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Insomnia in the military: application and effectiveness of cognitive and pharmacological therapies.
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Abstract
Insomnia is one of the most common complaints of American military personnel. Diagnosing and treating insomnia among active-duty and veterans is often complicated by comorbid conditions among military personnel, such as: B. post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Cognitive behavioral therapy for insomnia (CBTi), pharmacological interventions, and alternative therapies are discussed as relevant to their use in the military population. Future research directions are suggested.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Walter Reed National Military Medical Center
- Congress commits:Nee
- Funding source:Defense Health Agency (voorheen TRICARE Management Activity)
- Release Date/Release:1. October 2015
- Quote:Capaldi VF 2e, Kim JR, Grillakis AA, Taylor MR, York CM. Insomnia in the military: application and effectiveness of cognitive and pharmacological therapies. Curr Representative for Psychiatry. 2015 Oct;17(10):85
Influence of severity and location of physical injury on reporting of post-concussion and combat stress symptoms after military-related concurrent mild traumatic brain injury and polytrauma.
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Abstract
A combat traumatic brain injury (TBI) often results in significant physical injury. Intuitively, a major physical injury may be associated with increased symptom reporting. In 2012, French et al. showed that there is an inverse association between the severity of physical injury and the reporting of symptoms. This study extends this work by examining the impact of location and severity of physical injury on symptom reporting after mild traumatic brain injury. The participants were 579 US service members who experienced uncomplicated minor traumatic brain injury with simultaneous physical injury and were evaluated at two military medical centers. The severity of the physical injury was quantified using a modified Injury Severity Score (ISSmod). Participants completed the Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Stress Disorder Checklist (PCL-C) an average of 2.5 months after injury. There was a significant negative association between ISSmod scores and NSI (r=-0.267, p<0.001) and PCL-C (r=-0.273, p<0.001) total scores. Using linear regression to examine the relationship between symptom reporting and injury severity in the six ISS body regions, three body regions were significant predictors of NSI total score (face; p<0.001; abdomen; p=0.003; extremities; p<0.001). and accounted for 9.3% of the variance (p<0.001). For PCL-C, two body regions were significant predictors of PCL-C total score (face; p<0.001; extremities; p<0.001) and accounted for 10.5% of the variance. In this sample, there was an inverse relationship between the severity of the assault and the reporting of symptoms. Hypothetical explanations include underreporting of symptoms, increased peer support, anxiety conditioning disorder due to acute morphine use, or delayed onset of symptoms, among others.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Defense and Veterans Brain Injury Center
- Congress commits:Nee
- Funding source:Defense Health Agency (voorheen TRICARE Management Activity)
- Release Date/Release:1. October 2014
- Quote:French LM, et al. Influence of the severity and location of an assault on the reporting of post-concussion and combat stress symptoms after military-related concurrent mild traumatic brain injury and polytrauma. J Neurotrauma. 2014 Oct 1;31(19):1607-16.
Head trauma in infants of a military cohort.
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Abstract
OBJECTIVE: To assess the incidence and risk factors for abusive head trauma (AHT) in infants born to military families and compare them to civilian population figures. METHODS: The Electronic International Classification of Disease Records from the United States Department of Defense (DoD) Birth and Infant Health Registry was used to identify infants born to military families between 1998 and 2005 (N = 676,827) and the study definition for AHT corresponded. Data from the DoD Family Advocacy Program was used to identify young children with substantiated reports of abuse. Numbers within the military were compared to civilian numbers using an alternative AHT case definition used in a civilian study. RESULTS: Using the study definition, the estimated number of justified military AHT was 34.0 cases in the first year of life per 100,000 live births. Using the alternative case definition, the estimated AHT rate was 25.6 cases per 100,000 live births. Risk factors for AHT in infants included male gender, preterm delivery, and a diagnosed major congenital anomaly. Parental risk factors included the mother's young age (<21 years), a lower sponsor rank or salary scale, and the mother's current military service. CONCLUSIONS: This is the first large database study by AHT with the ability to link research results to cases. Overall rates of AHT were consistent with those of civilians using the same case definition codes. Among the babies most at risk and deserving special attention in military family support programs are babies born to parents in lower military grades, babies born to military mothers, and babies born prematurely or with birth defects.
- Release status:Published
- Sponsororganisation:Marine
- Sponsor Office:Marine Health Research Center
- Congress commits:Nee
- Funding source:Authority, office or organization under the authority of the Sec Def (not affiliated with the Army, Navy or Air Force)
- Release Date/Release:October 1, 2013
- Quote:Gumbs GR, Keenan HT, Sevick CJ, Conlin AM, Lloyd DW, Runyan DK, Ryan MA, Smith TC. Head trauma in infants of a military cohort. paediatrics. 2013 Oct;132(4):668-76.
