Prevention of Unwanted Sexual Contact Among Cadets at the United States Air Force Academy: A Brief Small-Group Intervention.

This study tested the effectiveness of a small-group preventive intervention designed to prevent unwanted sexual contact among cadets at the US Air Force Academy. Among cadets in the incoming class of 2021, unwanted sexual contact was cut by nearly half in the intervention group relative to the control group. This study is one of the first rigorously designed trials to demonstrate a significant impact on unwanted sexual contact among students attending a US military service academy.Trial Registration. ClinicalTrials.gov identifier: NCT03839797.

Military Mental Health Personnel Deployment Survey: A Secondary Analysis.

INTRODUCTION: Military mental health personnel (MMHP) have increasingly engaged in deployment-related roles in closer proximity to combat environments. Although studies examining deployment-related outcomes among military health care personnel have found combat exposure (CE) positively related to psychological problems, no studies of MMHP have investigated CE or its association with psychological outcomes. This study seeks to provide descriptive data on CE and perceived impacts associated with deployment, as well as explore how CE, perceptions of preparedness for deployment, difficulties during deployment (DDD), and meaningful work during deployment relate to appraisal of problems after deployment (ie, sleep problems, interpersonal withdrawal, depressive symptoms, and work problems). MATERIALS AND METHODS: Archival postdeployment survey data from 113 U.S. Air Force MMHP previously deployed to Iraq or Afghanistan were utilized to determine descriptive statistics on CE and other factors. Additionally, hierarchical linear regression was utilized to test relationships between CE, DDD, preparation for deployment, and meaningful work with reports of sleep problems, interpersonal withdrawal, work problems, and depression symptoms. The study was approved by the Institutional Review Board of the U.S. Air Force Academy. RESULTS: MMHP reported an average of 1.58 (standard deviation = 1.03) combat-related events and DDD included: (1) being away from family/close friends (62%), (2) uncertain redeployment date (35%), (3) difficulty adapting to a new situation (35%), and (4) working long hours (31%), with 66% endorsing two or more areas of difficulty. Most MMHP reported feeling prepared for deployment both professionally (91%) and personally (87%), as well as that their family was prepared (83%). Additionally, nearly all reported at least one meaningful work experience while deployed (96%) with positive impacts on their clients, being the most frequent (89%). Furthermore, CE predicted both sleep difficulties and interpersonal withdrawal. MMHP who perceived their deployment experience as difficult also had higher rates of postdeployment difficulties. Finally, we found no relationship between perceived deployment preparation and postdeployment outcomes. CONCLUSIONS: This is the first study of MMHP reporting CE rates and examining relationships between perceived outcomes and CE, deployment preparation, difficulties during deployment, and meaningful work. The vast majority of MMHP were exposed to more than one combat-related event; however, this rate of CE appears lower than what has been reported among a similar sample of military health care personnel. Although CE predicted difficulties, appraisals of difficulties during deployment experience predicted the highest rates of postdeployment difficulties, accounting for nearly a quarter or more of the outcome variance. The lack of relationship between deployment preparation and meaningful work is inconsistent with prior research and may be because of the limited response range in our sample. Additionally, other methodological limitations include: (1) cross-sectional study design, (2) lack of validated measures, and (3) the long-term retrospective nature of the assessment. Future research should incorporate more rigorous methodologies and assess constructs absent in this archival data set. Despite these limitations, this study provides important preliminary data to support future research development and funding. Additionally, the results may be used to normalize associated impacts and promote help seeking among MMHP.

Air Force Chaplains' Perceived Effectiveness on Service Member's Resilience and Satisfaction.

This study examined how 3,777 active duty male United States Air Force service members' (SMs) rank and residence location moderated the associations between perceived chaplain effectiveness, SMs' resilience, family coping, marital satisfaction, and satisfaction with the Air Force (AF). A multiple-sample structural equation model was conducted with four subgroups of SMs who had received chaplain support: enlisted members living on base, enlisted members living off base, officers living on base, and officers living off base. Chaplain effectiveness was significantly related, both directly and indirectly, to SM's spirituality, resilience, family coping, marital satisfaction, and AF satisfaction. Resilience was significantly associated with increased AF satisfaction for all SMs, except for those living on base. However, living on base was found to strengthen the protective factor between family coping and relationship satisfaction. Rank was found to moderate the link between resilience and family coping. Family coping was significantly related to increased relationship satisfaction.

Intimate Partner Maltreatment Recidivism in U.S. Air Force Families.

Research has demonstrated that perpetrator characteristics (gender, age, and military status) and incident characteristics (perpetrator substance use and initial incident severity) are associated with intimate partner maltreatment recidivism. This study assessed whether these variables were associated with intimate partner maltreatment recidivism in U.S. Air Force families during a 16-yr period (1997-2013). During the study period, 21% of the intimate partner maltreatment perpetrators in the U.S. Air Force committed more than one incident of maltreatment. In terms of perpetrator characteristics, male perpetrators reoffended more than female perpetrators, younger perpetrators reoffended more than older perpetrators, and active duty perpetrators reoffended more than civilians. Whether a perpetrator was enlisted or an officer was not associated with the likelihood of recidivism. In terms of incident characteristics, substance use (which was mainly alcohol use) during an initial maltreatment incident was associated with recidivism, but the severity of perpetrators' initial maltreatment incident was not. However, for perpetrators who reoffended, the severity of their initial incident was associated with the severity of subsequent incidents. On the basis of these findings, the need for targeted interventions to reduce intimate partner maltreatment recidivism is discussed.

