National Guard Personnel Research Articles

The Impact of Varying Levels of Confidentiality on Disclosure of Suicidal Thoughts in a Sample of United States National Guard Personnel.

Increasing rates of suicide in the military indicate current assessment approaches are not yielding accurate determinations of risk. Concern that endorsement of suicidal ideation may result in obstacles to career advancement may be resulting in nondisclosure. To test this, we recruited a sample of US National Guard personnel (n = 789; 81.7% male; 63.2% white) and administered two measures of current thoughts of suicide. One measure was integrated into our risk assessment protocol and soldiers were thus aware that answers could result in referral to on site military mental health professionals. The other measure was not integrated into the risk assessment protocol and soldiers were thus aware that results would not be reported to on site military mental health professionals. As hypothesized, a higher proportion of individuals reported current thoughts of suicide on the measure not integrated into the risk protocol (9.4%) than on the measure that was (6.0%). Also as hypothesized, a higher proportion of those willing to endorse current thoughts of suicide on the measure not integrated into the risk protocol denied current thoughts of suicide on the one that was (61.5%) than vice versa (39.0%). Limitations include cross-sectional self-report data and a lack of counter-balancing of measures. The results indicate that increasing the confidentiality of risk assessments within the National Guard increases the likelihood of reporting of current thoughts of suicide.

Civilian Unemployment and Mental Health: The Moderating Impact of Alcohol Misuse in Returning National Guard.

Postdeployment civilian unemployment has become a common problem and source of additional stress for National Guard (NG) personnel. This study evaluated 126 California NG members, exploring the relationship between immediate postdeployment employment status and self-reported mental health symptoms, including evidence of alcohol misuse. Participants were recruited from a NG unit within the first 3 months after returning home in August 2011. Over one-third of participants reported being unemployed beyond the part-time NG commitment. Mental health symptoms were greater in those participants without civilian employment. Additionally, those participants with comorbid alcohol misuse with either depression or post-traumatic stress disorder were significantly more likely to lack civilian employment. Interaction testing revealed a significant interaction between employment status and alcohol misuse for both depression and post-traumatic stress disorder. Alcohol use was concluded to moderate the relationship between civilian unemployment and mental health symptoms. Results suggest that the part-time employment provided through NG service may serve as a protective factor in the development of negative psychological outcomes, except for cases where alcohol misuse is present.

Adverse Childhood Events and the Risk for New-Onset Depression and Post-Traumatic Stress Disorder Among U.S. National Guard Soldiers.

This article examines the relationship between childhood adversity and postdeployment new-onset psychopathology among a sample of U.S. National Guard personnel deployed during Operation Iraqi Freedom and Operation Enduring Freedom with no history of post-traumatic stress disorder (PTSD) or depression. We recruited a sample of 991 Ohio Army National Guard soldiers and conducted structured interviews to assess traumatic event exposure, a history of childhood adversity, and postdeployment depression, and PTSD, consistent with the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. We assessed childhood adversity by using questions from the Childhood Adverse Events Survey. In multivariable logistic models, a history of any childhood adversity was significantly associated with new-onset depression, but not PTSD, postdeployment. This finding suggests that a history of childhood adversity is predisposing for new-onset depression, among U.S. National Guard soldiers who were deployed with no prior history of PTSD or depression. This highlights the centrality of childhood experience for the production of mental health among soldiers.

Posttraumatic stress disorder post Iraq and Afghanistan: prevalence among military subgroups.