Indirect associations between combat exposure and post-deployment physical symptoms in US soldiers: role of post-traumatic stress disorder, depression, and insomnia.
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Abstract
OBJECTIVE: To characterize the indirect associations of combat exposure with post-deployment physical symptoms through shared associations with post-traumatic stress disorder (PTSD) symptoms, depression, and insomnia. METHODS: Interviews were conducted on a sample of US military personnel (N = 587) three months after a 15-month deployment to Iraq. A multiple indirect effects model was used to characterize direct and indirect associations between combat exposure and physical symptoms. RESULTS: Despite a zero-order correlation between combat exposure and physical symptoms, analysis of several indirect effects provided no evidence of a direct association between these variables. Evidence of a significant indirect relationship between combat exposure and physical symptoms was found using symptoms of post-traumatic stress disorder, depression and insomnia. In fact, 92% of the overall effect of combat exposure on physical symptom assessments was indirect. These results were evident even after adjusting for physical injuries and relevant demographics. CONCLUSION: This is the first empirical study to suggest that PTSD, depression, and insomnia jointly and independently contribute to the association between combat exposure and post-combat physical symptoms. Limitations, future research directions and possible policy implications are discussed.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Walter Reed National Military Medical Center
- Congress commits:Nee
- Funding source:Defense Health Agency (voorheen TRICARE Management Activity)
- Release Date/Release:1. May 2015
- Quote:Quartana PJ, Wilk JE, Balkin TJ, High CW. Indirect associations between combat exposure and post-deployment physical symptoms in US soldiers: role of post-traumatic stress disorder, depression, and insomnia. J Psychosome Res. 2015 May;78(5):478-83.
Increased Risk of Functional Gastrointestinal Sequelae Following Clostridium difficile Infection in Active Duty US Military Personnel (1998-2010).
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Abstract
BACKGROUND AND PURPOSE Some acute intestinal infections are associated with the development of functional gastrointestinal disorders, most commonly irritable bowel syndrome, but also other functional and organic gastrointestinal sequelae. The incidence and severity of Clostridium difficile infection has increased, but few studies have examined functional impairment following this infection. METHODS: We evaluated the epidemiology and impact of C difficile in the US military population using the US Department of Defense Armed Forces Health Surveillance Center Medical Counter Database. We then conducted a retrospective cohort study of 891 active duty US military personnel who developed C difficile between 1998 and 2010 and 3231 matched subjects who were not exposed to C difficile. Subjects were identified based on the 9th revision of the International Classification of Diseases and clinical modification codes for C difficile disease. RESULTS: C difficile was independently associated with increased rate ratios (RRs) for incident irritable bowel syndrome (RR 6.1; 95% confidence interval [CI] 2.9-12.9) and gastroesophageal reflux disease (GERD) (RR 1.9 ; 95%) associated. CI, 1.4-2.6), dyspepsia (RR, 3.3, 95%, 1.4-7.7) and constipation (RR, 2.2, 95% CI, 1.3-3.7 ). About 14.1% of patients with C difficile later developed one of these functional gastrointestinal disorders (REA) compared to 6% of controls. Community and health-associated C difficile were similarly associated with these outcomes. Patients were at increased risk for FGDs within three months of a C difficile episode, with one additional case of FGD for every 12 C difficile diagnoses. CONCLUSIONS: The incidence of C. difficile related to community and health care increased in the US military population from 1998-2010. As with other gastrointestinal infections, C. difficile disease in this military population is associated with clinically relevant functional consequences.
- Release status:Published
- Sponsororganisation:Marine
- Sponsor Office:Naval Medical Research Center
- Congress commits:Nee
- Funding source:Marine
- Release Date/Release:1. November 2015
- Quote:Gutierrez RL, Riddle MS, Porter CK. Increased Risk of Functional Gastrointestinal Sequelae Following Clostridium difficile Infection in Active Duty US Military Personnel (1998-2010). gastroenterology. 2015 Nov;149(6):1408-14.
