Effects of war exposure on air force personnel's mental health, job burnout and other organizational related outcomes.

Longitudinal data from a stratified representative sample of U.S. Air Force personnel (N = 1009) deployed to the wars in Iraq, Afghanistan, and other locations were analyzed in this study. Using structural equation models, we examined the effects of war exposure on traumatic experiences, Post Traumatic Stress (PTS) symptoms, resource loss, and on subsequent functioning, perceived health, and on job and organizationally relevant outcomes. The job and organizational outcomes included job burnout, job involvement, job strain, job satisfaction, work-family conflict, organizational commitment, deployment readiness, and intention to reenlist. We found that deployment to the theater of the war increased risk of exposure to trauma, which in turn, predicted elevated PTS symptoms and resource loss. PTS symptoms predicted later loss of resources and deterioration in perceived health and functioning. In turn, resource loss predicted negative job and organizational outcomes. Exposure to trauma fully mediated the effects of deployment to the theater of war on PTS symptoms and resource loss and had additional significant indirect effects on several job and organizational relevant outcomes. For returning veterans, deployment to the theater of war, exposure to trauma, PTS symptoms, and resource loss represents a “cascading” chain of events that over time results in a decline of health and functioning as well as in adverse job and organizationally relevant outcomes that may affect organizational effectiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of killing on mental health symptoms in Gulf War veterans.

This study examined the impact of killing on posttraumatic stress symptomatology (PTSS), depression, and alcohol use among 317 U.S. Gulf War veterans. Participants were obtained via a national registry of Gulf War veterans and were mailed a survey assessing deployment experiences and postdeployment mental health. Overall, 11% of veterans reported killing during their deployment. Those who reported killing were more likely to be younger and male than those who did not kill. After controlling for perceived danger, exposure to death and dying, and witnessing killing of fellow soldiers, killing was a significant predictor of PTSS, frequency and quantity of alcohol use, and problem alcohol use. Military personnel returning from modern deployments are at risk of adverse mental health symptoms related to killing in war. Postdeployment mental health assessment and treatment should address reactions to killing in order to optimize readjustment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Level of nitric oxide-dependent cGMP in patients with migraine

The United States Air Force Academy (USAFA) is one of the nation's military universities, with the mission to educate and motivate cadets to be career Air Force officers. This diverse population arrives at the USAFA with varying immunization records and disease histories. A review of USAFA cadet medical records identified an alarming cost of treating a simple, preventable, generally childhood disease: chickenpox. In July 1995, a cost-benefit analysis was performed on the use of varicella vaccine among cadets and preparatory school students at the USAFA. Based on this analysis, the USAFA implemented a strategy of serologic screening and vaccination. Although this study does not establish causation, follow-up data showed a dramatic decrease in cases, associated hospitalizations, and therefore costs during the first year after implementation. Fiscal projections indicate that these costs savings should increase through year 4 of the program and continue thereafter. At year 4, the total cadet population will have been serologically screened and/or vaccinated against chickenpox.     

Hazardous drinking and military community functioning: Identifying mediating risk factors.

Objective: Hazardous drinking is a serious societal concern in military populations. Efforts to reduce hazardous drinking among military personnel have been limited in effectiveness. There is a need for a deeper understanding of how community-based prevention models apply to hazardous drinking in the military. Community-wide prevention efforts may be most effective in targeting community functioning (e.g., support from formal agencies, community cohesion) that impacts hazardous drinking via other proximal risk factors. The goal of the current study is to inform community-wide prevention efforts by testing a model of community functioning and mediating risk factors of hazardous drinking among active duty U.S. Air Force personnel. Method: A large, representative survey sample of U.S. Air Force active duty members (N = 52,780) was collected at 82 bases worldwide. Hazardous drinking was assessed with the widely used Alcohol Use Disorders Identification Test (Saunders, Aasland, Babor, de la Fuente, & Grant, 1993). A variety of individual, family, and community measures were also assessed. Structural equation modeling was used to test a hypothesized model of community functioning, mediating risk factors and hazardous drinking. Results: Depressive symptoms, perceived financial stress, and satisfaction with the U.S. Air Force were identified as significant mediators of the link between community functioning and hazardous drinking for men and women. Relationship satisfaction was also identified as a mediator for men. Conclusions: These results provide a framework for further community prevention research and suggest that prevention efforts geared at increasing aspects of community functioning (e.g., the U.S. Air Force Community Capacity model) may indirectly lead to reductions in hazardous drinking through other proximal risk factors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Postservice mortality of US Air Force veterans occupationally exposed to herbicides in Vietnam: 15-year follow-up

