Army National Guard Soldiers Research Articles

Posttraumatic Stress Disorder, Depression, and HIV Risk Behavior Among Ohio Army National Guard Soldiers

We examined the relationship between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and human immunodeficiency virus (HIV) risk behavior among the Ohio Army National Guard (OHARNG). We analyzed data collected from a sample of OHARNG enlisted between June 2008 and February 2009. Participants completed interviews assessing HIV risk activities defined by the Behavioral Risk Factor Surveillance System, and were screened for PTSD and MDD based on DSM-IV criteria according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994). Logistic regression was used to examine the independent and combined effects of PTSD and MDD on past-year HIV risk behavior. Of 2,259 participants, 142 (6.3%) reported at least 1 past-year HIV risk behavior. In adjusted models, relative to soldiers with neither disorder, screening positive for MDD only was associated with HIV risk behavior (adjusted odds ratio [AOR] = 2.33, 95% CI = [1.15, 4.71]), whereas PTSD was not significant (AOR = 1.60, 95% CI = [0.80, 3.20]). Participants with both PTSD and depression were most likely to report HIV risk behavior (AOR = 2.75, 95% CI = [1.06, 7.11]). Soldiers with PTSD and MDD may be at greater risk for HIV infection due to increased engagement in HIV risk behavior. Integrated interventions to address mental health problems and reduce HIV risk behavior are in need of development and evaluation.

Cigarette smoking and subsequent risk of suicidal ideation among National Guard Soldiers

BackgroundSuicide rates are alarmingly high among military personnel, and particularly Army National Guard soldiers. Smoking is also disproportionately common in the military. In this study, we intend to investigate the relationship between cigarette smoking and suicidal ideation among a representative sample of national guard soldiers. MethodsA representative sample of Ohio Army National Guard soldiers were followed prospectively and information was gathered on smoking, suicidal ideation and depression at baseline and one year later. ResultsSmoking at baseline was associated with significantly increased likelihood of suicidal ideation at follow-up (OR=2.0 (1.3, 3.2)). This association persisted after adjusting for demographics and history of depression at baseline, but was no longer statistically significant after adjusting for depression at follow-up. LimitationsMeasurement of smoking was somewhat limited. ConclusionsArmy National Guard soldiers who smoke have a greater risk of subsequent suicidal ideation. Depression concurrent with suicidal ideation appears to explain this relationship. If these results are replicated, screening of soldiers who smoke may be recommended as a proactive step towards mitigating the high risk of suicide in military personnel.

Correlates of Suicide Among Army National Guard Soldiers

Associations among sociodemographic characteristics, mood, trauma-related experiences, and suicidal behaviors were examined with archival data from Army National Guard (ARNG) soldiers that included suicide cases combined with annual random samples of nonsuicide cases for calendar years 2007–2011 (N = 5,390); postdeployed ARNG soldiers (N = 4,567); and home-stationed ARNG soldiers (N = 15,597). Suicidal behavior was associated with demographic characteristics (e.g., young age, male, and White) and loss of a significant other; childhood abuse experiences moderated the relationship between current stressors and suicidal behavior; suicidal behavior appeared to be consistent across the deployment cycle.

Readiness and Associated Health Behaviors and Symptoms in Recently Deployed Army National Guard Solders

To examine major factors affecting readiness in the Army National Guard (ARNG), 265 soldiers of the Pennsylvania ARNG redeploying in 2010 from Iraq and Afghanistan were evaluated with validated questionnaires during their first unit formation. The questionnaires assessed demographic information, health habits, levels of perceived stress, mood, diet, sleep, and exercise habits, and included a screening question for depression. Our analysis revealed no negative effects of multiple deployments in this cohort of ARNG soldiers. There was no apparent impact on readiness attributable to soldiers' living locations; there did not appear to be an urban-rural divide. There were, however, numerous opportunities to improve health behaviors, including smoking (prevalence of 41%), poor dietary choices and sleep habits, as well as management of stress and mood disorders. A striking prevalence of sleep apnea exists in these ARNG soldiers (40%), approximately double that previously measured in the general U.S. population. Soldiers with high stress, depression, poor sleep quality, and sleep apnea are at increased long-term risk for cardiovascular complications and deserve focused interventions to encourage lifestyle behavior change.

