Interaction of Combat Exposure and Unit Cohesion in Predicting Suicide‐Related Ideation Among Post‐Deployment Soldiers

Suicide is one of the leading causes of death among U.S. Army soldiers. Suicide‐related ideation, which is associated with suicide attempts and suicide, can cause considerable distress. In a sample of 1,663 recently redeployed soldiers, we used factor analysis and structural equation modeling to test the associations between combat exposure, unit cohesion, and their interaction in predicting suicide‐related ideation. We found that combat exposure was a significant risk factor for suicide‐related ideation, while unit cohesion was a significant protective factor. The significant interaction between the two factors indicated that soldiers who experienced greater combat exposure but also had higher levels of unit cohesion had relatively lower levels of suicide‐related ideation. In addition, those who had higher levels of combat exposure and lower unit cohesion were most at risk for suicide‐related ideation. Our findings indicate the importance of unit cohesion in protecting soldiers from suicide‐related ideation and suggest a higher risk group of soldiers who should be targeted for interventions.     

Predictors of Cognitive Behavioral Therapy for Insomnia (CBTi) Outcomes in Active-Duty U.S. Army Personnel

Cognitive behavioral therapy for insomnia (CBTi) is well established as the first-line treatment for the management of chronic insomnia. Identifying predictors of response to CBTi should enable the field to efficiently utilize resources to treat those who are likely to respond and to personalize treatment approaches to optimize outcomes for those who are less likely to respond to traditional CBTi. Although a range of studies have been conducted, no clear pattern of predictors of response to CBTi has emerged. The purpose of this study was to examine the impact and relative importance of a comprehensive group of pretreatment predictors of insomnia outcomes in 99 active-duty service members who received in-person CBTi in a randomized clinical trial. Results indicated that higher levels of baseline insomnia severity and total sleep time predicted greater improvements on the Insomnia Severity Index (ISI) following treatment. Higher depression symptoms and a history of head injury predicted a worse response to treatment (i.e., smaller improvements on the ISI). Clinically meaningful improvements, as measured by the reliable change index (RCI), were found in 59% of the sample. Over and above baseline insomnia severity, only depressive symptoms predicted this outcome. Future studies should examine if modifications to CBTi based on these predictors of response can improve outcomes.     

A New Multidimensional Measure of Spirituality‐Religiosity for Use in Diverse Substance Abuse Treatment Populations

Extant measures of spirituality‐religiosity, not developed specifically with substance abuse treatment populations in mind, may not be culturally appropriate in regard to either: (1) the 12‐step “culture” found in many treatment programs; or (2) racial‐ethnic minority populations overrepresented in publicly funded programs. A 40‐item four‐dimensional measure was developed, which differentiates “religiosity” (religious practices) from “spirituality” (an individual's relationships with God/higher power, others, and self). Instrument development involved: qualitative focus groups with individuals in seven diverse Texas treatment programs; quantitative exploratory and confirmatory (CFA) analyses to test the four‐factor model conducted using data from 237 diverse clients in treatment programs in Tennessee and Virginia. Confirmatory analyses indicate acceptable fit indices (>0.90) for the four‐factor model, and acceptable reliability estimates for all subdimensions (≥0.70) provide further support for the measures. Results support the potential usefulness of the measures.     

Self‐Harm Focus Leads to Greater Collective Guilt: The Case of the U.S.‐Iraq Conflict

Collective guilt from harm one's group has caused an out‐group is often undermined because people minimize or legitimize the harm done (i.e., they generate exonerating cognitions). When a group action has harmed both the in‐group and an out‐group, focusing people on “self‐harm”—ways in which the in‐group has harmed itself—may elicit more collective guilt because self‐harm is less likely to be exonerated. In Study 1, American participants who focused on how the invasion of Iraq had harmed the United States expressed greater collective guilt over harm inflicted on the people of Iraq than those who focused on Iraqi suffering. Study 2 showed that this effect is due to reductions in exonerating cognitions among people focused on self‐harm. We consider the implications of these findings for intergroup reconciliation, particularly in situations where two groups have been involved in open conflict.     

Associations of Stress Exposures and Social Support With Long-Term Mental Health Outcomes Among U.S. Iraq War Veterans

The long-term mental health effects of war-zone deployment in the Iraq and Afghanistan wars on military personnel are a significant public health concern. Using data collected prospectively at three distinct assessments during 2003–2014 as part of the Neurocognition Deployment Health Study and VA Cooperative Studies Program Study #566, we explored how stress exposures prior, during, and after return from deployment influence the long-term mental health outcomes of posttraumatic stress disorder (PTSD), depression, anxiety disorders, and problem drinking. Longer-term mental health outcomes were assessed in 375 service members and military veterans an average of 7.5 years (standard deviation = 1.0 year) after the initial (i.e., “index”) Iraq deployment following their predeployment assessment. Anxiety disorder was the most commonly observed long-term mental health outcome (36.0%), followed by depression (24.5%), PTSD (24.3%), and problem drinking (21.0%). Multivariable regression models showed that greater postdeployment stressors, as measured by the Post-Deployment Life Events scale, were associated with greater risk of depression, anxiety disorders, and problem drinking. Anxiety disorder was the only outcome affected by predeployment stress concerns. In addition, greater postdeployment social support was associated with lower risk of all outcomes except problem drinking. These findings highlight the importance of assessing postdeployment stress exposures, such as stressful or traumatic life events, given the potential impact of these stressors on long-term mental health outcomes. This study also highlights the importance of postdeployment social support as a modifiable protective factor that can be used to help mitigate risk of long-term adverse mental health outcomes following war-zone exposure.     

