Adolescent Pregnancy in the U.S. Military: What We Know and What We Need to Know
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Adolescent pregnancy is a significant public health problem in the United States, but little is known about this condition in military-affiliated populations. This article reviews what is known about adolescent pregnancy among (1) dependent children of active duty and retired personnel and (2) active duty military personnel. Sparse and conflicting evidence exists regarding the prevalence of, the risk factors for, and the impacts of pregnancy in the dependent child population. Limited evidence regarding active duty service members reveals risky behavior by young military personnel, failure to effectively use contraception, and resulting pregnancies that consume military resources and diminish deployability and retention. We suggest research questions for further study that could lead to interventions targeting unintended adolescent pregnancy and its attendant tolls on health, budgets, military readiness, and fighting strength.Keywords:
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Individuals employed in first responder professions are at risk for the development of psychiatric symptoms. Two of these professions,
firefighting and military service, demonstrate a strong overlap of employees. Prior research has demonstrated increased prevalence rates of
psychiatric symptoms, including suicide-related behaviors among firefighters. Subpopulations within this occupation provide an opportunity to
inform tailored prevention and intervention tactics. One such subpopulation are firefighters with military service history (concurrent and
prior). The current study looks to investigate psychiatric symptom differences between firefighters with and without military service
history. We hypothesized an additive effect of military service, such that firefighters with a history of military service will be at
increased risk for various psychiatric symptoms compared to their civilian-only counterparts. In addition, potential theoretically-based
explanatory constructs will be used to investigate mechanisms of significant relationships between military service and psychiatric outcomes.
Results did not support an additive effect of military service history within the firefighting profession, as firefighters with military
service history were not more likely to endorse various psychiatric symptoms. Military service history was found to be significantly related
to career NSSI, such that firefighters with a history of military service were 2.52 times more likely to report a career history of NSSI.
Emotion dysregulation did not explain this relationship. Further investigation into the type of military service history suggests
firefighters who are also reservists in the armed forces are at particular risk for suicide-related behaviors. Compared to civilian-only
firefighters, firefighters with a history of active duty service and national guard service also demonstrated increased risk for
suicide-related behaviors. The present study’s results indicate the type of military service, rather than military service in general, is
particularly relevant for suicide-related behaviors within a firefighter population. Future directions for further investigation into this
unique population are discussed.%%%%A Thesis submitted to the Department of Psychology in partial fulfillment of the requirements for the degree
of Master of Science.%%%%Fall Semester 2017.%%%%October 23, 2017.%%%%Firefighters, Military, Psychiatric Symptoms, Risk, Suicide%%%%Thomas E. Joiner, Professor Directing Thesis; Colleen Ganley, Committee Member; Joseph Franklin,
Committee Member.
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Abstract : This thesis examined the military affiliation intentions of first term Army enlistees with less than one year remaining on their active duty obligations. The influence of demographic, experience, economic, and alternative employment factors on affiliation was explored. Results indicated that insights into understanding military turnover can be gained by expanding traditional analysis, wherein active duty reenlistees are contrasted with non-reenlisting peers, to include reserve military service as an option available to soldiers facing the reenlistment decision. Originator supplied keywords include: Retention; Army Reserves; Military Affiliation; Total Army; Career Decisions.
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United States military medical planning must reevaluate the practices of combat casualty resuscitation, transportation, and triage to secondary echelon care. Analysis of the experiences of other medical commands, such as that of the Israeli Defense Force, offers insight into improvements in equipment and training that are achievable with minimal cost. Training programs must involve formal instruction in Advanced Trauma Life Support for the combat corpsman, and ongoing experience in trauma surgery for personnel who are placed in the role of military surgeons. Today in military medicine there exists a major deficiency of expertise in trauma care, arising through a near total lack of involvement in active trauma surgery on the part of military medical training facilities. Civilian trauma centers offer an abundance of opportunity for military-like casualty management, and successful efforts at our command have integrated active duty personnel into this experience.
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Chronic pain related to musculoskeletal conditions is the leading cause of medical discharge from active duty military service. The present study is the first randomized controlled trial of an interdisciplinary pain treatment program (functional restoration, FR) to decrease chronic musculoskeletal pain and increase functioning in an active duty military population. Sixty-six military participants were randomly assigned to either an FR treatment group or a standard anesthesia pain clinic treatment comparison group. A repeated measures design was employed and data were analyzed for pre- to post-treatment differences, as well as for 6-months and 1-year post-treatment outcomes. Findings revealed significantly greater improvements for the FR group on self-reported pain, disability, functional status, and fitness for military duty at the post-treatment and follow-up points, relative to the comparison group. These results clearly demonstrate the efficacy and military relevance of a FR program for active duty military personnel who have chronic musculoskeletal pain disorders.
