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Pre-deployment Year Mental Health Diagnoses and Treatment in Deployed Army Women

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Abstract

We estimated the prevalence of select mental health diagnoses (MHDX) and mental health treatment (MHT), and identified characteristics associated with MHT during the pre-deployment year (365 days before deployment) in active duty Army women (N = 14,633) who returned from Iraq or Afghanistan deployments in FY2010. Pre-deployment year prevalence estimates were: 26.2 % for any select MHDX and 18.1 % for any MHT. Army women who had physical injuries since FY2002 or any behavioral health treatment between FY2002 and the pre-deployment year had increased odds of pre-deployment year MHT. During the pre-deployment year, a substantial percentage of Army women had MHDX and at least one MHT encounter or stay. Future research should determine if pre-deployment MHDX among Army women reflect vulnerability to future MHDX, or if pre-deployment MHT results in protection from chronic symptoms.

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References

  • Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36, 1–10.

    Article  CAS  PubMed  Google Scholar 

  • Andersen, R. M. (2008). National health surveys and the behavioral model of health services use. Medical Care, 46, 647–653. doi:10.1097/MLR.0b013e31817a835d00005650-200807000-00002.

    Article  PubMed  Google Scholar 

  • Armed Forces Health Surveillance Center. (2010). Mental disorders and mental health Problems, active component, U.S. Armed Forces, January 2000–December 2009. Medical Surveillence Monthly Report, 17, 6–13.

    Google Scholar 

  • Armed Forces Health Surveillance Center. (2011a). Associations between repeated deployments to Iraq (OIF/OND) and Afghanistan (OEF) and post-deployment illnesses and injuries, active component, U.S. Armed Forces, 2003-2010. Part II. Mental disorders, by gender, age group, military occupation, and “dwell times” prior to repeat (second through fifth) deployments. Medical Surveillance Monthly Report, 18, 2–11.

    Google Scholar 

  • Armed Forces Health Surveillance Center. (2011b). Causes of medical evacuations from Operations Iraqi Freedom (OIF), New Dawn (OND) and Enduring Freedom (OEF), active and reserve components, US Armed Forces, October 2001–2010. Medical Surveillance Monthly Report, 18, 2–7.

    Google Scholar 

  • Armed Forces Health Surveillance Center. (2011c). Numbers and characteristics of women in the active component, US Armed Forces 2011. Medical Surveillance Monthly Report, 18, 18–19.

    Google Scholar 

  • Armed Forces Health Surveillance Center. (2012). Health of women after wartime deployments: Correlates of risk for selected medical conditions among females after initial and repeat deployments to Afghanistan and Iraq, active component, U.S. Armed Forces. Medical Surveillance Monthly Report, 19, 2–10.

    Google Scholar 

  • Armed Forces Health Surveillance Center. (2014). Numbers and proportions of U.S. Military members in treatment for mental disorders over time, active component, January 2000–September 2013. Medical Surveillance Monthly Report, 21(5), 2–7.

    Google Scholar 

  • Biehn, T., Contractor, A., Elhai, J., Tamburrino, M., Fine, T., Prescott, M., & Liberzon, I. (2013). Relations between the underlying dimensions of PTSD and major depression using an epidemiological survey of deployed Ohio National Guard soldiers. Journal of Affective Disorders, 144(1), 106–111.

    Article  PubMed  Google Scholar 

  • Blackwell, D., Lucas, J., & Clarke, T. (2014). Summary health statistics for U. S. adults: National Health Interview Survey, 2012. National Center for Health Statistics. Vital Health Statistics, 10(260). Retrieved from http://www.cdc.gov/nchs/data/series/sr_10/sr10_260.pdf

  • Castro, C., & McGurk, D. (2007). The intensity of combat and behavioral health status. Traumatology, 13(4), 6–23. doi:10.1177/1534765607309950.

