Gary Wynn

Gary Wynn
Uniformed Services University of the Health Sciences | USUHS · Department of Psychiatry

MD

About

98
Publications
14,933
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1,270
Citations
Additional affiliations
July 2013 - present
Uniformed Services University of the Health Sciences
Position
  • Research Assistant

Publications

Publications (98)
Article
Introduction Emotion reactivity (ER) and distress intolerance (DI) may be associated with increased suicide attempt (SA) risk among U.S. Army soldiers. Method In this case–control study, 74 soldiers recently hospitalized for SA (cases) were compared with 133 control soldiers from the same Army installations selected based on either propensity scor...
Article
Objective: The authors sought to identify predictors of imminent suicide attempt (within 30 days) among U.S. Army soldiers following their first documented suicidal ideation. Methods: Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers, the authors identified 11,178 active-duty Regular Army enlisted sold...
Article
Full-text available
Background Sleep disturbances are common in individuals with post traumatic stress disorder (PTSD). However, little is known about how daily variation in sleep characteristics is related to PTSD. This study examined the night-to-night and weekday versus weekend variation in sleep duration, sleep quality, trouble falling asleep, and difficulty stayi...
Article
Introduction Little is known about the degree to which U.S. Army soldiers in the Reserve Components (Army National Guard and Army Reserve) and Active Component (Regular Army) differ with respect suicide attempt (SA) risk during high-stress times, such as deployment. Method Using administrative person-month records of enlisted soldiers on active du...
Article
Post-traumatic stress disorder (PTSD) is a common trauma and stressor-related disorder. Trauma-focused psychotherapies and selective serotonin reuptake inhibitors represent current state of the art treatment for PTSD, with current evidence favouring psychotherapy as first-line treatment. Much room remains for development of more effective therapeut...
Article
Objective: To examine sex differences in risk for administratively documented suicide attempt (SA) among US Army soldiers during the Iraq/Afghanistan wars. Method: Using administrative person-month records of Regular Army enlisted soldiers from 2004 to 2009, we identified 9650 person-months with a first documented SA and an equal-probability con...
Article
Full-text available
Background Risk for suicide attempt (SA) versus suicide ideation (SI) is clinically important and difficult to differentiate. We examined whether a history of self‐injurious thoughts and behaviors (SITBs) differentiates soldiers with a recent SA from nonattempting soldiers with current/recent SI. Methods Using a unique case‐control design, we admi...
Article
Full-text available
The endocannabinoid system is a key regulator of the response to psychological stress. Inhibitors of monoacylglycerol lipase (MGL), the enzyme that deactivates the endocannabinoid 2-arachidonoyl-sn-glycerol (2-AG), exert anxiolytic-like effects in rodent models via 2-AG-dependent activation of CB1 cannabinoid receptors. In the present study, we exa...
Article
Full-text available
Background: Post traumatic stress disorder (PTSD) and sleep problems are highly related. The relationship between nighttime sleep characteristics and next day post traumatic stress symptoms (PTSS) is not well known. This study examined the relationship between the previous night's sleep duration, number of awakenings, sleep quality, trouble fallin...
Article
Full-text available
Importance Understanding suicide ideation (SI) during combat deployment can inform prevention and treatment during and after deployment. Objective To examine associations of sociodemographic characteristics, lifetime and past-year stressors, and mental disorders with 30-day SI among a representative sample of US Army soldiers deployed in Afghanist...
Article
Full-text available
Cytokines, including chemokines, are small secreted proteins, which specifically effect on the interactions and communications between cells. Pro-inflammatory cytokines are produced predominantly by activated macrophages and are involved in the upregulation of inflammatory reactions. Dysregulation of cytokines is associated with post-traumatic stre...
Article
Full-text available
Post-traumatic stress disorder (PTSD) is a debilitating mental disorder with a prevalence of more than 7% in the US population and 12% in the military. An interaction of childhood trauma with FKBP5 (a glucocorticoid-regulated immunophilin) has been reported to be associated with PTSD in the general population. However, there are few reports on the...
Article
Background: Deployment-related experiences might be risk factors for soldier suicides, in which case identification of vulnerable soldiers before deployment could inform preventive efforts. We investigated this possibility by using pre-deployment survey and administrative data in a sample of US Army soldiers to develop a risk model for suicide att...
Article
Objective: During the wars in Afghanistan and Iraq, suicidal behaviors increased among U.S. Army soldiers. Although Reserve Component (RC) soldiers (National Guard and Army Reserve) comprise approximately one third of those deployed in support of the wars, few studies have examined suicidal behaviors among these "citizen-soldiers". The objective of...
