Military Members Research Articles

Continuing the Mission: Findings from a Needs Assessment Supporting the New Generation of Student Veterans

ABSTRACT For the better part of two decades, military personnel have deployed to the wars in Iraq and Afghanistan. With the drawdown in troops and the ending of most active operations in the Middle East, military members have transitioned out of the military back to their communities, to their civilian lives, and to search for their next mission. During this transition, reports indicate that up to 40% choose to pursue degrees in higher education institutions where they can access their educational benefits and follow new career paths. This article examines the current literature on student Veterans’ educational challenges and how one large higher education institution assessed the needs of its student Veterans (n = 221). Based on the empirical evidence, the research team proposes recommendations for program development to support student Veterans. The article also suggests implications for clinical social work practice and education.

Impact of Low-Level Blast Exposure From Military Training and Career Cumulation on Hearing Outcomes.

Occupational trades expose military service members to unique sound exposure profiles, distinct in frequency and amplitude to those commonly studied in industrial settings. Characteristics of the energy exposure incurred through blast exposure exercises a distinct mechanism of injury in the auditory system that yield acute and cumulative health impacts. The following paper considers physiological and self-reported data attributed to repeated low-level blast exposure. We focused our analysis to examine objective audiological metrics of blast overpressure damage to quantify the impact of discrete and accumulated blast exposure for military service members. This study was reviewed and approved by the Human Research Ethics Committee of Defense Research and Development Canada. Data were collected in a cross-sectional, repeated measures observational design. Participants comprised service members who took part in a training course using controlled explosives (n = 46) and an age- and sex-matched control group (n = 42) with noise exposure but no history of blast exposure. Extensive demographic and subjective health data were captured additional to a battery of quantitative health data. Nonlinear mixed effect models with bivariate generalized additive architecture, Friedman's test, and repeated measures ANOVA models were applied. Subjective tinnitus and hearing scores were sensitive to life-time blast overpressure exposure (P = .034) and a delta of low- (2-4 kHz) and high-frequency (4-8 kHz) audiometric threshold averages significantly differentiated by both cumulative (P = .0016) and training course exposure (P = .0142). Furthermore, audiometric values showed progressive increasing variance in high frequencies (>4 kHz) in blast-exposed participants with worsening audiometric outcomes. Variation in high-frequency hearing thresholds may be attributed to differences in energy exposure because of structural differences between individuals or differences in exposure profiles (produced either by diversity in PPE compliance or exposure sources). Military members exposed to blasts in a training environment and accumulated through a career experience adverse hearing and audiometric impacts. However, better measures of hearing injury should be pursued to improve understanding of injury mechanism and injury progression which may inform risk and medical interventions. Blast-induced hearing injuries are dynamic and change over time between acute and chronic phases which are further exacerbated with multiple blast exposures presented consecutively.

Pilot Study Exploring the Perspectives of Canadian Clients Who Received Digitally Delivered Psychotherapies Utilized for Trauma-Affected Populations.

The digital delivery of mental health services became increasingly common following the onset of the COVID-19 pandemic. There is still much to learn regarding tailoring interventions for trauma-affected populations (military members, Veterans, public safety personnel). Through the current pilot study, we explored the perceptions of digitally delivered psychotherapies utilized for trauma-affected populations, as reported by Canadian military members, Veterans, and public safety personnel who completed such interventions. Quantitative data were collected from 11 Canadian clients (military members, Veterans, and public safety personnel with posttraumatic stress injury). Survey questions were based on the Alberta Quality Matrix of Health and the Unified Theory of Acceptance and Use of Technology model. As a follow-up, clients were invited to partake in a semi-structured interview to further explore their perspectives on digitally delivered trauma-focused and adjunct therapies. Four clients participated in an interview. The client participants reported that digitally delivered trauma and adjunct therapies offered similar treatment effectiveness to in-person delivery while also improving treatment access. The participants indicated several unique advantages of digital delivery, including the increased accessibility of treatment, cost-effectiveness, and more efficient use of resources, although the small sample size limits the generalizability of our findings. Further research with a larger, more diverse population is required to corroborate our results and identify other avenues in which psychotherapies utilized for trauma-affected populations can be engaged with and improved upon.

