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O'Neal CW, Lavner JA, Jensen TM, Lucier-Greer M. Mental health profiles of depressive symptoms and personal well-being among active-duty military families. FAMILY PROCESS 2024. [PMID: 38653488 DOI: 10.1111/famp.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024]
Abstract
Although some research has examined the mental health of individual family members in military families, additional research is needed that considers mental health among multiple members of the family system simultaneously and that characterizes subsets of families with distinct patterns. Mental health patterns of depressive symptoms and well-being in and among families were identified using latent profile analysis with a community sample of 236 military families with a service member (SM) parent, civilian partner, and adolescent. Drawing from the Family Adjustment and Adaptation Response model, we examined several military-related family demands (e.g., relocations, deployments) and capabilities (e.g., family cohesion, social support outside the family) as correlates of the family profiles. Three profiles emerged: thriving families (62.3% of the sample where all three family members reported relatively low depressive symptoms and high personal well-being), families with a relatively distressed SM (24.2%), and families with a relatively distressed adolescent (13.5%). Overall, there were no differences between the groups of families regarding military-related demands, yet there were differences between the groups regarding their capabilities, namely family cohesion and social support. In general, families in the thriving profile tended to have higher family cohesion and social support as reported by multiple family members compared to the other two profiles. Findings can inform the development of family needs assessments and tailored interventions (and intervention points) based on family profiles and current capabilities.
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Affiliation(s)
- Catherine Walker O'Neal
- Department of Human Development and Family Science, The University of Georgia, Athens, Georgia, USA
| | - Justin A Lavner
- Department of Psychology, The University of Georgia, Athens, Georgia, USA
| | - Todd M Jensen
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mallory Lucier-Greer
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
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Polusny MA, Marquardt CA, Hubbling M, Campbell EH, Arbisi PA, Davenport ND, Lim KO, Lissek S, Schaefer JD, Sponheim SR, Masten AS, Noorbaloochi S. Adaptation in Young Military Recruits: Protocol for the Advancing Research on Mechanisms of Resilience (ARMOR) Prospective Longitudinal Study. JMIR Res Protoc 2023; 12:e51235. [PMID: 37792432 PMCID: PMC10585449 DOI: 10.2196/51235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Military services provide a unique opportunity for studying resilience, a dynamic process of successful adaptation (ie, doing well in terms of functioning and symptoms) in response to significant adversity. Despite the tremendous interest in positive adaptation among military service members, little is known about the processes underlying their resilience. Understanding the neurobiological, cognitive, and social mechanisms underlying adaptive functioning following military stressor exposure is essential for enhancing the resilience of military service members. OBJECTIVE The primary objective of the Advancing Research on Mechanisms of Resilience (ARMOR) longitudinal study is to characterize the trajectories of positive adaptation among young military recruits in response to basic combat training (BCT), a well-defined, uniform, and 10-week period of intense stress (aim 1), and identify promotive and protective processes contributing to individual variations in resilience (aim 2). The secondary objective is to investigate the pathways by which neurobehavioral markers of self-regulation assessed using electroencephalography and magnetic resonance imaging contribute to adaptive trajectories (aim 3). METHODS ARMOR is an ongoing, prospective longitudinal cohort study of young military recruits who recently joined the National Guard but have not yet shipped out for BCT. Participants (N=1201) are assessed at 5 time points over the initial >2 years of military service beginning before BCT (baseline) and followed up at 2 weeks and 6, 12, and 18 months after BCT. Participants complete web-based questionnaires assessing vulnerability and protective factors, mental health, and socioemotional functioning at each time point and a battery of neurocognitive tests at time 0. A subset of participants also complete structured diagnostic interviews and additional self-report measures and perform neurobehavioral tasks before and after BCT during electroencephalography sessions and before BCT only during magnetic resonance imaging sessions. RESULTS This UG3/UH3 project was initially funded in August 2017, with the UG3 pilot work completed at the end of 2018. The UH3 phase of the project was funded in March 2019. Study enrollment for the UH3 phase began on April 14, 2019, and ended on October 16, 2021. A total of 1201 participants are enrolled in the study. Follow-up data collection for the UH3 phase is ongoing and projected to continue through February 2024. We will disseminate the findings through conferences, webinars, open access publications, and communications with participants and stakeholders. CONCLUSIONS The ARMOR study provides a rich data set to identify the predictors and mechanisms of resilient and nonresilient outcomes in the context of military stressors, which are intended to empirically inform the development of prevention and intervention strategies to enhance the resilience of military trainees and potentially other young people facing significant life challenges. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51235.