Suicide and War: The Mediating Effects of Negative Mood, Posttraumatic Stress Disorder Symptoms, and Social Support among Army National Guard Soldiers

The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard soldiers (N=4,546). Results from structural equation modeling suggested that war experiences may precipitate a sequence of psychological consequences leading to suicidality. However, suicidality may be an enduring behavioral health condition. War experiences showed no direct effects on postdeployment suicidality, rather its effect was indirect through PTSD symptoms and negative mood. War experiences were, however, predictive of PTSD symptoms, as would be expected. PSTD symptoms showed no direct effect on postdeployment suicidality, but showed indirect effects through negative mood. Results also suggested that suicidality is relatively persistent, at least during deployment and postdeployment. The percentage of those at risk for suicide was low both during and after deployment, with little association between suicidality and time since returning from deployment. Additionally, few soldiers were initially nonsuicidal and then reported such symptoms at postdeployment. Implications of relationships of both negative mood and combat trauma to suicidality are discussed, as well as possible mediating effects of both personal dispositions and social support on relationships of war experiences to PTSD, negative mood, and suicidality.

The factor structure of major depression symptoms: A test of four competing models using the Patient Health Questionnaire-9

Little research has examined the underlying symptom structure of major depressive disorder (MDD) symptoms based on DSM-IV criteria. Our aim was to analyze the symptom structure of major depression, using the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 was administered to a sample of 2615 Army National Guard soldiers from Ohio. A one-factor model of depression and three separate two-factor models previously established in the literature were evaluated using confirmatory factor analysis. Results demonstrated greater support for the two-factor models of depression than for the one-factor model. The best fitting model was the two-factor model of somatic and non-somatic symptoms supported previously by Krause et al. (2010) and Richardson and Richards (2008). Implications for understanding the components and mechanisms of MDD are discussed.

Coincident posttraumatic stress disorder and depression predict alcohol abuse during and after deployment among Army National Guard soldiers

BackgroundAlthough alcohol problems are common in military personnel, data examining the relationship between psychiatric conditions and alcohol abuse occurring de novo peri-/post-deployment are limited. We examined whether pre-existing or coincident depression and post-traumatic stress disorder (PTSD) predicted new onset peri-/post-deployment alcohol abuse among Ohio Army National Guard (OHARNG) soldiers. MethodsWe analyzed data from a sample of OHARNG who enlisted between June 2008 and February 2009. Participants who had ever been deployed and who did not report an alcohol abuse disorder prior to deployment were eligible. Participants completed interviews assessing alcohol abuse, depression, PTSD, and the timing of onset of these conditions. Logistic regression was used to determine the correlates of peri-/post-deployment alcohol abuse. ResultsOf 963 participants, 113 (11.7%) screened positive for peri-/post-deployment alcohol abuse, of whom 35 (34.0%) and 23 (32.9%) also reported peri-/post-deployment depression and PTSD, respectively. Soldiers with coincident depression (adjusted odds ratio [AOR]=3.9, 95%CI: 2.0–7.2, p<0.01) and PTSD (AOR=2.7, 95%CI: 1.3–5.4, p<0.01) were significantly more likely to screen positive for peri-/post-deployment alcohol abuse; in contrast, soldiers reporting pre-deployment depression or PTSD were at no greater risk for this outcome. The conditional probability of peri-/post-deployment alcohol abuse was 7.0%, 16.7%, 22.6%, and 43.8% among those with no peri-/post-deployment depression or PTSD, PTSD only, depression only, and both PTSD and depression, respectively. ConclusionsCoincident depression and PTSD were predictive of developing peri-/post-deployment alcohol abuse, and thus may constitute an etiologic pathway through which deployment-related exposures increase the risk of alcohol-related problems.

Potentially Modifiable Pre-, Peri-, and Postdeployment Characteristics Associated With Deployment-Related Posttraumatic Stress Disorder Among Ohio Army National Guard Soldiers

To evaluate potentially modifiable deployment characteristics-- predeployment preparedness, unit support during deployment, and postdeployment support-that may be associated with deployment-related posttraumatic stress disorder (PTSD). We recruited a sample of 2616 Ohio Army National Guard (OHARNG) soldiers and conducted structured interviews to assess traumatic event exposure and PTSD related to the soldiers' most recent deployment, consistent with DSM-IV criteria. We assessed preparedness, unit support, and postdeployment support by using multimeasure scales adapted from the Deployment Risk and Resilience Survey. The prevalence of deployment-related PTSD was 9.6%. In adjusted logistic models, high levels of all three deployment characteristics (compared with low) were independently associated with lower odds of PTSD. When we evaluated the influence of combinations of deployment characteristics on the development of PTSD, we found that postdeployment support was an essential factor in the prevention of PTSD. Results show that factors throughout the life course of deployment-in particular, postdeployment support-may influence the development of PTSD. These results suggest that the development of suitable postdeployment support opportunities may be centrally important in mitigating the psychological consequences of war.

