James C Malley

Central Connecticut State University, New Britain, Connecticut, United States

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Publications (8)24.01 Total impact

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    ABSTRACT: A growing body of research has examined the prevalence and correlates of psychopathology, mild traumatic brain injury, and related problems in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF). While these studies help characterize the deleterious effects of combat, no known study has examined factors that may enhance posttraumatic growth or positive changes experienced as a result of combat in this population. A total of 272 predominantly older Reservist/National Guard OEF-OIF Veterans completed an anonymous mail survey that assessed combat exposure, psychopathology, psychosocial functioning, social support, and posttraumatic growth. Seventy-two percent of the sample endorsed a significant degree of posttraumatic growth in at least one of the areas assessed, the most common of which were changing priorities about what is important in life (52.2%), being able to better appreciate each day (51.1%), and being better able to handle difficulties (48.5%). Hierarchical regression analysis revealed that younger age, greater posttraumatic stress disorder (PTSD) symptoms, and increased perceptions of unit member support and effort/perseverance were significantly associated with posttraumatic growth. Respondents with PTSD scored higher on an overall measure of posttraumatic growth and on items reflecting appreciation of life and personal strength. This study is limited by a relatively low survey return rate and employment of an abbreviated measure of posttraumatic growth. Results of this study suggest that interventions to bolster unit member support and to enhance perceptions of effort and perseverance may help promote posttraumatic growth in OEF-OIF Veterans.
    Journal of affective disorders 10/2010; 126(1-2):230-5. · 3.76 Impact Factor
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    ABSTRACT: Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric conditions in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but little is known about the structure of PTSD symptoms, and associations between PTSD symptom clusters and psychosocial functioning in this population. A total of 272 OEF-OIF Veterans in Connecticut completed a mail survey containing measures of psychopathology, resilience, and psychosocial functioning. Confirmatory factor analyses revealed that the 4-factor dysphoria model, which is comprised of separate re-experiencing, avoidance, dysphoria, and hyperarousal symptom clusters, provided the best representation of PTSD symptom structure in this sample. Dysphoria symptoms were independently associated with a broad range of psychosocial measures, even after controlling for age, combat exposure, and other PTSD symptom clusters. Re-experiencing symptoms were associated with alcohol use problems, and avoidance symptoms were associated with increased psychosocial difficulties and decreased perceptions of postdeployment social support. These results suggest that dysphoria symptoms were strongly related to a broad range of psychosocial measures in this sample of OEF-OIF Veterans. Dysphoria symptoms may deserve special attention in the assessment and treatment of symptomatic OEF-OIF Veterans.
    Psychiatry Research 07/2010; 178(2):323-9. · 2.68 Impact Factor
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    ABSTRACT: Little is known about variables associated with suicidality in veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). A total of 272 OEF/OIF veterans completed a survey containing measures of psychopathology, resilience, and social support. Thirty-four respondents (12.5%) reported contemplating suicide in the two weeks prior to completing the survey. Suicide contemplators were more likely to screen positive for posttraumatic stress disorder (PTSD), depression, and an alcohol problem, and scored higher on measures of psychosocial difficulties, stigma, and barriers to care, and lower on measures of resilience and social support. Logistic regression analysis revealed that positive PTSD and depression screens, and increased psychosocial difficulties were associated with suicidal ideation, and that increased postdeployment social support and sense of purpose and control were negatively associated with suicidal ideation. Interventions for PTSD, depression, and psychosocial difficulties, and to bolster postdeployment social support and resilience may be helpful in preventing suicidal ideation in OEF/OIF veterans.
    Journal of affective disorders 10/2009; 123(1-3):102-7. · 3.76 Impact Factor
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    ABSTRACT: This study evaluated whether posttraumatic stress disorder (PTSD) mediated the relationship between mild traumatic brain injury (MTBI) and general health ratings, psychosocial functioning, and perceived barriers to receiving mental healthcare 2 years following return from deployment in veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). A total of 277 OEF/OIF veterans completed the Connecticut OEF/OIF Veterans Needs Assessment Survey; 18.8% of the sample screened positive for MTBI. Compared with respondents who screened negative for MTBI, respondents who screened positive for MTBI were younger, more likely to have PTSD, more likely to report fair/poor overall health and unmet medical and psychological needs, and scored higher on measures of psychosocial difficulties and perceived barriers to mental healthcare. Injuries involving loss of consciousness were associated with greater work-related difficulties and unmet psychological needs. PTSD mediated the relationship between MTBI and all of these outcomes. These results underscore the importance of assessing PTSD in OEF/OIF veterans who screen positive for MTBI.
