Faculty Bibliography

Objective: Identify unique correlates of clinically significant emotional abuse (CS-EA) in a large representative U.S. sample of men and women. Method: Active duty members of the U.S. Air Force in relationships (N = 42,744) and civilian spouses (N = 17,266) from 82 bases worldwide completed an anonymous online survey on CS-EA, individual, family, community, and workplace risk factors. Results: Relationship dissatisfaction, poor self-efficacy, financial stress, and alcohol problems were among the strongest correlates of emotional abuse among the 21 factors examined. In addition, community factors such as support from neighbors and community cohesion independently related to men's CS-EA, whereas workplace factors were uniquely related to victimization among active duty and civilian women. The strength of bivariate associations with CS-EA for several family, workplace, and community factors differed by military/civilian status, gender, and marital status, but overall ecological models replicated across gender. Conclusions: Although many workplace and community factors were related to CS-EA bivariately, only a select few were related after accounting for individual and family factors. CS-EA is an understudied but important public health problem and the current study helps to identify key correlates of CS-EA that can help inform prevention and treatment efforts aimed at reducing partner violence.

Posttraumatic stress disorder (PTSD) is assessed across many different populations and assessment contexts. However, measures of PTSD symptomatology often are not tailored to meet the needs and demands of these different populations and settings. In order to develop population- and context-specific measures of PTSD it is useful first to examine the item-level functioning of existing assessment methods. One such assessment measure is the 17-item PTSD Checklist-Military version (PCL-M; Weathers, Litz, Herman, Huska, & Keane, 1993). Although the PCL-M is widely used in both military and veteran health-care settings, it is limited by interpretations based on aggregate scores that ignore variability in item endorsement rates and relatedness to PTSD. Based on item response theory, this study conducted 2-parameter logistic analyses of the PCL-M in a sample of 196 service members returning from a yearlong, high-risk deployment to Iraq. Results confirmed substantial variability across items both in terms of their relatedness to PTSD and their likelihood of endorsement at any given level of PTSD. The test information curve for the full 17-item PCL-M peaked sharply at a value of theta = 0.71, reflecting greatest information at approximately the 76th percentile level of underlying PTSD symptom levels in this sample. Implications of findings are discussed as they relate to identifying more efficient, accurate subsets of items tailored to military service members as well as other specific populations and evaluation contexts.

Although previous research has indicated an elevated prevalence of posttraumatic stress disorder (PTSD) and other mental health problems among veterans of Operations Iraqi Freedom and Enduring Freedom following deployment, most of this research has been cross-sectional and has focused on a limited range of military groups and outcome criteria. This investigation was a longitudinal study of U.S. Air Force security forces assigned to a year-long high-threat ground mission in Iraq to determine the degree to which airmen's emotional and behavioral health and committed relationships were adversely impacted by an extended deployment to a warzone. Participants were a cohort of 164 security forces airmen tasked to a 365-day deployment to train Iraqi police. Airmen completed study measures both prior to and 6-9 months following deployment. Rates of deterioration in individual and interpersonal adjustment were both significant and medium to large in magnitude of effect, d = 0.43 to 0.90. Results suggest that the negative effects of deployment are related to levels of traumatic experiences and do not spontaneously remit within the first 6-9 months following return from deployment-particularly among those service members having relatively lower levels of social support.

The association of environmental and genetic variation in caries with child externalizing behavior problems (inattention, hyperactivity, impulsivity, and defiance) was studied in a sample of 239 pairs of 3- to 8-year-old impoverished Brazilian twins. It was hypothesized that externalizing problems would show a stronger positive association with environmental than genetic variation in caries. Univariate twin models were estimated to parse variation in caries into three components: additive genetic (A), shared environment (C) and non-shared environment/error (E). Age-adjusted associations between externalizing problems and each variance component were tested. Contrary to the hypothesis, modest but very consistent negative associations were found between externalizing problems and both genetic and environmental variation in caries. Mutans streptococci and sweetness preference did not explain the negative associations of caries and externalizing problems. Externalizing problems in non-medicated children were associated with less dental decay that could be explained by both genetic and environmental factors. (c) 2014 S. Karger AG, Basel.

The psychometrics of the Parenting Scale's Overreactivity and Laxness subscales were evaluated using item response theory (IRT) techniques. The IRT analyses were based on 2 community samples of cohabiting parents of 3- to 8-year-old children, combined to yield a total sample size of 852 families. The results supported the utility of the Overreactivity and Laxness subscales, particularly in discriminating among parents in the mid to upper reaches of each construct. The original versions of the Overreactivity and Laxness subscales were more reliable than alternative, shorter versions identified in replicated factor analyses from previously published research and in IRT analyses in the present research. Moreover, in several cases, the original versions of these subscales, in comparison with the shortened versions, exhibited greater 6-month stabilities and correlations with child externalizing behavior and couple relationship satisfaction. Reliability was greater for the Laxness than for the Overreactivity subscale. Item performance on each subscale was highly variable. Together, the present findings are generally supportive of the psychometrics of the Parenting Scale, particularly for clinical research and practice. They also suggest areas for further development.

