Rates of Subthreshold PTSD Among U.S. Military Veterans and Service Members: A Literature Review

The current study’s goal was to provide a comprehensive review of current subthreshold posttraumatic stress disorder (PTSD) rates among U.S. military veterans and service members. PubMed, PsycInfo, ProQuest, Web of Knowledge, Google Scholar, and any relevant articles’ reference lists identified studies of subthreshold PTSD in the U.S. military. Search terms included PTSD in combination with partial, subthreshold or sub-threshold, subsyndromal or sub-syndromal, subclinical or sub-clinical, and military or veteran. Sixteen articles met criteria for review. Current subthreshold PTSD rates ranged from 2.3% to 22.3%, with a weighted mean rate of 7.6%. Definitional variation within and across the “below threshold” terms produced some variability in rates reported. Few studies consistently reported on impairment and comorbidity in the subthreshold PTSD population. Variability of current subthreshold PTSD rates may be due to methodological issues such as sampling methods, sample sizes, and how below threshold PTSD was assessed and defined. Based on our findings, we provide a number of recommendations that can be used to inform future research of subthreshold PTSD among U.S. military veterans and service members. These recommendations include having a standardized term and definition, determining how to more properly assess subthreshold PTSD symptomatology, clarifying subthreshold PTSD diagnostic stability, and identifying appropriate sampling methods.     

Small Unit Leader Perceptions of Managing Soldier Behavioral Health and Associated Factors

This investigation explored squad leaders’ perceptions of their roles managing subordinate soldiers’ behavioral health (BH) needs. The data were obtained through an anonymous survey of 458 squad leaders (i.e., small unit leaders who oversee 4–10 soldiers). More than 80% of squad leaders perceived management of soldier BH needs before, during, and after treatment as their responsibility, and felt comfortable and capable of executing these roles. Latent class analysis was used to determine groups of “most active,” “moderately active,” and “least active” leaders. Multinomial logistic regression was used to compare the least and most active classes. The most active leaders were more likely to report high BH knowledge, dedication to a common purpose, and low levels of “associative” stigma. These results should inform leader management of soldier BH. Future research should examine active leader characteristics and whether evidence-based training can increase support for preventing and managing BH issues.     

The Role of Effort–Reward Imbalance for Reservists on a Military Deployment

The present study extended the effort–reward imbalance (ERI) model (Siegrist, 1996b Siegrist, J. 1996b. “Soziale Krisen und Gesundheit [Social crises and health]”. In Gesundheitspsychologie [Health psychology] Edited by: Krohne, H. W., Schmidt, L., Netter, P. and Schwarzer, R. Vol. 5, Göttingen, , Germany: Hogrefe.  [Google Scholar]), first by differentiating between separate reward components, second by including intrinsic reward, and third by additionally predicting a non-health outcome (i.e., turnover intention) in a military context. Regression analyses of 789 reservists found financial and esteem reward to moderate the impact of extrinsic effort on depressive symptoms, whereas only financial reward moderated the effort turnover intentions relationship. Results supported the usefulness of the extended ERI model in the military context. Relevant areas for future research on the military effort–reward perspective are discussed.     

Giant African Pouched Rats as Detectors of Tuberculosis in Human Sputum: Comparison of Two Techniques for Sputum Presentation

Previous studies have shown that pouched rats can detect the presence of Mycobacterium tuberculosis, which causes tuberculosis, in human sputum samples obtained from clinical facilities. Although pouched rats evaluate sputum samples quickly, preparing the samples is relatively slow. The present study evaluated whether the rats can detect tuberculosis in microscope slides, which are routinely prepared at these facilities. Results indicate that they can do so, but their accuracy is considerably lower than that of rats exposed to pots containing sputum, as in prior studies.

