Valerie A Stander

Naval Health Research Center, San Diego, California, United States

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Publications (28)36.07 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Posttraumatic stress disorder is often diagnosed with other mental health problems, particularly depression. Although PTSD comorbidity has been associated with more severe and chronic symptomology, relationships among commonly co-occurring disorders are not well understood. The purpose of this study was to review the literature regarding the development of depression comorbid with combat-related PTSD among military personnel. We summarize results of commonly tested hypotheses about the etiology of PTSD and depression comorbidity, including (1) causal hypotheses, (2) common factor hypotheses, and (3) potential confounds. Evidence suggests that PTSD may be a causal risk factor for subsequent depression; however, associations are likely complex, involving bidirectional causality, common risk factors, and common vulnerabilities. The unique nature of PTSD-depression comorbidity in the context of military deployment and combat exposure is emphasized. Implications of our results for clinical practice and future research are discussed.
    Clinical psychology review 12/2013; 34(2):87-98. · 7.18 Impact Factor
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    ABSTRACT: Patterns of healthcare use in a sample of young adults entering the US Navy (N = 1137) were examined in a longitudinal survey study. Baseline data provided information about healthcare use as a civilian, whereas follow-up data were used to examine changes in patterns of use over time following entry into the Military Health System (MHS). Entrance into the MHS was marked by increased use of preventive care. Although few systematic differences were noted with respect to socioeconomic status or race/ethnicity, women consistently used more healthcare than did men, and women's use increased more over time; however, this increase was largely driven by pregnancy during military service. Findings suggest that individuals with access to universal healthcare are likely to increase their overall use of services. However, these effects were quite small in absolute terms, and they were strongest for preventive care rather than more intensive and expensive services. Published 2013. This article is a US Government work and is in the public domain in the USA.
    International Journal of Health Planning and Management 04/2013; · 0.64 Impact Factor
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    ABSTRACT: The U.S. Navy Sexual Assault Intervention Training (SAIT) program for women was evaluated in a randomized clinical trial. The SAIT uses multiple presentation modalities (lecture, slides, discussion, film) to provide information related to sexual assault, including risk factors, consequences, prevention, and relevant military regulations. Female personnel who had completed basic training (N = 550) participated in the SAIT or a Comparison condition, and then completed measures of rape knowledge, empathy for rape victims, and acceptance of rape myths (false beliefs about rape justifying sexual violence). Results showed that the SAIT increased factual knowledge about rape. In addition, the SAIT increased empathy with rape victims in some groups of women. However, the program did not reduce women's rape myth acceptance. Given the enormity of the problem of sexual assault and these promising initial findings, additional research on the efficacy of the SAIT is clearly warranted.
    Military medicine 10/2011; 176(10):1178-83. · 0.77 Impact Factor
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    ABSTRACT: Although research has documented negative effects of combat deployment on mental health, few studies have examined whether deployment increases risky or self-destructive behavior. The present study addressed this issue. In addition, we examined whether deployment effects on risky behavior varied depending on history of pre-deployment risky behavior, and assessed whether psychiatric conditions mediated effects of deployment on risky behavior. In an anonymous survey, active duty members of the U.S. Marine Corps and U.S. Navy (N = 2116) described their deployment experiences and their participation in risky recreational activities, unprotected sex, illegal drug use, self-injurious behavior, and suicide attempts during three time frames (civilian, military pre-deployment, and military post-deployment). Respondents also reported whether they had problems with depression, anxiety, or PTSD during the same three time frames. Results revealed that risky behavior was much more common in civilian than in military life, with personnel who had not deployed, compared to those who had deployed, reporting more risky behavior and more psychiatric problems as civilians. For the current time period, in contrast, personnel who had deployed (versus never deployed) were significantly more likely to report both risky behavior and psychiatric problems. Importantly, deployment was associated with increases in risky behavior only for personnel with a pre-deployment history of engaging in risky behavior. Although psychiatric conditions were associated with higher levels of risky behavior, psychiatric problems did not mediate associations between deployment and risky behavior. Implications for understanding effects of combat deployment on active duty personnel and directions for future research are discussed.
    Journal of psychiatric research 05/2011; 45(10):1321-31. · 3.72 Impact Factor
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    ABSTRACT: This study explored individual and military risk factors for intimate partner aggression (IPA) perpetration among Navy personnel in their second year of service. We found some evidence that job stress was related to higher perpetration among men. Contrary to expectations, ship duty was related to lower perpetration rates, even though it involves more military operational stress and more frequent deployments than does shore duty. Premilitary alcohol problems were a stronger risk factor for men than for women, whereas premilitary patterns of aggressive behavior were a stronger risk factor for women. Recommendations for future research and public health interventions are discussed.
