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Monteith LL, Kinney AR, Holliday R, Miller C, Schneider AL, Hoffmire CA, Simonetti JA, Brenner LA, Forster JE. Associations between deployment experiences, safety-related beliefs, and firearm ownership among women Veterans. J Psychiatr Res 2023; 157:72-81. [PMID: 36442409 DOI: 10.1016/j.jpsychires.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/15/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Among women Veterans, firearms are the leading suicide means. This has prompted efforts to elucidate factors associated with women Veterans' firearm ownership. This cross-sectional study examined if deployment experiences were associated with firearm ownership among women Veterans and if safety-related beliefs mediated these associations. METHODS 492 previously deployed post-9/11 women Veterans participated in a national survey that included the Deployment Risk and Resilience Inventory-2, subscales of the Posttraumatic Cognitions Inventory and Posttraumatic Maladaptive Beliefs Scale, and firearm ownership questions. Path analysis was used. RESULTS Perceived threat during deployment was associated with firearm ownership, irrespective of safety-related beliefs. Indirect effects did not support that safety-related beliefs mediated relations between deployment experiences and firearm ownership. The other deployment experiences (sexual harassment, sexual assault, general harassment, combat experiences) were not indirectly associated with firearm ownership, nor were safety-related beliefs (negative cognitions about the world, threat of harm, beliefs about others' reliability and trustworthiness) directly associated with firearm ownership. In an exploratory serial mediation analysis, perceived threat during deployment mediated the association between combat experiences and firearm ownership. In a sensitivity analysis examining firearm acquisition following military service, results were similar, except the indirect effect of combat experiences upon firearm acquisition through perceived threat was not significant. CONCLUSION Post-9/11 women Veterans' firearm acquisition and ownership may relate to specific deployment experiences, such as perceived threat; however, longitudinal studies are needed to fully ascertain this. Efforts to address firearm access among post-9/11 women Veterans may benefit from assessing heightened sense of danger during deployment.
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Affiliation(s)
- Lindsey L Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Rm 1201G, Aurora, CO, 80045, USA.
| | - Adam R Kinney
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Rm 1201G, Aurora, CO, 80045, USA.
| | - Ryan Holliday
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA.
| | - Christin Miller
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA.
| | - Alexandra L Schneider
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA.
| | - Claire A Hoffmire
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Rm 1201G, Aurora, CO, 80045, USA.
| | - Joseph A Simonetti
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA; Division of Hospital Medicine, University of Colorado Anschutz Medical Campus, 12401 East 17th Avenue, 4th Floor, Aurora, CO, 80045, USA.
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Rm 1201G, Aurora, CO, 80045, USA.
| | - Jeri E Forster
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Rm 1201G, Aurora, CO, 80045, USA; Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 East 17th Place, 3rd Floor, Mail Stop B119, Aurora, CO, 80045, USA.
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Cucciare MA, Mengeling MA, Han X, Kennedy K, Torner J, Sadler AG. Experiencing Sexual Assault and/or Stalking-Related Behavior is Associated with Binge Drinking and Substance Use Consequences in Deployed U.S. Servicewomen. Womens Health Issues 2022; 32:402-410. [PMID: 34991954 DOI: 10.1016/j.whi.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Being deployed is a risk factor for poor postdeployment mental health outcomes in U.S. servicewomen, including harmful drinking. However, to our knowledge, no studies have examined deployment-related sexual assault and exposure to stalking-related behavior in relation to binge drinking and substance use consequences in this population. METHODS A community sample of post-9/11 servicewomen from the Midwest, including both veterans and those actively serving (N = 991), completed computer-assisted telephone interviews after deployment. Logistic regression models examined associations between deployment-related sexual assault (attempted or completed) and stalking-related behavior (e.g., being left unwanted things, having property vandalized), and the likelihood of reporting binge drinking and substance use consequences after controlling for covariates. RESULTS U.S. servicewomen experiencing deployment-related sexual assault and/or stalking-related behavior were more likely to report binge drinking in the past 4 weeks and at least one negative consequence of substance use in the past year. Also, 21.56% of the sample reported experiencing any deployment-related sexual assault and/or stalking-related behavior, 17.34% reported any stalking-related behavior and no sexual assault, 2.42% reported both sexual assault and stalking-related behavior, and 1.80% reported sexual assault and no stalking-related behavior. The most commonly endorsed behaviors were being followed or spied on (9.09%), receiving unsolicited correspondence (8.34%-8.74%), and having someone show up at places you were (6.90%). CONCLUSIONS U.S. servicewomen experiencing sexual assault and/or stalking-related behavior during deployment may be at higher risk for binge drinking and experiencing negative consequence of substance use when compared with their peers not reporting these stressors.
