Carol Chu1,2, Chelsey R Wilks1,2, Kelly L Zuromski1,2, Samantha L Bernecker1,2, Andrew King2, Peter M Gutierrez3,4, Thomas E Joiner5, Matthew K Nock1, Robert J Ursano6, Ronald C Kessler1. 1. Department of Psychology, Harvard University , Cambridge, MA, USA. 2. Department of Health Care Policy, Harvard Medical School , Boston, MA, USA. 3. Rocky Mountain Mental Illness Research, Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center , Aurora, CO, USA. 4. Department of Psychiatry, University of Colorado School of Medicine , Aurora, CO, USA. 5. Department of Psychology, Florida State University , Tallahassee, FL, USA. 6. Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine in Bethesda , Bethesda, MD, USA.
Abstract
Objective: Rates of some psychological disorders are higher among enlisted U.S. military personnel than socio-demographically matched civilians. Indirect evidence suggests some internalizing and externalizing psychological problems among enlistees onset prior to enlistment. However, the consistency and strength of the associations between pre-enlistment psychological problems and enlistment over time is unknown. We address this uncertainty by examining whether internalizing and externalizing problems in high school predicted subsequent military enlistment using a large cohort-sequential panel study. Method: The Monitoring the Future study administered baseline surveys from 1989-2014 and biennial follow-up surveys two and four years later to national samples of high-school seniors (N = 20,823). Validated self-report scales assessed internalizing (depression, low self-esteem) and externalizing (risk-taking, school misbehavior, conduct disorder, interpersonal violence, alcohol, and drug use) problems in each survey. Follow-up surveys assessed military enlistment. Logistic regression models were used to estimate associations of problems scales with subsequent enlistment. Results: School misbehavior in 12th grade, and risk-taking in 12th grade and two years after graduation were associated with significantly elevated odds of enlistment at follow-up. Although modest, these associations were linear and invariant across respondent sex and baseline survey year. Conclusions: School misbehavior and risk-taking predicted subsequent enlistment and there was no evidence of historical changes in these associations over the course of 25 years; these pre-enlistment psychological problems do not fully explain the high rates of psychological disorders among enlisted military personnel. Further research is needed to determine whether these predictors are associated with negative outcomes during or after military service.
Objective: Rates of some psychological disorders are higher among enlisted U.S. military personnel than socio-demographically matched civilians. Indirect evidence suggests some internalizing and externalizing psychological problems among enlistees onset prior to enlistment. However, the consistency and strength of the associations between pre-enlistment psychological problems and enlistment over time is unknown. We address this uncertainty by examining whether internalizing and externalizing problems in high school predicted subsequent military enlistment using a large cohort-sequential panel study. Method: The Monitoring the Future study administered baseline surveys from 1989-2014 and biennial follow-up surveys two and four years later to national samples of high-school seniors (N = 20,823). Validated self-report scales assessed internalizing (depression, low self-esteem) and externalizing (risk-taking, school misbehavior, conduct disorder, interpersonal violence, alcohol, and drug use) problems in each survey. Follow-up surveys assessed military enlistment. Logistic regression models were used to estimate associations of problems scales with subsequent enlistment. Results: School misbehavior in 12th grade, and risk-taking in 12th grade and two years after graduation were associated with significantly elevated odds of enlistment at follow-up. Although modest, these associations were linear and invariant across respondent sex and baseline survey year. Conclusions: School misbehavior and risk-taking predicted subsequent enlistment and there was no evidence of historical changes in these associations over the course of 25 years; these pre-enlistment psychological problems do not fully explain the high rates of psychological disorders among enlisted military personnel. Further research is needed to determine whether these predictors are associated with negative outcomes during or after military service.
Authors: G Bandoli; L Campbell-Sills; R C Kessler; S G Heeringa; M K Nock; A J Rosellini; N A Sampson; M Schoenbaum; R J Ursano; M B Stein Journal: Psychol Med Date: 2017-04-26 Impact factor: 7.723
Authors: Murray B Stein; Laura Campbell-Sills; Robert J Ursano; Anthony J Rosellini; Lisa J Colpe; Feng He; Steven G Heeringa; Matthew K Nock; Nancy A Sampson; Michael Schoenbaum; Xiaoying Sun; Sonia Jain; Ronald C Kessler Journal: J Clin Psychiatry Date: 2018 Mar/Apr Impact factor: 4.384
Authors: Katherine D Hoerster; Keren Lehavot; Tracy Simpson; Miles McFall; Gayle Reiber; Karin M Nelson Journal: Am J Prev Med Date: 2012-11 Impact factor: 5.043
Authors: R C Kessler; S Aguilar-Gaxiola; J Alonso; E J Bromet; O Gureje; E G Karam; K C Koenen; S Lee; H Liu; B-E Pennell; M V Petukhova; N A Sampson; V Shahly; D J Stein; L Atwoli; G Borges; B Bunting; G de Girolamo; S F Gluzman; J M Haro; H Hinkov; N Kawakami; V Kovess-Masfety; F Navarro-Mateu; J Posada-Villa; K M Scott; A Y Shalev; M Ten Have; Y Torres; M C Viana; A M Zaslavsky Journal: Mol Psychiatry Date: 2017-09-19 Impact factor: 15.992