Publications

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American Journal of Epidemiology | Jul 2024

Risk and protective factors of probable binge eating disorder in US military spouses: Findings from the Millennium Cohort Family Study

Ray TN, Esquivel AP, McMaster HS, Jacobson IG, Maguen S

This longitudinal study of more than 5,000 military spouses identified risk and protective factors of binge eating disorder. Risk factors included a positive screen of posttraumatic stress disorder, adverse childhood experiences, former smoking, and being married to a service member who did not deploy or deployed with combat exposure. Age greater than 34 was protective against binge eating disorder.

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BMC Public Health | May 2024

Longitudinal association of health behaviors and health-related quality of life with military spouse readiness

Corry NH, Radakrishnan S, Williams CS

Health-related quality of life had direct effects on five readiness outcomes: military satisfaction, lost workdays, healthcare utilization, military-related stress and satisfaction. Additionally, insomnia, smoking, binge drinking and exercise were significantly associated with spouse readiness outcomes. These results show spouse health behaviors are directly and indirectly associated with readiness indicators.

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Measurement and Evaluation in Counseling and Development | Feb 2024

The development, validity, and reliability of a brief self-report measure of family resilience in military families

Ray, T.R., Esquivel, A.P., Stander, V. A., McMaster, H.S., Roesch, S. C., & Walsh, F.

Military service is associated with a host of stressors that can adversely affect the health and well-being of service members and their families. We developed and validated a brief measure of military family resilience based on the Walsh Family Resilience Framework to assess shared belief systems, organizational patterns, and communication processes. The brief 9-item scale demonstrated strong reliability and validity and has practical utility for military family research.

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Stress & Health | Jan 2024

The role of the problem solving appraisal and support in the relationship between stress exposure and posttraumatic stress symptoms of military spouses and service member partners

Sullivan, K.S., Park, Y., Richardson, S., Stander, V., & Jaccard, J.

This paper examined the relationship between individual and family-level stress exposures and military spouse resources, and their association with posttraumatic stress symptoms (PTSS) among both partners. Spouse resources had both protective and promotive effects on PTSS for both service members and spouses. These findings emphasize the central role spouses play in military families.

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Social Development | Oct 2023

Family Separation from Military Service and Children's Externalizing Symptoms: Exploring Moderation by Non-military Spouse Employment, Family Financial Stress, Marital Quality, and the Parenting Alliance

Richardson, S.M., Pflieger, J.C., Hisle-Gorman, E., Briggs, E.C., Fairbank, J.A., & Stander, V.A.

During a 3-year follow-up period, we investigated how family separation from the military affects the behavioral adjustment of early school-age children. We also explored whether factors such as military spouse employment, parental financial stress, marital quality, or the parenting alliance influenced children’s adjustment during this transition. Our results indicated that when the spouse was employed and the family separated from the military, children exhibited fewer behavioral problems. Additionally, we found that a strong parenting alliance was associated with decreased behavioral problems among children in families that remained in the military.

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Journal of Traumatic Stress | Jun 2023

Early and Recent Military and Nonmilitary Stressors Associated with Posttraumatic Stress Symptoms Among Military Service Members and Their Spouses

Sullivan, K. S., Park, Y., Richardson, S., Cederbaum, J., Stander, V., & Jaccard, J.

This study examined the associations between various military and nonmilitary stressors and posttraumatic stress symptoms (PTSS) among military couples. For both partners, childhood maltreatment was the strongest predictor of PTSS, followed by other nonmilitary stressors.

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American Journal of Preventative Medicine | Apr 2023

Partner Effects: Analyzing Service Member and Spouse Drinking Over Time

Joneydi, R., Sparks, A.C., Kolenikov, S., Jacobson, I. G., Knoblock, L.K., Williams, C.S., Pflieger, J.C., Corry, N.H., Stander, V.A.

Excessive alcohol use is a significant problem in the military. Although there is a growing emphasis on family-centered alcohol prevention approaches, little is known about the interplay between partners’ drinking behaviors. This study examines how service members and their spouses influence each other's drinking behavior over time and explores the complex individual, interpersonal, and organizational factors that may contribute to alcohol use.

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Family Relations | Aug 2022

Influence of family factors on service members' decisions to leave the military.

