Publications
Research Publication 2
Title Publication Date/Location
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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Guidance for use of weights: An analysis of different types of weights and their implications when using SAS PROCs. General Psychiatry 2019 Feb 20;32(1):e100038

Richardson, S., Lin, T., Li, Y., Niu, X., Xu, M., Stander, V., & Tu, X.

SAS and other popular statistical packages provide support for survey data with sampling weights. For example, PROC MEANS and PROC LOGISTIC in SAS have their counterparts PROC SURVEYMEANS and PROC SURVEYLOGISTIC to facilitate analysis of data from complex survey studies. On the other hand, PROC MEANS and many other classic SAS procedures also provide an option for including weights and yield identical point estimates, but different standard errors (SEs), as their corresponding survey procedures. This paper takes an in-depth look at different types of weights and provides guidance on use of different SAS procedures.

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Gender differences in marital and military predictors of service member career satisfaction. Family Relations 2022 May; 1-23

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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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 2023 November Published, online

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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Families serve too: military spouse well-being after separation from active-duty service Anxiety, Stress & Coping ePub; 2022 March

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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Engaging military couples in marital research: Does requesting referrals from service members to recruit their spouses introduce sample bias? BMC Medical Research Methodology 2018 Oct;18(1):114

McMaster HS, Stander VA, Williams CS, Woodall KA, O'Malley CA, Bauer LM, Davila EP

Enrolling couples in research studies is not uncommon; however, most research reports fail to provide details about recruitment strategies or have the ability to examine selection biases. This paper examined two recruitment strategies used to enroll military couples in a longitudinal study, assessing the impact of both strategies on the representativeness of the final study sample. Using data from the Millennium Cohort Program, results suggest that requesting referrals from service members to recruit their spouses introduced minimal bias compared to contacting spouses directly. Service members appeared to be more likely to refer their spouses if they perceived the research topic as relevant to their spouse, and these spouses were more likely to respond for similar reasons. Even though referred spouses were more likely to respond, the overall success rate of using a referral strategy was less than that of recruiting spouses directly.

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Early and Recent Military and Nonmilitary Stressors Associated with Posttraumatic Stress Symptoms Among Military Service Members and Their Spouses Journal of Traumatic Stress 2023 June

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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Depression among military spouses: Demographic, military, and service member psychological health risk factors Depression and Anxiety 2018 Dec;35(12):1137-1144

Donoho CJ, LeardMann CA, O’Malley CA, Walter KH, Riviere LA, Curry JF, Adler AB

In this study, 4.9% of military spouses had a probable diagnosis of major depression disorder (MDD). Spouses married to enlisted service members or those with PTSD had increased risk for MDD, after adjustment for demographic and military factors. Less education, unemployment, and prior military service among spouses, as well as having more than three children, were also associated with increased risk for MDD. These findings imply that deployment alone may not negatively impact military spouses, but rather adverse mental health of the service member, especially PTSD, may increase the risk for MDD among military spouses.

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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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