    Article  Google Scholar 

  • Cohen, S. P., Brown, C., Kurihara, C., Plunkett, A., Nguyen, C., & Strassels, S. A. (2010). Diagnoses and factors associated with medical evacuation and return to duty for service members participating in Operation Iraqi Freedom or Operation Enduring Freedom: A prospective cohort study. The Lancet, 375(9711), 301–309.

    Article  Google Scholar 

  • Contractor, A., Durham, T., Brennan, J., Armour, C., Wutrick, H., Frueh, B., & Elhai, J. (2014). DSM-5 PTSD’s symptom dimensions and relations with major depression’s symptom dimensions in a primary care sample. Psychiatry Research, 215(1), 146–153.

    Article  PubMed  Google Scholar 

  • Foynes, M., Shipherd, J., & Harrington, E. (2013). Race and gender discrimination in the Marines. Cultural Diversity and Ethnic Minority Psychology, 19(1), 111–119. doi:10.1037/a0030567.

    Article  PubMed  Google Scholar 

  • Funk, W. (2012). III, Injured, and Wounded (IIW) cohort file for the Military Health System Data Reposity (MDR). Falls Church, VA: Kennell & Associates Inc.

    Google Scholar 

  • Gehrman, P., Seelig, A. D., Jacobson, I. G., Boyko, E. J., Hooper, T. I., Gackstetter, G. D.,… Smith, T. C. (2013). Predeployment sleep duration and insomnia symptoms as risk factors for new-onset mental health disorders following military deployment. SLEEP, 36(7), 1009–1018.

  • Gelberg, L., Andersen, R., & Leake, B. D. (2000). The behavioral model for vulnerable populations: Application to medical care use and outcomes for homeless people. Health Services Research, 34, 1273–1302.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Haskell, S. G., Gordon, K. S., Mattocks, K., Duggal, M., Erdos, J., Justice, A., & Brandt, C. A. (2010). Gender differences in rates of depression, PTSD, pain, obesity, and military sexual trauma among Connecticut war veterans of Iraq and Afghanistan. Journal of Women’s Health, 19(2), 267–271.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kamarck, K. (2015). Women in combat: Issues for Congress (R42075). Washington, DC: Congressional Research Service.

  • Kelton, M., LeardMann, C., Smith, B., Boyko, E., Hooper, T., Gackstetter, G., & Smith, T. (2010). Exploratory factor analysis of self-reported symptoms in a large, population-based military cohort. BMC Medical Research Methodology, 10(94), 1. doi:10.1186/1471-2288-10-94.

    Google Scholar 

  • Klabunde, C. N., Warren, J. L., & Legler, J. M. (2002). Assessing comorbidity using claims data: An overview. Medical Care, 40(8), IV-26–IV-35.

  • Kline, A., Ciccone, D., Weiner, M., Inerian, A., St. Hill, L., Falca-Dodson, M., & Losonczy, M. (2013). Gender differences in the risk and protective factors associated with PTSD: A prospective study of National Guard troops deployed to Iraq. Psychiatriy, 76(3), 256–272.

    Article  Google Scholar 

  • Larson, M. J., Adams, R. S., Mohr, B. A., Harris, A. H., Merrick, E. L., Funk, W., et al. (2013). Rationale and methods of the Substance Use and Psychological Injury Combat Study (SUPIC): A longitudinal study of army service members returning from deployment in FY2008–2011. Substance Use & Misuse, 48(10), 863–879. doi:10.3109/10826084.2013.794840.

    Article  Google Scholar 

  • Larson, M. J., Funk, W., Mohr, B. A., Adams, R. S., Merrick, E. L., Harris, A. H., & Wooten, N. R. (2012). Pre-deployment behavioral health history and post-deployment mental health referrals of Army service members. Substance Abuse, 33(2), 211–212.

    Google Scholar 

  • Larson, G., Hammer, P. S., Conway, T. L., Schmied, E. A., Galarneau, M. R., Konoske, P., & Johnson, D. C. (2011). Predeployment and in-theater diagnoses of American military personnel serving in Iraq. Psychiatric Services, 62(1), 15–21.