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Affiliation(s)
- Melissa A Polusny
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Center for Care Delivery and Outcomes Research, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Craig A Marquardt
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Michelle Hubbling
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Emily Hagel Campbell
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Center for Care Delivery and Outcomes Research, Minneapolis, MN, United States
| | - Paul A Arbisi
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Nicholas D Davenport
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Kelvin O Lim
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota-Twin Cities, Minneapolis, MN, United States
| | - Jonathan D Schaefer
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
| | - Scott R Sponheim
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
- Department of Psychology, University of Minnesota-Twin Cities, Minneapolis, MN, United States
| | - Ann S Masten
- Institute of Child Development, University of Minnesota-Twin Cities, Minneapolis, MN, United States
| | - Siamak Noorbaloochi
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
- Center for Care Delivery and Outcomes Research, Minneapolis, MN, United States
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
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Polusny MA, Erbes CR. A dynamic, multilevel approach to conceptualising and designing resilience research in the context of military stress. Stress Health 2023; 39:40-47. [PMID: 37248806 PMCID: PMC10528202 DOI: 10.1002/smi.3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Challenges in conceptualising resilience have impeded advancements in resilience science. In response, the National Institutes of Health (NIH) developed a general framework for harmonising the conceptualisation of resilience as a dynamic process determined by multiple systems and levels of analysis. Consistent with the NIH Resilience Framework, this paper presents a conceptual model of resilience applied to military service members. This model encompasses four core components necessary for resilience research: (1) the presence of significant challenge, (2) successful adaptation in response to the challenge, (3) the capacity for resilience (i.e., protective factors), and (4) the processes (i.e., mechanisms) by which protective factors exert positive effects on an individual's response. Guided by this conceptual model, we outline key methodological recommendations to advance resilience research and illustrate each using the Advancing Research on Mechanisms of Resilience study as an exemplar. We emphasise the need for future research to examine resilience as a dynamic process and apply a multilevel approach. We hope to provide a basic road map to those interested in improving the rigour of future research on resilience in a military context, the results of which can inform the development of interventions.
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Affiliation(s)
- Melissa A. Polusny
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Minneapolis, MN
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School
| | - Christopher R. Erbes
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Minneapolis, MN
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School
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Polusny MA, Marquardt CA, Hubbling S, Campbell EH, Arbisi PA, Davenport ND, Lim KO, Lissek S, Schaefer JD, Sponheim SR, Masten AS, Noorbaloochi S. Advancing Research on Mechanisms of Resilience (ARMOR) Prospective Longitudinal Study of Adaptation in Young Military Recruits: Protocol and rationale for methods and measures. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.07.23292348. [PMID: 37502945 PMCID: PMC10370239 DOI: 10.1101/2023.07.07.23292348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background Military service provides a unique opportunity for studying resilience, a dynamic process of successful adaptation (i.e., doing well in terms of functioning and symptoms) in response to significant adversity. Despite tremendous interest in positive adaptation among military service members, little is known about the processes underlying their resilience. Understanding neurobiological, cognitive, and social mechanisms underlying adaptive functioning following military stressor exposure is essential to enhance the resilience of military service members. Objectives The primary objective of the Advancing Research on Mechanisms of Resilience (ARMOR) longitudinal study is to characterize trajectories of positive adaptation among young military recruits in response to Basic Combat Training (BCT), a well-defined, uniform, 10-week period of intense stress (Aim 1) and identify promotive and protective processes contributing to individual variations in resilience (Aim 2). The secondary objective is to investigate pathways by which neurobehavioral markers of self-regulation assessed by electroencephalography (EEG) and magnetic resonance imaging (MRI) contribute to adaptive trajectories (Aim 3). Methods ARMOR is an ongoing, prospective longitudinal cohort study of young military recruits who recently joined the National Guard but have not yet shipped for BCT. Participants (N=1,201) are assessed at five timepoints over the initial 2+ years of military service beginning before BCT (baseline) and followed up at 2 weeks, 6, 12, and 18 months post-BCT. At each time point, participants complete online questionnaires assessing vulnerability and protective factors, mental health and social-emotional functioning, and, at Time 0 only, a battery of neurocognitive tests. A subset of participants also complete structured diagnostic interviews, additional self-report measures, and perform neurobehavioral tasks before and after BCT during EEG sessions, and, at pre-BCT only, during MRI sessions. Results Study enrollment began April 14, 2019 and ended in October 16, 2021. A total of 1,201 participants are enrolled in the study (68.9% male; mean age = 18.9, SD = 3.0). Follow-up data-collection is ongoing and projected to continue through March 2024. We will disseminate findings through conferences, webinars, open access publications, and communications with participants and stakeholders. Conclusions Results are expected to elucidate how young military recruits adapt to military stressors during the initial years of military service. Understanding positive adaptation of military recruits in the face of BCT has implications for developing prevention and intervention strategies to enhance resilience of military trainees and potentially other young people facing significant life challenges.