    The Journal of nervous and mental disease 10/2009; 197(10):748-53. · 1.77 Impact Factor
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    ABSTRACT: This study examined whether social support and beliefs about mental health care are associated with stigma, barriers to care, and mental health care utilization in a sample of veterans of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom (OEF-OIF). A sample of 272 predominantly reservist and National Guard OEF-OIF veterans in Connecticut completed a needs assessment survey. Negative beliefs about mental health care, particularly psychotherapy, and decreased perceived unit support predicted increased perceptions of stigma and barriers to care. Negative beliefs about mental health care were also associated with decreased likelihood of mental health counseling and medication visits in the past six months, even after adjustment for demographic characteristics, psychiatric disorders, and support variables. Educational interventions for modifying negative beliefs about mental health care and bolstering unit support may help decrease stigma and barriers to care and increase mental health treatment seeking among OEF-OIF veterans.
    Psychiatric services (Washington, D.C.) 09/2009; 60(8):1118-22. · 2.81 Impact Factor
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    ABSTRACT: Background: A number of studies have examined the prevalence and correlates of posttraumatic stress disorder (PTSD), depression, and related psychiatric conditions in soldiers returning from Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), but none have examined whether factors such as psychological resilience and social support may protect against these conditions in this population. Methods: A total of 272 predominantly older reserve/National Guard OEF/OIF veterans completed a mail survey assessing traumatic stress and depressive symptoms, resilience, and social support. Results: Resilience scores in the full sample were comparable to those observed in civilian outpatient primary-care patients. Respondents with PTSD, however, scored significantly lower on this measure and on measures of unit support and postdeployment social support. A hierarchical regression analysis in the full sample suggested that resilience (specifically, increased personal control and positive acceptance of change) and postdeployment social support were negatively associated with traumatic stress and depressive symptoms, even after adjusting for demographic characteristics and combat exposure. Conclusions: These results suggest that interventions to bolster psychological resilience and postdeployment social support may help reduce the severity of traumatic stress and depressive symptoms in OEF/OIF veterans. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc.
    Depression and Anxiety 07/2009; 26(8):745 - 751. · 4.61 Impact Factor
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    ABSTRACT: This study examined health and psychosocial correlates of subsyndromal/partial posttraumatic stress disorder (PTSD) and full PTSD in veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). Five hundred and fifty-seven OEF/OIF veterans in Connecticut completed measures of PTSD and health and psychosocial functioning. A total 22.3% of the sample met screening criteria for partial PTSD and 21.5% for full PTSD. Veterans with partial PTSD reported an intermediate level of impairment (e.g., health ratings, work problems, relationship problems) relative to veterans without PTSD and veterans with full PTSD. These results suggest that subsyndromal/partial PTSD is associated with significant health and psychosocial difficulties and underscore the importance of assessing for partial PTSD in OEF/OIF veterans.
    Depression and Anxiety 07/2009; 26(8):739-44. · 4.61 Impact Factor
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    ABSTRACT: Little research has examined the role of protective factors such as psychological resilience, unit support, and postdeployment social support in buffering against PTSD and depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF). A total of 272 OEF/OIF veterans completed a survey containing PTSD and depression screening measures, and questionnaires assessing resilience, social support, and psychosocial functioning. Lower unit support and postdeployment social support were associated with increased PTSD and depressive symptoms, and decreased resilience and psychosocial functioning. Path analyses suggested that resilience fully mediated the association between unit support and PTSD and depressive symptoms, and that postdeployment social support partially mediated the association between PTSD and depressive symptoms and psychosocial functioning. Generalizability of results is limited by the relatively low response rate and predominantly older and reserve/National Guard sample. These results suggest that interventions designed to bolster unit support, resilience, and postdeployment support may help protect against traumatic stress and depressive symptoms, and improve psychosocial functioning in veterans.
    Journal of special operations medicine : a peer reviewed journal for SOF medical professionals 02/2009; 9(3):74-8.