    Article  PubMed  Google Scholar 

  • LeardMann, C. A., Powell, T. M., Smith, T. C., et al. (2013). Risk factors associated with suicide in current and former us military personnel. JAMA, 310(5), 496–506. doi:10.1001/jama.2013.65164.

    Article  CAS  PubMed  Google Scholar 

  • MacDonald, H. Z., Proctor, S. P., Heeren, T., & Vasterling, J. J. (2013). Associations of postdeployment PTSD symptoms with predeployment symptoms in Iraq-deployed Army soldiers. Psychological Trauma: Theory, Research, Practice, and Policy, 5(5), 470–476. doi:10.1037/a0029010.

    Article  Google Scholar 

  • Maguen, S., Luxton, D. D., Skopp, N. A., & Madden, E. (2011). Gender differences in traumatic experiences and mental health in active duty soldiers redeployed from Iraq and Afghanistan. Journal of Psychiatric Research, 46(3), 311–316.

    Article  PubMed  Google Scholar 

  • Maguen, S., Ren, L., Bosch, J. O., Marmar, C. R., & Seal, K. H. (2010). Gender differences in mental health diagnoses among Iraq and Afghanistan veterans enrolled in Veterans Affairs health care. American Journal of Public Health, 100(12), 2450.

    Article  PubMed  PubMed Central  Google Scholar 

  • Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. Journal of the American Medical Association, 298(18), 2141–2148. doi:10.1001/jama.298.18.2141.

    Article  CAS  PubMed  Google Scholar 

  • Murdoch, M., Bradley, A., Mather, S. H., Klein, R. E., Turner, C. L., & Yano, E. M. (2006). Women and war: What physicians should know. Journal of General Internal Medicine, 21(Suppl 3), S5–10. doi:10.1111/j.1525-1497.2006.00368.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nevin, R. (2009). Low validity of self-report in identifying recent mental health diagnosis among US service members completing Pre-Deployment Health Assessment (PreDHA) and deployed to Afghanistan, 2007: A retrospective cohort study. BMC Public Health, 9(1), 376.

    Article  PubMed  PubMed Central  Google Scholar 

  • Office of the Secretary of Defense for Health Affairs. (2012). Guide to DoD researchers on using MHS data. Falls Church, VA: Department of Defense.

    Google Scholar 

  • Polusny, M. A., Kumpula, M. J., Meis, L. A., Erbes, C. R., Arbisi, P. A., Murdoch, M.,… Johnson, A. K. (2014). Gender differences in the effects of deployment-related stressors and pre-deployment risk factors on the development of PTSD symptoms in National Guard Soldiers deployed to Iraq and Afghanistan. Journal of Psychiatric Research, 49, 1–9.

  • Pratt, L. A., & Brody, D. J. (2014). Depression in the U. S. household population, 2009–2012. (NCHS Data Brief #172). Hyattsville, MD: Centers for Disease Control and Prevention, National Center for Health Statistics. Retrieved from http://www.cdc.gov/nchs/data/databriefs/db172.htm.

  • Riddle, J., Smith, T., Smith, B., Corbeil, T., Engel, C., Wells, T., & Blazer, D. (2007). Millennium Cohort: The 2001–2003 baseline prevalence of mental disorders in the US military. Journal of Clinical Epidemiology, 60(2), 192–201.

    Article  PubMed  Google Scholar 

  • SAS Institute Incorporated. (2008). SAS for Windows 9.2. Cary, NC: SAS Institute Inc.

  • Schaefer, A. G., Wenger, J. W., Kavanagh, J., Wong, J. P., Oak, G. S., Trail, T. E., & Nichols, T. (2015). Implications of integrating women into the Marine Corps infantry (RR-1103-USMC). Retrieved from Santa Monica, CA

  • Schneeweiss, S., & Avorn, J. (2005). A review of uses of health care utilization databases for epidemiologic research on therapeutics. Journal of Clinical Epidemiology, 58(4), 323–337.