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Affiliation(s)
- Melissa A Polusny
- Minneapolis VA Health Care System, Minneapolis, MN
- Center for Care Delivery Outcomes Research, Minneapolis, MN
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Craig A Marquardt
- Minneapolis VA Health Care System, Minneapolis, MN
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Shelly Hubbling
- Minneapolis VA Health Care System, Minneapolis, MN
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Emily Hagel Campbell
- Minneapolis VA Health Care System, Minneapolis, MN
- Center for Care Delivery Outcomes Research, Minneapolis, MN
| | - Paul A Arbisi
- Minneapolis VA Health Care System, Minneapolis, MN
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Nicholas D Davenport
- Minneapolis VA Health Care System, Minneapolis, MN
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Kelvin O Lim
- Minneapolis VA Health Care System, Minneapolis, MN
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
| | - Shumel Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | | | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Ann S Masten
- Institute of Child Development, University of Minnesota, Minneapolis, MN
| | - Siamak Noorbaloochi
- Minneapolis VA Health Care System, Minneapolis, MN
- Center for Care Delivery Outcomes Research, Minneapolis, MN
- Department of Medicine, University of Minnesota Medical School
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5
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Hitz AC, Hubbling SBD, Hodges A, Campbell EMH, Bangerter A, Polusny MA. Feasibility of a prospective, longitudinal study of resilience among young military recruits with embedded laboratory sub-study: the ARMOR pilot trial. RESEARCH SQUARE 2023:rs.3.rs-3112652. [PMID: 37461702 PMCID: PMC10350231 DOI: 10.21203/rs.3.rs-3112652/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Background Multilevel, longitudinal studies are integral to resilience research; however, they are costly and present unique methodological challenges. The objective of this study was to examine the feasibility of study methods (recruitment, retention, data collection) for a large-scale prospective, longitudinal study of resilience among young National Guard recruits. Methods This feasibility trial used a pre-test/post-test design with embedded laboratory sub-study. Participants were young military recruits who had recently enlisted in the Army National Guard and had not yet shipped to Basic Combat Training (BCT). Recruitment and baseline data collection (Time 1), which included a battery of computerized self-report measures and neurocognitive tests, were conducted at local armories. Participants completed an online follow-up (Time 2) survey outside of drill training after returning from BCT. A subset of participants was recruited to complete extensive laboratory procedures pre-and post-BCT, including clinical interview, additional self-report measures, and performance on a series of neurobehavioral tasks during electroencephalogram recordings and, at pre-BCT only, magnetic resonances imaging. Feasibility outcomes assessed our ability to recruit, retain, and collect data from participants. Analysis of outcomes was based on descriptive statistics and evaluation of the feasibility of the larger study was based on pre-determined go/no go progression criteria. Results All pre-determined progression criteria were met. A total of 102 (97.1%) of eligible military service members consented to participate. Of these, 73 (73.7%) completed the Time 2 survey. Of the 24 participants approached, 14 agreed to participate in the laboratory sub-study, 13 completed follow-up laboratory visits. Overall, completion of online surveys and laboratory tasks was excellent. However, participants had difficulties completing online surveys during BCT and the computerized neurocognitive testing battery at Time 2. Conclusions Study methods were feasible, and all predetermined criteria for progression to the large-scale longitudinal study were met. Some minor protocol adaptations were identified from this feasibility study. Lessons learned and recommendations for future research are discussed.