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Affiliation(s)
- Michael A Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arizona; VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, Arkansas.
| | - Michelle A Mengeling
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa; VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa; Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Xiaotong Han
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arizona; VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, Arkansas
| | - Kristina Kennedy
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arizona
| | - James Torner
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Anne G Sadler
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa; Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Thomas CL, Nieh C, Hooper TI, Gackstetter GD, LeardMann CA, Porter B, Blazer DG. Sexual Harassment, Sexual Assault, and Physical Activity Among U.S. Military Service Members in the Millennium Cohort Study. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:7043-7066. [PMID: 30827142 DOI: 10.1177/0886260519832904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sexual harassment (SH) and sexual assault (SA) continue to be a focus of prevention efforts in the U.S. military because of the prevalence and potential to affect the health and readiness of service members. Limited research exists on the association of SH and SA with coping behaviors, such as physical activity, within the military. Data including self-reported SA, SH, and physical activity were obtained from the Millennium Cohort Study, a longitudinal cohort study designed to examine the impact of military service on the health and well-being of service members. A hierarchical regression approach was applied to examine the association between SH or SA and subsequent physical activity levels. Hierarchical regression showed that, among those self-reporting recent SA, the odds of medium-high (300-449 min/week) and high physical activity levels (≥450 min/week) were significantly increased. Although the magnitude of these associations was attenuated with an increasing amount of adjustment, the odds of high physical activity levels remained statistically significant in the fully adjusted model (medium-high: odds ratio [OR] = 1.72, 95% confidence interval [CI] = [1.08, 2.73]; high: OR = 1.58, 95% CI = [1.02, 2.44]). We observed statistically significant negative associations between recent SH and medium-high physical activity levels in adjusted models (OR = 0.70, 95% CI = [0.54, 0.91]). The current results demonstrate that SA is generally associated with increased levels of physical activity among military service members. Analyzing the relationship between sexual trauma and physical activity is valuable because of the high prevalence of SH and SA in the military, long-term health implications including physical and emotional well-being, and potential impact on military readiness.
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Affiliation(s)
- Connie L Thomas
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Chiping Nieh
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Tomoko I Hooper
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Cynthia A LeardMann
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Ben Porter
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
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Hood KB, Pollack LM, Jackson DD, Boyer CB. Associations Among Behavioral Risk, Sociodemographic Identifiers, and Sexually Transmitted Infections in Male and Female Army Enlisted Personnel. Mil Med 2020; 186:e75-e84. [PMID: 32909601 DOI: 10.1093/milmed/usaa247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/29/2020] [Accepted: 07/30/2020] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Rates of sexually transmitted infections (STIs) are higher among U.S. military personnel than their civilian counterparts. Yet there is a paucity of military-specific research that has utilized theoretical frameworks to describe the relative influence of the multiple and interrelated risk factors associated with STIs in this population of young, healthy men and women. The aim of this study was to examine the relative influence of Information, Motivation, and Behavioral Skills Model (IMB) factors known to be associated with condom use and STI diagnosis, as well as examine gender differences among a cohort of young, active duty enlistees who are in the very early stages of their military careers. MATERIALS AND METHODS Data were collected in 2011 to 2013 through self-administered questionnaires and laboratory-confirmed tests of STIs. Logistic regression analyses were used to assess IMB constructs, behavioral risk variables, and sociodemographic factors associated with STI diagnosis and condom use separately among female and male military personnel. RESULTS STIs among males were significantly associated with nonwhite race, lower STI behavioral intentions and STI behavioral skills, and engaging in sex after drinking alcohol. Further, males who reported more positive attitudes toward using condoms, higher confidence in preventing drinking, higher alcohol prevention norms among peers, a lower frequency of drinking alcohol before engaging in sexual intercourse, more sexual partners, and higher STI behavioral intentions were significantly more likely to report using condoms consistently during sexual encounters. Among female participants, a history of STIs was significantly associated with higher numbers of reported sexual partners and greater alcohol prevention efficacy while lifetime consistent condom use was significantly associated only with stronger intentions to avoid behaviors that might result in STI acquisition. CONCLUSION Our findings support the need for development of STI prevention strategies that include education and skills-building approaches to reduce alcohol misuse among enlisted military personnel, and especially male personnel. Such programs should include factors that uniquely influence the experiences of males and females in the military context.
