Military and Veterans Studies Commons^™

Consensus On Best Practices In Neuroscience-Informed Treatment Of Combat-Related Posttraumatic Stress In Military Veterans: A Delphi Study Of Experts In The Field Of Mental Health, Danielle Lauren Winters

Counseling & Human Services Theses & Dissertations

The purpose of this study was to capture consensus among mental health professionals who work with combat trauma-afflicted veterans and/or utilize a neuroscience-informed counseling approach, about a set of best practices for uniting neuroscience-informed treatment modalities with the treatment of veterans who present with Post Traumatic Stress (PTS). A multi-round Delphi study was used to elicit information from mental health professionals, which led to the proposition of ways in which mental health professionals may more efficiently work with combat veterans while utilizing neuroscience-informed treatments such as Prolonged Exposure Therapy, Eye Movement Desensitization and Reprocessing (EMDR) neuro-informed Cognitive Behavioral therapy (nCBT), …

The Association Of Skin Cancer Prevention Knowledge, Sun-Protective Attitudes, And Sun-Protective Behaviors In A Navy Population, Rachel Newnam, Uyen Le-Jenkins, Carolyn Rutledge, Craig Cunningham

Ellmer School of Nursing Faculty Publications

Introduction: U.S. Navy service members are primarily between the ages of 18 and 30 years and often required to be outside for extended periods of time in geographical locations with increased and often unfamiliar ultraviolet indexes that collectively increase their risk for skin cancer. Skin cancer is the country's most common form of cancer, yet there is a paucity of skin cancer prevention literature, especially within the U.S. Navy. The purpose of this study was to describe skin cancer risk and skin cancer prevention "cues-to-action" and to determine if skin cancer prevention knowledge was associated with sun-protective attitudes (e.g., prevention …

Sleep Disturbances And Psychological Well-Being Among Military Medical Doctors Of The Swiss Armed Forces: Study Protocol, Rationale And Development Of A Cross-Sectional And Longitudinal Interventional Study, Dena Sadeghi-Bahmani, Viola Rigotti, Zeno Stanga, Undine E. Lang, Rebecca K. Blais, Michelle L. Kelley, Serge Brand

Psychology Faculty Publications

Background: Compared to civilians and non-medical personnel, military medical doctors are at increased risk for sleep disturbances and impaired psychological well-being. Despite their responsibility and workload, no research has examined sleep disturbances and psychological well-being among the medical doctors (MDs) of the Swiss Armed Forces (SAF). Thus, the aims of the proposed study are (1) to conduct a cross-sectional study (labeled ‘Survey-Study 1’) of sleep disturbances and psychological well-being among MDs of the SAF; (2) to identify MDs who report sleep disturbances (insomnia severity index >8), along with low psychological well-being such as symptoms of depression, anxiety and stress, but …

An Objective Assessment Of Neuromotor Control Using A Smartphone App After Repeated Subconcussive Blast Exposure, Charlend K. Howard, Masahiro Yamada, Marcia Dovel, Rie Leverett, Alexander Hill, Kenneth A. Manlapaz, David O. Keyser, Rene S. Hernandez, Sheilah S. Rowe, Walter S. Carr, Michael S. Roy, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Subconcussive blast exposure has been shown to alter neurological functioning. However, the extent to which neurological dysfunction persists after blast exposure is unknown. This longitudinal study examined the potential short- and long-term effects of repeated subconcussive blast exposure on neuromotor performance from heavy weapons training in military personnel. A total of 214 participants were assessed; 137 were exposed to repeated subconcussive blasts and 77 were not exposed to blasts (controls). Participants completed a short stepping-in-place task while an Android smartphone app placed on their thigh recorded movement kinematics. We showed acute suppression of neuromotor variability 6 h after subconcussive blast …

Individual And Organizational Challenges To Implementing Prolonged Exposure Therapy In The Military Health System: A Systematic Review Of Client And Provider Perspectives, Paris R. Cloutier

