Newswise — Among military veterans identifying as transgender, 90 percent have at least one mental health diagnosis, such as posttraumatic stress disorder (PTSD) or depression, and nearly 50 percent had a hospitalization after a suicide attempt or suicidal thoughts. These study findings, from a single veterans’ hospital, will be presented Friday at The Endocrine Society’s 98th annual meeting in Boston. “As more of our active military returns from deployment and transitions to veteran status, the health care system will be faced with treating more transgender veterans who have mental health issues,” said principal investigator Marissa Grotzke, MD, an endocrinologist at Salt Lake City Veterans Affairs Medical Center (VAMC), Salt Lake City. Compared with the general U.S. population, the military and its veterans have a fourfold higher rate of gender dysphoria, according to Grotzke. Formerly called gender identity disorder, gender dysphoria is substantial distress associated with nonconformity to one’s assigned sex. Patients with gender dysphoria have unique health care concerns, Grotzke said. In general, they have high rates of depression, anxiety and suicidal thoughts. Past research also has shown high rates of mental health disorders in military veterans, including PTSD and depression. Less is known, however, about the mental health of veterans with gender dysphoria, she noted. By examining medical records at Salt Lake City VAMC between January 1, 2014, and October 1, 2015, Grotzke and her colleagues found 39 patients who had a diagnosis of gender dysphoria. Eight transgender patients identified as transitioning from female to male, and the other 39 as male-to-female. They included both combat and noncombat veterans and ranged in age from 21 to 68 years. The researchers then searched the medical records for mental health conditions that coexisted with the gender dysphoria. They found that PTSD was the most commonly identified mental health diagnosis, affecting 46 percent of these veterans, followed by depression in 41 percent. Tobacco use disorder reportedly occurred in one-third, and anxiety was present in 15 percent. Nine patients (23 percent) had other substance abuse, bipolar disorder or schizotypal personality disorder. Eighteen patients (46 percent) carried two or more mental health diagnoses, according to the researchers. Only four patients (10 percent) with gender dysphoria had no additional mental health problem. “These findings highlight the need to improve the quality of care for our transgender veterans,” Grotzke said. To address these concerns, the Salt Lake City VAMC formed a multidisciplinary gender dysphoria team composed of an endocrinologist, mental health professional, pharmacist, speech therapist and vocational rehabilitation providers. Team members meet together twice a month to discuss patients and treatment plans, which Grotzke said already has been “very beneficial” for patients. Probably multiple reasons exist for the increased rates of mental health disorders they observed in transgender veterans. Grotzke said that traumatic brain injuries sustained in combat, military sexual abuse, and stigma related to gender struggles are common in this population. Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.  
Newswise —  A study in military veterans finds that explosive blast-related concussions frequently result in hormone changes leading to problems such as sleep disturbances, fatigue, depression and poor quality of life. The research, to be presented Saturday at the Endocrine Society’s 98th annual meeting in Boston, evaluated hormone levels in 41 male veterans who had been deployed to Iraq or Afghanistan. “Some of these hormone deficiencies, which mimic some symptoms of post-traumatic stress disorder, may be treated successfully with hormone replacement if correctly diagnosed,” said the study’s leader, Charles Wilkinson, PhD, a researcher with the Veterans Affairs (VA) Puget Sound Health Care System, Seattle. Wilkinson wants to raise awareness of this hormonal problem in light of the high frequency of head injuries from improvised explosive devices in modern warfare. Concussion, also called mild traumatic brain injury (TBI), represents 80 percent of TBI diagnoses among U.S. military service members, according to government estimates in 2010. “Although studies in civilians indicate a 25 to 50 percent prevalence of hormonal deficiencies resulting from brain injuries, surprisingly there are limited data on their prevalence and symptoms in military veterans,” Wilkinson said. In this Department of Veterans Affairs-funded study, the researchers took blood samples from 27 veterans with one or more blast concussions sustained at least one year earlier and from 14 previously deployed veterans with no history of blast exposure. They measured 11 hormones in the blood related to the pituitary systems. The pituitary gland, located at the base of the brain, is called the master gland because it affects almost all parts of the body. They found that 12, or 44 percent, of blast-concussed veterans had irregular hormone levels indicating an underactive pituitary gland—also known as hypopituitarism. In contrast, only one (7 percent) of the 14 study participants without blast injuries had abnormal hormone levels, he said. To try to relate specific hormone problems with particular symptoms, the researchers administered questionnaires and tests about sleep, fatigue, depression, social isolation, memory, PTSD and quality of life. Wilkinson said he was surprised that on every test, participants who had mild TBI and hypopituitarism had more problems than did participants with mild TBI but no hypopituitarism and those with no blast exposure. Veterans with mild TBI with hormonal abnormalities had significantly poorer overall sleep quality, more depressive symptoms and were more easily fatigued than were veterans with mild TBI and normal hormone levels, he noted. “The value of screening for hormonal abnormalities after concussions, particularly in the presence of chronic symptoms, is currently a matter of debate,” Wilkinson said. “Yet, if the possibility of hormone deficiencies in our veterans is not considered, appropriate treatment may not occur.” Co-author Elizabeth Colasurdo from VA Puget Sound Health Care will present the study results.