Implementing collaborative primary care for depression and post-traumatic stress disorder: Design and sampling for a randomized trial in the US military health care system
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Abstract
BACKGROUND: War trauma, post-traumatic stress disorder (PTSD), depression, and suicide are common among US military personnel. Often those affected do not seek treatment due to stigma and barriers to treatment. When care is used, it often does not meet the quality requirements. A randomized study examines whether collaborative primary care improves the quality and outcomes of PTSD and depression care in the US military health care system. AIM: Describe the design and sample of a randomized efficacy study of collaborative care for PTSD and depression among military personnel attending primary care. METHODS: The Stepped Enhancement of PTSD Services Using Primary Care (STEPS-UP) study is a 6-site (18-clinic) randomized efficacy study in the US military healthcare system. Research rationale, design, enrollment, and sample characteristics are summarized. RESULTS: Military personnel attending primary care who were referred to care management with suspected PTSD or depression or both were recruited into the study (2,592) and 1,041 agreed to be contacted to participate in the study. Of these, 666 (64%) met eligibility criteria, completed baseline assessments, and were randomized to 12 months of usual cooperative primary care versus STEPS-UP cooperative care. The deployment was managed locally for usual collaborative care and centrally for STEPS-UP. Reassessments of the study took place after 3, 6 and 12 months. Baseline characteristics were comparable between the two intervention groups. CONCLUSIONS: STEPS-UP will be the first large-scale randomized efficacy study to be completed in the US military health system examining how a deployment model influences the impact of collaborative care on mental health outcomes. It promises lessons for the transformation of the healthcare system.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Uniformed Services University of Health Sciences
- Congress commits:Nee
- Funding source:indefinite
- Release Date/Release:1. October 2014
- Quote:Engel CC, et al. Implementing Collaborative Primary Care for Depression and Post-Traumatic Stress Disorder: Design and Sample for a Randomized Trial in the US Military Health System. Contemp Clinical Studies. 2014 Oct 10
Effects of military action and wartime parental injuries on the safety and mental health of young children.
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Abstract
OBJECTIVE: Children are at risk of adverse consequences if their parents serve in the military. We seek to determine the impact of parental engagement and injury control on post-deployment mental health, injury and abuse in young children. METHOD: This is a population-based, retrospective cohort study of young children of active military parents during the high-stakes fiscal year (FY) 2006-2007. A total of 487,460 children between the ages of 3 and 8 were admitted to the military health care system. The relative attendance rates of children whose parents were deployed and children whose parents were injured in combat were compared to those of children who were not exposed to parental involvement. RESULTS: Of the trapped children, 58,479 (12%) had a parent on duty and 5,405 (1%) had a parent injured on duty. Compared to children whose parents were not deployed, children of deployed or injured parents received additional visits to assess their mental health (incidence ratio [IRR] = 1.09 [95% CI = 1.02-1.17 ], IRR = 1.67 [95% CI). = 1.47-1.89]), injuries (IRR = 1.07 [95% CI = 1.04-1.09], IRR = 1.24 [95% CI = 1.17-1, 32]) and child abuse (IRR = 1.21 [95% CI = 1.11–1.32). ], IRR 2.30 = [95% CI 2.02 -2.61]) after deployment. CONCLUSION: Young children of deployed military parents who are injured receive more post-deployment visits for mental health, injuries, and child abuse. Mental health problems, injuries and abuse following a parent's return from combat are more common among children of combat-injured parents. More prevention and intervention services are needed for young children when parents return from missions. Child health and mental health providers are critical to effectively identifying these vulnerable children to ensure effective care
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Uniformed Services University of Health Sciences
- Congress commits:Nee
- Funding source:Defense Health Agency (voorheen TRICARE Management Activity)
- Release Date/Release:1. April 2015
- Quote:Hisle-Gorman E, Harrington D, Nylund CM, Tercyak KP, Anthony BJ, Gorman GH. Effects of military action and wartime parental injuries on the safety and mental health of young children. J Ben Acad Child Adolescent Psychiatry. 2015 Apr;54(4):294-301.
Health-Related Pneumonia in U.S. War Victims, 2009 to 2010.
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Abstract
While there is peer-reviewed literature that assesses infectious complications associated with war-related injuries in Iraq and Afghanistan, none has specifically examined pneumonia. Therefore, we studied a series of cases of pneumonia in wounded military personnel admitted to Landstuhl Regional Medical Center and then evacuated to participating US military hospitals. Of the 423 victims evacuated to the United States, 36 developed pneumonia (8.5%) and 30 of these (83.3%) were ventilator related. If we restrict ourselves to 162 people admitted to the ICU, 30 patients had pneumonia (18.5%). The mean Injury Severity Score was higher in patients with pneumonia (23.0 vs. 6.0; p<0.01). From 31 patients with pneumonia, 61 first isolated airway specimens were obtained, of which 56.1% were gram negative, 18.2% were gram positive and 18.2% were fungal. Staphylococcus aureus and Pseudomonas aeruginosa were found most frequently (10.6% and 9.1%, respectively). Thirteen bacterial isolates (26.5%) were multidrug resistant. Outcome data were available for 32 patients, of whom 26 recovered from infection without progression, 5 improved after initial progression, and 1 died. In general, injured victims develop pneumonia relatively frequently, especially those requiring mechanical ventilation. Although gram-negative pathogens were common, S. aureus was the most commonly isolated. Pneumonia prevention strategies need continued attention to improve combat care. Reprint and Copyright © 2015 Association of Military Surgeons of the U.S.
