mental health conditions in spouses of U.S. Service members with 2 to 5 years of service and the association between deployment status and spousal outcomes, as well as concordance in psychopathology between spouses and Service members. Over one-third of spouses met criteria for at least one of the assessed psychiatric conditions. Having a partner who deployed with combat resulted in higher prevalence of anxiety, insomnia and somatization. Rates of depression, anxiety and somatization were similar between spouses and Service members.

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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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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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Gender differences in marital and military predictors of service member career satisfaction. Family Relations 2022 May; 1-23

Street, T., Lewin, A., Woodall, K., Cruz-Cano, R., Thoma, M., & Stander, V. A.

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. 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.

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Influence of family factors on service members' decisions to leave the military. Family Relations 2022 August; 1-20

Woodall, K., Esquivel, A., Powell, T., Riviere, L., Amoroso, P., & Stander, V. A.

Service member retention is a crucial aspect in maintaining and advancing the U.S. military and its mission. To increase retention, it is important to understand why active duty personnel voluntarily leave while they are still highly qualified. For married service members, spouses likely influence the decision to stay or leave military service. The current study used data from the Millennium Cohort Family Study for 4,539 dyads comprising service members and their spouses to investigate family predictors of voluntary military separation.

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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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The Millennium Cohort Family Study: A prospective evaluation of the health and well-being of military service members and their families International Journal of Methods in Psychiatric Research 2014 Sep;23(3):320-30

Crum-Cianflone NF, Fairbank JA, Marmar CR, Schlenger W

The Millennium Cohort Family Study is the largest prospective, epidemiologic study of military families in US history, and includes dyads of service members and their spouses. This paper provides a comprehensive description of this landmark study including details of the research objectives, study methodology, survey instrument, ancillary data sets, and plans for dissemination of research findings. The Family Study offers a unique opportunity to define the challenges that military families experience and advance the understanding of protective factors that will benefit military families today and into the future.

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

LeardMann CA, McMaster HS, Warner S, Esquivel AP, Porter B, Powell TM, Tu XM, Lee WW, Rull RP, Hoge CW

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

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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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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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