{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:06:24Z","timestamp":1791450384453,"version":"4.3.3"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1-2","funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["HU000012120068"],"award-info":[{"award-number":["HU000012120068"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The National Guard (NG) served as a critical component of the USA\u2019s response to the Coronavirus Disease 2019 (COVID-19) pandemic, while concurrently managing their personal responses to the pandemic. Determining whether the activation of NG service members in response to the COVID-19 pandemic was associated with a greater psychological strain can identify NG\u2019s needs for mental health support.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We surveyed 3993 NG unit (NGU) service members (75% Army NG, 79% enlisted, 52% 30-49\u2009years old, and 81% males) during the COVID-19 pandemic, with surveys administered between August and November 2020. Almost half (46%) of NGU service members reported being activated in response to COVID-19 (mean activation length\u2009=\u200918.6\u2009weeks). Activated service members completed the survey approximately 2 to 3\u2009months post-activation. Surveys assessed demographics, service-related characteristics, unit cohesion and positive leadership skills (leadership), and COVID-19 activation, and outcomes including probable post-traumatic stress disorder (PTSD), clinically significant anxiety and depression, and anger. Descriptive and logistic regression analyses were conducted. The study was approved by the Institutional Review Board of the Uniformed Services University of the Health Sciences in Bethesda, MD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In all, 9.7% met the criteria for probable PTSD, 7.6% reported clinically significant anxiety and depression, and 13.2% reported feeling angry\/anger outbursts. Multivariate logistic regression analyses, adjusting for demographic and service-related characteristics, indicated that COVID-19 activation was not associated with a greater risk of PTSD, anxiety and depression, or anger. Regardless of activation status, NGU service members with low levels of unit cohesion and leadership were more likely to report PTSD and anger, and low levels of unit cohesion were associated with clinically significant anxiety and depression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>COVID-19 activation did not increase the risk of mental health difficulties among NGU service members. However, low levels of unit cohesion were associated with the risk of PTSD, anxiety and depression, and anger, and low levels of leadership were associated with the risk of PTSD and anger. The results suggest a resilient psychological response to COVID-19 activation and the potential for strengthening all NG service members through enhancing unit cohesion and leadership support. Future research on specific activation exposures, including the type of work tasks in which service members are engaged, particularly those associated with high-stress work conditions, is needed to help better understand their activation experience and how it may influence post-activation responses.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad177","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T18:38:24Z","timestamp":1684607904000},"page":"e127-e135","source":"Crossref","is-referenced-by-count":6,"title":["National Guard Deployment in Support of COVID-19: Psychological and Behavioral Health"],"prefix":"10.1093","volume":"189","author":[{"given":"Holly B Herberman","family":"Mash","sequence":"first","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. , Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol S","family":"Fullerton","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy B","family":"Adler","sequence":"additional","affiliation":[{"name":"Walter Reed Army Institute of Research , Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua C","family":"Morganstein","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quinn M","family":"Biggs","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. , Bethesda, MD 20817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J","family":"Ursano","sequence":"additional","affiliation":[{"name":"Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"2024013017253203900_R1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1093\/epirev\/mxu007","article-title":"Mental health among reserve component military service members and veterans","volume":"37","author":"Cohen","year":"2015","journal-title":"Epidemiol Rev"},{"issue":"10","key":"2024013017253203900_R2","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.7205\/MILMED-D-15-00445","article-title":"Post-traumatic stress disorder, depression, and binge 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