- Release status:Published
- Sponsororganisation:Leger
- Sponsor Office:Uniformed Services University of Health Sciences
- Congress commits:Nee
- Funding source:Authority, office or organization under the authority of the Sec Def (not affiliated with the Army, Navy or Air Force)
- Release Date/Release:01 January 2015
- Quote:Yun HC, et al. Infectious Diseases Clinical Research Program, Study Group Trauma Outcomes of Infectious Diseases. Health-Related Pneumonia in U.S. War Victims, 2009–2010. Mil Med. 2015 Jan;180(1):104-10.
Influence of Mucorales and other invasive fungi on the clinical outcome of polymicrobial traumatic wound infections.
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Abstract
Trauma-related wounds with invasive fungal infections (IFIs) are often polymicrobial with both fungal and bacterial growth, but the impact of wound microbiology on clinical outcomes is uncertain. Our aim was to compare the microbiological characteristics between IFI and non-IFI wounds and to assess whether clinical outcomes differed between IFI wounds depending on the fungal type. Records of US military personnel with IFI wounds wounded in Afghanistan were examined. Controls were consistent with the pattern/severity of injury, including blood transfusion requirements. The timing of wound closure was compared between IFI and non-IFI control wounds (with/without bacterial infections). IFI wound closure was also evaluated based on the isolation of fungal species. 82 IFI wounds and 136 non-IFI wounds (63 with skin and tissue infections [SSTIs] and 73 without) were studied. Time to wound closure was longer in the IFI wounds (median 16 days) than in the non-IFI controls with/without SSTIs (median 12 and 9 days, respectively; P<0.001). Growth of multidrug-resistant gram-negative rods was reported in 35% and 41% of IFI and non-IFI wounds with SSTIs, respectively. For the IFI wounds, the time to wound closure was significantly longer in wounds with mucorales growth than in wounds with non-mucorales growth (median 17 days versus 13 days; P<0.01). When wounds infected with Mucorales and Aspergillus spp. When comparing growth, there was no significant difference in the timing of wound closure. Trauma wounds with SSTIs were often polymicrobial, but the presence of invasive fungi (predominant species: Order Mucorales, Aspergillus spp., and Fusarium spp.) significantly increased the time to wound closure. In general, the time to wound closure was longest in IFI wounds with Mucorales growth.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Walter Reed National Military Medical Center
- Congress commits:Nee
- Funding source:Defense Health Agency (voorheen TRICARE Management Activity)
- Release Date/Release:01 July 2015
- Quote:Warkentien TE, et al., Influence of Mucorales and other invasive fungi on clinical outcomes of polymicrobial traumatic wound infections. J Clin Microbiol. 2015 Jul;53(7):2262-70.
Outcomes of group pregnancy care in a military population: a retrospective cohort study.
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Abstract
OBJECTIVE: To evaluate pregnancy outcomes in centering pregnancy patients. METHODS: This was an IRB-approved retrospective cohort study from November 2009 to January 2013 in 202 centering pregnant patients and 202 certified nurse midwifery patients. The primary endpoint was mean gestational age at delivery. Secondary outcome measures included caesarean sections and operative vaginal deliveries, frequency of triage visits, number of neonatal ICU admissions, APGAR scores at 1 and 5 minutes, birth weight, number of breastfeeds at discharge and 6 weeks postpartum, as well as the number of third and fourth degree lacerations, weight gain in pregnancy and excess weight gain. RESULTS: There was no statistically significant difference in obstetric outcome, including preterm birth. Pregnant patients were more likely to be actively employed (52.0 vs. 35.6%, p=0.001), younger (24.8 vs. 26.3 years, p<0.001) and nulliparous (75.2 vs. 56.9%, p<0.001). There was a statistically significant increase in triage visits ≥6 in centering pregnant patients (11.9% vs. 8.9%, p=0.011). CONCLUSION: There were no clinically significant differences in primary or secondary outcomes. Significant cost savings can be realized by extending Centering Pregnancy to the entire military healthcare system.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Walter Reed National Military Medical Center
- Congress commits:Nee
- Funding source:indefinite
- Release Date/Release:01 July 2015
- Quote:Walton RB, Shaffer S, Heaton J. Group outcomes of prenatal care in a military population: a retrospective cohort study. Mil Med. 2015 Jul;180(7):825-9.