Characteristics and VA health care utilization of U.S. Veterans who completed suicide in Oregon between 2000 and 2005

Oregon Violent Death Reporting System data were linked with Veterans Affairs (VA) administrative data to identify and describe veterans who completed suicide in Oregon from 2000 to 2005 (n = 968), and to describe their VA health care utilization in the year prior to death. Twenty-two percent had received health care in the VA system. Of these, 57% did not have mental health diagnoses and 58% had not seen mental health professionals. A larger proportion of those who accessed care were VA-enrolled and received service-connected disability benefits. Fifty-five veterans were hospitalized during the year prior to death. Of these, 33% completed suicide within 30 days of a hospitalization. Further development of suicide prevention strategies for veterans in the community, including general medical treatment settings, is indicated.     

Injury risk among children of low-income U.S.-born and immigrant mothers.

The number of immigrants in the United States is at an all time high, yet psychologists have largely ignored the domain of immigrant health. This article considers 1 aspect of immigrant health, risk for pediatric injury. A sample of over 5,000 5-year-old children from impoverished families was studied; approximately 13% had immigrant mothers. Children of immigrants had a significantly lower rate of injury in the prior year. This was particularly true of non-White children of immigrants. Three possible mediators for this finding--assistance with parenting, parenting style, and health care accessibility--were considered, but none explained the difference. The need for further research on the topic and implications of results for injury prevention are discussed.     

Conversation Orientation and Cognitive Processes: A Comparison of U.S. Students in Initial Interaction With Native‐ Versus Nonnative‐Speaking Partners

The present study compares thought patterns, perceptions of interaction (perceived interaction smoothness and interaction involvement), and conversation orientation of U.S. students (N = 60) in dyadic interaction with a partner who is either another American or a non‐American nonnative speaker of English. As hypothesized, U.S. participants with nonnative‐speaking partners perceived interaction as more difficult, or less smooth, than did their counterparts with native‐speaking partners. U.S. participants with nonnative‐speaking partners also displayed different thought patterns, having more thoughts showing confusion, as well as more thoughts focused on the partner and less on the content of the ongoing conversation, than those with fellow native‐speaking partners. U.S. participants with a nonnative‐speaking partner also exhibited a different conversation orientation pattern, focusing more on understanding of the other's message, less on clarifying their own message, and less on displaying their own involvement. Specific thought categories and perceived interaction smoothness were correlated with conversation orientation indices for participants in interactions between native and nonnative speakers. Finally, interaction involvement was found to contribute most to variation in perceived interaction smoothness for both U.S. and non‐U.S. participants in interactions between native and nonnative speakers. Implications of the findings are discussed.     

Moderators and Predictors of Response After 36 Weeks of Treatment in the Treatment for Adolescents with Depression Study (TADS)

Research on Child and Adolescent Psychopathology - This study investigated pretreatment variables associated with depression severity in adolescents following maintenance treatment for major...     

Assessing the Internal Validity of Image Theory in the Context of Turkey‐U.S. Relations

This research examines propositions of international image theory in the context of Turkey‐U.S. relations. Study 1 derives and tests hypotheses regarding the interrelationships among theory components—perceived strategic relations, images, and behavioral tendencies. In addition, it extends image theory research by examining (1) the role of emotions, as well as (2) how variations in the strength of ingroup identifications (national and religious identity) inform our understanding of international images. Study 2 extends the findings of Study 1 by considering different dimensions of cultural status (cultural heritage vs. modernity) and by differentiating two targets of emotion: the U.S. government versus American citizens. Evidence is provided regarding the need for incorporation of emotions and group identifications onto the image theory framework. The results point to the need for more investigation of images and their relationships with other components of the theory in various intergroup contexts.     

Ethics education and value prioritization among members of U.S. hospital ethics committees

Calls for ethics education for members of hospital ethics committees presume that the effects and benefits of such education are well-established. This is not the case. A review of the literature reveals that studies consistently have failed to uncover any significant effect of ethics education on the moral reasoning, moral competency, and/or moral development of medical professionals. The present paper discuss this negative result and describes the author's national study of the value priorities of members of hospital ethics committees. This study discovered correlations between moral decision making and factors like age and type of institution where the committee operates. The results of this study also resemble those of previous studies in finding no correlation between ethics education and moral decision making. The author concludes that there is a need for more research on the effects of nonmoral personal, societal, and institutional factors on the moral reasoning of members of hospital ethics committees. Further, in the absence of any firm empirical basis, calls for ethics education for medical professionals and ethics committee members should be rethought.     

