Publications
Research Publication 2
Title Publication Date/Location
Associations between spouse and service member prescriptions for high-risk and long-term opioids: a dyadic study Addictive Behaviors Reports 2021 June; 14

Sparks AC, Radakrishnan S, Corry NH, McDonald D, Carlson K, Carballo CE, Stander, V.

This study explores the extent to which military spouses’ obtainment of opioids is associated with their service member partners’ obtainment of opioid prescriptions, in addition to other factors such as service member health, state prescribing patterns, and sociodemographic characteristics. Findings suggest that reducing the number of long-term and high-risk opioid prescriptions to service members may subsequently reduce the number of similar prescriptions obtained by their spouses. Reducing the number of service members and spouses at risk for adverse events may prove to be effective in stemming the opioid epidemic and improve the overall health and safety of military spouses and thus, the readiness of the U.S. Armed Forces.

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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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A Model of Deployment Readiness among Military Spouses: The Role of Mental Health and Deployment-Related Personal Growth Military Behavioral Health 2020 Oct; 8(4): 378-395

Richardson SM, Pflieger JC, Woodall KA, Stander VA, Riviere LA

The purpose of the current investigation was to examine deployment-related risks, resources, and mediators contributing to military spouse perception of readiness for future service member deployments. Findings indicated that service member combat and injury negatively impacted spouse perception of deployment readiness through detriments to service member and spouse mental health. However, informal support and deployment communication were positively related to mental health for both partners, leading to improved spouse-perceived deployment readiness.

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Perceived barriers to mental healthcare among spouses of military service members Psychological Services In press

Schvey NA, Burke DJ, Pearlman AT, Britt TW, Riggs DS, Carballo CE, Stander VA

The elucidation of barriers to mental healthcare among military spouses is critical to optimizing the health of the military family and ensuring military readiness. Utilizing data from the Millennium Cohort Family Study, the current study found that logistic factors, such as lack of time or cost of services (reported by 63%), and negative attitudes towards mental healthcare (reported by 52%) were the most frequently reported barriers to care. Other reported barriers included fear of negative consequences (reported by 35%) and internalized mental health stigma (reported by 32%). Spouses with prior or current military service themselves and individuals with probable psychiatric conditions were most likely to report barriers to mental healthcare. Prospective data are needed to elucidate the associations between perceived barriers to care and actual mental healthcare utilization.

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Demographic variation in military life stress and perceived support among military spouses Military Medicine 2021 Jan; 186(1):214-221

Corry NH, Williams CS, Radakrishnan S, McMaster HS, Sparks AC, Briggs-King EC, Karon SS, Stander VA

Military spouses play a critical role in supporting service members and the family unit, and experience unique stressors as a result of military life. Using data from the Millennium Cohort Family Study, a nationwide survey of 9,872 married spouses of service members with 2–5 years of military service, we examined differences in experiences of military life stress and perceived support across multiple subgroups of military spouses to identify groups potentially at risk. Key outcomes included military-related stressors, perceived social support and support from the military, and coping; predictors included spouse sociodemographic, military population, and family characteristics. Certain spouses (>35 years, had a high school diploma or less, fulltime or not employed, had 2+ children, or married to service members in the Army, Navy, or Marine Corps) were more likely to experience heightened military stress, less social support, and/or poorer coping skills. Findings may inform culturally relevant initiatives to enhance social support and connectedness among at-risk military spouses.

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The impact of family stressors and resources on military spouse's perception of post-deployment reunion stress Military Psychology 2020 Nov; 32(6):369-379

Mallonee SD, Riggs D, Stander VA

This study explored the relationship between a variety of variables and the spouse's perception of reunion stress both independently and within their shared context. Results largely confirmed prior research on the independent relationship between each variable and reunion stress. However, the results found that many of these variables did not remain significant in the full model. Indeed, only poorer mental health among spouses and service members and greater perceived stressfulness of communication was associated with increased reunion stress as reported by spouses across all models tested.

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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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Alcohol misuse and separation from military service: A dyadic perspective Addictive Behaviors 2020 Nov;110:106512

Porter B, Rodriguez LM, Woodall KA, Pflieger JC, Stander VA

Poor outcomes result from service member alcohol misuse, but the extent to which military spouses' alcohol misuse impacts service members is unclear. This study evaluated the influence of dyadic patterns of alcohol misuse on likelihood of separating from the military among 7,965 opposite sex married couples with one military and one civilian/veteran spouse. The prevalence of alcohol misuse among military couples was high, but alcohol misuse frequently was reported by only one member of a couple. Results indicated that service member alcohol misuse was more strongly related to military separation than spouse alcohol misuse. Additionally, the study indicated that heavy weekly drinking was a stronger predictor of separation among female than male service members. Future research should replicate this finding and further evaluate the implications of this gender difference.

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Influence of work and life stressors on marital quality among dual and non-dual military couples Journal of Family Issues 2020 Nov;41(11):2045-2064

Woodall KA, Richardson SM, Pflieger JC, Hawkins SA, Stander VA

Maintaining a healthy marriage may be challenging for military couples as they attempt to balance the demands of work and family; for dual-military couples, this can be even more challenging. Using data from the Millennium Cohort Family Study, we examined whether military stress experiences negatively impact marital quality through the mediation of work-family conflict. Spouse gender and dual-military status were included as moderators. Results demonstrated that more military stress experiences was related to lower marital quality, which was mediated by work-family conflict. Additionally, female dual spouses reported lower marital quality than male dual spouses and civilian spouses. Findings from this study highlight the importance of providing support to military spouses for stressful military events and potentially tailoring support services for female dual spouses to improve marital quality.

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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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