Honors Undergraduate Theses

Military veterans and active-duty service members face high rates of posttraumatic stress disorder (PTSD), a chronic and debilitating condition that is comorbid with other negative psychological and social outcomes. PTSD symptomology in military careers is attributed to unique organizational factors and risks both during and post-deployment. Delivering modern, effective PTSD treatments derived from evidence-based research to the military population is a multi-faceted effort. Among these interventions, prolonged exposure therapy (PE) is a safe and effective trauma-focused treatment for veterans. To yield higher rates of PE success, common challenges faced by both military clients and their clinicians that may be impairing …

Childhood Unpredictability Is Associated With Increased Risk For Long- And Short-Term Depression And Anhedonia Symptoms Following Combat Deployment, Christopher Hunt, Meghan Vinograd, Laura M. Glynn, Elysia Poggi Davis, Tallie Z. Baram, Hal S. Stern, Caroline M. Nievergelt, Bruna Cuccurazzu, Cindy Napan, Dylan Delmar, Dewleen G. Baker, Victoria B. Risbrough

Psychology Faculty Articles and Research

High unpredictability has emerged as a dimension of early-life adversity that may contribute to a host of deleterious consequences later in life. Early-life unpredictability affects development of limbic and reward circuits in both rodents and humans, with a potential to increase sensitivity to stressors and mood symptoms later in life. Here, we examined the extent to which unpredictability during childhood was associated with changes in mood symptoms (anhedonia and general depression) after two adult life stressors, combat deployment and civilian reintegration, which were assessed ten years apart. We also examined how perceived stress and social support mediated and /or moderated …

Moral Injury, Identity Dissonance, And Reintegration: A Compendium Of Reintegration And Survey Of United States Military Veterans, Thomas Hodges

Doctor of International Conflict Management Dissertations

How do military moral injuries affect reintegration? All service members leave the military eventually, but reintegration can be challenging, bringing changes in career, family life, and friendships, potentially prompting a loss of purpose, drive, and connection. Service members may also struggle with a crisis of identity upon separating from the military, feeling their military identity is incompatible with civilian life. While these difficulties are common for service members in reintegration, they may be worsened by moral injury, the adverse biological, social, psychological, and spiritual effects of experiencing an event that deeply offends a person’s sense of right and wrong. People …

Serving Those Who Served: Renegotiating Support And Benefits For U.S. Military Veterans With Less Than Honorable Discharges, Mariah Brennan, Emily Graham

Population Health Research Brief Series

Approximately 1 in 7 veterans are discharged from the military under less than “Honorable” conditions. Veterans with less than “Honorable” discharges experience bias and stigma related to their discharge, which can lead to elevated risk for behavioral and mental health challenges and homelessness. This brief summarizes the different military discharge types, explains how less than “Honorable” discharges can affect veteran health, identifies groups of veterans who are at risk of receiving a less than “Honorable” discharge, and makes policy recommendations for the Department of Defense (DoD), civilian employers, and community healthcare providers.

The Mediation Effects Of Adaptive Blindness Strategies On The Relation Between Institutional Betrayal From Military Sexual Assault And Mental Health Symptoms, Rachel L. Davies

Psychology Theses & Dissertations

Military sexual assault is a serious and prevalent issue. The frequency with which military sexual assault occurs and the nature of the response to these events within the military system may contribute to institutional betrayal. Institutional betrayal is the failure of an institution, such as the military, to prevent sexual assault from occurring and/or the failure to support a survivor after sexual assault. Adaptive blindness strategies are forms of coping strategies that help individuals navigate a relationship they depend on when there is a betrayal. Two adaptive blindness strategies are self-blame and minimization. Although the adaptive blindness strategies may allow …