The Role of Natural Support Systems in the Post-deployment Adjustment of Active Duty Military Personnel.

This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.

Child maltreatment among U.S. Air Force parents deployed in support of Operation Iraqi Freedom/Operation Enduring Freedom.

This study examined child maltreatment perpetration among 99,697 active-duty U.S. Air Force parents who completed a combat deployment. Using the deploying parent as the unit of analysis, we analyzed whether child maltreatment rates increased postdeployement relative to predeployment. These analyses extend previous research that used aggregate data and extend our previous work that used data from the same period but used the victim as the unit of analysis and included only deploying parents who engaged in child maltreatment. In this study, 2% (n = 1,746) of deploying parents perpetrated child maltreatment during the study period. Although no overall differences were found in child maltreatment rates postdeployment compared to predeployment, several maltreatment-related characteristics qualified this finding. Rates for emotional abuse and mild maltreatment were lower following deployment, whereas child maltreatment rates for severe maltreatment were higher following deployment. The finding that rates of severe child maltreatment, including incidents involving alcohol use, were higher postdeployment suggests a need for additional support services for parents following their return from combat deployment, with a focus on returning parents who have an alcohol use problem.

Characteristics associated with incidents of family maltreatment among United States Air Force families.

From 2002 until 2007, the United States Air Force (USAF) revised the process of determining whether incidents of suspected family maltreatment met the criteria for maltreatment. In this study, all reported child maltreatment and partner abuse incidents in the USAF from January 2008 to July 2011 were examined to determine the extent to which characteristics of victims, offenders, and incidents affected whether incidents were determined to have met criteria for maltreatment. For both child maltreatment and partner abuse, alleged incidents in which offenders used substances and more severe incidents were more likely to have met maltreatment criteria than alleged incidents that did not involve offender substance use and less severe incidents. However, characteristics of the persons involved (e.g., age, gender, military status) were generally unassociated with an incident meeting criteria. Consistent with the goals of the criteria revisions, these results suggest that the current USAF criteria are associated with incident characteristics and not with demographic characteristics of the persons involved in the incident.

What difference does a day make? Examining temporal variations in partner maltreatment.

Routine activities (RA) theory posits that changes in people's typical daily activities covary with increases or decreases in criminal behaviors, including, but not limited to, partner maltreatment. Using a large clinical database, we examined temporal variations among 24,460 incidents of confirmed partner maltreatment across an 11-year period within the U.S. Air Force (USAF). Specifically, we created regression models that predicted the number of partner maltreatment incidents per day. In addition to several control variables, we coded temporal variables for days of the week, month, year, and several significant days (e.g., holidays, Super Bowl Sunday), which allowed us to examine the independent influence of these variables on partner maltreatment prevalence. While accounting for the influence of all other study variables, we observed significant increases in partner maltreatment for weekend days, New Year's Day, Independence Day, and Super Bowl Sunday. Similar results were found for partner maltreatment incidents involving offender alcohol/drug use. Furthermore, the proportion of incidents involving offender alcohol/drug use increased on New Year's Day and Independence Day. Consistent with RA theory and data from civilian samples, the current results indicate that certain days are associated with increased incidents of partner maltreatment within the USAF. These findings should be used to inform future preventive efforts.

Spouse abuse among United States Air Force personnel who deployed in support of Operation Iraqi Freedom/Operation Enduring Freedom.

The authors examined spouse abuse perpetration among all married U.S. Air Force personnel who deployed in support of Operation Iraqi Freedom/Operation Enduring Freedom. Using Poisson and conditional Poisson regression, they compared rates of spouse abuse perpetration predeployment and postdeployment in the population of married U.S. Air Force personnel who had a combat-related deployment between October 1, 2001 and October 31, 2008 (N = 156,296). Just over 2% (n = 3,524) of deployers perpetrated at least one substantiated incident of spouse physical or emotional abuse within the 308,197,653 days at risk for abuse during the study period. Male deployers perpetrated spouse abuse at approximately twice the rate of female deployers. Regarding changes in rates of spouse abuse perpetration postdeployment versus predeployment among all deployers, the authors found no differences overall; however, several deployer and incident-related characteristics moderated this effect. Rates of emotional abuse, mild abuse, and abuse not involving alcohol were significantly lower postdeployment, whereas rates of moderate/severe abuse and abuse involving alcohol were significantly higher postdeployment. Although the majority of U.S. Air Force deployers did not perpetrate any substantiated incidents of spouse abuse, there was variability in the impact of deployment on spouse abuse rates before versus after deployment. The finding that rates of moderate/severe spouse abuse incidents involving alcohol were higher postdeployment suggests a need for focused prevention/intervention efforts.