    Military Psychology - MIL PSYCHOL. 01/2011; 23(6):639-658.
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    ABSTRACT: A randomized clinical trial was conducted to evaluate the effectiveness of the Navy Sexual Assault Intervention Training (SAIT) program for men. A four-group Solomon design was used to control for possible pretest sensitization effects. Male Navy personnel (N = 1,505) were assessed for rape knowledge, rape myth acceptance (two scales), and rape empathy after participating in the SAIT program or viewing an educational video about HIV/AIDS (comparison condition). The SAIT program was found to be effective in increasing rape knowledge, reducing rape myth acceptance, and increasing empathy for rape victims. As expected, men who had exhibited previous coercive sexual behavior, compared with those who had not, reported lower levels of knowledge, higher levels of rape myth acceptance, and less rape empathy. However, the SAIT program was generally effective in changing men's knowledge, beliefs, and feelings on the key measures, regardless of participants' histories of coercive sexual behavior.
    Military medicine 06/2010; 175(6):429-34. · 0.77 Impact Factor
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    ABSTRACT: Although the intergenerational transmission of family violence has been well documented, the mechanisms responsible for this effect have not been fully determined. The present study examined whether trauma symptoms mediate the relationship between a childhood history of child physical abuse (CPA) and adult CPA risk, and whether any such mediation was similar for women and men. Female and male US Navy (USN) recruits (N=5,394) and college students (N=716) completed self-report measures of their history of child abuse (i.e., CPA and child sexual abuse [CSA]), exposure to intimate partner violence (IPV), current trauma symptoms, and adult CPA risk. As expected, there was a strong association between a childhood history of CPA and adult CPA risk. This association was significant even after controlling for demographic variables and childhood exposure to other forms of violence (CSA and IPV), and the strength of the relationship did not vary depending on demographics or exposure to other forms of violence. However, the association between a history of CPA and adult risk of CPA was stronger for individuals high in defensive avoidance compared to those low in defensive avoidance. The association between a history of CPA and adult CPA risk was largely, although not entirely, mediated by psychological trauma symptoms. Mediation was observed for both women and men in both the USN and college samples. Trauma symptoms associated with a history of CPA accounted for a substantial part of the relationship between a history of CPA and adult CPA risk in both women and men. To the extent that trauma symptoms are a mechanism by which the intergenerational transmission of child abuse occurs, intervening to reduce trauma symptoms in CPA victims has the potential of reducing their risk of continuing the cycle of violence.
    Child abuse & neglect 03/2010; 34(5):332-44. · 2.34 Impact Factor
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    ABSTRACT: This study examined the frequency and characteristics of repeated attempted and completed rape (ACR) incidents reported by newly enlisted male navy personnel (N=1146) who participated in a longitudinal study during the transition from civilian to military life. Overall, 13% (n=144) reported engaging in sexual behavior that approximates legal definitions of ACR since the age of 14. Among those men, most (71%) reperpetrated ACR incidents (M = 6.36, SD = 9.55). Demographic variables were unrelated to perpetration history. Regardless of time period, respondents reported perpetrating primarily completed rather than attempted rape, perpetrating multiple ACR incidents rather than a single incident, using substances to incapacitate victims more frequently than force, and knowing their victim rather than targeting a stranger in completed rape incidents.
    Violence and Victims 02/2009; 24(2):204-18. · 1.28 Impact Factor
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    ABSTRACT: This study examined the incidence and consequences of receipt of intimate partner violence (IPV) as reported by 1,035 (576 female and 459 male) Navy personnel during their second year of service. Overall, 21.1% of respondents reported that they had been victims of some form of IPV during their second year of service, of which 10.5% of respondents experienced moderate IPV only and 10.6% experienced severe (with or without moderate) IPV. Women reported experiencing higher rates of moderate IPV only (12.2 vs. 8.2% of men), whereas men reported higher rates of severe IPV (16.7 vs. 6.2% of women). With regard to injury, slightly more female (54%) than male (45%) IPV victims reported one or more forms of injury. Male victims, compared with female victims, were more likely to report that they were restraining their partner or had touched their partner in a sexual way prior to their partners' violence. After controlling for pre-military levels of trauma symptoms, women with past-year experiences of IPV, compared with those with no past-year IPV, had significantly higher levels of all 10 types of trauma symptoms assessed; for men, IPV was associated with significantly higher scores on all trauma symptom scales except for those related to sexual concerns/behaviors.