Health-related quality of life within the first 5 years after military-related simultaneous mild craniocerebral trauma and polytrauma.
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Abstract
This study examined health-related quality of life within the first 5 years after concomitant mild traumatic brain injury (MTBI) and polytrauma. Participants were 167 US service members who had acquired an MTBI and completed a brief neurobehavioral assessment and at least one subsequent telephone interview within three months of injury, aged 6 (n=46), 12 (n=89) , 24 (n =) completed 54), 36 (n = 42), 48 (n = 30), or 60 months (n = 25) after injury. Within the first 5 years after injury, service members reported persistent headaches (67.4% to 92.0%), body aches (66.7% to 88.9%), medication use (71.7% to 92.0%) and mental health care (28.3% to 60.0%). %) and the need for assistance with daily activities (18.5% to 40.0%). Problem alcohol use was common in the first 24 months after injury (23.9% to 29.2%). Many service workers worked for pay (36.0% to 70.8%), although many reported a decrease in job quality (16.0% to 30.4%). Despite the continued reporting of symptoms, many military personnel reported medication effectiveness (43.3% to 80.0%), good/excellent health (68.0% to 80.0%), and life satisfaction (79.6% up to 90.5%). A minority reported suicidal or homicidal thoughts (5.6% to 14.8%). Recovery from MTBI in the military setting is complex and multifaceted. Continued support and care is recommended for all service members who have contracted combat-related MTBI with polytrauma, whether or not symptoms were reported in the first few months after injury.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Defense and Veterans Brain Injury Center
- Congress commits:Nee
- Funding source:Defense Health Agency (voorheen TRICARE Management Activity)
- Release Date/Release:1. August 2014
- Quote:Brickell TA, Long RT, French LM. Health-related quality of life within the first 5 years after military-related simultaneous mild craniocerebral trauma and polytrauma. Mil Med. 2014 Aug;179(8):827-38.
Gender differences in the manifestation of PTSD symptoms among active-duty military personnel.
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Abstract
This study examined gender differences in post-traumatic stress disorder (PTSD) symptoms and symptom factors across the US active-duty force. The data comes from the Department of Defense's 2008 Survey of Health-Related Behaviors Among Active Military Personnel, including 17,939 men and 6,751 women in all armed services. The results showed that women reported more anxiety than men for almost all of the symptoms on the PTSD checklist, with the exception of hypervigilance. Women also performed significantly better on all four factors examined: reliving, avoidance, emotional numbness, and over-arousal. More women than men suffered from combat experiences involving some form of violence, such as being wounded, witnessing or participating in atrocities, hand-to-hand combat and, to a lesser extent, handling corpses. Men who had been sexually abused had a greater number of symptoms and were consistently more distressed than women because of individual symptoms and symptom factors.
- Release status:Published
- Sponsororganisation:indefinite
- Sponsor Office:
- Congress commits:Nee
- Funding source:indefinite
- Release Date/Release:December 1, 2014
- Quote:Hourani L, Williams J, Bray R, Kandel D. Gender differences in the expression of PTSD symptoms in active military personnel. J Anxiety Disorder. 5 Dec 2014;29C:101-108.
Gender Differences in Post-Traumatic Stress Disorder and Seeking Help in the U.S. Military.
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Abstract
BACKGROUND: Inconsistent results between studies on gender differences in mental health outcomes in military samples have left open questions about differential prevalence of post-traumatic stress disorder (PTSD) among all U.S. Army soldiers, as well as differential psychosocial and comorbid risk and protective factor profiles associated with its association with receipt a treatment. METHODS: This study assesses the prevalence and risk factors of a positive PTSD screening in men and women using two large population-based Army samples collected as part of the 2005 and 2008 US survey. Department of Defense surveys of health-related behaviors among active-duty military personnel. RESULTS: The study showed that overall rates of PTSD, as measured by various PTSD checklist cutoffs, are similar in active-duty men and women, with rates increasing between the two study years in both men and women. Points. Depression and problem alcohol use were strongly associated with a positive PTSD screen in both sexes, and combat exposure was significantly associated with a positive PTSD screen in men. In general, active-duty men and women who met criteria for PTSD were equally likely to receive mental health care or treatment, although differences in treatment between men and women varied by age, race, and social background support (husband's presence at work) were different. , history of sexual abuse, illness, depression, alcohol use and loss of control. CONCLUSIONS: The study shows that the prevalence of PTSD and overall mental health utilization in active-duty men are similar to those in women. However, there are significant gender differences in the predictors of positive PTSD screening and PTSD treatment.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Walter Reed National Military Medical Center
- Congress commits:Nee
- Funding source:indefinite
- Release Date/Release:01 January 2016
- Quote:Hourani L, Williams J, Bray RM, Wilk JE, High CW. Gender Differences in Post-Traumatic Stress Disorder and Seeking Help in the U.S. Military. J Women's Health (Larchmt). 2016 Jan;25(1):22-31.