Mixed Methods in a Post-Deployment Study of U.S. Army National Guard Soldiers

Mixed methods research combines quantitative and qualitative methodologies to achieve a product that is more than the sum of its parts. Here, the authors combine two different data reduction techniques—factor and content analyses of quantitative and qualitative data, respectively—to tap the dimensions of deployment-related variables among U.S. Army National Guard (ARNG) soldiers: stressors and supports, resilience, post-traumatic stress disorder symptoms, and post-traumatic growth. Using these combined techniques, the authors explore the validity and substance of these variables and their measures so that employers and practitioners can better understand what deployment means for their employees and clients who are in the ARNG.

The distinctiveness of hardiness, positive emotionality, and negative emotionality in National Guard soldiers

Exploratory and confirmatory factor analyses were used to investigate the distinctiveness of hardiness (using the Short Hardiness Scale; Bartone, 1995) from the broader personality traits of negative emotionality and positive emotionality (NEM and PEM; assessed with items from the MMPI-2 PSY-5 scales); in a sample of 981 Army National Guard soldiers. Exploratory factor analyses demonstrated that hardiness items loaded on a separate factor from PEM and NEM items, and confirmatory factor analysis suggested that hardiness is not simply a sub-facet of either PEM or NEM. However, subsequent regression analyses found that hardiness did not predict symptoms of PTSD or depression beyond the effects of PEM and NEM among combat exposed soldiers.

Talking to Iraq and Afghanistan War Veterans About Tobacco Use

Our goal in this study was to examine beliefs and attitudes about tobacco use in the newest generation of combat veterans, those who served in Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]). We held 5 focus groups (n = 17) with Minnesota Army National Guard soldiers who had recently returned from combat deployment in support of OEF/OIF. Sessions were audiorecorded, transcribed, coded, and analyzed using a grounded theory approach. We found that it is common to use tobacco in the combat zone for stress and anger management and boredom relief. Tobacco was also a tool for staying alert, a way to socialize, and provided a chance to take breaks. Participants recognized the culture of tobacco use in the military. Stress, nicotine dependence, the tobacco environment at drill activities, and perceived inaccessibility of cessation tools perpetuated use at home and served as a barrier to cessation. Repeatedly, participants cited tobacco policies (such as increased taxes and smoke-free workspaces) as motivators for quitting. There are specific circumstances common to combat zones that promote tobacco use. Results suggest that environmental changes that address the prominence of tobacco in military culture, the acceptance of nonsmoking breaks, and cessation programs that address stress issues and make cessation aids available may be effective in reducing tobacco use.

Public-Academic Partnerships: Working Together to Meet the Needs of Army National Guard Soldiers: An Academic-Military Partnership

The conflicts in Afghanistan and Iraq have greatly increased the number of veterans returning home with combat exposure, reintegration issues, and psychiatric symptoms. National Guard soldiers face additional challenges. Unlike active duty soldiers, they do not return to military installations with access to military health services or peers. The authors describe the formation and activities of a partnership among two large state universities in Michigan and the Michigan Army National Guard, established to assess and develop programming to meet the needs of returning soldiers. The process of forming the partnership and the challenges, opportunities, and benefits arising from it are described.

Public-Academic Partnerships: Working Together to Meet the Needs of Army National Guard Soldiers: An Academic-Military Partnership

The conflicts in Afghanistan and Iraq have greatly increased the number of veterans returning home with combat exposure, reintegration issues, and psychiatric symptoms. National Guard soldiers face additional challenges. Unlike active duty soldiers, they do not return to military installations with access to military health services or peers. The authors describe the formation and activities of a partnership among two large state universities in Michigan and the Michigan Army National Guard, established to assess and develop programming to meet the needs of returning soldiers. The process of forming the partnership and the challenges, opportunities, and benefits arising from it are described. (Psychiatric Services 61: 1069–1071, 2010)

When Does Soldier Patriotism or Nationalism Matter? The Role of Transformational Small‐Unit Leaders

Patriotism and nationalism, 2 sets of attitudes often associated with the military, are examined in relation to perceived combat readiness and intention to remain in military service. Transformational leadership served as an intervening variable in these relationships. Survey data obtained from a sample of Army National Guard soldiers (N = 415) were used to examine relationships. Among junior‐ranking enlisted soldiers, both patriotism and nationalism showed significant, positive associations with perceived combat readiness and intention to remain in military service. The structural equation model fit soldiers' nationalistic attitudes best, having a considerable indirect effect through transformational leadership on perceived combat readiness. Implications of nationalistic and patriotic attitudes combined with charismatic leaders to benefit soldier readiness and retention are discussed.

