Sherrie L. Wilcox

Sexual Functioning in Military Personnel: Preliminary Estimates and Predictors

INTRODUCTION Although the military is a young and vigorous force, service members and veterans may experience sexual functioning problems (SFPs) as a result of military service. Sexual functioning can be impaired by physical, psychological, and social factors and can impact quality of life (QOL) and happiness. AIMS This study aims to estimate rates and correlates of SFPs in male military personnel across demographic and psychosocial characteristics, to examine the QOL concomitants, and to evaluate barriers for treatment seeking. METHODS This exploratory cross-sectional study was conducted using data from a larger nationwide study conducted between October 2013 and November 2013. This sample consists of 367 male active duty service members and recent veterans (military personnel) age 40 or younger. MAIN OUTCOME MEASURES Erectile dysfunction (ED) was determined using the five-item International Index of Erectile Function, sexual dysfunction (SD) was determined using the Arizona Sexual Experiences Scale, Male, and QOL was determined using the World Health Organization Quality of Life, Brief. RESULTS SFPs were associated with various demographic, physical, and psychosocial risk factors. The rates of SD and ED were 8.45% and 33.24%, respectively, for male military personnel aged 21-40. Those who were 36-40, nonmarried, nonwhite, and of lower educational attainment reported the highest rates of SFPs. Male military personnel with poor physical and psychosocial health presented the greatest risk for ED and SD. SFPs were associated with reduced QOL and lower happiness, and barriers for treatment were generally related to social barriers. CONCLUSIONS SFPs in young male military personnel are an important public health concern that can severely impact QOL and happiness.

A brief introduction to the military workplace culture

BACKGROUND Military culture and workplace are areas of interest for researchers across disciplines. However, few publications on military culture exist. OBJECTIVE The purpose of this article is to introduce general concepts regarding the structure and culture of the United States Military and discuss how this creates challenges for reintegrating into the civilian world. METHOD Topics that will be covered in this article include an overview of the Department of Defense (DoD) and Department of Veterans Affairs (VA), socialization to military culture, the unique features of the military as a workplace, the cultural experiences of military personnel reintegrating back into the community, and the challenges faced by military members and their spouses. RESULTS The provided information on military culture will expand military cultural competency so that civilian employers can enhance their ability to create supportive workplaces for veterans and military spouses during times of transition and reintegration. DISCUSSION The unique characteristics of the military culture should be understood by those who work with or plan to work with military populations.

Genital image, sexual anxiety, and erectile dysfunction among young male military personnel.

INTRODUCTION More than a third of young military personnel report experiencing some level of erectile dysfunction (ED). Preoccupation with body image, particularly genitals, is a distraction that can influence sexual anxiety (SA) and sexual functioning problems (SFPs), particularly ED. AIMS This study assessed the relationships between male genital self-image (MGSI), SA, and ED in a sample of male military personnel age 40 or younger. METHODS Data were from a larger study on SFPs in military populations. This sample consisted of 367 male military personnel age 40 or younger. Hierarchical regression analyses and process modeling using mediation analysis were performed to examine the effects of MGSI on ED with SA as an intermediate variable. We predicted that SA would mediate the relationship between MGSI and ED. MAIN OUTCOME MEASURES ED severity was assessed with the International Index of Erectile Function. MGSI was assessed using the MGSI Scale. SA was assessed with the SA subscale of the Sexual Needs Scale. RESULTS As hypothesized, greater satisfaction with MGSI was predictive of significantly lower SA (F[8, 352] = 4.07, P = 0.001) and lower ED (F[8, 352] = 13.20, P = 0.001). Lower levels of SA were predictive of lower levels of ED (F[8, 354] = 21.35, P < 0.001). Additionally, results also revealed a significant indirect effect of MGSI on ED through SA (b = -0.07, standard error = 0.03, confidence interval = [-0.14,-0.02], P < 0.05), indicating mediation of MGSI on ED via SA. CONCLUSIONS This study underscores the complex etiologic basis of SFPs, particularly ED, and highlights the importance of considering psychologic contributors to ED, such as SA and MGSI. Strategies aimed at reducing SA may be useful in improving ED in young military populations and are worth considering as complements to strategies that improve SFPs.

A scope of the problem: Post-deployment reintegration challenges in a National Guard Unit.