Article
Objective: We examined early first deployment and subsequent suicide attempt among U.S. Army soldiers. Method: Using 2004-2009 administrative data and person-month records of first-term, Regular Army, enlisted soldiers with one deployment (89.2% male), we identified 1,704 soldiers with a documented suicide attempt during or after first deploymen...
Article
Full-text available
Background Prior investigations have found negative associations between military unit cohesion and posttraumatic stress disorder (PTSD); however, most relied on cross‐sectional data and few examined relationships of unit cohesion to other mental disorders. This study evaluates prospective associations of perceived unit cohesion with a range of men...
Article
Full-text available
Background Most people with suicide ideation (SI) do not attempt suicide (SA). Understanding the transition from current/recent SI to SA is important for mental health care. Our objective was to identify characteristics that differentiate SA from 30‐day SI among representative U.S. Army soldiers. Methods Using a unique case–control design, soldier...
Article
Background Whereas genetic susceptibility increases the risk for major depressive disorder (MDD), non-genetic protective factors may mitigate this risk. In a large-scale prospective study of US Army soldiers, we examined whether trait resilience and/or unit cohesion could protect against the onset of MDD following combat deployment, even in soldier...
Article
Hostility is a common form of emotionally charged anger which can lead to maladaptive and unhealthy behaviors. Significant association between shortened telomeres and greater levels of hostility has been observed in civilian populations, but has not yet been comprehensively studied in military populations. Our study investigates the relationship be...
Article
Full-text available
Objective: Suicide is one of the ten leading causes of death in United States and the suicide rate in the military population has increased since the start of the Iraq and Afghanistan wars. However, few biomarkers for current suicidal ideation (CSI) have been identified. The current study examined the association of four candidate genes with CSI i...
Article
Full-text available
Background Although the majority of active duty U.S. Army soldiers are full-time personnel in the Active Component (AC), a substantial minority of soldiers on active duty are in the Reserve Components (RCs). These “citizen-soldiers” (Army National Guard and Army Reserve) represent a force available for rapid activation in times of national need. RC...
Chapter
Acute stress disorder (ASD) as defined by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) is a mental condition that can develop shortly after exposure to a traumatic event. ASD shares many features with posttraumatic stress disorder (PTSD) (see Chapter 26, this volume), but most notably differs in timing with symp...
Article
Full-text available
Insomnia is a worldwide problem with substantial deleterious health effects. Twin studies have shown a heritable basis for various sleep-related traits, including insomnia, but robust genetic risk variants have just recently begun to be identified. We conducted genome-wide association studies (GWAS) of soldiers in the Army Study To Assess Risk and...
Article
Full-text available
Rationale The endocannabinoid neurotransmitter, anandamide, has been implicated in the central modulation of stress responses. Previous animal experiments have shown that inhibitors of the anandamide-degrading enzyme, fatty acid amide hydrolase (FAAH), enhance the ability to cope with acute and chronic stress. Objectives Here, we investigated the...
Chapter
War and its psychological effects have been a part of the human experience for thousands of years. While not every person, tribe, group, or country may experience the horrors of war, the written record of the human response co conflict and its attendant tragedies can be traced back to some of the earliest writings. What we would now call PTSD was n...
Article
Importance The US Army suicide attempt rate increased sharply during the wars in Afghanistan and Iraq. Although soldiers with a prior mental health diagnosis (MH-Dx) are known to be at risk, little is known about risk among those with no history of diagnosis. Objective To examine risk factors for suicide attempt among soldiers without a previous M...
Article
Objective: The U.S. Army suicide rate increased sharply during the wars in Iraq and Afghanistan. There is limited information about medically documented, nonfatal suicidal behaviors among soldiers in the Army's Reserve Component (RC), which is composed of the Army National Guard and Army Reserve. Here we examine trends and sociodemographic correla...
Article
Objective: To investigate race disparities in the US Military among Asian, White, Black, Native American and Other, seeking mental health care in the context of stigma defined by perceived damage to career. Design: Using 2008 survey data taken from US military personnel, mental disorders including depression, generalized anxiety disorder, suicidal...
Preprint
Full-text available
Background Whereas genetic susceptibility increases risk for major depressive disorder (MDD), non-genetic protective factors may mitigate this risk. In a large-scale prospective study of US Army soldiers, we examined whether trait resilience and/or unit cohesion could buffer against the onset of MDD following combat deployment, even in soldiers at...