The US Air Force continues to assess the mortality of veterans of Operation Ranch Hand, the unit responsible for aerially spraying herbicides in Vietnam. The authors of this study found that the cumulative all-cause mortality experience of these veterans was not different from that expected (standardized mortality ratio (SMR) = 1.0). Overall, cause-specific mortality did not differ from that expected regarding deaths from accidents, cancer, or circulatory system diseases, but the authors found that there was an increased number of deaths due to digestive diseases (SMR = 1.7, 95% confidence interval (CI) 0.9-3.2). When analyzing by military occupation, they found an increase in the number of deaths caused by circulatory system diseases (SMR = 1.5, 95% CI 1.0-2.2) among enlisted ground personnel, the subgroup with the highest dioxin levels. Most of the increase in the number of deaths from digestive diseases was caused by chronic liver disease and cirrhosis, and more than half of the increase in the number of deaths from circulatory system diseases was a result of atherosclerotic heart disease. In the subgroup of Ranch Hand veterans who had survived more than 20 years since their military service in Southeast Asia, the authors found no significant increase in the risk of death due to cancer at all sites (SMR = 1.1) and a nonsignificant increase in the number of deaths due to cancers of the bronchus and lung (SMR = 1.3).     

Musculoskeletal manifestations, pain, and quality of life in Persian Gulf War veterans referred for rheumatologic evaluation

OBJECTIVE: Pain in the joints and other areas has been a frequent complaint among veterans of Operation Desert Storm who are experiencing unexplained illness. We characterized the rheumatic manifestations of a group of veterans of the Persian Gulf War who were referred to a rheumatology clinic. METHODS: Consecutive South Texas veterans of the Persian Gulf War who were referred for evaluation of rheumatic manifestations underwent a comprehensive evaluation of their musculoskeletal symptoms, pain, and health related quality of life. RESULTS: Of 928 veterans evaluated in a screening clinic for unexplained symptoms, 145 had rheumatic manifestations (15.6%) and were referred to a rheumatology clinic. The most common diagnosis was fibromyalgia, present in 49 patients (33.8%), followed by various soft tissue problems in 25 (17.2%), nonspecific arthralgias in 14 (9.6%), and clinical or radiographic osteoarthritis in 16 (11.0%). In 39 patients (26.9%), no symptoms were present at the time of the evaluation, a careful musculoskeletal examination and laboratory tests were normal, and no diagnosis was possible. Two patients had Reiter's syndrome. Four had a positive rheumatoid factor and 3 had antinuclear antibodies, but none of these had clinical evidence of rheumatoid arthritis or systemic lupus erythematosus. Pain was present in nearly all patients and was widely distributed, with no body area spared in this group of patients. The most frequent painful areas were the knees in > 65%, the lower back in > 60%, the shoulders in 50%, and the hands and wrists in 35%. Widespread body pain was present in 65.1% of the veterans. Average values of all 8 scales measured by the SF-36 health survey were below the 25th percentile of published national norms, with pain and the number of nonarticular rheumatic symptoms explaining most of the decreased health related quality of life in the veterans we evaluated. CONCLUSION: No specific rheumatic diagnosis is characteristic of Gulf War veterans with unexplained illness referred to a rheumatology clinic. However, pain is common and widespread in these patients, and their health related quality of life is poor. Further research is necessary to determine the cause of the symptoms of veterans of the Gulf War.     

Relationship between measured interest patterns and satisfactory vocational adjustment for Air Force officers in the comptroller and personnel fields.

Comparison of personnel data sheet responses and Strong VIB scores for 243 comptroller officers and 1155 personnel officers led to the conclusion that the SVIB reflects the degree of satisfactory adjustment for Air Force officers in each field. For both groups, a significantly larger proportion of those Ss with SVIB patterns most similar to the SVIB patterns of their civilian counterparts express a preference for the Air Force specialty in which they are and a preference to engage in the activity in civilian life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive potentials in children with learning disabilities

This study investigated factors predicting help-seeking from the Department of Veterans' Affairs (DVA) by Vietnam veterans. Data used were from a national Australian survey of Vietnam veterans' health (n = 641) conducted between July 1990 and April 1993. The survey involved current clinical assessments and retrospective questionnaires, supplemented with health and service records retrieved from the DVA and Army personnel files. Measures included the 1989-90 Australian Bureau of Statistics Health Survey questionnaire, and mental health, sociodemographic and operational deployment history questionnaires. For both current and lifetime diagnoses of post-traumatic stress disorder, a third of the veterans with the disorder had never obtained any health care entitlement from the DVA. Other than physical and mental problems, which accounted for the greatest proportion of the help-seeking odds, significant factors predicting help-seeking included factors such as: predeployment personality, combat exposure, the veterans' own attitudes towards their deployment, experiences during deployment, experiences during repatriation and membership of ex-service organisations. These findings on how post-traumatic stress disorder and other health problems relate to help-seeking patterns could help in developing prevention and care programs for stress disorder.     