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Affiliation(s)
- Andrea C Hitz
- University of Minnesota Medical School Twin Cities Campus: University of Minnesota Twin Cities School of Medicine
| | | | - Annika Hodges
- Minneapolis VA Health Care System: Minneapolis VA Medical Center
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6
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Knobloch LK, Monk JK, MacDermid Wadsworth SM. Relationship Maintenance among Military Couples. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2023; 40:734-772. [PMID: 37200941 PMCID: PMC10191153 DOI: 10.1177/02654075221105025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
A burgeoning body of research on the relationship maintenance of military couples over the past two decades suggests the time is right to organize, assimilate, and critique the literature. We conducted a systematic review informed by the integrative model of relationship maintenance (Ogolsky et al., 2017) that considered issues of intersectionality (Crenshaw, 1991). Our literature search identified 81 relevant journal articles representing 62 unique samples. With respect to theory, 59.3% of the journal articles employed one or more formal theoretical frameworks. In terms of research design, 88.7% of the studies focused on the U.S. military, 83.9% of the studies recruited convenience samples, 54.8% of the studies utilized quantitative methods, and 30.6% of the studies collected longitudinal data. Among the studies reporting sample demographics, 96.8% of participants were married, 77.2% of participants identified as non-Hispanic White, and only one same-sex relationship was represented. Our narrative synthesis integrated findings about relationship maintenance from studies examining (a) relationship maintenance overtly, (b) communicating to stay connected across the deployment cycle, (c) disclosure and protective buffering, (d) support from a partner, (e) dyadic coping, and (f) caregiving and accommodating a partner's symptoms. We interpret our results with an eye toward advancing theory, research, and practice.
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Affiliation(s)
| | - J. Kale Monk
- Department of Human Development and Family Science, University of Missouri
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Kuhn E, Sayers SL, Babusci C, Conroy C, Erbes CR. Internet-based family training with telephone coaching to promote mental health treatment initiation among veterans with posttraumatic stress disorder: A pilot study. J Trauma Stress 2022. [PMID: 36562921 DOI: 10.1002/jts.22900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/05/2022] [Accepted: 10/27/2022] [Indexed: 12/24/2022]
Abstract
Posttraumatic stress disorder (PTSD) is common among military veterans, yet many affected veterans do not seek treatment. Family members of these veterans often experience compromised well-being and a desire for the veteran to receive mental health care. The Veterans Affairs (VA)-Community Reinforcement and Family Training (VA-CRAFT) for PTSD is an internet-based intervention intended to teach veterans' family members skills to encourage veterans to initiate mental health care. This study assessed the feasibility, acceptability, and potential efficacy of VA-CRAFT with telephone coaching in a sample of 12 spouses and intimate partners of veterans with PTSD. Participants completed the intervention over 12 weeks and were assessed pre- and posttreatment. For feasibility, 75.0% (n = 9) of participants completed the intervention and reported few difficulties and ease of use. Supporting acceptability, all nine completers had mostly favorable impressions of the intervention and perceived it as helpful. Finally, six (50.0%) participants got the PTSD-affected veteran to engage in mental health care; however, aside from potentially increasing treatment talk frequency, outcome expectancy, and self-efficacy, ds = 0.60-1.08, no apparent improvements were observed for any well-being outcomes, ds = 0.01-0.40. Although the findings are promising, given the study limitations, future research is required to evaluate this approach in a full-scale randomized controlled trial.