Assessment and Management of Patients at Risk for Suicide: Synopsis of the 2024 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines.

The U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DOD) updated the 2019 joint clinical practice guideline (CPG) for assessing and managing patients who are at risk for suicide. This synopsis provides primary care physicians with a summary of the updated 2024 recommendations regarding evaluation and management of military members and veterans at risk for suicide. In 2023, the VA/DOD Evidence-Based Practice Work Group convened to develop a joint VA/DOD guideline, including clinical stakeholders, which conformed to the National Academy of Medicine's tenets for trustworthy CPGs. The Work Group drafted 12 key questions, reviewed systematically identified literature (1 April 2018 to 15 March 2023), evaluated the evidence, created algorithms, and advanced 24 recommendations in accordance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Despite insufficient evidence to recommend for or against suicide risk screening programs as a means for reducing suicide attempts or deaths, the VA/DOD Work Group identified validated tools that could be used to identify populations at higher risk for suicide-related behaviors. Cognitive behavioral therapy was also recommended for reducing the risk for suicide attempts and decreasing suicidal ideation among those with a history of suicidal behavior or a history of self-directed violence. Periodic communications after previous suicide attempts were also recommended as a prevention strategy. Pharmacologic treatments, such as clozapine or ketamine infusion, also have a role in the management of suicide risk among those with schizophrenia or major depressive disorder, respectively.

No One Left Behind: Incidence of Sudden Cardiac Arrest and 30-Day Survival in Military Members.

No One Left Behind: Incidence of Sudden Cardiac Arrest and 30-Day Survival in Military Members.

Canadian military members’ experiences of using programs and services to support upcoming release: A qualitative study

Canadian military members’ experiences of using programs and services to support upcoming release: A qualitative study

P-153. Malaria in a military hospital in Bogotá, Colombia, 2023 – 2024

Abstract Background In Colombia malaria is an endemic mosquito-borne disease. Although military personnel are recognized as a high-risk group for malaria, little is known about on features of this parasitic disease in Colombian military members. Methods We recorded data on demographic, clinical, laboratory and treatment of patients with confirmed malaria diagnosis (positive thick blood smear or Rapid Diagnostic Test), attended in a reference military hospital, located in Bogotá, Colombia, from February 2023 to April 2024. Cases of severe malaria and recurrence were classified following the last WHO guidelines. Dengue and malaria coinfection were defined as a confirmed malaria case with positive dengue NS1 antigen. Results During the study period, 97 patients were attended; all of them males, in active military service, and the median age was 25 years. Most (70%) consulted between November 2023 and April 2024 (Figure 1), and the main Colombian departments where the infections were acquired were Chocó (29%), Córdoba (22%) and Nariño (12%) (Figure 2). Plasmodium vivax was the main etiology (79%), follow by P. falciparum (17%), mixed infections (3%) and Plasmodium sp. (1%); four patients had coinfection with dengue. Most (51%) were attended at the emergency department, 39% at general ward, and 10% required intensive care unit. Recurrences were diagnosed in 36%, and the remaining as new infections. Among clinical features, the main symptoms were fever (88%), headache (75%) and chills (64%); and the main signs were jaundice (25%), abdominal pain (21%) and mild dehydration (12%) (Table 1). The median days of fever at hospital admission was five. Severe malaria was diagnosed in 8 patients. Among laboratory findings, thrombocytopenia was the most frequent (77%), follow by hyperbilirubinemia (71%). Hepatosplenomegaly was the most finding at the abdominal ultrasound (49%) (Table 2). Regarding treatment, 92% of P. vivax cases received chloroquine-primaquine; 69% of P. falciparum cases received artemether-lumefantrine and single dose primaquine; mixed infections cases received artemether-lumefantrine and primaquine; and all severe malaria received intravenous artesunate. No deaths were recorded. Conclusion Malaria remains a potential health threat to Colombian military personnel. Disclosures All Authors: No reported disclosures