Comparing posttraumatic stress disorder's symptom structure between deployed and nondeployed veterans.

We tested two empirically validated 4-factor models of posttraumatic stress disorder (PTSD) symptoms using the PTSD Checklist: King, Leskin, King, and Weathers' (1998) model including reexperiencing, avoidance, emotional numbing, and hyperarousal factors, and Simms, Watson, and Doebbeling's (2002) model including reexperiencing, avoidance, dysphoria, and hyperarousal. Our aim was to determine which fit better in two groups of military veterans: peacekeepers previously deployed to a war zone (deployed group) and those trained for peacekeeping operations who were not deployed (nondeployed group). We compared the groups using multigroup confirmatory factor analysis. Adequate model fit was demonstrated among the nondeployed group, with no significant difference between King et al.'s (1998) model (separating avoidance and numbing) and Simms et al.'s (2002) similar model involving a dysphoria factor. A better fitting factor structure consistent with Simms et al.'s (2002) model was found in the deployed group. Comprehensive measurement invariance testing demonstrated significant differences between the deployed and nondeployed groups on all structural parameters, except observed variable intercepts (thus indicating similarities only in PTSD item severity). These findings add to researchers' understanding of PTSD's factor structure, given the revision of PTSD that will appear in the forthcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2010)—namely, that the factor structure may be quite different between groups with and without exposure to major traumatic events. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Risk for suicidal ideation in the U.S. Air Force: An ecological perspective.

Objective: Suicidal members of the U.S. military often fail to disclose their suicidal urges and behaviors. Military suicide prevention efforts may therefore be enhanced if they also target less stigmatized psychosocial factors that may decrease risk of suicidality. In keeping with Bronfenbrenner's (1977, 1994) model, this study simultaneously examined 4 ecological levels (i.e., individual, family, workplace, and community) of factors variously associated with increased or decreased risk for suicidal ideation. Method: Active-duty U.S. Air Force members (N = 52,780; 79.3% male; 79.2% non-Hispanic White; mean age = 31.78 years, SD = 7.38) completed the 2006 Community Assessment survey (a biennial, anonymous survey conducted at 82 U.S. Air Force bases worldwide), including the Centers for Disease Control and Prevention's (2008) 5-item measure of past-year suicidality along with scales assessing an array of potential predictors. Results: The 1-year rate of suicidal ideation, defined as (a) more than rarely thinking about suicide or (b) ever seriously considering suicide, was approximately 4%. In multivariate models, for men and women, individual- (depressive symptoms and alcohol problems), family- (relationship satisfaction and intimate partner victimization), workplace- (hours worked), and community-level (social support) variables were retained in the final model. However, some sex differences in retained predictors were noted (e.g., men: dissatisfaction with the U.S. Air Force way of life; women: workplace relationship satisfaction and financial stressors). Conclusions: Addressing depressive symptoms and alcohol use, facilitating healthy relationship functioning, and increasing job satisfaction and social support may aid military suicide prevention efforts. These findings illustrate the importance of attending to multiple levels of potential influence when designing integrated suicide prevention and intervention programs. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Relationship between stated and measured interests of two groups of United States Air Force officers.

Strong VIB scores and interests recorded on personal history forms were compared for Air Force officers in the personnel and accountant-comptroller areas. 3 judges interpreted the SVIB's and 3 classified the stated interests into occupational groups on the SVIB. There was good agreement among the judges on both tasks. Air Force officers tended to select civilian occupations (stated interests) similar to their military occupations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical evaluation of Persian Gulf veterans with fatigue and/or chemical sensitivity

The purpose of this study was to determine if Gulf War veterans with complaints of severe fatigue and/or chemical sensitivity (n = 72) fulfill case definitions for chronic fatigue syndrome (CFS) and/or multiple chemical sensitivity (MCS) and to compare the characteristics of those veterans who received a diagnosis of CFS (n = 24) to a group of non-veterans diagnosed with CFS (n = 95). Thirty-three veterans received a diagnosis of CFS with 14 having MCS concurrently; an additional six had MCS but did not fulfill a case definition for CFS. The group of fatigued veterans receiving a diagnosis of CFS was comprised of significantly fewer women and fewer Caucasians than the civilian group, and significantly fewer veterans reported a sudden onset to their illness. Veterans with CFS had a milder form of the illness than their civilian counterparts based on medical examiner assessment of the severity of the symptoms, reported days of reduced activity, and ability to work. Since CFS in veterans seems less severe than that seen in civilians, the prognosis for recovery of veterans with this disorder may be better.     