Army Physical Fitness Test Scores Predict Coronary Heart Disease Risk in Army National Guard Soldiers

An increased rate of cardiac symptoms at combat theater hospitals brings concerns about the predeployment health of Army National Guard (ARNG) soldiers on the basis of older age, lower fitness level, and sedentary lifestyle than active duty troops. The purpose of this study was to examine the association of physical fitness, reported physical activity (PA), and coronary risk factors to calculated 10-year hard coronary heart disease (CHD) risk in 136 ARNG soldiers, aged 18-53 years, who failed the 2-mile run of the Army Physical Fitness Test (APFT). The APFT score, derived from a composite of 2-mile run time, sit-ups, and push-ups, related inversely to 10-year CHD risk (r = -0.23, p < 0.01) but no relationship with CHD risk was observed for PA. APFT scores were positively associated with high-density lipoprotein (HDL) cholesterol and inversely with triglycerides, total cholesterol:HDL ratio, diastolic blood pressure, and body mass index (BMI). No relationship existed between PA and any of the CHD risk factors. We conclude that a higher APFT score is associated with a healthier CHD risk factor profile and is a predictor of better predeployment cardiovascular health.

After 9/11, What Kind of Reserve Soldier?

Two concepts, Moskos's institutional—occupational orientations and Meyer and Allen's organizational commitment, were used to develop several hypotheses concerning relationships of soldiers' stated reasons for joining and staying in reserve military service to their stated career intentions and to perceived unit readiness. Survey data were obtained from first-term, junior-ranking enlisted Army National Guard soldiers nationwide at three time periods. Time periods corresponded to different phases of the Iraq conflict— before, during, and after the initial invasion. The number of soldiers at each time period equaled about 7,000 to 8,500. Results suggest material incentives may increase recruitment and retention, yet at the same time, such incentives may not enhance readiness. Rather, incentives fostering normative and affective commitments, such as joining and staying for camaraderie and service to country, were related both to self-reported career intentions and perceived unit readiness.

A pilot study of posttraumatic stress and associated functioning of Army National Guard following exposure to Iraq warzone trauma.

This study examines the experiences of a convenience sample of Army National Guard soldiers who were combat exposed during the Iraq War. Thirty-one men volunteered to complete an interview and ques...

An Assessment of Beliefs About Mental Health Care Among Veterans Who Served in Iraq

This study assessed beliefs about mental health treatment in a group of soldiers newly returning from the war in Iraq. Participants were 20 National Guard soldiers who had served in Operation Iraqi Freedom. Soldiers who in phone interviews screened positive for a mental disorder were asked about advantages and disadvantages of seeking treatment, who would or would not support treatment seeking, and facilitators and barriers to treatment seeking. Stigma was portrayed as a major disadvantage to treatment seeking. Yet most participants indicated that people would be supportive of treatment seeking. Reducing symptoms was a major advantage of care. Barriers, especially those viewed as "self-induced," such as pride, not being able to ask for help, and not being able to admit to having a problem, were considered major impediments. The findings suggest that interventions developed to engage veterans in care must be directed toward cognitive factors that motivate treatment seeking.

Task Force St. Bernard: Operational Issues and Medical Management of a National Guard Disaster Response Operation

After Hurricane Katrina struck the Gulf Coast of the United States on 29 August 2005, it became obvious that the country was facing an enormous national emergency. With local resources overwhelmed, governors across the US responded by deploying thousands of National Guard soldiers and airmen. The National Guard has responded to domestic disasters due to natural hazards since its inception, but an event with the magnitude of Hurricane Katrina was unprecedented. The deployment of >900 Army National Guard soldiers to St. Bernard Parish, Louisiana in the aftermath of the Hurricane was studied to present some of the operational issues involved with providing medical support for this type of operation. In doing so, the authors attempt to address some of the larger issues of how the National Guard can be incorporated into domestic disaster response efforts. A number of unforeseen issues with regards to medical operations, medical supply, communication, preventive medicine, legal issues, and interactions with civilians were encountered and are reviewed. A better understanding of the National Guard and how it can be utilized more effectively in future disaster response operations can be developed.