Reactions to refusals of sexual advances among U.S. and Brazilian men and women

This study examined cultural variation and gender differences in the perception of female sexual intent when women said no to sexual advances. American (n = 205) and Brazilian (n = 200) undergraduates responded to one of two scenarios describing a female s consistent or inconsistent resistance. Most students were white (88% and 95% of Americans and Brazilians, respectively), single (96% of Americans and 100% of Brazilians), in their early twenties, and 50% were men and 50% women. The data showed that Americans and Brazilians have different conceptualizations of how a heterosexual encounter may develop, given the preliminary pattern of consistent or inconsistent resistance. Brazilians have a strong consensual-sexual-intercourse schema, while Americans (especially in the context of consistent resistance) have a strong date-rape schema. The relevance of these findings for (mis)communication between men and women is discussed.     

Relationships between drinking and type of practice among U.S. female and male attorneys.

The author investigated the relationship between drinking and type of practice among U.S. attorneys. Participants were attorneys from 2 large midwestern cities, chosen through stratified random sampling from bar-association membership lists. Type of law practice was related to whether the participants drank in business-related situations but not to the frequency or the quantity of consumption. The participants in solo, corporate, or government practices were more likely than were those in private group practices to report no business-related drinking in the past 30 days. Female and male attorneys in similar practices reported similar abstention rates and quantities of consumption in business situations, suggesting that occupational norms were strongly salient for both genders. Criminal trial work was related to drinking only for the women. Results are discussed in terms of the influence of occupational culture on drinking.     

Prevalence and psychosocial correlates of forced sexual intercourse among U.S. high school adolescents

Although a history of forced sexual intercourse affects a relatively small number of U.S. adolescents, it is a persistent and alarming public health problem. This study examined the robustness of the risk profile of adolescents who report a history of forced sexual intercourse using the most current and representative data from the national 2005 Youth Risk Behavior Survey. Overall, 8.01% of high school adolescents reported a history of forced sexual intercourse. The lifetime prevalence for females (10.3%) was roughly twice of that for males (4.8%). Important differences in the risk profile associated with forced sexual intercourse were found by gender.     

The Long-Term Effects of Operation Desert Storm on the Psychological Distress of U.S. Army Reserve and National Guard Veterans1

This study assessed factors related to the long-term psychological health of a sample of U.S. Army National Guard and Reserve Unit veterans who served during Operation Desert Storm (ODS). In the analysis, general distress symptom measures were obtained and comparisons made from soldiers who deployed to Germany, the Persian Gulf region, and throughout the United States, with soldiers who did not deploy. Elevated symptom levels were found for veterans of the Persian Gulf that could not be explained by variance attributed to demographics, or current life stress events. Reported exposure and the degree of current concern due to petrochemical fires in Kuwait were found to be significantly related to elevated symptom measures beyond the effect of combat-zone-related stresses. These findings suggest that a subset of Persian Gulf reserve veterans continue to have elevated levels of distress that are related to oil fire exposure.     

Faith,Race‐Ethnicity,and Public Policy Preferences: Religious Schemas and Abortion Attitudes Among U.S. Latinos

Research has demonstrated that white conservative Protestants are more opposed to abortion than their Catholic counterparts. At the same time, conservative Protestantism has made significant inroads among U.S. Latinos. This study augments existing research on religion and racial‐ethnic variations in abortion attitudes by comparing levels of support for legalized abortion among Catholic and conservative Protestant Latinos. Data are drawn from a nationally representative sample of U.S. Latinos. Significantly greater opposition to abortion is found among religiously devout conservative Protestant Latinos when compared with their Catholic counterparts. Latino Catholicism, which functions as a near‐monopolistic, highly institutionalized faith tradition among Hispanics, produces weaker antiabortion attitudes than those exhibited in Latino conservative Protestantism. Among Latinos, conservative Protestantism operates as a niche voluntaristic faith. These factors produce a religious schema that yields robust antiabortion attitudes. This study has important implications for understanding the intersection of race‐ethnicity, religion, and public policy preferences.     

Body mass index and environmental supports for physical activity among active and inactive residents of a U. S. southeastern county.

OBJECTIVE: This study examined the associations between body mass index (BMI) and environmental supports for physical activity in active and inactive adults based on national recommendations for physical activity and walking. Residents of a southeastern community (N = 1,111; ages 18-75 years) were contacted using a random-digit-dial method and were asked about neighborhood and community social and environmental supports for physical activity. MAIN OUTCOME MEASURE: Physical activity was measured using the 2001 Behavioral Risk Factor Surveillance System (BRFSS) physical activity module. RESULTS: There was a positive association between higher physical activity and walking levels and lower BMI levels. Trusting neighborhoods, having recreational facilities present, and using trails were each associated with twice the odds of being overweight versus obese among those not meeting the national physical activity recommendations. Using trails was also associated with 2.7 times the odds of being overweight as opposed to obese among participants who were not regular walkers. CONCLUSION: Improving environmental supports for access and use of trails and recreational facilities may be important for future environmental interventions aimed at reducing obesity among inactive individuals.