Publications
Research Publication 2
Title Publication Date/Location
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.
Demographic variation in military life stress and perceived support among military spouses Military Medicine In press

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.
The impact of family stressors and resources on military spouse's perception of post-deployment reunion stress Military Psychology In press

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.
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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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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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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Reducing the length of the Multidimensional Scale of Perceived Social Support European Journal of Psychological Assessment 2019 Nov

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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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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