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Affiliation(s)
- Eric Kuhn
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Steven L Sayers
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christina Babusci
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Catherine Conroy
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Christopher R Erbes
- Center for Chronic Disease Outcomes Research, Minneapolis VA HealthCare System, Minneapolis, Minnesota, USA.,Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Geraci JC, Finley EP, Edwards ER, Frankfurt S, Kurz AS, Kamdar N, Vanneman ME, Lopoo LM, Patnaik H, Yoon J, Armstrong N, Greene AL, Cantor G, Wrobleski J, Young E, Goldsmith M, Seim RW, Goodman M. Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness-implementation trial. Implement Sci 2022; 17:43. [PMID: 35804354 PMCID: PMC9264302 DOI: 10.1186/s13012-022-01212-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The USA is undergoing a suicide epidemic for its youngest Veterans (18-to-34-years-old) as their suicide rate has almost doubled since 2001. Veterans are at the highest risk during their first-year post-discharge, thus creating a "deadly gap." In response, the nation has developed strategies that emphasize a preventive, universal, and public health approach and embrace the value of community interventions. The three-step theory of suicide suggests that community interventions that reduce reintegration difficulties and promote connectedness for Veterans as they transition to civilian life have the greatest likelihood of reducing suicide. Recent research shows that the effectiveness of community interventions can be enhanced when augmented by volunteer and certified sponsors (1-on-1) who actively engage with Veterans, as part of the Veteran Sponsorship Initiative (VSI). METHOD/DESIGN The purpose of this randomized hybrid type 2 effectiveness-implementation trial is to evaluate the implementation of the VSI in six cities in Texas in collaboration with the US Departments of Defense, Labor and Veterans Affairs, Texas government, and local stakeholders. Texas is an optimal location for this large-scale implementation as it has the second largest population of these young Veterans and is home to the largest US military installation, Fort Hood. The first aim is to determine the effectiveness of the VSI, as evidenced by measures of reintegration difficulties, health/psychological distress, VA healthcare utilization, connectedness, and suicidal risk. The second aim is to determine the feasibility and potential utility of a stakeholder-engaged plan for implementing the VSI in Texas with the intent of future expansion in more states. The evaluators will use a stepped wedge design with a sequential roll-out to participating cities over time. Participants (n=630) will be enrolled on military installations six months prior to discharge. Implementation efforts will draw upon a bundled implementation strategy that includes strategies such as ongoing training, implementation facilitation, and audit and feedback. Formative and summative evaluations will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and will include interviews with participants and periodic reflections with key stakeholders to longitudinally identify barriers and facilitators to implementation. DISCUSSION This evaluation will have important implications for the national implementation of community interventions that address the epidemic of Veteran suicide. Aligned with the Evidence Act, it is the first large-scale implementation of an evidence-based practice that conducts a thorough assessment of TSMVs during the "deadly gap." TRIAL REGISTRATION ClinicalTrials.gov ID number: NCT05224440 . Registered on 04 February 2022.
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Affiliation(s)
- Joseph C Geraci
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA. .,Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA. .,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Erin P Finley
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, New York, USA
| | - Emily R Edwards
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheila Frankfurt
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Central Texas Veterans Healthcare System, Temple, TX, USA
| | - A Solomon Kurz
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA
| | - Nipa Kamdar
- Center for Innovations in Quality, Effectiveness and Safety, VA, VA, Houston, USA
| | - Megan E Vanneman
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Leonard M Lopoo
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - Hannah Patnaik
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - Jean Yoon
- VA Health Economics Resource Center, VA Palo Alto Healthcare System, Livermore, CA, USA.,Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, CA, USA
| | - Nicholas Armstrong
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Ashley L Greene
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gilly Cantor
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Joseph Wrobleski
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA
| | - Erin Young
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA.,Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Matthew Goldsmith
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA
| | - Richard W Seim
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA
| | - Marianne Goodman
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Polusny MA, Marquardt CA, Campbell EH, Filetti CR, Noël VV, Disner SG, Schaefer JD, Davenport N, Lissek S, Noorbaloochi S, Sponheim SR, Erbes CR. Advancing Research on Mechanisms of Resilience (ARMOR) Longitudinal Cohort Study of New Military Recruits: Results from a Feasibility Pilot Study. RESEARCH IN HUMAN DEVELOPMENT 2021; 18:212-229. [PMID: 34887706 DOI: 10.1080/15427609.2021.1964898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Psychological resilience as a longitudinal process is highly relevant for understanding the functioning outcomes of military populations. Here, we review the extant literature on resilience among military service members, focusing on National Guard Soldiers. Our specific project (Advancing Research on Mechanisms of Resilience, "ARMOR") aims to develop a comprehensive model of resilience using a multilevel perspective. We report results from our prospective pilot study (n = 103) conducted in preparation for our large-scale longitudinal cohort study of Basic Combat Training (BCT) and its impact on military recruits' wellbeing. Results support feasibility of the larger study, evidence for a new measure of BCT stressor exposure, and demonstrate preliminary associations with BCT-related stressors and longitudinal changes in adaptive functioning. Future directions for our larger study will utilize data from survey responses, structured clinical interviews, neurobehavioral tasks, and neurobiological measures (functional and structural MRI and electroencephalography [EEG]) to examine individual differences in self-regulation as a predictor of resilience-related processes. ARMOR is well positioned to elucidate mechanisms that could be targeted for promoting wellbeing, preventing psychopathology, and facilitating long-term recovery.