A large body of research has been produced in recent years investigating posttraumatic stress disorder (PTSD) among military personnel following deployment to Iraq and Afghanistan, resulting in apparent differences in PTSD prevalence. We compare prevalence estimates for current PTSD between military subgroups, providing insight into how groups may be differentially affected by deployment. Systematic literature searches using the terms PTSD, stress disorder, and acute stress, combined with terms relating to military personnel, identified 49 relevant papers. Studies with a sample size of less than 100 and studies based on data for treatment seeking or injured populations were excluded. Studies were categorized according to theatre of deployment (Iraq or Afghanistan), combat and noncombat deployed samples, sex, enlistment type (regular or reserve and [or] National Guard), and service branch (for example, army, navy, and air force). Meta-analysis was used to assess PTSD prevalence across subgroups. There was large variability in PTSD prevalence between studies, but, regardless of heterogeneity, prevalence rates of PTSD were higher among studies of Iraq-deployed personnel (12.9%; 95% CI 11.3% to 14.4%), compared with personnel deployed to Afghanistan (7.1%; 95% CI 4.6% to 9.6%), combat deployed personnel, and personnel serving in the Canadian, US, or UK army or the navy or marines (12.4%; 95% CI 10.9% to 13.4%), compared with the other services (4.9%; 95% CI 1.4% to 8.4%). Contrary to findings from within-study comparisons, we did not find a difference in PTSD prevalence for regular active-duty and reserve or National Guard personnel. Categorizing studies according to deployment location and branch of service identified differences among subgroups that provide further support for factors underlying the development of PTSD.

Self-reported stressors of National Guard women veterans before and after deployment: the relevance of interpersonal relationships.

ABSTRACTBACKGROUNDWith their rapidly expanding roles in the military, women service members experience significant stressors throughout their deployment experience. However, there are few studies that examine changes in women Veterans’ stressors before and after deployment.OBJECTIVEThis study examines the types of stressors women Veterans report before deployment, immediately after deployment, 3 months after deployment, and 1 year post-deployment.DESIGNDescriptive data on reported stressors was collected at four time points of a longitudinal study (HEROES Project). Open-ended responses from the Coping Response Inventory (CRI) were coded into six possible major stressor categories for analysis.PARTICIPANTSSeventy-nine Army National Guard and Reserve female personnel deploying to Operation Enduring Freedom (OFF)/Operation Iraqi Freedom (OIF) were surveyed prior to deployment. Of these participants, 35 women completed Phase 2, 41 completed Phase 3, and 48 completed Phase 4 of the study.KEY RESULTSWe identified six major stressor categories: (1) interpersonal (i.e., issues with family and/or friends), (2) deployment-related and military-related, (3) health concerns, (4) death of a loved one, (5) daily needs (i.e., financial/housing/transportation concerns), and (6) employment or school-related concerns. At all time points, interpersonal issues were one of the most common type of stressor for this sample. Daily needs concerns increased from 3 months post-deployment to 1 year post-deployment.CONCLUSIONSInterpersonal concerns are commonly reported by women Veterans both before and after their combat experience, suggesting that this is a time during which interpersonal support is especially critical. We discuss implications, which include the need for a more coordinated approach to women Veterans’ health care (e.g., greater community-based outreach), and the need for more and more accessible Veterans Affairs (VA) services to address the needs of female Veterans.

Hepatitis B virus among Saudi National Guard Personnel: Seroprevalence and risk of exposure

Data on HBV prevalence among active military personnel in Saudi Arabia (SA) are lacking. In addition, the work-related risk of exposure is unclear. The objective of this study was to estimate the seroprevalence of HBV and the risk of HBV exposure among SA National Guard (SANG) soldiers. A cross-sectional study was performed and included 400 male SANG soldiers working in Jeddah during January 2009. All soldiers completed a questionnaire to assess their risk of exposure and gave a blood sample to test for hepatitis serology markers. A total of 16 (4.0%) soldiers were positive for HbsAg, 53 (13.2%) were positive for anti-HBc, and 230 (57.5%) were positive for anti-HBs. None of the soldiers had acute HBV infection, but 15 (3.8%) were chronic HBV carriers. A total of 152 (38.0%) soldiers were susceptible to HBV infection, and 230 (57.5%) were immune to HBV infection, primarily (84.3%) due to HBV vaccination. Compared with those who were negative for anti-HBc (never exposed), soldiers who were positive for anti-HBc were more likely to be older, have a lower education level, have a higher income, have a longer service duration, have a household member with HBV disease, have undergone surgery, or have undergone endoscopy. In the multivariate logistic regression model, older age, presence of a household member with HBV disease and previous endoscopy were independent predictors of HBV exposure. We report a 4% prevalence of HBsAg in the Saudi military population. This HBV prevalence was higher than those in the general Saudi population and military populations from Western countries. Both work-related and community-related risk factors for exposure are suggested.