WOMEN IN MILITARY FAMILIES IN INDONESIA

ABSTRACT This study explores the roles and experiences of women in military families, focusing on their contributions and challenges in managing family life and military obligations. Women in these families, whether as spouses of military personnel or as military members themselves, face unique pressures that include emotional, psychological, and logistical challenges. The research aims to provide a comprehensive understanding of how these women navigate their responsibilities and the support systems available to them. Using a scoping review methodology, relevant literature was synthesized to identify key themes, including emotional support, mental health, role balancing, and community involvement. The findings reveal that women in military families often shoulder significant burdens, yet their contributions are essential to family stability and the success of military operations. The study concludes that stronger mental health services and gender-sensitive policies within military institutions are needed to better support these women. The research also highlights the importance of community and policy interventions to enhance the well-being and sustainability of military families, especially in non-Western contexts where cultural factors may add additional layers of complexity. These insights can inform future policies aimed at improving the welfare of military families and their communities.

The impact of bible use on human flourishing among U.S. Military members

The impact of bible use on human flourishing among U.S. Military members The impact of Bible use on human flourishing among U.S. military members is detailed by Sung Joon Jang and Byron R. Johnson from Baylor University and Pepperdine University. It has been long recognized that military members, active and retired, and their families often face various challenges associated with military service, particularly, frequent deployment and combat experience. Despite this recognition, evidence-based and cost-effective interventions that can help them meet these challenges tend to be lacking. Religion and spirituality may be worth more attention for this understudied population of individuals with unique needs largely unrecognized by those outside the military community.

Sexual Networks and Behavioral Characteristics of HIV-Positive Male Military Members, Female Sex Workers, and Male Civilians

Military members and female sex workers (FSWs) may be more likely to acquire or transmit HIV. Mapping HIV transmission across these high-risk populations and identifying behaviors associated with sexual network clustering are needed for effective HIV prevention approaches. A cross-sectional study recruited participants newly diagnosed with HIV among militaries, civilians, and FSWs in Zambia, Senegal, and Democratic Republic of the Congo (DRC). Participants were interviewed on behaviors and provided blood samples for HIV-1 partial pol sequencing. Genetic-distance based network analyses inferred putative relationships between HIV-1 partial pol sequences. Bivariate logistic regression models identified variables associated with clustering in a sexual network. 908 participants were included (n = 313 FSWs, n = 297 military, n = 298 civilians). 311 blood samples were sequenced and had survey data, of which 93 (29.9%) were genetically linked, forming 36 transmission clusters. All but one cluster were comprised of participants from the same country, including one large cluster (n = 12; 9 FSWs and 3 civilians) from DRC. A large mixed-country cluster (n = 9) including 7 men (4 civilians, 3 military) and 2 FSWs was observed. The odds of clustering in a sexual network were elevated for DRC participants, FSWs, and those cohabitating with a sexual partner. Findings underscore the importance of identifying linkages in high-risk populations to develop tailored HIV prevention strategies. Linkages across risk groups and countries illustrate the potential role of mobile populations in HIV transmission and acquisition. Larger studies including HIV recency testing may better elucidate biological and behavioral interactions between military, civilians, and FSWs.

Psychosocial Factors and Electronic Cigarette Use in the Military Population.

Over 35.7% of military members report trying electronic cigarettes, and 11.1% report daily electronic cigarette use. In the general population, however, only 14.9% admit trying electronic cigarettes, and 3.2% report using electronic cigarettes daily. This is a major disparity. The aim of this study was to identify, measure, and examine the association between psychosocial factors in military members using electronic cigarettes compared to tobacco cigarettes, dual use, and nonuse. This cross-sectional, correlational study includes military members aged 18 years and older using the Behavioral Risk Factor Surveillance System and military-related questions. Data analysis was performed using descriptive statistics presented as percentages and frequencies. Pearson's chi-square tests were performed to examine association among variables. There were 434 participants in this study, 369 (85%) men and 61 (14.1%) women. There were 419 (97%) of participants who felt stressed or depressed between 1 and 30 days each month. Participants with electronic cigarette use and dual use believed electronic cigarettes decreased their anxiety, helped them concentrate, and helped them eat less. Dual use is concerning among the military population. Military members experiencing anxiety and trouble concentrating may be turning to nicotine products such as electronic cigarettes or dual use. Additional findings revealed several associated psychosocial factors including stress and depression were related to use. Future studies should focus on these psychosocial factors to reduce dual use in the military population.