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Affiliation(s)
- Kristina B Hood
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Lance M Pollack
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, CA 94143, USA
| | | | - Cherrie B Boyer
- Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco, CA 94118, USA
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Sadler AG, Mengeling MA, Cook BL, Torner JC. Factors Associated with U.S. Military Women Keeping Guns or Weapons Nearby for Personal Security Following Deployment. J Womens Health (Larchmt) 2020; 30:103-112. [PMID: 32460621 DOI: 10.1089/jwh.2019.8029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The relationship between postdeployment health characteristics and U.S. military women and women Veteran's gun/weapons use for personal safety outside of military is not well understood. The purpose of this exploratory study was to determine if Operation Enduring and Iraqi Freedom era military women and women Veterans keep guns/weapons nearby for personal security outside of military duties postdeployment and factors associated with this. Methods: A Midwestern community sample of US Army and Air Force currently serving Military women and women Veterans (N = 978) who had deployed to Iraq/Afghanistan (I/A) or outside of the United States completed telephone interviews (March 2010 to December 2011) querying sociodemographic and military characteristics, combat and gender-based trauma, and guns/weapons use postdeployment. Data were analyzed in June 2019 with chi-square, Fisher's Exact test, and odds ratios. A classification tree analysis identified subgroups with the greatest proportion of keeping guns/weapons nearby for security. Results: One-fifth of participants reported having guns/weapons nearby to feel secure. Women more likely to report this were younger, patrolled their homes for security (age adjusted odds ratio [aOR] 7.0); experienced combat (aOR 3.0-4.9) or gender-based traumas (aOR 1.9-2.0); self-reported mental health conditions (aOR 1.5-4.3), including post-traumatic stress disorder (PTSD; aOR 4.3); or relied on friends/family for housing (aOR 4.8). Most had seen a provider in the preceding year. The classification tree found women patrolling their homes, PTSD positive, and injured/wounded in I/A had the largest proportion of women keeping guns/weapons nearby for security. Conclusions: Keeping gun/weapons nearby for personal self-defense is a potential marker for complex postdeployment readjustment conditions and an overlooked public health concern. Provider recognition and assessment of women's postdeployment fears and safety-related activities are essential to address military women and women Veterans and their families' safety in this high-risk population.
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Affiliation(s)
- Anne G Sadler
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa, USA
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center, Iowa City, Iowa, USA
| | - Michelle A Mengeling
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa, USA
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center, Iowa City, Iowa, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine Iowa City, Iowa City, Iowa, USA
| | - Brian L Cook
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa, USA
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - James C Torner
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
- Department of Neurosurgery and Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
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Cucciare MA, Mengeling MA, Han X, Torner J, Sadler AG. Associations between Augmentee Status, Deployment Stress Preparedness and Depression, Post-Traumatic Stress Disorder, and Binge Drinking in U.S. Servicewomen. Womens Health Issues 2020; 30:207-213. [PMID: 32081595 DOI: 10.1016/j.whi.2020.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Being deployed without one's home unit (individual-augmentee) and low perceived deployment preparedness are risk factors for mental health symptoms and substance use in male service members. However, these relationships have not been examined specifically in U.S. servicewomen. This study sought to fill this gap by examining associations between augmentee status and deployment stress preparedness (independent variables) and depression, probable post-traumatic stress disorder (PTSD), and binge drinking (dependent variables) in a sample of U.S. servicewomen. METHODS A community sample of service women from the Midwest, including both veterans and those serving at the time of data collection (N = 991), completed structured telephone interviews. Logistic regression was used to examine associations between augmentee status, deployment stress preparedness, and the likelihood of reporting depression, probable PTSD, and binge drinking after controlling for covariates. RESULTS Findings showed that U.S. servicewomen in the Reserve/Guard who deployed as individual-augmentees were more likely to screen positive for depression, report probable PTSD, and disclose recent binge drinking than servicewomen in the Reserve/Guard deployed with their home unit. Also, among servicewomen deployed as individual-augmentees, those in the Reserve/Guard were more likely to report binge drinking than servicewomen in the active component. No statistically significant associations between deployment stress preparedness and mental health symptoms or binge drinking were observed. CONCLUSIONS Servicewomen in the Reserve/Guard who deployed as individual-augmentees may be at increased risk for depression, probable PTSD, and hazardous drinking when compared with their active component and Reserve/Guard peers deployed with their home units.
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Affiliation(s)
- Michael A Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas; VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, Arkansas.
| | - Michelle A Mengeling
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa; VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, Iowa; Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Xiaotong Han
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas; VA South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, Arkansas
| | - James Torner
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Anne G Sadler
- Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa; Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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