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Affiliation(s)
- Melissa A Polusny
- Minneapolis VA Health Care System, Minneapolis, MN.,Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Craig A Marquardt
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Emily Hagel Campbell
- Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Clarissa R Filetti
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Valentin V Noël
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | | | - Nicholas Davenport
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota - Twin Cities
| | - Siamak Noorbaloochi
- Minneapolis VA Health Care System, Minneapolis, MN.,Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Christopher R Erbes
- Minneapolis VA Health Care System, Minneapolis, MN.,Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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10
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Coppola EC, Christ SL, Topp D, Southwell K, Bailey K, MacDermid Wadsworth S. Trajectories of depression symptoms during the process of deployment in military couples. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1974807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Elizabeth C. Coppola
- Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - Sharon L. Christ
- Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - David Topp
- Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
| | | | - Keisha Bailey
- Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
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11
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Erbes CR, Kuhn E, Polusny MA, Ruzek JI, Spoont M, Meis LA, Gifford E, Weingardt KR, Campbell EH, Oleson H, Taylor BC. A Pilot Trial of Online Training for Family Well-Being and Veteran Treatment Initiation for PTSD. Mil Med 2020; 185:401-408. [PMID: 31621884 DOI: 10.1093/milmed/usz326] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/27/2019] [Accepted: 08/13/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Family members are important supports for veterans with Posttrauamtic Stress Disroder (PTSD), but they often struggle with their own distress and challenges. The Veterans Affairs-Community Reinforcement and Family Training (VA-CRAFT) website was designed to teach family members of veterans with PTSD effective ways to interact with their veterans to encourage initiation of mental health services as well as to care for themselves and improve their relationships. This article presents a pilot investigation of VA-CRAFT. MATERIALS AND METHOD Spouse/partners of veterans who had screened positive for PTSD but were not in mental health treatment were randomized to either use the VA-CRAFT website (n = 22) or to a waitlist control condition (n = 19) for 3 months. Veteran mental health service initiation was assessed posttreatment. Spouse/partner distress, caregiver burden, quality of life, and relationship quality were assessed pre and posttreatment. The study was approved by the Minneapolis VA Health Care System Institutional Review Board (IRB). RESULTS Differences between groups on veteran treatment initiation were small (Phi = 0.17) and not statistically significant. VA-CRAFT participants reported large and statistically significantly greater decreases in overall caregiver burden (η2 = 0.10) and objective caregiver burden (η2 = 0.14) than control participants. Effects were larger for those with greater initial distress. Effects sizes for other partner outcomes were negligible (η2 = 0.01) to medium (η2 = 0.09) and not statistically significant. Postintervention interviews suggested that only 33% of the VA-CRAFT participants talked with their veterans about starting treatment for PTSD during the trial. CONCLUSION Results from this pilot trial suggest that VA-CRAFT holds initial promise in reducing caregiver burden and as such it could be a useful resource for family members of veterans with PTSD. However, VA-CRAFT does not enhance veteran treatment initiation. It may benefit from enhancements to increase effectiveness and caregiver engagement.