Du Undergraduate Showcase: Research, Scholarship, And Creative Works, Caitlyn Aldersea, Justin Bravo, Sam Allen, Anna Block, Connor Block, Emma Buechler, Maria De Los Angeles Bustillos, Arianna Carlson, William Christensen, Olivia Kachulis, Noah Craver, Kate Dillon, Muskan Fatima, Angel Fernandes, Emma Finch, Colleen Cassidy, Amy Fishman, Andrea Francis, Stacia Fritz, Simran Gill, Emma Gries, Rylie Hansen, Shannon Powers, Jacqueline Martinez, Zachary Harker, Ashley Hasty, Mykaela Tanino-Springsteen, Kathleen Hopps, Adelaide Kerenick, Colin Kleckner, Ci Koehring, Elijah Kruger, Braden Krumholz, Maddie Leake, Lyneé Alves, Seraphina Loukas, Yatzari Lozano Vazquez, Haley Maki, Emily Martinez, Sierra Mckinney, Audrey Mitchell, Kipling Newman, Audrey Ng, Megan Lucyshyn, Andrew Nguyen, Stevie Ostman, Casandra Pearson, Alexandra Penney, Julia Gielczynski, Tyler Ball, Anna Rini, Christina Rorres, Simon Ruland, Helayna Schafer, Emma Sellers, Sarah Schuller, Claire Shaver, Kevin Summers, Isabella Shaw, Madison Sinar, Claudia Pena, Apshara Siwakoti, Carter Sorensen, Madi Sousa, Anna Sparling, Alexandra Revier, Brandon Thierry, Dylan Tyree, Maggie Williams, Lauren Wols

DU Undergraduate Research Journal Archive

DU Undergraduate Showcase: Research, Scholarship, and Creative Works

A Mindfulness Intervention For Veterans With Post-Traumatic Stress Disorder, Ashley N. Ries, Steven M. Gerardi Phd, Otd, Mss, Otr, Mary Horne Lcsw

Spring 2023 Virtual OTD Capstone Symposium

Every day, many United States veterans are suffering from the effects of post-traumatic stress disorder (PTSD). Responses to trauma may vary from person to person; however, a diagnosis of PTSD includes the individual experiencing clinically significant distress in their social and occupational areas of functioning. The impact of PTSD on a veteran’s life could impact their ability to carry out activities of daily living, decrease the amount of social participation they have, and limit their ability to perform instrumental daily activities, such as grocery shopping. Mindfulness is the practice of paying full attention to the present moment, without judgment, and …

Impacts Of Stigma On Female Service Members, Alisha Weatherly-Kershaw

Doctor of Psychology (PsyD)

There are a variety of factors that prevent people from seeking mental health treatment. The stigma associated with mental health disorders or seeking treatment is a primary deterrent. This stigma is particularly impactful within the armed forces when they are assessed for fitness for duty. Because most research examines stigma’s impact on male military members, this study aims to identify the type of stigma that creates the most significant barrier to female service members seeking mental health treatment. Results indicate that stigmatizing perceptions of service members significantly impact female service members holding negative views towards seeking treatment.

A New Christmas Eve: Match Day Eve, Gehan A. Pendlebury

be Still

The transition of medical student to resident physician represents the student becoming the teacher -- a teacher that will continue to evolve over time. Residents teach medical students, yet residents are taught by their attending physicians. In many ways, Match Day is a milestone marking the beginning of that incremental learning process. The word "doctor" derives from the Latin word “docere” meaning "to teach" as doctors should be teaching their patients good health in their practice of medicine. Likewise, it is an inherent responsibility of all physicians to pass on their knowledge and skills for the betterment of the next …

Comparison Of General Population Vs. U.S. Military Veterans Eating Disorder Prevalence, Micah Callahan

University Honors Theses

Eating disorders disrupt the psychological wellbeing, work ability and daily functioning of many individuals. There is currently no data to compare the prevalence of eating disorders in the general public compared to the military population. The hypothesis was that the military population would be significantly higher in prevalence compared to the general population within the general eating disorder, subcategories of eating disorders and between sex. To analyze the data collected from two studies, sixteen two-proportion Z tests were conducted to determine if the proportions of DSM-V eating disorders differed within and between sex for total incidence and sub-category incidence for …