Promoting Reintegration of National Guard Veterans and Their Partners Using a Self-Directed Program of Integrative Therapies: A Pilot Study

This article reports pilot data from phase I of a project to develop and evaluate a self-directed program of integrative therapies for National Guard personnel and significant relationship partners to support reintegration and resilience after return from Iraq or Afghanistan. Data are reported on 43 dyads. Intervention was an integrated multimedia package of guided meditative, contemplative, and relaxation exercises (CD) and instruction in simple massage techniques (DVD) to promote stress reduction and interpersonal connectedness. A repeated measures design with standardized instruments was used to establish stability of baseline levels of relevant mental health domains (day 1, day 30), followed by the intervention and assessments 4 and 8 weeks later. Significant improvements in standardized measures for post-traumatic stress disorder, depression, and self-compassion were seen in both veterans and partners; and in stress for partners. Weekly online reporting tracked utilization of guided exercises and massage. Veterans reported significant reductions in ratings of physical pain, physical tension, irritability, anxiety/worry, and depression after massage, and longitudinal analysis suggested declining baseline levels of tension and irritability. Qualitative data from focus groups and implications for continued development and a phase II trial are discussed.

Improvement of the low knowledge, attitude and practice of hepatitis B virus infection among Saudi national guard personnel after educational intervention

BackgroundAlthough the risk of hepatitis B virus (HBV) was reported to be higher in military personnel than the general population in Saudi Arabia (SA), there is lack of studies assessing HBV awareness among them. The objective was to evaluate the knowledge, attitude and practice (KAP) of HBV infection among military personnel.MethodsAn intervention design with pre- and post-education KAP questionnaire was completed among National Guard soldiers working in Jeddah during January 2009. Educational intervention was provided through educational leaflets, group and individual discussions, visual show, and a lecture. A score was created from the correct answers to 58 questions.ResultsA total of 400 male soldiers with mean age 30.7 ± 6.1 years completed both questionnaires. The majority had school education (96.8%) and in the lower military ranks (66.0%). Only 19.5% of soldiers reported HBV vaccine intake. The low median and inter-quartile range of the pre-intervention score (16, 6–26) markedly increased after education (to 53, 50–55, p<0.001). The overall improvement of mean KAP score (204%) was also observed in all its component scores; disease nature (272%), methods of transmission (206%), prevention and control (109%), attitude (155%), and practice (192%). The improvement was evident irrespective of socio-demographic characteristics and history of HBV vaccine. KAP scores were significantly associated with higher educational levels, higher monthly income, administrative jobs, and higher job ranks.ConclusionWe are reporting a low level of HBV awareness among Saudi military population. The study confirms the need and effectiveness of focused multifaceted educational campaigns among the military population.

Civilian Social Work with Veterans Returning from Iraq and Afghanistan: A Call to Action