    Military Psychology 01/2009; 21(S2):S1-S15. · 0.72 Impact Factor
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    ABSTRACT: Female (n = 5,226) and male (n = 5,969) U.S. Navy recruits completed a survey assessing their premilitary histories of adult sexual assault (SA), defined as attempted or completed rape since the age of 14. The survey was completed under anonymous or identified conditions. Overall, 39% of women reported premilitary SA victimization and 13% of men admitted premilitary SA perpetration. As predicted, rates were significantly higher in the anonymous than in the identified condition. For the sample of women as a whole, marital status, ethnicity, and family income were associated with SA victimization; for men, only marital status was associated with SA perpetration. Compared to previous college samples, Navy recruits were more likely to have previous SA experience. Given the negative consequences associated with SA victimization and perpetration, the present study reinforces the desirability of developing additional treatment, education, and prevention programs to reduce the occurrence of SA among military recruits.
    Journal of Interpersonal Violence 04/2008; 23(11):1636-53. · 1.64 Impact Factor
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    ABSTRACT: A prospective study examined whether adult premilitary sexual victimization predicted women's military attrition. In a survey of female Navy recruits (N = 2,431), 56% reported some form of adult unwanted sexual contact before entering the military, with 25% reporting completed rape. Approximately one-third of respondents left the Navy before completing their 4-year term of service. When rape, attempted rape, and lower-level unwanted sexual contact were considered simultaneously, only rape predicted attrition. Women who reported premilitary rape, compared with those who did not, were 1.69 times more likely to leave the military. The pattern of results held across the 4-year period examined and after controlling for demographic predictors.
    Military medicine 04/2007; 172(3):254-8. · 0.77 Impact Factor
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    ABSTRACT: Individuals in the military are often required to endure high levels of stress as a result of demanding operational requirements or deployments. Individuals who enter the military with pre-existing mental health problems such as posttraumatic stress disorder (PTSD) are likely to be at heightened risk of adverse reactions to military stressors. The present study documents the prevalence of PTSD symptoms among new Navy recruits and compares the prevalence of PTSD symptomology among recruits to prevalence rates that have been reported for comparable civilian populations. Results suggest that 15 percent of new Navy recruits are experiencing measurable symptoms of posttraumatic stress. Prevalence of these symptoms among Navy recruits is comparable to that among civilian adolescent and young adult populations.
    Journal of Anxiety Disorders 02/2007; 21(6):860-70. · 2.96 Impact Factor
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    ABSTRACT: To examine relationships between childhood maltreatment and alcohol-related problems among U.S. Navy recruits. An anonymous sample of 5697 Navy recruits completed a survey regarding their alcohol consumption, alcohol problems (binge drinking, drinking until drunk, alcohol dependence, alcohol-related arrests), and experiences of childhood physical and sexual abuse. Most of the recruits used alcohol, and a substantial proportion reported histories of childhood maltreatment. Recruits who had been victimized as children were more likely to use alcohol. Furthermore, among drinkers, those who had been abused were more likely to exhibit alcohol problems than were non-abused drinkers. Substantial numbers of personnel with alcohol-related problems may be using alcohol to self-medicate due to a history of childhood abuse. Attention to the association between alcohol abuse and childhood maltreatment might help improve the efficacy of military alcohol reduction programs.
    Alcohol and Alcoholism 01/2007; 42(4):370-5. · 1.96 Impact Factor
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    ABSTRACT: A prospective study of U.S. Navy recruits (N = 5,498) examined whether premilitary intimate partner violence (IPV) was associated with attrition. Overall, more than one-fourth of recruits reported premilitary physical IPV and more than two-thirds reported premilitary verbal IPV. Women reported more perpetration and receipt of IPV than men, and married or cohabiting respondents reported more IPV than single respondents. Both perpetration and receipt of IPV significantly predicted attrition within 4 years. However, after controlling for other forms of IPV, only receipt of physical IPV significantly predicted attrition. In only one analysis did associations between IPV and attrition vary according to marital status or gender; premilitary receipt of verbal IPV had different effects on women and men.
    Military medicine 01/2007; 171(12):1206-10. · 0.77 Impact Factor
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    ABSTRACT: Prospective survey methods were used to investigate the effects of child sexual abuse (CSA) and premilitary rape on the likelihood that female U.S. Navy recruits (N = 465) would experience rape during their first year of military service and to examine ethnic differences in sexual victimization and revictimization. Rape during the first year of military service was 2.5 times more likely among women with (versus without) a history of CSA, 3.5 times more likely among women with (versus without) a history of premilitary rape, and 6.0 times more likely among women with a history of both CSA and premilitary rape (versus neither). CSA predicted rape during the first year of military service for African American and Hispanic women, but not for White women. Although premilitary rape predicted rape during the first year of military service for all three ethnic groups, the revictimization effects were strongest for African American women. These results highlight the need for additional research examining ethnic differences in patterns of interpersonal violence.