Potential Chemical Risks From Tattoos And Their Relevance To Military Health Policy In The United States, James D. Blando, Blas A. Guigni

Community & Environmental Health Faculty Publications

We summarize and consolidate disparate sources of information about the practice of tattooing and its potential implications for military population health and policy. Each branch of the United States military has policies about tattoos for service members, but these have varied over time and do not cover health protection. The number of veterans receiving disability payments and the cost of those payments has been rising over time; the broad category of skin conditions accounts for 11% of disability claims. Any additional factor, such as tattoos that may increase the occurrence of adverse skin reactions, can substantially impact veteran benefit expenses …

Veteran Access To Mental Health Services And How It Contributes To The Rates Of Suicide, Kameron R. Grigsby

Kentucky Journal of Undergraduate Scholarship

This essay is an exploration of the access Veterans have to mental health services and how such access or lack thereof contributes to the rates of suicide among the Veteran population. The purpose of this essay is to examine various factors that influence Veteran access to mental health care and how these factors can be improved or eliminated. By analyzing such factors, healthcare professionals may begin to further implement provisions and practices to decrease the rising rate of suicides among Veterans.

A Retrospective Review Of A Local Healthcare Process Designed To Improve Understandability, Actionability, And Readability Of Written Documents For Veterans, Erica Wilson

College of Health Sciences Posters

Preventable chronic diseases are plaguing our veterans. Health literacy is an important component of prevention and chronic disease self-management. People need health literacy skills to read and understand information. The Veterans Health Administration (VHA) calls the Veterans Health Education and Information (VHEI) Committee for a review process to improve the understandability, actionability, and readability of VHEI resources.

This retrospective review of a local evidence-based process improvement is being implemented at the Washington DC Veterans Affairs Medical Center (DCVAMC) to satisfy a VHA directive to improve the understandability, actionability, and readability of written materials. The local process improvement involves a robust …

Contributing Factors To Withdrawal Decisions Of Military And Nonmilitary Nursing Students, Beth Tremblay, Janice E. Hawkins, Robert E. Hawkins, Karen Higgins, Lynn Wiles, Jamela Martin

Ellmer School of Nursing Faculty Publications

Retaining nursing students in courses is key to increasing the number of new nurses. This study examined factors associated with nursing course or program withdrawal among students with and without prior military experience. The purpose of this study was to uncover differences between groups of students who withdrew compared to those who did not. A cross-sectional study using an online questionnaire surveyed current or recent nursing students (n = 420) using the Educational Requirement Subscale and the Student Withdrawal Questionnaire from Jeffreys’ toolkit. Uncovering differences between groups of students who did and did not withdraw from nursing courses or programs …

Ptsd And Alcohol Use Disorders Predict The Pace Of Cellular Aging, Sage E. Hawn, Xiang Zhao, Mark W. Miller, Sara Wallander, Christine Govan, Anjanette Stone, Steven A. Schichman, Mark W. Logue, Erika J. Wolf

Psychology Faculty Publications

Advanced epigenetic age is associated with psychopathology and may help to explain the link between psychopathology and physical health morbidity and mortality. Using a longitudinal sample of 171 trauma-exposed Veterans, we modeled the rate of change in epigenetic age across two time points (averaging 5.58 years apart) using two epigenetic age algorithms (GrimAge and Horvath) and tested associations with posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and depression. Results showed that PTSD (β = .199) and AUD (β = .186) were associated with a quickened pace of epigenetic aging over time (ps < .021). Results replicate and extend prior work and offer foundational support for identifying interventions that slow the pace of biological aging among those with psychopathology.