Article
Importance There has been limited systematic examination of whether risk of suicide attempt (SA) among US Army soldiers is associated with time-related deployment variables, such as time in service before first deployment, duration of first deployment, and dwell time (DT) (ie, length of time between deployments). Objective To examine the associati...
Article
No clinically validated biomarkers have yet been found to assist in the diagnosis and treatment of posttraumatic stress disorder (PTSD). Innovation in clinical trial design, however, has led to the study of biomarkers as part of testing new medications and psychotherapies. There may soon be viable biomarkers to assist in diagnosis of PTSD and predi...
Chapter
Those who serve in the military represent a distinct cultural group whose perceptions of illness and treatment are often influenced by factors specific to military service. This chapter explores the unique influences military service can have on care. These cultural and subcultural influences come from groups including active duty members from a va...
Chapter
Full-text available
Those who serve in the military represent a distinct cultural group whose perceptions of illness and treatment are often influenced by factors specific to military service. This chapter explores the unique influences military service can have on care. These cultural and subcultural influences come from groups including active duty members from a va...
Article
Suicide attempt (SA) rates in the U.S. Army increased substantially during the wars in Afghanistan and Iraq. This study examined associations of family violence (FV) history with SA risk among soldiers. Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified person-month records of...
Chapter
This chapter provides an overview of the most up-to-date understanding of the neuroscience of posttraumatic stress disorder (PTSD). A variety of topics are covered throughout this chapter in a systematic fashion with the goal that each section can be read and understood as a stand-alone piece of a greater whole. The first section presents an overvi...
Article
Importance Mental health of soldiers is adversely affected by the death and injury of other unit members, but whether risk of suicide attempt is influenced by previous suicide attempts in a soldier’s unit is unknown. Objective To examine whether a soldier’s risk of suicide attempt is influenced by previous suicide attempts in that soldier’s unit....
Article
Natural and human-generated disaster represent increasing threats to global public health. Disasters are inherently chaotic events that frequently involve death and injury to large numbers of individuals. Medical students are exposed to disaster as victims and responders. Adequate preparation can enhance performances and reduce distress. Mass casua...
Article
Full-text available
BACKGROUND: The U.S. Army suicide attempt rate increased sharply during the wars in Iraq and Afghanistan. Risk may vary according to occupation, which significantly influences the stressors that soldiers experience. METHODS: Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS), we identified p...
Article
Homecoming after war is a task of the military, the servicemember, the servicemember’s family and community, and the nation. From time immemorial it has been a challenge,¹ requiring a difficult integration of remembering and forgetting. Relationships forged during deployment require ongoing attention while servicemembers struggle to reestablish con...
Article
BACKGROUND: Improvised explosive devices (IEDs) were a prominent and initially new threat in the Iraq and Afghanistan war which raised concerns and anticipatory fear in and out of theater. This study examined the association of monthly IED rates with risk of soldier suicide attempt among those deployed and nondeployed. METHODS: Person-month records...
Chapter
This chapter provides an overview of the most up-to-date understanding of the neuroscience of posttraumatic stress disorder (PTSD). A variety of topics are covered throughout this chapter in a systematic fashion with the goal that each section can be read and understood as a stand-alone piece of a greater whole. The first section presents an overvi...
Book
This volume focuses on the culture of the U.S. Army. Many of the major points also apply to other military services. The concepts are important for those who desire to understand U.S. Army culture for research - particularly those early in their careers. We hope that this book helps those interested in conducting research in the Army to better navi...
Article
We used administrative data to examine predictors of medically documented suicide ideation (SI) among Regular Army soldiers from 2006 through 2009 (N = 10,466 ideators, 124,959 control person-months). Enlisted ideators (97.8% of all cases) were more likely than controls to be female, younger, older when entering service, less educated, never or pre...
Article
Objective: High levels of alcohol use and alcohol-related problems are associated with suicidal behaviors (i.e., seriously considering and/or attempting suicide) in military and civilian populations. Examination of reasons for drinking alcohol may identify subgroups of soldiers who may either be at risk for suicidal behaviors or resilient to suici...
Article
Full-text available
The Amygdala, Stress, and Posttraumatic Stress Disorder (PTSD) Conference, often referred to simply as The Amygdala Conference, is a continuing education conference held each April at the Uniformed Services University (USU) and sponsored by The Center for the Study of Traumatic Stress in collaboration with the USU Department of Psychiatry, USU Neur...
Article
IMPORTANCE: Suicide attempts in the US Army have risen in the past decade. Understanding the association between suicide attempts and deployment, as well as method and timing of suicide attempts, can assist in developing interventions. OBJECTIVE: To examine suicide attempt risk factors, methods, and timing among soldiers currently deployed, previou...