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Affiliation(s)
- Christopher R Erbes
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
- University of Minnesota Medical School, 420 Delaware St., Minneapolis, MN 55455
| | - Eric Kuhn
- Veterans Affairs Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025
- Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305
- National Center for PTSD, 795 Willow Road Menlo Park, CA 94025
| | - Melissa A Polusny
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
- University of Minnesota Medical School, 420 Delaware St., Minneapolis, MN 55455
| | - Josef I Ruzek
- Veterans Affairs Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025
- Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305
- National Center for PTSD, 795 Willow Road Menlo Park, CA 94025
| | - Michele Spoont
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
- University of Minnesota Medical School, 420 Delaware St., Minneapolis, MN 55455
- National Center for PTSD, 795 Willow Road Menlo Park, CA 94025
| | - Laura A Meis
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
- University of Minnesota Medical School, 420 Delaware St., Minneapolis, MN 55455
| | - Elizabeth Gifford
- Veterans Affairs Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025
| | | | - Emily Hagel Campbell
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Heather Oleson
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
| | - Brent C Taylor
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, One Veterans Drive, Minneapolis, MN 55417
- University of Minnesota Medical School, 420 Delaware St., Minneapolis, MN 55455
- University of Minnesota School of Public Health, 420 Delaware St., Minneapolis, MN 55455
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12
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Sinclair RR, Paulson AL, Riviere LA. The Resilient Spouse: Understanding Factors Associated With Dispositional Resilience Among Military Spouses. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/21635781.2019.1608876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Robert R. Sinclair
- Department of Military Psychiatry, Center for Military Psychiatry and Neurosciences, Silver Spring, Maryland
- Department of Psychology, Clemson University, Clemson, South Carolina
| | | | - Lyndon A. Riviere
- Department of Military Psychiatry, Center for Military Psychiatry and Neurosciences, Silver Spring, Maryland
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13
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Monney MK. Resilience Among Spouses of United States Service Members During Deployment. Issues Ment Health Nurs 2019; 40:362-364. [PMID: 30570342 DOI: 10.1080/01612840.2018.1491657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Meghan K Monney
- a School of Nursing , University of Texas Health Science Center , San Antonio , Texas , USA
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14
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Berzins TL, Van Dulmen MHM, Deluca H. Alcohol use affects sleep duration among military couples. MILITARY PSYCHOLOGY 2018. [DOI: 10.1080/08995605.2018.1521684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | - Haylee Deluca
- Department of Psychological Sciences, Kent State University, Kent, Ohio
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15
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Vest BM, Heavey SC, Homish DL, Homish GG. Alcohol Misuse in Reserve Soldiers and their Partners: Cross-Spouse Effects of Deployment and Combat Exposure. Subst Use Misuse 2018; 53:800-807. [PMID: 29161165 PMCID: PMC5951303 DOI: 10.1080/10826084.2017.1385632] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Military deployment and combat are associated with worse outcomes, including alcohol misuse. Less is known about how these experiences affect soldiers' spouses. OBJECTIVE The study objective was to explore relationships between deployment, combat exposure, and alcohol misuse; especially cross-spouse effects (effect of one partner's experiences/behavior on the other partner), which has been under-examined in military samples. METHODS U.S. Army Reserve/National Guard soldiers and their partners completed a questionnaire covering physical and mental health, military service and substance use. Negative binomial regression models examined number of deployments and combat exposure individually for alcohol misuse and frequent heavy drinking (FHD). In additional models, we examined combat exposure's role on alcohol outcomes, controlling for the soldiers' number of deployments, PTSD symptoms, age, and in cross-spouse models, alcohol use and FHD. We considered individuals' deployment experiences related to their alcohol outcomes and to their spouses' alcohol outcomes. RESULTS The study sample included male soldiers with current/lifetime military service (n = 248) and their female partners. Combat exposure was related to FHD (RR: 1.01, p < .05, 95% CI: 1.01, 1.01) among male soldiers while controlling for PTSD symptoms, number of deployments, and age. Female partners of male soldiers were more likely to engage in FHD (RR: 1.01, p < .05, 95% CI: 1.01, 1.01) if their spouse experienced combat. CONCLUSIONS Our results demonstrate that male soldiers and their spouses are at increased risk of FHD if the soldier experienced combat. This points to the need for better screening, particularly of spouses of soldiers, whose alcohol misuse may be overlooked.
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Affiliation(s)
- Bonnie M. Vest
- Department of Family Medicine, University at Buffalo, Buffalo NY
| | - Sarah Cercone Heavey
- Department of Community Health & Health Behavior, University at Buffalo, Buffalo NY
| | - D. Lynn Homish
- Department of Community Health & Health Behavior, University at Buffalo, Buffalo NY
| | - Gregory G. Homish
- Department of Family Medicine, University at Buffalo, Buffalo NY
- Department of Community Health & Health Behavior, University at Buffalo, Buffalo NY
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