The impact of war on people with type 2 diabetes in Ukraine: a survey study

The impact of war on people with type 2 diabetes in Ukraine: a survey study

Five-Year Serial Brain MRI Analysis of Military Members Exposed to Chronic Sub-Concussive Overpressures.

The Canadian Special Operations Forces Command conducts explosives operations and training which exposes members to explosive charges at close proximity. This 5-year longitudinal trial was conducted in follow-up to our initial trial which examined military breachers with MRI and EEG pre and post blast exposure. To examine brain MRI findings in military personnel exposed to multiple repeated blast exposures. Five-year longitudinal prospective trial. Ninety-two males aged 23-42 with an average of 9.4 years of blast exposure. 3 T brain MRI/T1-weighted 3D with reconstruction in three planes, T2-weighted, T2-weighted fluid attenuated inversion recovery (FLAIR) 3D with reconstruction in three planes, T2-weighted gradient spin echo (GRE), saturation weighted images, DWI and ADC maps, diffusion tensor imaging. All MRI scans were interpreted by the two neuroradiologists and one neuroradiology Fellow in a blinded fashion using a customized neuroradiology reporting form. Matching parametric statistics represented the number of participants whose brain parameters improved or deteriorated over time. Odds ratio (OR) and 95% confidence intervals (CI) were computed using log regression modeling to determine volume loss, white matter lesions, hemosiderosis, gliosis, cystic changes and enlarged Virchow Robin (VR) spaces. A Kappa (κ) statistic with a 95% CI was calculated to determine rater variability between readers. A significant deterioration was observed in volume loss (OR = 1.083, 95% CI 0.678-1.731, permutation test), white matter changes (OR: 0.754, 95% CI 0.442-1.284, permutation test), and enlargement of VR spaces (OR: 0.775, 95% CI 0.513-1.171). Interrater reliability was low: κ = 0.283, 0.156, and 0.557 for volume loss, white matter changes, and enlargement of VR spaces, respectively. There were significant changes in brain volume, white matter lesions, and enlargement of VR spaces. 2 TECHNICAL EFFICACY: Stage 2.

Protection for Victims of Domestic Violence Perpetrated by Military Members

This study examines the protection of Domestic Violence (KDRT) victims perpetrated by military personnel in Indonesia. Domestic violence cases involving military members are complex issues requiring serious attention, as they encompass aspects of general criminal law and military disciplinary law. Based on Law No. 23 of 2004 on the Elimination of Domestic Violence and Law No. 25 of 2014 on Military Discipline, military personnel who commit domestic violence can be subjected to both criminal and disciplinary sanctions. The legal process for military domestic violence cases involves two pathways: the criminal pathway, managed by the police and prosecution, and the military disciplinary pathway, handled by the authorized superior. Besides law enforcement, this study highlights the importance of protecting victims’ rights, such as security, physical and psychological recovery, and legal support. However, there are several obstacles to victim protection, including the strong patriarchal culture, lack of understanding about domestic violence within the military, and the complexity of the legal enforcement process. This study recommends increasing awareness of domestic violence, strengthening support for victims, and improving legal procedures to make the protection of domestic violence victims more effective.