Noise, the "arousal hypothesis," and monotonous work.

The original group of Ss was 30 Royal Canadian Air Force personnel. 3 basic conditions were used in 4 sessions. Susceptibility to hypnosis seemed important. The findings concerning the effect of noise were contradictory. "The implications of these findings are discussed in terms of their relation to 'vigilance' tasks, and their applicability to personnel selection practice." (15 ref.) From Psyc Abstracts 36:05:5LG09M. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal and congenital syphilis

Testing for syphilis during pregnancy reveals a positive serologic status in 0.02% of cases. However, a 66% rate of stillbirths is noted in women who are infected and who have not benefited from any treatment. Routine screening is at present performed during the early stages of pregnancy but a second serologic test during the third trimester is useful in the diagnosis of a late infection especially in drug users or HIV (human immunodeficiency virus) positive patients. Congenital syphilis is diagnosed in utero when a positive maternal serologic status is associated with ultrasound images showing fetal abnormalities; these include hepatosplenomegaly, hyperechogenic bowel, signs of bowel obstruction or fetal hydrops. Maternal syphilis is treated by delayed action penicillin and is indicated even for patients allergic to the antibiotic which in this particular case is delivered after desensitization. First line therapy by intravenous penicillin is indicated when confronted with the following high risk factors of congenital syphilis: an elevated titre of VDRL (venereal disease research laboratory) at the time of diagnosis or delivery, unknown date of the precise onset of the infection, the appearance of a rash or of a chancre during pregnancy, ultrasound fetal abnormalities or late therapy during the third trimester. Treatment of the new-born child will depend on the results of clinical, serologic and X-ray evaluation. Long term follow-up for at least a year is mandatory.     

Is testicular cancer an occupational disease? A case-control study of Royal Naval personnel

Testicular cancer is the commonest malignancy arising in men actively serving in the Royal Navy. This study, which includes a literature review of the aetiology of the disease, is designed to determine the relative risk of developing testicular cancer in various occupational groups within the Service by means of a Case-Control study. All cases of testicular cancer occurring in serving personnel between 1976 and June 1994, inclusive, were identified. One hundred and ten cases were found. Four randomly selected controls were matched on the basis of date of birth and length of service to each case. Results reveal statistically significant increased Odds Ratios for members of the Fleet Air Arm (OR = 1.90 95% CI: 1.04-3.48). Air Engineers (OR = 2.32 95% CI: 1.20-4.48) and the Aircraft Handling sub-specialty (OR = 7.31 95% CI: 1.81-29.53). It is speculated that exposure to glycol ethers in aviation fuel may be the causative mechanism. No associations were found in relation to ionising radiation exposures or length of time served in nuclear submarines.     

The effect of vitamin B12 deficiency on older veterans and its relationship to health

OBJECTIVE: To examine the effect of vitamin B12 deficiency on older veterans and its relationship to general health and cognitive impairment. DESIGN: Cross-sectional study. SETTING: Oklahoma City Veterans Affairs Medical Center. PARTICIPANTS: Data for this research were obtained from 303 ambulatory, older veterans who used the outpatient laboratories of the Oklahoma City Department of Veterans Affairs Medical Center. Subjects were included in the study if they were 65 years of age and older and if they had no known diagnosis associated with B12 deficiency. The sample in this study consisted of 301 men and 2 women aged 65 to 89 years. MEASUREMENTS: This study used two separate measurements of vitamin B12 deficiency: (1) a strict definition of B12 deficiency (serum B12 level < laboratory norm) and (2) a broader definition of B12 deficiency (serum B12 level < laboratory norm or laboratory norm < B12 < 300 pg/mL and methyl malonic acid (MMA) or homocysteine (HC) elevated by more than two standard deviations). The laboratory norm is 200 pg/mL. The dependent variables were measures of cognitive impairment and general health. Cognitive impairment was measured using the Folstein Mini-Mental State Examination (MMSE) and general health was measured using the RAND 36-Item Health Survey Version 1.0. The control variables for this study were the subjects' daily alcohol intake, daily intake of a vitamin/mineral supplement, annual income, and level of education. RESULTS/CONCLUSIONS: Nineteen subjects (6%) were vitamin B12-deficient as measured by the strict definition of B12 deficiency (serum B12 level < laboratory norm), and 49 subjects (16%) were vitamin B12-deficient as measured by the broader definition of B12 deficiency (serum B12 level < laboratory norm or laboratory norm < B12 < 300 pg/mL and MMA or HC elevated by more than two standard deviations). Vitamin B12 level decreases as age increases. Of the nine general health outcomes measured by using the RAND 36-Item Health Survey, only bodily pain is associated with vitamin B12 deficiency, and only then when B12 deficiency is measured as serum B12 level < laboratory norm, the strict definition of B12 deficiency. Vitamin B12-deficient subjects experience more bodily pain than those with normal vitamin B12 levels. There is a significant difference between B12-deficient subjects and B12 normal subjects on cognitive impairment, with B12 normal subjects indicating less cognitive impairment, only when B12 deficiency is measured as B12 level < laboratory norm, the strict definition of B12 deficiency. The broader measurement of vitamin B12 deficiency (i.e., serum B12 level < laboratory norm or laboratory norm < B12 < 300 pg/mL and MMA or HC elevated by more than two standard deviations) is not a significant correlate of cognitive impairment and general health.     