Peer Counseling, Family Education Could Ease Vets' Transition

Back to table of contents Previous article Next article Government NewsFull AccessPeer Counseling, Family Education Could Ease Vets' TransitionAaron LevinAaron LevinSearch for more papers by this authorPublished Online:1 Jun 2007https://doi.org/10.1176/pn.42.11.0004aThe heavy reliance on National Guard and Reserve troops, with many units drawn from small towns, has increased the need for mental health services far from the usual sites of the Department of Veterans Affairs, Ralph Ibson of Mental Health America told senators in Washington, D.C., in April.The stress of combat is only worsened by repeated tours of duty, he said at a hearing of the Senate Committee on Veterans Affairs.“Half of all Army National Guard soldiers and 45 percent of Army and Marine reservists report mental health issues on their return from war,” he said. “The VA can do more and should do more for them.”The VA health system has great strengths, he added. However, “it is a facility-based system that does not necessarily provide good access to care for veterans in rural America or in other areas remote from health care facilities.”Readjustment counseling could benefit most returning veterans, he said, but that help was usually limited to the 200 readjustment counseling centers (also called vet centers) and is not available at the VA's medical centers and clinics. There was no barrier preventing these larger sites from also providing such services, however, Ibson said.Women make up 15 percent of the forces in Iraq and Afghanistan and even their “noncombat” roles—like driving trucks, flying helicopters, or serving as military police—frequently exposed them to traumatic episodes that would meet any definition of warfare.“The jury is still out on care of women veterans and the perceptions of the VA as a welcoming, caring place for them,” said Ibson.Ibson offered several suggestions for helping veterans and their families cope with the return of service members.The VA should develop peer-based outreach programs by training veterans of Iraq and Afghanistan to work at the VA or in the community to provide support for vets and make VA facilities welcoming environments. Families should also be offered services, at least for a specified period after a service member's return home. Help for small-town or rural veterans might be offered at local community mental health centers, where they exist.Finally, the window of eligibility during which veterans may sign up with the VA without proving a service connection for any complaints should be extended from two to five years.Earlier in the hearing, the senators heard from families of a soldier and a Marine who had returned from Iraq and later died.The parents of Spc. Joshua Omvig of Grundy Center, Iowa, an Army Reserve military policeman, told how their son was “unable to live with the physical, mental, and psychological effects” of his time in Iraq and committed suicide a year after he returned home from an 11-month tour in Iraq.To avoid tragedies like their son's, other troops need peer counseling before they come home, family education and outreach, increased training on recognizing symptoms that could lead to suicide, and substance abuse treatment, said Randall Omvig. While troops are still in uniform, their transition back into civilian life might be eased by having them spend days doing service-connected work while spending evenings and nights with their families.“It helps them process their experience,” said Omvig. “It would help them live the American dream that they fought for.”Justin Bailey, a Marine veteran of the invasion of Iraq, died on January 27 in the West Los Angeles Veterans Affairs Hospital of an apparent overdose of prescription drugs, his father, Tony Bailey, told the senators. Despite a history of overusing drugs prescribed for pain from a war injury and for PTSD, Justin was given two-to four-week supplies of benzodiazepines, antidepressants, and methadone. Tony Bailey blamed “apathy and complacency” in the VA for his son's death.“Nobody cared until I was on ABC News,” said Bailey, who served 20 years in the armed forces. Families of veterans needed to advocate for patients in the VA, he said. “Always ask questions. Don't assume the VA will help without someone to push.”Speaking on behalf of the VA, Ira Katz, M.D., Ph.D., deputy chief patient care services officer for mental health, said the VA was already hiring more suicide prevention coordinators and was working to integrate its approach to substance abuse and mental health care.“We want accountability,” said Katz. “But we must go beyond narrow silos.”The effects of the “invisible wounds” suffered by veterans of the current conflicts will be felt for many years, said Sen. Daniel Akaka (D-Hawaii), the committee's chair, but he expected that the VA would adapt to meet the mental health needs of those and all veterans.Written testimony from the Senate hearing is posted at<http://veterans.senate.gov/index.cfm?FuseAction=Hearings.CurrentHearings&rID=996>.▪ ISSUES NewArchived