Suicidal Ideation Severity in Transgender and Cisgender Elevated-Risk Military Service Members at Baseline and Three-Month Follow-Up

2020 ◽  
Vol 8 (3) ◽  
pp. 256-264
Author(s):  
Roshni Janakiraman ◽  
Ian H. Stanley ◽  
Mary E. Duffy ◽  
Anna R. Gai ◽  
Jetta E. Hanson ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Military Service ◽  
Elevated Risk ◽  
Service Members ◽  
Military Service Members

Examining the link between prior suicidality and subsequent suicidal ideation among high-risk US military service members

2018 ◽  
Vol 49 (13) ◽  
pp. 2237-2246 ◽  
Author(s):  
Melanie A. Hom ◽  
Mary E. Duffy ◽  
Megan L. Rogers ◽  
Jetta E. Hanson ◽  
Peter M. Gutierrez ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Military Service ◽  
Suicide Risk ◽  
Self Report ◽  
Service Members ◽  
Thwarted Belongingness ◽  
Us Military ◽  
Military Service Members ◽  
The Relationship

AbstractBackgroundResearch is needed to identify the factors that explain the link between prior and future suicidality. This study evaluated possible mediators of the relationship between: (1) the severity of prior suicidality and (2) suicidal ideation severity at 3-month follow-up among a sample of high-risk military personnel.MethodsUS military service members referred to or seeking care for suicide risk (N = 624) completed self-report psychiatric domain measures and a clinician interview assessing prior suicidality severity at baseline. Three months later, participants completed a self-report measure of suicidal ideation severity. Three separate percentile bootstrap mediation models were used to examine psychiatric factors (i.e. alcohol abuse, anxiety sensitivity, hopelessness, insomnia, posttraumatic stress symptoms, suicidal ideation, and thwarted belongingness) as parallel mediators of the relationship between prior suicidality severity (specifically, suicidal ideation, suicide attempt, and overall suicidality – i.e. ideation/attempt severity combined) at baseline and suicidal ideation severity at follow-up.ResultsHopelessness, specifically, and the total effect of all mediators, each significantly accounted for the relationship between prior suicidality severity and subsequent ideation severity across models. In the models with attempt severity and overall suicidality severity as predictors, thwarted belongingness was also a significant mediator.ConclusionsHopelessness, thwarted belongingness, and overall severity of psychiatric indices may explain the relationship between prior suicidality severity and future suicidal ideation severity among service members at elevated suicide risk. Research is needed to replicate these findings and examine other possible mediators.

scholarly journals A-116 Predicting Chronic Neurobehavioral Symptoms based on Acute Injury Characteristics and Symptoms in U.S. Military Service Members with and without history of TBI

2020 ◽  
Vol 35 (6) ◽  
pp. 909-909
Author(s):  
Lippa S ◽  
Bailie J ◽  
Brickell T ◽  
French L ◽  
Hungerford L ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Military Service ◽  
Service Members ◽  
Injury Characteristics ◽  
Military Service Members ◽  
History Of ◽  
Neurobehavioral Symptoms ◽  
Severe Tbi

Abstract Objective Recovery following traumatic brain injury (TBI) is complex. Often following mild TBI, recovery occurs within days or weeks, though this is not always the case. Following more severe TBI, some recover quickly, while many never fully recover. This study examines acute predictors of chronic neurobehavioral symptoms in U.S. military service members (Age: M = 33.9 years, SD = 10.2) without injury (n = 86), or with history of uncomplicated mild traumatic brain injury (TBI; n = 56), complicated mild, moderate, or severe TBI (mod-sev TBI; n = 43), or bodily injury (n = 25). Method Participants completed the Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist, Alcohol Use Disorder Checklist, Combat Exposure Scale, and TBI Quality of Life and passed symptom validity tests at 0–8 months and ≥ 2 years post-injury. Forward stepwise logistic regression included 26 potential predictors (demographics, injury characteristics, military characteristics, and self-report measures at baseline) of International Statistical Classification of Diseases and Related Health Problems-10 Postconcussional Syndrome (PCSy) at follow-up. Results Cognitive Concerns (Exp(B) = .896, p = .001), Sleep (Exp(B) = 1.874, p < .001), Somatosensory Symptoms (Exp(B) = 1.194, p = .012), and mod-sev TBI (Exp(B) = 2.959, p = .045) significantly predicted follow-up PCSy. When baseline NSI symptoms were removed from the model, Cognitive Concerns (Exp(B) = .902, p < .001), Post-traumatic stress (Exp(B) = 1.173, p = .001), and Resilience (Exp(B) = .950, p < .031) significantly predicted PCSy. For all included measures in both models, higher symptoms at baseline predicted increased likelihood of follow-up PCSy. Both models correctly classified 81.3% of participants. Conclusion Findings suggest patients reporting psychological distress and cognitive concerns acutely should be targeted for treatment to mitigate prolonged neurobehavioral symptoms.