INTRODUCTION: Tobacco use among military personnel is associated with significant health care expenditures, lost productivity, and compromised combat readiness. The prevalence remains high among military personnel and may increase in high-risk situations such as deployment. We assessed the prevalence of tobacco use across the deployment cycle, changes in tobacco use (nonuse, continued use, initiation/harm escalation, cessation/harm reduction) during deployment, and the impact of deployment history on tobacco use. METHOD: Cigarette smoking, smokeless tobacco (ST) use, and dual tobacco use were evaluated among 278U.S. Air Force Security Forces personnel undertaking a 1-year deployment to a high-threat combat environment. Multinomial regression was used to examine prediction of tobacco use patterns both cross-sectionally and longitudinally. RESULTS: More than half (53%-63%) of all Security Forces used tobacco at all stages of the deployment cycle. Individual tobacco use trajectories showed significant differences in prevalence rates of initiation/harm escalation and cessation/harm reduction when comparing the transition from predeployment to the deployed environment versus returning to postdeployment status. Airmen who had deployed more than once previously had a higher likelihood of using ST use at predeployment and engaging in dual tobacco use during deployment. CONCLUSIONS: Findings suggest the potential benefit of targeted or universal interventions at each stage of the deployment cycle to reduce the onset, maintenance, or escalation of tobacco use behaviors in the U.S. military.

Although previous research has shown a negative relation between partner support and posttraumatic stress disorder (PTSD) symptom severity among military service members following deployment, the mediating mechanisms of this effect remain poorly understood. This study examined willingness to disclose deployment- and combat-related experiences as a mediating mechanism underlying the linkage between intimate partner support and PTSD symptom severity in a sample of 76 U.S. Air Force service members deployed to Iraq in a year-long, high-risk mission. Airmen's reports of overall social support, and partner support specifically, significantly predicted concurrent postdeployment PTSD symptom severity. Subsequent mediation analyses demonstrated that level of disclosure of deployment- and combat-related experiences by service members to their intimate partners accounted for a significant portion of the relation between partner support and postdeployment PTSD symptom severity. The level of Airmen's disclosure was also inversely related to levels of relationship distress. Implications of these findings for prevention and intervention strategies and for further research are discussed.

OBJECTIVE: Cardiovascular reactivity to laboratory stressors was investigated as (a) a moderator of associations of partner aggression with affective functioning, alcohol problems, and parenting; and (b) a consequence of partner aggression. METHOD: Cohabiting adult couples (N = 453) with 3- to 7-year-old children were recruited by random digit dialing and completed questionnaires assessing couple physical aggression, discipline practices, anger, stress, depressive symptoms, and problem alcohol use. Heart rate and blood pressure were measured at rest and in response to laboratory stressors (mental arithmetic and video presentations of family conflict). RESULTS: Males' physical aggression more strongly predicted women's affective functioning and alcohol problems when the women had greater cardiovascular reactivity. This pattern did not extend to men. Physical victimization was associated with lower cardiovascular reactivity. CONCLUSIONS: The present results provide partial support for the biological sensitivity to context model of Boyce and Ellis (2005) and suggest that incorporating the moderating influence of biological reactivity may improve the precision of models of the effects of aggression on adult adjustment.

Dental fear affects over 20% of those presenting for treatment, leading to unnecessary pain and suffering, health and quality of life degradation, and increased financial and societal costs. In contrast to the broad dissemination of highly effective non-pharmaceutical treatment of other anxiety disorders, effective treatment of dental fear is anything but ubiquitous. Although this reflects the common-place problems for disseminating evidence based practices, it is also reflects that (a) dentists have neither the training in behavioral health treatment, nor the time, nor the reimbursement incentives to perform such treatment; (b) exceedingly few patients present to a mental health (MH) provider for dental fear; (c) there is no training or tradition placing MH providers in dental practices; and (d) all of the approximately 21 randomized, controlled trials of behavioral dental fear treatment were conducted by researchers at specialized university dental fear clinics, using participants who saw advertisements or were referred by health professionals for dental fear treatment. In this paper, we call for research (a) placing MH providers in the dental home - not just in dental fear specialty clinics - treating patients who present for dental treatment and within the confines of standard dental operations; (b) testing the acceptability and effectiveness of the intervention as administered by integrated MH professionals or by dental hygienists (a more af-fordable dissemination vector in the U.S. than dentists); (c) patient moderators of effectiveness; (d) anxiety facet and provider moderators of effectiveness; and (e) cost-effectiveness of placing dental fear treatment within the dental home