Article
Background: Lowered eye blink rate may be a clinically useful indicator of acute, imminent, and severe suicide risk. Diminished eye blink rates are often seen among individuals engaged in heightened concentration on a specific task that requires careful planning and attention. Indeed, overcoming one's biological instinct for survival through suicid...
Article
The brain comprises an excitatory/inhibitory neuronal network that maintains a finely tuned balance of activity critical for normal functioning. Excitatory activity in the basolateral amygdala (BLA), a brain region that plays a central role in emotion and motivational processing, is tightly regulated by a relatively small population of γ-aminobutyr...
Research
Full-text available
Brief review, to be a part of a larger document provisionally titled Grand Challenges for Military Behavioral Health, resulting from a summit held at the Center for Innovation and Research on Veterans and Military Families (CIR) USC School of Social Work, University of Southern California in early 2015.
Article
Full-text available
Complementary and alternative medicine is a diverse set of practices and treatments that has seen a significant increase among Americans over the past decade. These approaches have been applied to a myriad of medical and mental health disorders with varying levels of efficacy. Recent years have seen an increased interest in the use of complementary...
Chapter
osttraumatic stress disorder (PTSD) is a devastating wound of war (Tanielian and Jaycox, 2008) and a debilitating consequence of trauma in civilian settings (Santiago et al., 2013). The disorder is characterized by four groups of symptoms, including persistent and intrusive recollections of the event, avoidance of situations that trigger memories o...
Article
The cumulative length of a war deployment over a given period of time is a measure of various important elements relevant to mental and behavioural health outcomes after war. Length of deployment is an index of the degree of exposure to stressful and traumatic events, and indicates the amount of non-deployed time available for recovery and to resto...
Article
The cumulative length of a war deployment over a given period of time is a measure of various important elements relevant to mental and behavioural health outcomes after war. Length of deployment is an index of the degree of exposure to stressful and traumatic events, and indicates the amount of non-deployed time available for recovery and to resto...
Article
Although chronic use of opiates can induce physical dependence and addiction, individual differences contributing to these symptoms are largely unknown. Using intravenous morphine self-administration (MSA), we investigated whether individual differences in drug intake are associated with weight change, acoustic startle reflex (ASR), pre-pulse inhib...
Article
Several studies have examined the relationship between concussion/mild traumatic brain injury (mTBI), posttraumatic stress disorder (PTSD), depression, and postdeployment symptoms. These studies indicate that the multiple factors involved in postdeployment symptoms are not accounted for in the screening processes of the Department of Defense/Vetera...
Article
Full-text available
Suicide is a leading cause of death among men and women in the United States Military. Using a retrospective chart review design, the current study investigated gender differences on documented traumas for people admitted to a military inpatient psychiatric unit for suicide-related thoughts or behaviors (N = 656). Men more often had no documented l...
Article
Full-text available
Poststroke depression (PSD) is a common sequela of stroke associated with increased morbidity and mortality among stroke survivors. PSD has been associated with poorer rehabilitative outcomes, longer inpatient stays, inefficient use of medical resources, worsened cognitive decline, and increased suicidality. This article reviews the definition and...
Article
Post-stroke depression has been noted to be one of the most frequent complications of stroke with an estimated prevalence of as high as 80%. However, the incidence of stroke in the young is extremely low and evidence based therapy for this complication is quite limited. The case of a 28-year-old woman who experienced a basilar artery vasospasmic st...
Article
Full-text available
Several new atypical antipsychotics have become available for use, but knowledge about their pharmacology may not be widespread. This review aims to increase awareness and knowledge about risperidone (R) and paliperidone (9-hydroxyrisperidone [9-OHR]), their pharmacokinetics, and pharmacodynamics. The authors present a review of the literature on R...
Article
Earlier reviews have covered pharmacokinetic drug interactions of natural and semi-synthetic opioid analgesics. This review will focus on the pharmacokinetic drug-drug interactions of methadone, propoxyphene, levomethadyl, meperidine, other phenylpiperidines (such as fentanyl), pentazocine, diphenoxylate, loperimide, and tramadol. The authors prese...
Chapter
An understanding of drug interactions has become essential to the practice of medicine. The increasing pharmacopoeia, coupled with prolonged human life spans, makes polypharmacy commonplace. The better-studied metabolism phase, phase I, includes the P450 system (in this manual, we use the term P450 rather than cytochrome P450 or CYP450). The need...