{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T09:48:06Z","timestamp":1787996886365,"version":"build-2784847793"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"11-12","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"United States Army Special Operations Command"},{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Special Operations Forces (SOF) combat arms and combat support Soldiers are at risk for impaired mental health, such as mood- and stress-related disorders, due to operational and training demands. Additionally, these individuals experience high risk for sustaining mild traumatic brain injury (mTBI). These mTBIs have also been linked to negative psychological outcomes, such as anxiety and depressive symptoms. Studying mental illnesses and their related symptoms alone does not fully address mental health, which may be better understood by 2 separate but overlapping continua measuring both mental illness and subjective well-being (ie, emotional, psychological, and social well-being). Due to the lack of research in this area, current mental health symptoms in active SOF combat Soldiers in relation to mTBI warrants investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this study, 113 SOF combat and combat support Soldiers completed self-report psychological and mTBI history measures during an in-person laboratory setting. These psychometric measures included (1) psychological distress (Brief Symptom Inventory 18), (2) anxiety (Generalized Anxiety Disorder 7-item), (3) posttraumatic stress (PTSD Checklist for DSM-5), (4) somatization (Patient Health Questionnaire-15), and (5) subjective well-being (Mental Health Continuum Short Form).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On average, SOF combat Soldiers endorsed moderate well-being and low psychological distress, somatization, posttraumatic stress, and anxiety. Most SOF combat Soldiers had sustained 1 or more mTBI. We observed mTBI history had significant effects on each dependent variable in the expected directions. History of more mTBIs, controlling for age, was associated with lower subjective well-being as well as higher psychological distress, somatization, posttraumatic stress, and anxiety symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although SOF combat Soldiers reported relatively adaptive mental health symptoms across participants, there was considerable variance in the measures reported. Some of the variance in mental health symptoms was accounted for by mTBI history while controlling for age, with reporting higher numbers of lifetime mTBIs and older age being associated with worse mental health symptoms. Longitudinal investigations into these associations and their impact on Soldier performance is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaa167","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T13:58:29Z","timestamp":1594994309000},"page":"e1946-e1953","source":"Crossref","is-referenced-by-count":10,"title":["Mental Health Symptoms Are Associated With Mild Traumatic Brain Injury History in Active Special Operations Forces (SOF) Combat and Combat Support Soldiers"],"prefix":"10.1093","volume":"185","author":[{"given":"Nikki E","family":"Barczak-Scarboro","sequence":"first","affiliation":[{"name":"Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 2201 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC 27599"},{"name":"Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Bondurant Hall, Campus Box 7120, Chapel Hill, NC 27599"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley R","family":"Cole","sequence":"additional","affiliation":[{"name":"Intrepid Spirit Center, Womack Army Medical Center, 3908 Longstreet Road, Building #3-403, Fort Bragg, NC 28310"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M","family":"DeLellis","sequence":"additional","affiliation":[{"name":"Defense Medical Strategies, LLC, 136 Timberlake Drive, Fayetteville, NC 28314"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary E","family":"Means","sequence":"additional","affiliation":[{"name":"United States Army Special Operations Command, E-2929 Desert Storm Drive, Fort Bragg, NC 28310"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn F","family":"Kane","sequence":"additional","affiliation":[{"name":"Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 2201 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC 27599"},{"name":"Department of Family Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, Chapel Hill, NC 27514"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H","family":"Lynch","sequence":"additional","affiliation":[{"name":"United States Army Special Operations Command, E-2929 Desert Storm Drive, Fort Bragg, NC 28310"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P","family":"Mihalik","sequence":"additional","affiliation":[{"name":"Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 2201 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC 27599"},{"name":"Human Movement Science Curriculum, Department of 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