    Article  PubMed  Google Scholar 

  • Seelig, A. D., Jacobson, I. G., Smith, B., Hooper, T. I., Gackstetter, G. D., Ryan, M. A., & Smith, T. C. (2012). Prospective evaluation of mental health and deployment experience among women in the US military. American Journal of Epidemiology, 176(2), 135–145.

    Article  PubMed  Google Scholar 

  • StataCorp. (2015). Stata statistical software: Release 14. College Station, TX: StataCorp LP.

  • Stecker, T., Shiner, B., Watts, B. V., Jones, M., & Conner, K. R. (2013). Treatment-seeking barriers for veterans of the Iraq and Afghanistan conflicts who screen positive for PTSD. Psychiatric Services, 64(3), 280–283.

    Article  PubMed  Google Scholar 

  • Stoltenborgh, M., van IJzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. J. (2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Child Maltreatment, 16(2), 79–101.

    Article  PubMed  Google Scholar 

  • Street, A. E., Gradus, J. L., Giasson, H. L., Vogt, D., & Resick, P. A. (2013). Gender differences among veterans deployed in support of the wars in Afghanistan and Iraq. Journal of General Internal Medicine, 28(2), 556–562.

    Article  PubMed Central  Google Scholar 

  • Street, A. E., Vogt, D., & Dutra, L. (2009). A new generation of women veterans: Stressors faced by women deployed to Iraq and Afghanistan. Clinical Psychology Review, 29(8), 685–694.

  • Substance Abuse and Mental Health Services Administration. (2010). Results from the 2009 National Survey on Drug Use and Health: Mental health findings Rockville, MD: Center for Behavioral Health Statistics and Quality.

  • Tjaden, P. G., & Thoennes, N. (2000). Extent, nature, and consequences of intimate partner violence. Washington, DC: US Department of Justice, Office of Justice Programs, National Institute of Justice.

  • U. S. Department of Defense. (1997). Implementation and application of Joint Medical Surveillance for deployments. (DoDI 6490.3). Washington, DC: U. S. Department of Defense.

  • U. S. Department of Defense. (2011). Deployment health. (DOD Instruction 6490.03). Washington, DC: U. S. Government Printing Office.

  • U. S. Department of Defense. (2013a). Final report of the 2011 Department of Defense Health Related Behaviors Survey of Active Duty Military Personnel. Falls Church, VA: Defense Health Agency, Office of the Assistant Secretary of Health (Health Affairs). Retrieved from http://www.murray.senate.gov/public/_cache/files/889efd07-2475-40ee-b3b0-508947957a0f/final-2011-hrb-active-duty-survey-report.pdf.

  • U. S. Department of Defense. (2013b). Mental health assessments for service members deployed in connection with a contingency operation. (DoD Instruction 6490.12). Washington, DC: U. S. Department of Defense.

  • U. S. Department of the Army. (2011). Medical services: Standards of medical fitness. (AR 40-501). Washington, DC: Headquarters, Department of the Army.

  • Vogt, D., Pless, A., King, L., & King, D. (2005). Deployment stressors, gender, and mental health outcomes among Gulf War I veterans. Journal of Traumatic Stress, 18, 272–284.

    Article  PubMed  Google Scholar 

  • Warner, C. H., Appenzeller, G. N., Parker, J. R., Warner, C. M., & Hoge, C. W. (2011). Effectiveness of mental health screening and coordination of in-theater care prior to deployment to Iraq: A cohort study. American Journal of Psychiatry, 168(4), 378–385.