Gender differences among military combatants: do social support, exclusion, and perception of pain affect mental health?
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Abstract
The literature on gender disparities in the mental health of deployed military personnel deployed in a combat role is limited. Subsequent reports from service employees who have returned from the operation are given great attention. Potential key factors contributing to gender disparities in combatant mental health can be found in the literature on a variety of topics, but cross-disciplinary integration of evidence is lacking. A growing body of literature on gender differences in the mental health of service members after deployment suggests that men and women respond differently to perceived levels of social support before and after deployment. A survey of deployed military personnel found that there were no significant gender differences in reported mental health symptoms, but appeared to find significant gender differences in reported perceptions of unit morale. In another related area, research examines how exclusion affects the physical and mental health of individuals and organizations and can lead to perceptions of physical pain, although there is little research on gender differences related to the effects of exclusion. Research has also begun to focus on gender differences in pain response, identifying several biopsychosocial, genetic, and hormonal factors that may play a role as possible underlying mechanisms. In this brief overview, we focus on relevant evidence on the mental health of women in combat roles, gender differences in the impact of perceptions of social support on mental health, the psychological and physical effects of exclusion on individuals and organizations, and starting with integration Recent literature on gender differences in pain perception. We conclude with a synthesis and discussion of the research gaps identified in this review, the implications for clinical practice, and possible future research directions. In summary, there appear to be gender differences in the presence or absence of social support, the impact of exclusion and perceptions of pain. These differences can play a crucial role in the mental health of female combatants. Further research on this topic is required.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Defense Centers of Excellence for Mental Health and Traumatic Brain Injury
- Congress commits:Nee
- Funding source:Defense Health Agency (voorheen TRICARE Management Activity)
- Release Date/Release:01 January 2016
- Quote:McGraw K. Gender differences among military combatants: do social support, exclusion, and pain perception affect mental health? Mil Med. January 2016; 181 (1 supplement): 80-5.
Frequent binge drinking following traumatic brain injury in active duty military personnel during combat operations in the past year.
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Abstract
OBJECTIVE: To determine whether combat traumatic brain injury (TBI) is associated with frequent post-deployment binge drinking in a random sample of active-duty military personnel. PARTICIPANTS: Active duty military personnel who returned home from a deployment to a combat zone within the past year and underwent a health assessment (N=7155). METHODS: Cross-sectional observational study with multivariate analysis of responses to the 2008 US Department of Defense Health-Related Behavior Survey of Active Duty Military Personnel, an anonymous, randomized, population-based assessment of the armed forces. KEY ACTIONS: Frequent binge drinking: 5 or more drinks on the same occasion, at least once a week, for the last 30 days. TBI-AC: Self-reported altered consciousness only; Loss of consciousness (LOC) less than 1 minute (TBI-LOC < 1); and LOC of 1 minute or more (TBI-LOC 1+) after exposure to a Combat Injury. RESULTS: Of active-duty military personnel who had participated in combat operations in the past year, 25.6% had frequent binge drinking and 13.9% reported having a traumatic brain injury on the job, primarily TBI-AC (7th month). .5%). In regression models adjusted for demographics and a positive PTSD screening, active-duty service members with traumatic brain injury had an increased risk of frequent binge drinking compared to those not at risk of injury or without traumatic brain injury: TBI-AC (adjusted probability). ratio 1.48; 95% confidence interval 1.18-1.84); TBI-LOC 1+ (adjusted odds ratio 1.67; 95% confidence interval 1.00-2.79). CONCLUSIONS: Traumatic brain injury was significantly associated with frequent binge drinking in the past month after controlling for PTSD, combat exposure, and other covariates.
- Release status:Published
- Sponsororganisation:Defense Health Agency (voorheen TRICARE Management Activity)
- Sponsor Office:Defense Health Agency (voorheen TRICARE Management Activity)
- Congress commits:Nee
- Funding source:Department, agency, or organization of the federal government other than the Department of Defense
- Release Date/Release:1. September 2012
- Quote:Adams RS, Larson MJ, Corrigan JD, Horgan CM, Williams TV. Frequent binge drinking following traumatic brain injury in active duty military personnel during combat operations in the past year. J Director of Trauma Rehabilitation. 2012 Sep-Oct;27(5):349-60.