Hardships, Motivations, And Resiliency: Case Study Of Health Implications Of 2022 Russian Invasion On Ukrainian Resistance Members, Jessi Hanson-Defusco

Journal of Social, Behavioral, and Health Sciences

The 2022 Russian full-scale invasion of Ukraine caused millions of Ukrainians to flee. Yet most citizens continue to reside in the country, playing critical roles in the Ukrainian resistance. Today the Ukrainian fighting force includes trained military and police as well as citizens who either were conscripted or volunteered to take part in national war efforts. This mixed-method study conducted in Spring 2022 presents data collected from 79 respondents in a semistructured survey, using snowball sampling. Data analysis examined individual self-reported motivations, attitudes toward the conflict, resilience, quality-of-life hardships, and scaled perceived stress. Results indicated that Ukrainian resistance members face …

The Purple Heart And Suicidal Behaviors In Post-9/11 U.S. Army Combat Veterans With A Traumatic Brain Injury: A Mixed Methods Study, Jayna Moceri-Brooks

Electronic Theses and Dissertations

Military suicide rates remain high, despite years of targeted efforts to prevent suicide. Specifically, Army Combat Veterans who sustained a traumatic brain injury (TBI) while deployed in support of the Global War on Terrorism are at the highest risk for suicide. This dissertation highlights possible causes for suicidal behaviors within this unique group and provides specific military suicide prevention recommendations. The dissertation is organized into three publishable manuscripts: The first manuscript (Chapter 1) is a mixed-methods dissertation research proposal written according to the National Institute of Health proposal guidelines. The second manuscript (Chapter 2) is an integrative review of the …

Process Improvement To Return Stabilized Behavioral Health Patients To Primary Care, Tessa Woodroof

Epsilon Sigma at-Large Research Conference

Purpose: The purpose of this project is to increase the number of open patient appointments by implementing a validated process in which stabilized behavioral health patients are repatriated to primary care. Currently, there is an increased demand for behavioral health services and decreased supply of behavioral health clinicians at the Nashville Veterans Affairs Medical Center (VAMC).

Aims: This project aims to teach behavioral health providers how to identify appropriate patients and complete successful discharges while helping primary care providers integrate the repatriation process into their workflow. Without the proposed intervention, veterans initiating behavioral health services in the catchment area will …

A Comparison Of Factors That Impact Retention Of Nursing Students With And Without Military Experience: A Mixed Method Study, Janice E. Hawkins, Karen Higgins, Jamela Martin, Lynn Wiles, Ingrid Mahoney, Robert Hawkins, Beth Tremblay

Ellmer School of Nursing Faculty Publications

Military veteran students have unique characteristics and challenges that influence their academic success. The factors impacting retention of nursing students with prior military experience may differ from students with no military experience. This mixed methods study used an anonymous survey guided by Jeffreys' Nursing Undergraduate Retention and Success Model to identify factors that support or restrict prelicensure nursing program retention of military veteran students compared to students with no history of military service. Statistically significant differences between groups were detected for three factors including financial status, membership in nursing organizations or clubs, and financial aid and/or scholarship. There was a …

Sleeping With The Enemy: Examining The Relationship Between Sleep And Pain In Post-9/11 Veterans, John L. Schwartz Jr.

Psychology Theses & Dissertations

United States veterans are a diverse group of individuals, yet as a result of their service, they share a unique set of customs, traditions, and values. Post-9/11 veterans are more likely to experience elevated levels of pain and poor sleep quality compared to their civilian counterparts; however, little is known about how beliefs related to veterans’ pain impact their sleep and how levels of pain acceptance influence the sleep-pain association. This study examined relationships between sleep and pain in a sample of 102 post-9/11 veterans. Results support associations between pain and sleep identified in other populations. Positive correlations were found …

Great (Soft) Power Competition: Us And Chinese Efforts In Global Health Engagement, Michael W. Wissemann

The US Army War College Quarterly: Parameters

Global health engagement, an underutilized strategy rooted in the strengths of soft power persuasion, can lead to more military-to-military cooperation training, help establish relationships that can be relied on when crises develop, stabilize fragile states, and deny violent extremist organizations space for recruiting and operations. Examining Chinese efforts worldwide to curry favor and influence and the challenges posed by the COVID-19 pandemic, this article shows health as a medium is a very compelling and advantageous whole-of-government approach to national security policy concerns.