    04/2006;
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    ABSTRACT: Individuals in the military are often required to endure high levels of stress as a result of demanding operational requirements or deployments. Individuals who enter the military with pre-existing mental health problems such as posttraumatic stress disorder (PTSD) are likely to be at heightened risk of adverse reactions to military stressors. The present study documents the prevalence of PTSD symptoms among new Navy recruits and compares the prevalence of PTSD symptomatology among recruits to prevalence rates that have been reported for comparable civilian populations. Results suggest that 15% of new Navy recruits are experiencing measurable symptoms of PTSD. PTSD prevalence among Navy recruits is comparable to the prevalence among civilian adolescent and young adult populations.
    10/2005;
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    ABSTRACT: In a prospective study of U.S. Navy recruits (n = 5,491), we examined the relationship between childhood exposure to family violence (child physical abuse, child sexual abuse [CSA], and domestic violence) and attrition. Overall, 55% of recruits experienced one or more forms of childhood family violence and 34% of recruits attrited within 4 years after enlistment. Considered separately, each form of childhood violence was significantly associated with attrition. When considered simultaneously, all three types of childhood violence were associated with attrition in men, but only CSA was associated with attrition in women. Men and women who experienced all three types of childhood violence were 303% and 139%, respectively, more likely to attrite than recruits who reported no childhood violence. In analyses examining the timing of attrition, CSA was associated with early attrition, whereas child physical abuse and domestic violence were unrelated to timing of attrition.
    Military medicine 07/2004; 169(6):465-9. · 0.77 Impact Factor
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    ABSTRACT: Since 1999, the Department of the Navy (DON) has conducted an extensive suicide surveillance program, using the DON Suicide Incident Report (DONSIR) to collect data on completed suicides in the U.S. Navy (USN) and Marine Corps (USMC). The long-term goal of this program is to improve suicide prevention by identifying and modifying military-specific risk factors. The DONSIR significantly improves the capability of the DON to track and analyze data on completed suicides. It provides the DON with consistent data that can be compared across both the USN and the USMC. It establishes baselines for suicide rates and suicide event characteristics that can be used to track trends over time. It also evaluates military-specific correlates of suicide, which cannot be evaluated using civilian, academic literature. This is the fourth annual report on the DONSIR. This report presents findings from the first 4 years of data collected since the program was initiated in 1999 and summarizes the conclusions and recommendations that can be drawn based on the results to date.
    05/2004;
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    ABSTRACT: In 1999, the Department of the Navy (DoN) began a suicide surveillance program using the DoN Suicide Incident Report (DONSIR) to collect data on completed suicides in the Navy and Marine Corps. The DONSIR significantly advances the capability of DoN to track and analyze data on completed suicides over time. The long-term goal of this program is to improve suicide prevention by identifying and modifying military-specific risk factors. A DONSIR has been completed on 98% of the 200 DoN suicides that occurred from 1999 to 2001. Most DoN suicides occurred outside the military work environment and involved the use of a firearm. Most decedents were men, had experienced a recent relationship problem, and did not use any military support services in the 30 days before suicide. Results suggest that the promotion of support services may improve the effectiveness of DoN suicide prevention.
    Military medicine 05/2004; 169(4):301-6. · 0.77 Impact Factor
  • Cheryl B. Olson, Valerie A. Stander, Lex. L. Merrill
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    ABSTRACT: Surveys that directly ask participants whether they have been abused are likely to derive different results than studies that ask about specific childhood sexual experiences or about experiences with specific types of parental aggression that participants may or may not personally define as abusive. Rates are also likely to be affected by the level of confidentiality of the survey. We compared results from the nonconfidential military Sailor's Health Inventory Program (SHIP; Mittelman, Plunkett, & Bayer, 1998) with the results of the Survey of Recruits' Behaviors (SRB; Merrill, Newell, Hervig, Booth-Kewley, Patriarca, & Oilman, 1998). The SRB included both confidential and anonymous survey conditions. Rates of self-reported childhood abuse varied markedly. SHIP rates were lowest, with 5% of the participants identified as victims of abuse. Using SRB behavioral definitions under anonymous survey conditions resulted in the highest rate of 63%. Data derived using self-definitions and behavioral definitions independently accounted for variability in participants' symptoms of depression, anxiety, and sexual difficulties. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Military Psychology 12/2003; · 0.72 Impact Factor

Publication Stats

89 Citations
36.07 Total Impact Points

Institutions

  • 2001–2013
    • Naval Health Research Center
      San Diego, California, United States
    • Purdue University
      • Department of Human Development and Family Studies
      West Lafayette, IN, United States
  • 2010
    • Northern Illinois University
      • Department of Psychology
      DeKalb, IL, United States