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FAQs
Has the Brandon Act been implemented? ›
Congress passed the law in 2021. Caserta's parents are frustrated that the Pentagon is just now implementing the new rules across all services. Each branch has a higher suicide rate than the general public. The Brandon Act was officially rolled out May 5.
What is the brandon act? ›The Brandon Act is a law that creates a self-initiated referral process for service members seeking a mental health evaluation and aims to reduce stigma by allowing them to seek help confidentially. The Brandon Act is named after Petty Officer 3rd Class Brandon Caserta who died by suicide in 2018.
When and why was the Department of Defense created? ›It was formed in 1947 by an act of Congress (amended 1949) combining the War and Navy Departments. The mission of the Department of Defense is to provide, through its military strength, a solid foundation for the national policy of the United States.
What is the Department of Defense responsible for? ›The Department of Defense provides the military forces needed to deter war, and to protect the security of the United States.
What act created the Department of Defense? ›National Security Act of 1947.
Why would I receive a letter from the Department of Defense? ›If DoD suspects your personally identifiable information (PII) has been significantly compromised, you will be notified in writing.
What was the Department of Defense renamed? ›Organization. The United States Secretary of War, a member of the United States Cabinet, headed the War Department. The National Security Act of 1947 established the National Military Establishment, later renamed the United States Department of Defense.
What 3 things does the Department of Defense do? ›Operational energy efforts directly support DoD's Strategic Goal to Defeat our Adversaries, Deter War, and Defend the Nation.
Does the Department of Defense control the military? ›Under the President, who is also Commander in Chief, the Secretary of Defense exercises authority, direction, and control over the Department, which includes the separately organized military departments of Army, Navy, and Air Force, the Joint Chiefs of Staff providing military advice, the unified and specified ...
Who does the Department of Defense work with? ›The United States Department of Defense (DoD, USDOD, or DOD) is an executive branch department of the federal government of the United States charged with coordinating and supervising all agencies and functions of the U.S. government directly related to national security and the United States Armed Forces.
Is the CIA part of the Department of Defense? ›
All but the CIA reside in policy departments and serve departmental as well as national interests. Except for the CIA, which for reasons of security is funded in the Defense budget, they are funded by their parent department's appropriation.
What is the Defense Protection act USA? ›The US Congress adopted the Defense Production Act in 1950 to provide authorities to the President to ensure the supply of materials and services necessary for national defense. Under the Act, the President has access to an array of different actions.
What is the chain of command of the Department of Defense? ›DOD's Top Leaders
The deputy secretary of defense is the second-highest ranking DOD leader. The chairman of the Joint Chiefs of Staff is the principal military advisor to the president and the secretary of defense. The vice chairman of the Joint Chiefs of Staff is the next highest ranking military leader.
Every man who is registered with the Selective Service System will receive a registration acknowledgement letter with a registration card in the mail from Selective Service within 90 days of registering. This is proof of your registration and can be used when applying for: state-based aid in 31 states. federal jobs.
What is a target letter from the Feds? ›It is a letter from the federal prosecutor informing the recipient that they believe he or she has committed a crime or has information on a crime committed. Generally, the target letter will inform the recipient of many things, including, but not limited to: The crime they believe the recipient to have committed.
What powers does the Department of Defense have? ›The Department of Defense is responsible for providing the military forces needed to deter war and protect the security of our country. The major elements of these forces are the Army, Navy, Marine Corps, and Air Force, consisting of about 1.3 million men and women on active duty.
Why is Fort Benning changing its name? ›Harold "Hal" Moore and his wife Julia. Fort Benning, a massive US Army training base near Columbus, Georgia, was renamed Fort Moore on Thursday to honor the late Lt. Gen. Harold “Hal” Moore and his wife Julia, who both made “meaningful and lasting contributions” to the Army, officials said.
Why are Army bases being renamed? ›The Army is moving forward with renaming bases that for decades have honored Confederate rebels who waged war against the United States largely to protect and expand the slave trade.
Why is Fort Bragg changing its name? ›Last year, a committee approved the change, to avoid any association with its namesake. Genera; Braxton Bragg was a Confederate general and former slave owner. The base was also renamed nine streets because of Confederate ties. Officials estimate the change to Fort Liberty will cost more than $6 million.
Why is the US military so powerful? ›The U.S. Armed Forces has significant capabilities in both defense and power projection due to its large budget, resulting in advanced and powerful technologies which enables a widespread deployment of the force around the world, including around 800 military bases outside the United States.
What is the motto of the army? ›
But the motto of “This We'll Defend” lives on as the official motto of the modern US Army.
