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.

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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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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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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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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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The Role of Posttraumatic Stress Symptoms and Negative Affect in Predicting Substantiated Intimate Partner Violence Incidents Among Military Personnel Military Behavioral Health ePub ahead of print; 2021 Aug

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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The impact of military and nonmilitary experiences on marriage: Examining the military spouses' perspective Journal of Traumatic Stress 2018 Oct;31(5):719-729

Pflieger JC, LeardMann CA, McMaster HS, Donoho CJ, Riviere LA

This study examined the impact of military experiences and nonmilitary family stressors on the military spouse’s perception of marital quality. After adjusting for demographic, relationship, and military characteristics, results indicated that most military experiences did not have a direct association with low marital quality, with the exception of service member posttraumatic stress. Rather, nonmilitary experiences of the military spouse, including lack of social support, caregiver burden, work-family conflict, and financial strain, increased odds of low marital quality. These findings suggest that providing additional supports to address nonmilitary family stressors experienced by spouses may strengthen military marriages.

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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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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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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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