Juridical Analysis of Sexual Harassment Committed by Individual TNI Members

Indonesia is a legal state based on Pancasila and the 1945 Constitution of the Republic of Indonesia (UUDNRI 1945). The concept of a legal state proposed by Wiryono Projodikoro defines it as a state where rulers or the government, as the state organizers, are bound by the applicable legal regulations in carrying out state duties. The Indonesian National Armed Forces (TNI) is an integral part of the legal community, playing a crucial role in supporting the formation of legal culture within its ranks. Legal awareness within the TNI is upheld when military personnel, as supporters of legal culture, actively contribute by adhering to all applicable regulations and making the law a guide in their behavior and actions. Despite having rules in place governing prohibited behaviors for military personnel, the reality indicates that there are still individuals within the TNI involved in criminal activities. When a military member engages in sexual harassment, it creates dissonance in the execution of military duties and can undermine public trust in the military institution, which should be responsible for safeguarding and protecting the community. Unfortunately, reality does not always align with expectations, as evident in cases involving TNI members, who are a vital force in maintaining the integrity of the Republic of Indonesia. This phenomenon not only highlights individual problems but also significantly impacts public trust in the structure of the national defense institution. Therefore, when a TNI member or soldier is involved in sexual harassment, the most severe punishment that can be imposed is dismissal, or in other words, removal from their position. This sanction is not only administrative but also includes criminal consequences regulated in the Criminal Code. Protection of the integrity of the TNI, therefore, involves not only internal disciplinary aspects but also engages in a legal process that can provide criminal sanctions commensurate with the crime of sexual harassment committed by military personnel. Military members, being part of a unit, form an integrated family. It seems as though within a military unit, an "autonomous power" is created specifically within that unit. This military unit has a commander and a deputy commander, supported by section officers and unit commanders. When issues arise within the military unit, efforts for resolution are made, as much as possible, by the appointed unit commander.

Implementation of the Military Law on Military Members Involved in the Crime of Desertion

Desertion is a military crime involving members of the Indonesian National Armed Forces (TNI) leaving their duties or military obligations without proper authorization from their superiors. Desertion has serious implications for military discipline, cohesion, and operational efficiency, and it can threaten national defense. The legal enforcement of desertion offenses is regulated under the Military Penal Code (KUHPM), particularly Articles 87 and 88. The process of handling desertion cases involves investigation by the Military Police (POM), investigation by military investigators, and trial by military courts that issue rulings according to the applicable laws. The penalties imposed vary, ranging from imprisonment, demotion, dishonorable discharge, and even the death penalty during wartime.This study aims to explore in-depth the implementation of military law on individuals who commit desertion and to analyze the factors causing desertion. These factors include personal issues, psychological pressure, and unfavorable working environments. The study employs a normative juridical method, with an approach focused on relevant regulations and military court case studies concerning desertion offenses. The findings show that the application of military law to desertion is a crucial effort in maintaining the stability, discipline, and integrity of the TNI. However, there are several challenges in enforcing the law, such as internal and external factors affecting military personnel. In the relationship between the Military Penal Code (KUHPM) and the Criminal Code (KUHP), both are complementary, where general crimes are regulated by the Criminal Code (KUHP), while offenses related to military duties are governed by the Military Penal Code (KUHPM). This study recommends strengthening law enforcement and discipline training to minimize desertion within the military.

Social security for special categories of disabled people in the Ukrainian SSRin the 1920s.

The article is aimed at studying and analyzing the practical experience of the activities of state authorities in implementing the policy of social security for the disabled in the 1920s. The methodological basis of the study is the fundamental principles of historical research: historicism, consistency, objectivity in the course of working with documents. Among the special methods used in the study should be called problem-chronological, historical-systemic, historical-typological. The scientific novelty of the article is to highlight the features of state policy on the organization of social security of special categories of disabled. Conclusions. Having seized power on the territory of Ukraine, the Bolshevik government publicly announced its intentions to create an effective system of social security for the disabled strata of society. Material support for a special category of disabled people was assigned exclusively to the state. However, under the conditions of the new economic policy with its market principles, a small number of people could count on security. At the same time, despite the low size of social payments, the very fact of her appointment, the Soviet authorities tried to testify their value to the proletarian state. Social protection of special categories of the disabled, which included the Red Army, the disabled of the World War І and the Civil War, family members of the dead military, persons who had special merits before the Soviet state, was carried out by the People's Commissariat of Social Security through its departments on the ground at the expense of the state budget. Due to its limited volume, the amount of social payments was significantly inferior to payments made at the expense of insurance premiums.