scholarly journals PERIACETABULAR OSTEOTOMY IN ACTIVE DUTY U.S. MILITARY PERSONNEL: A SINGLE CENTER’S EXPERIENCE WITH A MINIMUM OF TWO YEARS FOLLOW-UP

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0014
Author(s):  
Andrew S. Murtha ◽  
Matthew R. Schmitz
Keyword(s):  
United States ◽  
Military Service ◽  
Periacetabular Osteotomy ◽  
The United States ◽  
Active Duty ◽  
Service Members ◽  
Military Service Members ◽  
Active Service ◽  
The Impact

Background: The primary focus of periacetabular osteotomy (PAO) literature has been survivorship until hip arthroplasty. This endpoint overlooks its impact on young, active patients. Hypothesis/Purpose: This study sought to assess the impact of the PAO on the careers of active duty members of the United States Armed Forces. Methods: A retrospective review identified 38 patients who underwent PAO performed by a single surgeon at an academic, military medical center from January 2014 through April 2017. Twenty-one of the patients were active duty United States military service members (16 female, 5 male) and had a minimum 28 months of post-operative follow-up at the time of review. Preoperative and postoperative duty restrictions were noted and referrals to the U.S Army and U.S. Air Force Medical Evaluation Boards (MEB) were queried. Results: The average age at surgery was 25.6 years (range, 19-40y). Preoperatively, sixteen patients (94.1%) were on duty restrictions, one had been referred to the MEB, and records were not available on three patients who separated from the military prior to review. Average follow-up was 3.4 years (range, 2.3 – 5.4y). Among the patients without a preoperative MEB referral, 85.0% remained on active duty (n = 12) or completed their military service commitment (n=5). Of the fourteen patients with temporary duty restrictions preoperatively, 35.7% (n=5) were relieved of their restrictions and returned to full duty and 50% (n=7) were retained on active service with permanent duty restrictions. Such permanent duty restrictions typically consisted of modifications to the aerobic component of the semiannual military fitness testing. Six patients (28.6%) were referred to the MEB including one who was referred prior to PAO. Of these patients, two were deemed fit to retain on active service with permanent duty restrictions, two were medically separated for non-hip conditions, and two were medically separated for a hip condition. The average Veteran Affairs (VA) disability score related to hip pathology in patients referred to MEB was 16% (range 0-40%). Conclusion: This is the first study to look at the PAO in active duty military service members. In patients with symptomatic acetabular dysplasia, PAO may provide an opportunity to relieve preoperative duty restrictions and allow for continued military service. Further study with the inclusion of patient reported outcomes are necessary assess the impact of the procedure in this active patient population.

Anteromedializing Tibial Tubercle Osteotomy for Patellofemoral Instability: Occupational and Functional Outcomes in U.S. Military Service Members

2017 ◽  
Vol 31 (04) ◽  
pp. 306-313 ◽  
Author(s):  
Philip Belmont ◽  
Julia Bader ◽  
Joseph Lanzi ◽  
Brett Owens ◽  
Brian Waterman ◽  
...  
Keyword(s):  
Military Service ◽  
Patellofemoral Instability ◽  
Active Duty ◽  
Service Members ◽  
Tibial Tubercle ◽  
Tibial Tubercle Osteotomy ◽  
Military Service Members ◽  
Patellar Subluxation ◽  
Pain Improvement

AbstractThis article sought to determine rates for return to work, pain relief, and recurrent patellofemoral instability for military service members undergoing tibial tubercle osteotomy (TTO) for persistent lateral patellar subluxation or dislocation. Patient demographic and surgical variables were isolated from the medical records of active duty service members with at least 2 years of postoperative follow-up, and correlated with return to work, pain improvement, recurrent patellofemoral instability, and perioperative complications. There were 51 service members (58 primary TTOs) with an average follow-up of 3.3 (range, 2.0–6.7) years. Service members had an average of 2.8 (1–12) instability events preoperatively. At a minimum of 2 years postoperatively, 41 (80%) military service members returned to full active duty service. Among the 58 TTOs, there was a 46% improvement in the patient-reported visual analog score from 4.1 to 2.2 (p < 0001). The postoperative recurrent instability rates were patellar dislocation (5.1%) and patellar subluxation (15.5%). Concomitant proximal realignment was performed in 48% of cases, which did not affect return to service, postoperative patellar instability events, or pain improvement (p > 0.05). The overall complication rate was 10%. Postoperative tibial fractures occurred in 6.9% of TTOs. At short- to mid-term follow-up, 80% of service members undergoing TTO for patellofemoral instability returned to military duty with significant improvement in pain scores and a moderate perioperative complication and postoperative instability rate. This study is a level IV therapeutic case series.