    Article  PubMed  Google Scholar 

  • Wells, T. S., LeardMann, C. A., Fortuna, S. O., Smith, B., Smith, T. C., Ryan, M. A., & Blazer, D. (2010). A prospective study of depression following combat deployment in support of the wars in Iraq and Afghanistan. American Journal of Public Health, 100(1), 90–99.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wooten, N. R. (2012). Deployment cycle stressors and posttraumatic stress symptoms in Army National Guard women: The mediating effect of resilience. Social Work in Health Care, 51, 828–849. doi:10.1080/00981389.2012.692353.

    Article  PubMed  Google Scholar 

  • Wooten, N. R., Mohr, B. A., Lundgren, L. M., Adams, R. S., Merrick, E. L., Williams, T. V., & Larson, M. J. (2013). Gender differences in substance use treatment utilization the year prior to deployment in Army service members. Journal of Substance Abuse Treatment, 45, 257–265. doi:10.1016/j.jsat.2013.04.001.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wright, K. M., Cabrera, O. A., Eckford, R. D., Adler, A. B., & Bliese, P. D. (2012). The impact of predeployment functional impairment on mental health after combat. Psychological Trauma: Theory, Research, Practice, and Policy, 4(3), 260–269. doi:10.1037/a0024373.

    Article  Google Scholar 

  • Zinzow, H., Britt, T., McFadden, A., Burnette, C., & Gillispie, S. (2012). Connecting active duty and returning veterans to mental health treatment: Interventions and treatment adaptations that may reduce barriers to care. Clinical Psychology Review, 32(8), 741–753. doi:10.1016/j.cpr.2012.09.002.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was funded by the National Institute of Drug Abuse (NIDA; #R01DA030150, PI: Dr. Larson). Dr. Wooten acknowledges support from a NIDA Diversity Supplement (R01DA030150-S1, PI: Dr. Larson) and NIDA Career Development Award (K01DA037412, PI: Dr. Wooten). Drs. Thomas V. Williams and Diana D. Jeffery were the DHA/Department of Defense (DoD) Government Project Managers who sponsored access to the DoD data sources. Wendy Funk and Kennell & Associates, Incorporated created the Mental Health Research file and the Ill, Injured, and Wounded dataset used in this study. The Office of the Assistant Secretary of Defense for Health Affairs/Defense Health Agency of the United States DoD provided access to these data. The opinions and assertions herein are those of the authors and do not necessarily reflect the views of the DoD or the National Institutes of Health. This research has been conducted in compliance with all applicable federal regulations governing the protection of human subjects. Findings from this study were presented at the 2016 Annual Research Meeting of Academy Health in Boston, MA.

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Authors and Affiliations

  1. College of Social Work, University of South Carolina, Columbia, SC, 29208, USA

    Nikki R. Wooten

  2. Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS035, Waltham, MA, 02454-9110, USA

    Rachel Sayko Adams, Beth A. Mohr & Mary Jo Larson

  3. Clinical Support Division, Healthcare Operations Directorate, Defense Health Agency (DHA), Office of the Assistant Secretary of Defense (Health Affairs), Department of Defense, Falls Church, VA, 22042, USA

    Diana D. Jeffery

  4. Kennell and Associates, Incorporated, Falls Church, VA, 22041, USA

    Wendy Funk

  5. Defense Health Agency, Department of Defense, Falls Church, VA, 20042, USA

    Thomas V. Williams

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  1. Nikki R. Wooten
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  2. Rachel Sayko Adams
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Correspondence to Nikki R. Wooten.

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Dr. Wooten is a lieutenant colonel in the U. S. Army Reserves with over 27 years of military service, but did not conduct this study as a part of her official military duties. Dr. Larson and Ms. Funk have several DoD contracts, but did not conduct this study as part of those contracts. Authors report no conflicts of interest.

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Wooten, N.R., Adams, R.S., Mohr, B.A. et al. Pre-deployment Year Mental Health Diagnoses and Treatment in Deployed Army Women. Adm Policy Ment Health 44, 582–594 (2017). https://doi.org/10.1007/s10488-016-0744-3

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