In the aftermath of the September 11, 2001, attack and tragic collapse of the World Trade Center towers in New York City, President George W. Bush promised to retaliate against the perpetrators of that national trauma. Not since the attack on Pearl Harbor seven decades earlier had our populace been so unified in its support of retaliation and so willing to make the personal sacrifices that might entail. Rather than focus a military retaliation primarily on the al-Qaeda perpetrators of the terrorist attack, however, the Bush administration persuaded the nation to support an invasion of Iraq. Rather than ask the nation as a whole to make sacrifices to support the war effort, President Bush encouraged the general public to go shopping. Rather than raise taxes to fund the costs of the war, the U.S. Congress left unchanged tax cuts that mainly benefited the affluent. Rather than reinstate a draft to supply the military personnel that would be needed for what came to be known as the Global War on Terror, the government relied exclusively on our small, all-volunteer armed forces. Doing so necessitated an unprecedented reliance on multiple deployments of National Guard and reservist personnel to provide the troops needed to carry out the longest combat engagement in our nation's history. It also necessitated an unprecedented reliance on lengthier tours of combat duty. The consequent burden experienced by the troops was compounded by the absence of front lines during these long tours of duty. Danger was ubiquitous and could come at any time from a roadside bomb or from enemies dressed as civilians. Moreover, the ubiquity of potential attack put female service members in combat situations they had not experienced in previous wars. Needless to say, all this has placed great and unprecedented strains on our military personnel and their families, who have borne the brunt of our nation's sacrifice for the war. As expressed in a New York Times commentary by Timothy Egan (2012), the yellow banners, the halftime tributes, the bloviating by politicians of both parties--it's so easy for the 99 percent of us who aren't serving in the military to act like we support them.... Those 2.3 million men and women who served in one of the two wars ... will be trying to live with the horrors they saw and felt for the rest of their lives.... Their suicide rate--38 per 100,000--is more than three times that of the population at large. [A] Pew poll found that 37 percent of the war veterans suffered from a degree of post-traumatic stress. ... If the Pew poll is accurate, more than 800,000 veterans are re-entering society with some form of psychological trauma. In light of our professional expertise and values, social work practitioners and educators have both the capability and obligation to do more than the general public to support and meet the needs of our returning troops and their families. Although military personnel, veterans, and their families have been served by social workers throughout the history of our profession, perhaps never before has the call for social workers to help this target population been as compelling as it is today. And this help is needed not just from uniformed military social workers or from social workers employed by the Veterans Administration. It is also needed from civilian social workers. As noted in the Preface of the Handbook of Military Social Work (Rubin, Weiss, & Coll, in press), Indeed, the vast numbers of service members returning from the wars in Iraq and Afghanistan likely will exceed the capacity of the Department of Veteran Affairs and affiliated programs such as the Vet Centers to serve them all adequately. These clients will be seeking services within the civilian sector, such as in community mental health agencies, [health maintenance organizations] and private practices. …

The Need to Increase the Size of the Deployable Army

After criticizing the Clinton Administration for overdeploying and overusing the US military in the 1990s, the Bush Administration is now doing exactly the same thing--except on a much larger scale. Having made the decision to overthrow Saddam Hussein, and having badly underestimated the difficulty as well as the force requirements of accomplishing the post-Saddam stabilization effort successfully, the Bush Administration or its successor now needs to get serious about making ends match means. At present, the latter are insufficient. The possibility exists that large numbers of active-duty troops and reservists may soon leave the service rather than subjecting themselves to a life continually on the road. The seriousness of the worry cannot be easily established. So far the problem has not become acute. Stop-loss orders that prevent some military personnel from leaving the service at the scheduled end of their tours, together with a surge of patriotism after 9/11, together with limited awareness to date of just how long the Iraq mission is likely to last, have limited the fallout of overdeployments. But there can be no assurance that this state of affairs will continue. Avoiding a personnel crisis in the all-volunteer military has become the chief force management challenge for Secretary of Defense Donald Rumsfeld or his successor, much more so than transforming the armed forces or relocating overseas bases. The problem is most acute for the US Army, which numbers only a half million active-duty troops, though it is also significant for the Marine Corps. The Air Force and Navy have benefited considerably from not only the end of the Iraq invasion but also from the end of the no-fly zone and sanctions enforcement operations that characterized the 1991-2003 period. However, US ground forces still have about 140,000 personnel in Iraq, another 30,000 or so in Kuwait and other parts of the Persian Gulf region, and nearly 20,000 in Afghanistan. More than 25,000 soldiers remain in Korea (even if several thousand of those are now slated to go to Iraq); nearly 2,000 are still in the Balkans; several thousand marines are on Okinawa; dozens here and hundreds there are on temporary assignments around the world. Virtually all of these soldiers, most of them married, are currently separated from their home bases and families. (1) This total of some 225,000 deployed troops must be generated from an Army of just over one million and a Marine Corps of just over 200,000 total personnel. The strain is greatest on the Army, with about 190,000 soldiers deployed out of its million-soldier total strength. As noted in Figure 1, the active-duty Army numbers just under 500,000, of which only about 320,000 soldiers are easily deployable at any given moment. The Army Reserve and Army National Guard together include 550,000 troops, a quarter or more of whom typically have been activated in recent times. For example, in late 2003, 156,000 Army reservists were mobilized out of a total of 558,000, and in June 2004 the number stood at 130,000. Cumulatively since 11 September 2001,213,000 Army reservists had been mobilized at least once by the end of the 2003-04 winter, just under 40 percent of the total. Roughly 30 percent of Air Force Reserve or National Guard personnel have been mobilized as well, just under 25 percent of Navy reserve personnel, and more than 50 percent of the Marine Corps' small reserve. But by now the reserve activations of those other services have dropped quite substantially, whereas the Army's remains at a high level. (2) Deployment demands are likely to remain great, even if Secretary Rumsfeld and President Bush hope otherwise. Foreign coalition partners in Iraq continue to provide about 25,000 troops, but that number is not trending upward. That makes it likely that US troop strength there will have to remain substantial for a long time to come. Indeed, the US military is preparing for the possibility that its current strength in Iraq of just over 140,000 may have to remain at that level for years. …