Viral hepatitis in the US Air Force, 1980-1989

Viral hepatitis and its acute and chronic complications continue to pose significant threats to the readiness of military personnel. Knowledge about the specific viral agents and their routes of transmission are important in developing prevention strategies. A recent analysis of hepatitis in the US Navy for the period 1975-1984 is reviewed. In order to better characterize the risk of viral hepatitis among US Air Force personnel, a comprehensive review of inpatient and quarters data for hepatitis A, B and 'non-A, non-B' were reviewed from Air Force medical treatment facilities worldwide for the period 1980-1989. Following a discussion of the study methodology, preliminary data and hepatitis type-specific demographic risk variables are discussed. Preliminary results from a hepatitis serosurvey (A, B and C antibody with use of a supplemental validating assay) of the subset of the study cohort who are currently on active duty are briefly reviewed.     

Musculoskeletal symptoms and job strain among nursing personnel: a study over a three year period

OBJECTIVES: To examine the variation of symptoms from the neck, shoulders, and back over a three year period among female nursing personnel and the relation between job strain and musculoskeletal symptoms. METHODS: At a county hospital the female nursing personnel answered a questionnaire at baseline and then once a year over a period of three years. There were 565, 553, 562, and 419 subjects who answered the questionnaire at the first, second, third, and fourth survey, respectively. Of the study group, 285 nursing personnel answered the questionnaire on four occasions. Ongoing symptoms of the neck, shoulders, and back were assessed by means of a 10 point (0-9) scale with the verbal end points "no symptoms" and "very intense symptoms." Cases were defined as nursing personnel reporting ongoing symptoms, score > 6, from at least one of the body regions. For assessments of job strain, a Swedish version of Karasek and Theorell's model was used. RESULTS: Of the 285 subjects, 13% were defined as cases at all four assessments, and 46% varied between cases and not cases during the study period. In the repeated cross sectional surveys the estimated rate ratio (RR) for being a case was between 1.1 and 1.5 when comparing the group with job strain and the group without job strain. For the combination of job strain and perceived high physical exertion the estimated RR was between 1.5 and 2.1. When the potential risk factors were assessed one, two, or three years before the assessment of symptoms the estimated RR for becoming a case was between 1.4 and 2.2 when comparing the group with job strain and the group without job strain. CONCLUSION: Almost half of the healthcare workers varied between being a case and not, over a three year period. The analysis indicated that job strain is a risk factor for musculoskeletal symptoms and that the risk is higher when it is combined with perceived high physical exertion.     

Operationalizing the Moskos institution-occupation model: An application of Gouldner's cosmopolitan-local research.

Evaluated the problems of developing and validating measures of institutional–occupational orientations in the US Air Force. The measures were developed by modifying A. W. Gouldner's (see PA, Vol 33:4757 and 33:8067) cosmopolitan–local measurement. A questionnaire was administered that contained 8 attitudinal items concerning military and civilian life, a measure of career intent, a job satisfaction measure, and several demographic questions. Factor analysis of the 8 attitudinal items revealed 2 independent dimensions: Institutional and Occupational Orientations. Hypothesized differences between various demographic groups in a survey of 10,687 Air Force personnel of various grades, seniority levels, and educational levels were observed. The Institutional orientation was positively associated with career intent, seniority, and job satisfaction, whereas the Occupational orientation was negatively associated with those criteria. It is concluded that the developed measures provide the means to assess trends longitudinally in the military, as posited by C. Moskos (1977). (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)