     

Reading against the grain: female sexuality in classical South Asian Buddhism

Responding to and building upon José Cabezón’s groundbreaking work, Sexuality in Classical South Asian Buddhism (2017), this essay challenges a hermeneutic that capitulates to the androcentrism and misogyny of classical South Asian Buddhist views on female sexuality by suggesting avenues for ‘reading against the grain’ in search of alternative gynocentric views. In particular, it points to glimpses of a female sexuality that is relational, active, and creative in premodern South Asian Buddhist sources, especially vinaya. It also argues that a full and balanced treatment of sexual violence against women is an essential component of any comprehensive study of sexuality in classical South Asian Buddhism.     

Adapting School-Based Substance Use Prevention Curriculum Through Cultural Grounding: A Review and Exemplar of Adaptation Processes for Rural Schools

A central challenge facing twenty-first century community-based researchers and prevention scientists is curriculum adaptation processes. While early prevention efforts sought to develop effective programs, taking programs to scale implies that they will be adapted, especially as programs are implemented with populations other than those with whom they were developed or tested. The principle of cultural grounding, which argues that health message adaptation should be informed by knowledge of the target population and by cultural insiders, provides a theoretical rational for cultural regrounding and presents an illustrative case of methods used to reground the keepin’ it REAL substance use prevention curriculum for a rural adolescent population. We argue that adaptation processes like those presented should be incorporated into the design and dissemination of prevention interventions.     

Learning time-varying categories

Many kinds of objects and events in our world have a strongly time-dependent quality. However, most theories about concepts and categories either are insensitive to variation over time or treat it as a nuisance factor that produces irrational order effects during learning. In this article, we present two category learning experiments in which we explored peoples’ ability to learn categories whose structure is strongly time-dependent. We suggest that order effects in categorization may in part reflect a sensitivity to changing environments, and that understanding dynamically changing concepts is an important part of developing a full account of human categorization.     

Anxiety, Sensory Over-Responsivity, and Gastrointestinal Problems in Children with Autism Spectrum Disorders

Children with autism spectrum disorders (ASD) experience high rates of anxiety, sensory processing problems, and gastrointestinal (GI) problems; however, the associations among these symptoms in children with ASD have not been previously examined. The current study examined bivariate and multivariate relations among anxiety, sensory over-responsivity, and chronic GI problems in a sample of 2,973 children with ASD enrolled in the Autism Treatment Network (ages 2–17 years, 81.6 % male). Twenty-four percent of the sample experienced at least one type of chronic GI problem (constipation, abdominal pain, bloating, diarrhea, and/or nausea lasting three or more months). Children with each type of GI problem had significantly higher rates of both anxiety and sensory over-responsivity. Sensory over-responsivity and anxiety were highly associated, and each provided unique contributions to the prediction of chronic GI problems in logistic regression analyses. The results indicate that anxiety, sensory over-responsivity and GI problems are possibly interrelated phenomenon for children with ASD, and may have common underlying mechanisms.     

Negative Affect Shares Genetic and Environmental Influences with Symptoms of Childhood Internalizing and Externalizing Disorders

The co-occurrence of internalizing and externalizing disorders suggests that they may have common underlying vulnerability factors. Research has shown that negative affect is moderately positively correlated with both internalizing and externalizing disorders in children. The present study is the first to provide an examination of negative affect in relation to a wide spectrum of childhood internalizing and externalizing problems using a biometric model. This study extends prior findings of more narrowly focused associations by using a factor approach including multiple disorders. The sample for this study included families of 691 same-sex 7- to 13-year old twin pairs. A multifactorial independent pathway model was used to examine the genetic and environmental influences underlying the covariation of parent-reported negative affect, internalizing symptoms, and externalizing symptoms. Results of the current study suggest that negative affect shares genetic and environmental influences with both internalizing and externalizing disorders in childhood. These common influences may partially explain their comorbidity. Understanding that negative affect is at least one contributor to the covariation among these disorders may highlight avenues for early risk assessment, intervention, and perhaps prevention.