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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Journal of Studies on Alcohol and Drugs | Jul 2022

Longitudinal patterns of military spousal alcohol consumption: Findings from the Millennium Cohort Family Study.

Sparks, A. C., Williams, C. S., Pflieger, J. C., Jacobson, I., Corry, N. H., Radakrishnan, S., & Stander, V. A.

Alcohol use in the military is prevalent and has short- and long-term health, safety, and career consequences. Although several studies have examined service members’ alcohol consumption, few have focused on alcohol use among military spouses. This study assessed factors at individual, interpersonal, and organizational levels to determine associations with risky alcohol use among military spouses.

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Psychological Services | May 2022

Perceived barriers to mental healthcare among spouses of military service members

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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Family Relations | May 2022

Gender differences in marital and military predictors of service member career satisfaction.

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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Child Maltreatment | Apr 2022

Pre- and perinatal risk factors for child maltreatment in military families across the first two years of life.

Sullivan, K., Richardson, S., Ross, A., Cederbaum, J., Pflieger, J., Abramovitz, L., Bukowinski, A., & Stander, V.

Military families are exposed to a unique constellation of risk factors, which may impact maltreatment outcomes. The present study examined prospective relationships between demographic, health, birth-related, and military-specific risk factors identified prior to a child’s birth on their risk for maltreatment in the first two years of life.

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Anxiety, Stress & Coping | Mar 2022

Families serve too: military spouse well-being after separation from active-duty service

Corry NH, Joneydi R, McMaster HS, Williams CS, Glynn S, Spera C, Stander VA

A life course model was applied to assess spouse well-being following the transition from military to civilian life. Spouses of service members who had separated from the military (versus those who had not) reported poorer mental health and family relationship quality. Spouses of active-duty service members reported greater increases in work-family conflict. Protective factors included having more psychological and social resources and less financial stress.

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Journal of Family Psychology | Dec 2021

Risk and Protective Factors Predictive of Marital Instability in U.S. Military Couples

Pflieger JC, Richardson SM, Stander VA, Allen ES

The objective of this study was to predict marital instability from a range of risk and protective factors in a large, representative cohort of military couples participating in the Millennium Cohort Family Study. Factors analyzed include mental health, family communication, military experiences, and education level. Findings from this study can be used to target specific couples risk factors for marital instability and to tailor programs to at-risk subgroups.

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Military Behavioral Health | Aug 2021

The Role of Posttraumatic Stress Symptoms and Negative Affect in Predicting Substantiated Intimate Partner Violence Incidents Among Military Personnel

Stander VA, Woodall KA, Richardson SM, Thomsen CJ, Milner JS, McCarroll JE, Riggs DS, Cozza SJ, for the Millennium Cohort Research Team.

Increasing rates of posttraumatic stress disorder (PTSD) in military populations may indicate heightened risk for aggression, including aggression among domestic partners. Using longitudinal data from the Millennium Cohort Study, we evaluated the association of PTSD symptom clusters and comorbid conditions as predictors of incidents of met criteria incidents of domestic abuse (physical and psychological) from DoD Family Advocacy Program (FAP) Central Registry data. Among 54,667 active-duty personnel who responded to the 2011 survey, FAP records documented 501 participants (1%) with incidents of emotional or physical met criteria incidents of aggression in the data collection period. Results showed that certain aspects of PTSD and behavioral health problems predicted incidents. In particular, general PTSD symptoms (e.g., anger/irritability, sleep disruption) and comorbid alcohol dependence were stronger predictors than trauma-specific PTSD symptomology (e.g., reexperiencing, hypervigilance). These results indicate that clinicians should consider the interpersonal consequences of PTSD and related behavioral problems.

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Addictive Behaviors Reports | Jun 2021

Associations between spouse and service member prescriptions for high-risk and long-term opioids: a dyadic study

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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JAMA Network Open | Apr 2021

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

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 Medicine | Jan 2021

Demographic variation in military life stress and perceived support among military spouses

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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Military Psychology | Nov 2020

The impact of family stressors and resources on military spouse's perception of post-deployment reunion stress

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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Addictive Behaviors | Nov 2020

Alcohol misuse and separation from military service: A dyadic perspective

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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