Effects Of Rucksack Military Accessory On Gait Dynamic Stability, Seong H. Moon, Christopher W. Frames, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Various factors are responsible for injuries that occur in the U.S. Army soldiers. In particular, rucksack load carriage equipment influences the stability of the lower extremities and possibly affects gait balance. The objective of this investigation was to assess the gait and local dynamic stability of the lower extremity of five subjects as they performed a simulated rucksack march on a treadmill. The Motek Gait Real-time Interactive Laboratory (GRAIL) was utilized to replicate the environment of the rucksack march. The first walking trial was without a rucksack and the second set was executed with the All-Purpose Lightweight Individual Carrying Equipment …

The Role Of Occupational Therapy: Military Dependents Transitioning Into Motherhood, Ria Allen, Becki Cohill, Susan Macdermott, Karen Park

Summer 2021 Virtual OTD Capstone Symposium

Background: Motherhood is a time of adjustments and changes. Mothers are learning how to balance taking care of a newborn, household responsibilities, and self-care. Adjustments of routine in everyday occupations can change quickly as the baby's needs evolve over time and established routines are disrupted and new routines are created. For military spouses, military culture and lifestyle can affect adjustments to motherhood as well including deployments, frequent moves, and reestablishing support systems. An in-depth literature review revealed that there is limited occupational therapy research, programming, and resources available to military dependent mothers

Purpose: The purpose of this study was to …

Incarceration And Suicide: Do The Risk Factors Differ For Civilians And Veterans?, Rheannon Gail Ramsey

Dissertations and Theses

Suicide is one of the leading causes of death in United States jails and prisons. Many researchers have looked at suicides in prisons and what can potentially cause suicidal ideation but there are conflicting findings among civilian incarcerated populations and United States military veteran incarcerated populations.

The intent of this study is to examine which risk factors are most prevalent among adults in custody, with a focus on mental health and substance use or abuse and how these risk factors differ between incarcerated civilians and incarcerated veterans. Using survey data from the 2002 Survey of Inmates in Local Jails conducted …

U.S. Military Veterans’ Attitudes And Perceptions Of Mental Healthcare, Bridget Milam Wells

Health, Human Performance and Recreation Undergraduate Honors Theses

The purpose of this research project is to measure whether U.S. military veterans experience any stigma related to mental healthcare and if this is associated with age, length of service, and military branch. U.S. military veterans are a high-risk group for developing mental illnesses. It is believed social stigma and personal attitudes, perceptions and beliefs of mental healthcare may influence whether a veteran will pursue mental healthcare. This cross-sectional study was conducted as an online survey via Qualtrics resulting in 75 total responses. 21 responses were excluded from the analysis due to incompletion or failure to pass the consciousness-awareness test …

Self-Reliance And Self-Efficacy As Determinants Of Mental Health Treatment Seeking Intention In A Sample Of Student Service Members/Veterans, Leigh Holdsambeck

DNP Projects

Problem Statement: High rates of mental illness and poor treatment seeking have plagued the military for decades. As an organization that demands resilience, sacrifice, strength, and courage from its members, many servicemembers develop deep-seated self-reliance and self-efficacy. Though essential in many critical situations, these traits often complicate a servicemember's willingness to seek care for a mental health concern. Student servicemembers/veterans (SSM/Vs) are at an increased risk for poor mental health outcomes owing to the compounded stressors of military service and academia. Purpose: To measure the impact of elements of military service, namely self-reliance and self-efficacy, on mental health …