scholarly journals Wearable Technology May Assist in Retraining Foot Strike Patterns in Previously Injured Military Service Members: A Prospective Case Series

2021 ◽  
Vol 3 ◽  
Author(s):  
Donald L. Goss ◽  
Daniel J. Watson ◽  
Erin M. Miller ◽  
Amy N. Weart ◽  
Eliza B. Szymanek ◽  
...  
Keyword(s):  
Military Service ◽  
Case Series ◽  
Exercise Program ◽  
Treadmill Running ◽  
Service Members ◽  
Post Intervention ◽  
Vertical Loading ◽  
Military Service Members ◽  
Foot Strike

A rearfoot strike (RFS) pattern with increased average vertical loading rates (AVLR) while running has been associated with injury. This study evaluated the ability of an instrumented sock, which provides real-time foot strike and cadence audio biofeedback, to transition previously injured military service members from a RFS to a non-rearfoot strike (NRFS) running pattern. Nineteen RFS runners (10 males, 9 females) were instructed to wear the instrumented socks to facilitate a change in foot strike while completing an independent walk-to-run progression and lower extremity exercise program. Kinetic data were collected during treadmill running while foot strike was determined using video analysis at initial (T1), post-intervention (T2), and follow-up (T3) data collections. Nearly all runners (18/19) transitioned to a NRFS pattern following intervention (8 ± 2.4 weeks after the initial visit). Most participants (16/18) maintained the transition at follow-up (5 ± 0.8 weeks after the post-intervention visit). AVLR of the involved and uninvolved limb decreased 29% from initial [54.7 ± 13.2 bodyweights per sec (BW/s) and 55.1 ± 12.7 BW/s] to post-intervention (38.7 ± 10.1 BW/s and 38.9 ± 10.0 BW/s), respectively. This effect persisted 5-weeks later at follow-up, representing an overall 30% reduction on the involved limb and 24% reduction on the uninvolved limb. Cadence increased from the initial to the post-intervention time-point (p = 0.045); however, this effect did not persist at follow-up (p = 0.08). With technology provided feedback from instrumented socks, approximately 90% of participants transitioned to a NRFS pattern, decreased AVLR, reduced stance time and maintained these running adaptations 5-weeks later.

scholarly journals A-124 Acute Predictors of Chronic PTSD Symptoms Following TBI in U.S. Military Service Members

2020 ◽  
Vol 35 (6) ◽  
pp. 917-917
Author(s):  
Lippa S ◽  
Bailie J ◽  
Brickell T ◽  
Hungerford L ◽  
Lange R ◽  
...  
Keyword(s):  
Military Service ◽  
Injury Severity ◽  
Combat Exposure ◽  
Self Report ◽  
Service Members ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Injury ◽  
Military Service Members

Abstract Objective Post-Traumatic Stress Disorder (PTSD) has been shown to be a major contributor to poor outcome after Traumatic Brain Injury (TBI). Understanding the factors that contribute to PTSD symptoms may lead to improved clinical management of PTSD and TBI. This study examines acute predictors of self-reported PTSD symptoms after TBI in military service members. Method Participants included 210 U.S. military service members (Age: M = 33.9 years, SD = 10.2) without injury (n = 86), or with history of uncomplicated mild TBI (n = 56), complicated mild, moderate, or severe TBI (n = 43), or bodily injury (n = 25) assessed at 0–8 months and ≥ 2 years post-injury. At both assessments, participants completed the PTSD Checklist (PCL-C), Neurobehavioral Symptom Inventory, Alcohol Use Disorder Checklist, Combat Exposure Scale, and TBI Quality of Life and passed symptom validity tests. Stepwise linear regression included 26 potential predictors (demographics, injury characteristics, military characteristics, and self-report measures at baseline) of PCL-C Total at follow-up. Results In this model, (F(4,188) = 68.0; p &lt; .001; R2 = .591), baseline PCL-C (R2Δ = .52) was the main predictor of follow-up PCL-C Total, followed by Cognitive Concerns (R2Δ = .04), number of deployments (R2Δ = .01), and injury severity (R2Δ = .02). When baseline PCL-C was excluded as a predictor, somatosensory symptoms (R2Δ = .361), Emotional/Behavioral Dyscontrol (R2Δ = .067), Sleep (R2Δ = .033), Combat Exposure (R2Δ = .024), and Cognitive Concerns (R2Δ = .017) predicted follow-up PCL-C (F(5,187) = 37.7; p &lt; .001; R2 = .502). Semipartial correlations revealed that most of the explained variance was shared among self-report predictors. Conclusion Findings suggest acute psychological distress impacts future PTSD symptomatology, whereas TBI characteristics, such as TBI severity and number of TBIs, have minimal influence.

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