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This study evaluated the association between military service and health-related quality of life (HRQOL), using a large, population-based sample of U.S. adults.Participants in the 2000 Behavioral Risk Factor Surveillance System were characterized as active duty personnel (N = 1,163), reserves (N = 1,055], veterans (N = 22,558), or no military service (N = 141,620). HRQOL was described by sex and military status. Logistic regression was used to calculate sex-specific adjusted odds ratios.Active duty men were more likely than men without military service to report 14 or more days of activity limitation, pain, and not enough rest in the past 30 days. Reserve personnel reported better overall HRQOL than nonmilitary participants, and no difference in HRQOL was observed between veterans and persons with no military service.Recommendations are made to monitor HRQOL of active duty and reserve personnel over time and to include HRQOL measures in military-based surveys of active duty troops.
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Post-traumatic stress disorder (PTSD) is a serious mental illness that affects current and former military service members at a disproportionately higher rate than the civilian population. Prior studies have shown that PTSD symptoms follow multiple trajectories in civilians and military personnel. The current study examines whether the trajectories of PTSD symptoms of veterans separated from the military are similar to continuously serving military personnel. The Millennium Cohort Study is a population-based study of military service members that commenced in 2001 with follow-up assessments occurring approximately every 3 years thereafter. PTSD symptoms were assessed at each time point using the PTSD Checklist. Latent growth mixture modeling was used to compare PTSD symptom trajectories between personnel who separated (veterans; n = 5292) and personnel who remained in military service (active duty; n = 16,788). Four distinct classes (resilient, delayed-onset, improving, and elevated-recovering) described PTSD symptoms trajectories in both veterans and active duty personnel. Trajectory shapes were qualitatively similar between active duty and veterans. However, within the resilient, improving, and elevated recovering classes, the shapes were statistically different. Although the low-symptom class was the most common in both groups (veterans: 82%; active duty: 87%), veterans were more likely to be classified in the other three classes (in all cases, p < 0.01). The shape of each trajectory was highly similar between the two groups despite differences in military and civilian life.
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We studied a group of active duty military personnel with well-defined, lumbar discogenic, radicular pain syndromes. Our study group included 29 patients, 12 of whom required surgery during the study period. Three of the 29 patients had to be medically retired from active military service. Two patients required permanent limited-duty assignment and 10 others required prolonged (6 months or more) periods of limited duty. These findings highlight the significant adverse impact of lumbar disk disease on fitness for full active duty in military personnel.
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Military reproductive health policies affect large numbers of women. In 2006 servicewomen numbered nearly 350,000 and comprised 14.5% of active-duty forces and 17.4% of the reserve force. In addition, approximately 165,000 female dependents of active duty military personnel and 157,000 female dependents of reserve duty personnel are between the ages of 12 and 22 and are eligible for military health care services. Dependents of military personnel are eligible for military health care coverage until age 21, or up to the age of 23 if considered a full-time student. About 10% of active duty female servicemembers become pregnant each year. Pregnant servicewomen are considered non-deployable and are usually not assigned to overseas commands. Pregnant women in the Army, the service branch with the greatest number of women on active duty, can choose to remain on active duty, request temporary leave from service, or request separation from service. Separation options include either discharge, honorable or uncharacterized depending on rank, or transfer to individual ready reserve.
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Over the past 30 years , alcohol use , misuse , and alcohol related problems have increased among military personnel. Researchers have tracked the rates of alcohol misuse and alcohol related problems among military personnel , but few have sought to understand alcohol exposure in the military. To fill this gap , the current study sought to understand the experience of alcohol exposure for active duty military personnel through a qualitative phenomenological design. Semi-structured interviews with participants were used to collect data. The grand tour question that guided this study was: How do active duty enlisted military personnel experience exposure to alcohol? Related sub-questions that directed the study included: 1. In what ways are active duty , enlisted military personnel exposed to alcohol during their enlistment period(s)? 2. How do active duty , enlisted military personnel describe their experiences with alcohol exposure? 3. In what ways , if any , does the military intrinsic and extrinsic cultures contribute to the use , misuse , and/or abuse of alcohol among active duty , enlisted military? Participant responses revealed three major themes that reflected their lived experiences of alcohol exposure during their military careers. These themes were drinking behaviors , military culture , and potential outcomes. Implications for counselor education , counseling service providers , military personnel , and future research are discussed.
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