Counseling and Connecting with the Military Undergraduate: The Intersection of Military Service and University Life

The majority of military undergraduates at universities are National Guard and Reserve personnel and prior-service military veterans, all difficult to identify on campus. These students face unique cultural challenges. Though the academic literature primarily addresses disability services and administrative programs often focus on “wounded warriors,” most military undergraduates are not physically or psychologically disabled and can be stigmatized by the “wounded warrior” stereotype. Minimal literature exists on the intersection of military culture with student life and on counseling center services for military undergraduates. This article offers a review of the literature, three core principles of care, and three vignettes of military undergraduates who received support from a counseling center provider, helping them manage both university and military life.

A Pedometer-Based Intervention to Improve Physical Activity, Fitness, and Coronary Heart Disease Risk in National Guard Personnel

To compare the effects of a pedometer-based behavioral intervention (Fitness for Life [FFL] program) and a traditional high-intensity fitness (TRAD) program on physical activity (PA), Army Physical Fitness Test (APFT), and coronary heart disease risk factors in Army National Guard members who failed the APFT 2-mile run. From a pool of 261 Army National Guard, a total of 156 were randomized to TRAD or FFL for 24 weeks consisting of a 12-week progressive conditioning program followed by 12 weeks of maintenance. For both groups, the total APFT score and 2-mile run time/score improved from baseline to 12 weeks (FFL: down 7.4%, p = 0.03; TRAD: down 5%, p = 0.08) but at 24 weeks they had regressed toward baseline. PA improved modestly and coronary risk profile changed minimally in both groups. A pedometer-based exercise intervention had results similar to a high-intensity program for improving PA, APFT, and 2-mile run times/score. Neither group sustained the improved run times over the 12 weeks of maintenance.

Providing Treatment Services for PTSD at an Army FORSCOM Installation

This article provides an overview of treatment services for posttraumatic stress disorder (PTSD) at a major U.S. Army medical center, including lessons learned that can be applied to a variety of military and civilian treatment settings. The processes of postdeployment and subsequent behavioral health screenings are detailed. Treatment options for active duty, National Guard, and reserve military personnel returning from deployment in Afghanistan and Iraq are discussed. Case vignettes on the utilization of treatment options by servicemembers are considered. Recommendations for providers regarding the facilitation of group and individual treatment for PTSD in servicemembers are provided.

Major Study Will Assess 'What Works' in PTSD Care

Major Study Will Assess 'What Works' in PTSD Care

Health impact of US military service in a large population-based military cohort: findings of the Millennium Cohort Study, 2001-2008.