How strong is the US military? ›United States is ranked 1 of 145 out of the countries considered for the annual Global Firepower review. The nation holds a Power Index score of 0.0712 with a score of 0.0000 being considered exceptional in the GFP assessment. This country is a Top 5 world power according to the GFP index formula.
Is Department of Defense a law enforcement? ›Duties. DoD Police perform a variety of law enforcement and security roles. One major function of a DoD Police officer is to conduct law enforcement and force protection duties.
Who is in charge of the U.S. military? ›General Mark A. Milley is the 20th Chairman of the Joint Chiefs of Staff, the nation's highest-ranking military officer, and the principal military advisor to the President, Secretary of Defense, and National Security Council.
Who controls the Pentagon? ›| The Pentagon | |
|---|---|
| Owner | United States Department of Defense |
| Height | |
| Roof | 77 ft (23 m) |
| Technical details | |
The President of the United States of America is the Commander-in-Chief of the Armed Forces. The Secretary of Defense is the principal defense policy advisor to the President. Under the direction of the President, the Secretary exercises authority, direction, and control over the DoD.
Does the Department of Defense control the National Guard? ›The National Guard is administered by the National Guard Bureau, a joint activity of the Army and Air Force under the DoD. The National Guard Bureau provides a communication channel for state National Guards to the DoD.
How big is the US military? ›The United States is also the world's third largest army in terms of manpower, with about 1.4 million active military personnel in 2022. The United States military consists of different service branches, including the Army, Navy, Airforce, Marine Corps, and Space Force.
When was the defense department created? ›This required a much larger military structure in Washington, of which the Pentagon became the flagship with the creation in 1947 of the National Military Establishment, re-titled the Department of Defense in 1949.
Why was the Department of Defence created quizlet? ›"to provide the military forces needed to deter war and protect the security of the United States."
What did the Department of Defence of the USA develop in 1969? ›
The ARPANET, the precursor of the Internet, began as a research project funded by the Defense Department's Advance Research Project Agency in 1969. The goal was to develop a robust, computer network that could function after a nuclear attack.
When was the Department of Defense created quizlet? ›Congress created the Department of Defense in 1947 when it combined the Department of War and the Department of the Navy. All of the country's armed forces are under the control of this department.
Who runs the Department of Defense? ›About. Lloyd J. Austin III is the 28th secretary of defense, sworn in on Jan. 22, 2021.
Which President started the Department of Defense? ›President Truman followed up the Forrestal proposals with a message to Congress on 5 March 1949 recommending specific changes in the National Security Act, most importantly converting the NME into an executive department–the Department of Defense–and providing the secretary of defense "with appropriate responsibility ...
Why was the Department of Defense created in 1947? ›On July 26, 1947, President Harry Truman signed the National Security Act with the goal of implementing a program that would provide security for the United States in the decades and even centuries to come. To achieve this end, the act made multiple organizational changes within the military and intelligence community.
What did the Department of Defense do during the Cold War? ›The DoD's primary mission during the Cold War era was to deter general war by maintaining sufficient American forces to contest any overt Soviet expansion, principally along the demarcation lines in Europe and Asia established at the end of World War II.
Why was the national defense strategy created? ›The National Defense Strategy (or NDS) is used to establish the objectives for military planning regarding force structure, force modernization, business processes, supporting infrastructure, and required resources (funding and manpower).
What is the U.S. military developing? ›New technologies include advanced computing, “big data” analytics, artificial intelligence, autonomy, robotics, directed energy, hypersonics, and biotechnology—the very technologies that ensure we will be able to fight and win the wars of the future.
What are the three civilian led military departments within the Department of Defense? ›Civilian control over matters other than operations is exercised through the three service departments, the Department of the Army, the Department of the Navy (which includes the Marine Corps), and the Department of the Air Force (which includes the Space Force).
What was the Department of Defense originally known as quizlet? ›The President's group of top advisers, made up of the 15 Secretaries who lead the 15 executive departments. Originally called the "War Department," it manages the military forces and attempts to prevent war, protect the security of the US, and develops new weapons.
What system was developed by the U.S. Department of Defense in the 1970's it is used to gather location time and speed information? ›
The ARPANET was established by the Advanced Research Projects Agency (ARPA) of the United States Department of Defense.
When did Department of War change to defense? ›The avoidance of war, as indicated by the 1947 name change from "Department of War" to "Department of Defense" today holds the highest priority, and the hope that the United States can play a role in limiting violent upheavals around the world is reflected in both its foreign and military policies.
When did it change from war department to Department of Defense? ›Abolished: By the National Security Act of 1947 (61 Stat. 495), July 26, 1947, which abolished the War Department and replaced it with a Department of the Army in the National Military Establishment, later the Department of Defense.