Examining Longitudinal Relations Between Eating Disorder Symptoms and Negative Emotion Variability in Military Members.

Up to a third of service members and Veterans experience disordered eating. Disordered eating can be maintained through negative reinforcement of painful and unpleasant emotions such as guilt, shame, sadness, and hostility. Hostility is a negative emotion that may be particularly relevant for service members and Veterans, yet hostility's relation to disordered eating remains understudied. Further, variability in emotions may be particularly relevant, given that variability in emotions is often a stronger predictor of psychopathology than mean levels. Thus, the goal of the present study was to assess a potential bidirectional relationship between disordered eating symptoms and individuals' variability of hostility, stress, anxiety, sadness, and shame. Participants (N = 94, Mage = 32.2, 75.8% men; 81.8% White) completed 30 days of ecological momentary assessment (EMA) with four assessments per day along with baseline and follow-up measures including the Eating Pathology Symptom Interview (EPSI), which assessed eight disordered eating symptom domains. Hierarchical regressions revealed that higher baseline levels of Binge Eating and Excessive Exercise predicted greater intraindividual hostility variability. Further, more hostility variability predicted higher Cognitive Restraint at 1-month follow-up. Baseline disordered eating symptoms were not associated with intraindividual variability in stress, anxiety, sadness, or shame. However, greater intraindividual variability in shame predicted higher Muscle Building at 1-month follow-up. Hostility variability was the only emotion that was predicted by, and predictive of, disordered eating symptoms. These findings suggest that hostility may be a relevant treatment target for service members with disordered eating.

The Basic Psychological Need Satisfaction and Frustration Scale: Some Satisfying and Frustrating Findings

As a tool for operationalizing basic psychological needs theory (an aspect of self-determination theory), the Basic Psychological Needs Satisfaction and Frustration Scale (BPNSFS) has become the primary self-report measure. Here, with a sample of 807 Canadian military members, we confirm the BPNSFS six content factor structure and, in supporting that structure, demonstrate the differential association of satisfaction and frustration scales with psychological functioning variables that are external to the factor analysis. Although the specific content interpretation of the BPNSFS can be debated, we support the continued use of the BPNSFS as a psychometrically sound instrument.

Exploring the association between moral injury and posttraumatic stress symptoms among Canadian public safety personnel.

Public safety personnel (PSP), such as police officers, firefighters, correctional workers, and paramedics, routinely face work stressors that increase their risk of developing posttraumatic stress disorder (PTSD). PSP may additionally face moral transgressions in the workplace (e.g., witnessing human suffering, working within broken systems), heightening the risk of moral injury (MI) in this population. Research among military personnel and health care workers shows an association between MI and PTSD; however, less is known about the association between these constructs among PSP. Canadian PSP completed an online survey between June 2022 and June 2023, including a demographic questionnaire and measures of PTSD, MI, dissociation, depression, anxiety, stress, and childhood adversity. Latent variable structural equation modeling (SEM) was performed to ascertain the impact of a latent MI construct (i.e., shame, trust violation, functional impairment) on a latent PTSD construct (i.e., intrusions, avoidance, negative alterations in cognition and mood, hyperreactivity, depersonalization, derealization). Sex, age, depression, anxiety, stress, and childhood adversity were included as covariates. A total of 314 PSP were included in the data analysis. A latent variable SEM regressing PTSD onto MI and including covariates accounted for 83.7% of the variance in PTSD. MI was the strongest predictor compared to all covariates and was significantly associated with PTSD symptoms, β =.506, p <.001, above and beyond the impacts of sex, age, depression, anxiety, stress, and childhood adversity. These findings are consistent with research among military members and health care providers and highlight the importance of further exploring MI among PSP.