BackgroundCombat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US military's all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments.MethodsThe Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data.ResultsOver 150 000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan.ConclusionThe Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment.

Polychlorinated Dibenzo-p-dioxins, Dibenzofurans, Biphenyls, and Naphthalenes in Plasma of Workers Deployed at the World Trade Center after the Collapse

Blood plasma samples (n = 43) collected retrospectively from New York State employees and National Guard personnel who had been assigned to work in the vicinity of the World Trade Center (WTC) during the week after the collapse of the buildings were analyzed for polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs), and polychlorinated naphthalenes (PCNs). On the basis of algorithms developed to rank individual exposures to dust and debris and to smoke, we categorized the samples as: more smoke exposure (MSE), more dust exposure (MDE), less smoke exposure (LSE), and less dust exposure (LDE). Mean concentrations of PCDDs were 1070, 223, 3690, and 732 pg/g lipid wt, and mean concentrations of PCDFs were 910, 1520, 230, and 117 pg/g lipid wt, for the MSE, MDE, LSE, and LDE groups, respectively. The concentrations of PCDFs were higher in the two "more exposure" groups than in the two "less exposure" groups. Calculated TEQ concentrations of coplanar PCBs and PCDD/Fs in plasma samples were, on average, 1.12 and 41.2 pg WHO-TEQ/g lipid wt, respectively. TEQ concentrations of PCDFs were higher than those of PCDDs in both "more exposure" groups but lower than those of PCDDs in "less exposure" groups. This result is suggestive of exposure of the WTC responders to PCDFs after the WTC collapse. PCDFs contributed the majority of TEQs and are therefore the critical dioxin-like compounds in MSE/MDE groups, whereas PCDDs are the critical compounds in the LSE/LDE groups.

Prospective assessment of neuropsychological functioning and mood in US Army National Guard personnel deployed as peacekeepers

The present study examined the impact of deployment on neuropsychological functioning and mood in Army National Guard personnel. We hypothesized that deployment on a peacekeeping mission, compared to non-deployment, would result in reduced proficiencies in neuropsychological performance and negative mood changes, and that such changes would relate to working in a high-strain job (high demands/low control), in accordance with Karasek's demand-control model. This prospective cohort study involved 119 male soldiers (67 participants examined before and after deployment to the Bosnia operational theatre and 52 non-deployed soldiers assessed twice over a comparable period). Unit-level adjusted, multivariate analyses found that deployed soldiers, compared to their non-deployed counterparts, demonstrated reduced proficiency in tasks involving motor speed [unstandardized coefficient B= -3.88, 95% confidence interval (95% CI) -6.38- -1.39; B= -3.84, 95% CI -5.55- -2.14; dominant and non-dominant hand, respectively] and sustained attention (B=0.031, 95% CI 0.009-0.054), along with decreased vigor (B= -2.71, 95% CI -3.63- -1.77). Deployed soldiers also showed improved proficiency in a working-memory task (B= -0.098, 95% CI -0.136- -0.060) with less depression symptomatology (B= -3.19, 95% CI -5.26- -1.13). Work stress levels increased over time in both deployed and non-deployed groups, but observed deployment effects remained significant after accounting for a high-strain job. The observed change in performance associated with peacekeeping deployment compared to non-deployment (slowed processing speed, reduced motor speed and reported vigor, together with improved proficiency in a working memory task) suggests an adaptive response to mission occupational stressors. This pattern does not appear to be influenced by working in a high-strain job. Further study is required to examine whether these results reflect transient or permanent changes in functioning.

The mobilization and return of undergraduate students serving in the National Guard and Reserves

AbstractThis chapter provides insight into the separation and return processes experienced when undergraduate National Guard and reserve personnel are mobilized for military duty. Suggestions for faculty and administrative staff on how to assist these individuals throughout this process are provided.

The Helping Heroes Bridge Program for Veterans

The Helping Heroes Bridge Program for Veterans

The Helping Heroes Bridge Program for Veterans

The Helping Heroes Bridge Program for Veterans