BACKGROUND More Reserve and Guard members have been activated in the past few years than in any other time in history. In addition to the high rates of psychological and behavioral challenges among military personnel, there are other equally important post-deployment reintegration challenges. Post-deployment reintegration challenges are particularly important to Reserve and Guard members, who transition rapidly from civilian-military-civilian. OBJECTIVE This study aims to describe the scope of challenges that a battalion of National Guard members (NGM) report experiencing after returning from a one-year deployment to Iraq. METHOD This article reports data from a sample of 126 NGM who recently returned from a one-year deployment to Iraq. The scope of post-deployment problems at baseline, 3- and 6-month post-deployment are presented. RESULTS Overall, the rates of post-deployment psychological and behavioral problems were elevated upon returning from deployment and remained fairly constant for up to 6 months post-deployment. Approximately 30% of respondents were unsatisfied with their relationship and upwards of 30% reported family reintegration challenges. CONCLUSIONS Comparisons with similar research and implications for prevention and improvement of post-deployment quality of life are addressed.

The Influence of Social Support on Dyadic Functioning and Mental Health Among Military Personnel During Postdeployment Reintegration

Objectives: Although many service members successfully cope with exposure to stress and traumatic experiences, others have symptoms of depression, posttraumatic stress disorder (PTSD), and anxiety; contextual factors may account for the variability in outcomes from these experiences. This work sought to understand mechanisms through which social support influences the mental health of service members and whether dyadic functioning mediates this relationship. Methods: We collected cross-sectional data as part of a larger study conducted in 2013; 321 military personnel who had at least 1 deployment were included in these analyses. Surveys were completed online; we collected data on demographic characteristics, social support, mental health measures (depression, PTSD, and anxiety), and dyadic functioning. We performed process modeling through mediation analysis. Results: The direct effects of social support on the mental health of military personnel were limited; however, across all types of support networks, greater social support was significantly associated with better dyadic functioning. Dyadic functioning mediated the relationships between social support and depression/PTSD only when social support came from nonmilitary friends or family; dyadic functioning mediated social support and anxiety only when support came from family. We found no indirect effects of support from military peers or military leaders. Conclusion: Findings here highlight the need to continue to explore ways in which social support, particularly from family and nonmilitary-connected peers, can bolster healthy intimate partner relationships and, in turn, improve the well-being of military service members who are deployed.

The Role of Service Member Mental Health and Marital Satisfaction in Postdeployment Family Reintegration

ABSTRACT The postdeployment period is critical for National Guard members readjusting to the family unit. This study sought to determine whether marital satisfaction protects against reintegration difficulties. Army National Guard members (N = 114) who recently returned from a 12-month deployment to Iraq completed mental health, marital satisfaction, and family reintegration assessments. Linear and ordinary least squares regression models were used. Although few service members reported symptoms of depression, anxiety, and posttraumatic stress disorder exceeding clinical cutoff points, marital satisfaction significantly moderated the relationship between service member mental health and family reintegration. These findings highlight the potentially protective role of satisfying and supportive marital relationships. Results have implications for the health of service members and well-being of military families after a combat deployment.

Sex and the Military: A model for provider education

Military populations have increased exposure to physical and psychological trauma, which increases their vulnerability to sexual dysfunction. Despite high rates of sexual functioning problems in military populations, including erectile dysfunction and anorgasmia, few behavioral health providers are adequately prepared to address these problems, partly due to a lack of training options. The Sex & the Military Toolkit is the first freely available training on sexual dysfunction in military populations that provides preliminary insight on this key issue and is translatable to civilian populations. This manuscript presents an overview of the toolkit with emphasis on the video vignettes (confabulated) and provides clinical considerations, therapy suggestions, and sex-specific intervention strategies. Correspondence to: Sherrie Wilcox, University of Southern California, USA, E-mail: slwilcox@usc.edu

Civilian Unemployment and Mental Health: The Moderating Impact of Alcohol Misuse in Returning National Guard

Postdeployment civilian unemployment has become a common problem and source of additional stress for National Guard (NG) personnel. This study evaluated 126 California NG members, exploring the relationship between immediate postdeployment employment status and self-reported mental health symptoms, including evidence of alcohol misuse. Participants were recruited from a NG unit within the first 3 months after returning home in August 2011. Over one-third of participants reported being unemployed beyond the part-time NG commitment. Mental health symptoms were greater in those participants without civilian employment. Additionally, those participants with comorbid alcohol misuse with either depression or post-traumatic stress disorder were significantly more likely to lack civilian employment. Interaction testing revealed a significant interaction between employment status and alcohol misuse for both depression and post-traumatic stress disorder. Alcohol use was concluded to moderate the relationship between civilian unemployment and mental health symptoms. Results suggest that the part-time employment provided through NG service may serve as a protective factor in the development of negative psychological outcomes, except for cases where alcohol misuse is present.