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 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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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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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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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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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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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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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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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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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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