Credit Newswise- The Institute for Veterans and Military Families (IVMF)  announced it received a $450,000 grant from Sam’s Club to support women veteran entrepreneurs through its business management training program V-WISE, Veteran Women Igniting the Spirit of Entrepreneurship. The Sam’s Club grant helps IVMF to launch the first V-WISE Alumni Chapters in key regions around the nation, in addition to hosting the inaugural V-WISE Graduate Conference. The conference will bring more than 300 V-WISE program graduates together to further cultivate their professional network and learn key business concepts required to take their ventures to the next level. The grant comes at a critical time for women veterans who face employment challenges in today’s economy. While the U.S. Bureau of Labor Statistics reports improvements to the job market, the unemployment rates of female post-9/11 veterans is worsening, increasing from 4.4 percent in March to 7.8 percent in April. Nonetheless, women veterans are interested in business opportunities. A study by Waldman Associates and REDA International found that nearly 27 percent of female veterans were interested in starting or purchasing a business. In recognition of the unique challenges female veteran and military spouse entrepreneurs face, the IVMF launched the V-WISE program in cooperation with the U.S. Small Business Administration. The V-WISE program is tailored to help this distinguished population navigate the complexities of business ownership. The success of the program hinges on the strong entrepreneurial skillset inherent in female veterans and military spouses – strong self-efficacy, a high need for achievement, comfort with autonomy and uncertainty, and effective decision-making in the face of dynamic environments. In June, the program will embark on its 10th iteration, growing its graduate population to nearly 1,500 female veterans. “In developing the graduate level training program, we know that business ownership is not something that happens at a moment in time, but evolves over time,” said IVMF Founder and Executive Director J. Michael Haynie, “V-WISE graduates are at a critical time in their entrepreneurial journey. Now is the time to help these female veterans build and activate a network of business owners and mentors that spans the nation.” The support from Sam’s Club allows IVMF to offer the V-WISE conference at no in-house expense to program graduates, with all lodging and food cost covered.  In addition, the launch of the V-WISE Alumni Chapters will help the IVMF further its local strategy and formalize organic meetings of graduates. This combined effort will support the long-term sustainability of the ventures launched by V-WISE graduates. “We are pleased to support all women- and veteran-owned small businesses and entrepreneurs, and to expand the distinguished V-WISE network that helps female veterans grow and prosper,” said Jason Kidd, senior vice president of Sam’s Club South Division. “Sam’s Club welcomes V-WISE alumnae to San Antonio this November and encourages new alumnae chapters to engage Sam’s Club for further small business training, savings and community support.”   About Sam's Club Sam's Club, the nation's eighth largest retailer and a leading U.S. membership club, offers savings and surprises to millions of members in 635 U.S. club locations and at The Sam's Club Giving Program, established by the Walmart Foundation in 2008, is dedicated to micro- and small business prosperity and committed to investing $32 million over the next five years to U.S. programs dedicated to improved training, education and increased access to capital for small business owners. For more information on national or local giving, visit   About the Institute for Veterans and Military Families at Syracuse University The IVMF is the first interdisciplinary national institute in higher education focused on the social, economic, education and policy issues impacting veterans and their families post-service. Through our focus on veteran-facing programming, research and policy, employment and employer support, and community engagement, the institute provides in-depth analysis of the challenges facing the veteran community captures best practices and serves as a forum to facilitate new partnerships and strong relationships between the individuals and organizations committed to making a difference for veterans and military families.    
Credit Newswise — Military Officers Association of America (MOAA) and the Institute for Veterans and Military Families at Syracuse University (IVMF) announce the results of a national study focused on military spouse employment.  A major finding was 90% of responding female spouses of active duty service members report being underemployed, meaning they possess more formal education/experience than needed at their current or most recent position. Additionally, the 2012 American Community Survey (ACS) data show military spouses make an average of 38% less total personal income and are 30% more likely to be unemployed than civilian counterparts. “The results of the Military Spouse Employment Survey demonstrate a need for concerted efforts to improve the employment issues currently faced by military spouses,” MOAA President Vice Adm. Norb Ryan said. “This critical research effort examined the range of economic impacts facing military spouses as a result of Permanent Change of Station (PCS) moves, licensure constraints, and lack of career enhancing opportunities which come as a result of their spouse’s service,” said IVMF Director of Research, Rosalinda Maury. “Through this project and our partnership with MOAA, we hope that this work will inform the national discussion, helping to create new programs, policies and initiatives that provide resources which will help this community to overcome challenges they face in the pursuit of economic empowerment. The results of this study demonstrate that these challenges are significant and pervasive.” While ACS data consistently show noticeable gaps in income and unemployment between armed forces spouses and their civilian counterparts, this survey discovered there is not a lack of desire to work that is causing these gaps; over 55% of respondents indicated they “need” to work, while 90% indicated they “want” to work. However, active duty military spouses are more likely to have moved within states, across states, and abroad, compared to their civilian and veteran counterparts. The increased likelihood of moving from one geographic location to another further compounds economic issues for these families. According to survey results, other factors affecting their unemployment or underemployment include relocating to geographic locations with limited employment opportunities, employer perceptions of military spouses, inability to match skills and education to jobs, inflexible work schedules and high childcare costs. Other study highlights: • In 2012, 18-24 year-old Armed Forces female spouses had the highest unemployment rates at 30 percent (which is almost three times higher than their civilian counterparts at 11 percent). 25-44 year-old Armed Forces female spouses had the second highest unemployment rates at 15 percent (almost three times higher than their civilian counterparts at 6 percent). • Over 50% of respondents indicated their chosen career field requires licensing or certification and 73% requires renewal/reissuing after a PCS move, costing an average of $223.03. • Respondents reported being underemployed with respect to education (33%), experience (10%), or both (47%). • Income significantly differs based on educational attainment and whether the military spouse is working in their preferred career field. These and other findings, including recommendations to address the issues of military spouse employment are detailed in a summary report entitled, “The Military Spouse Employment Report”. Infographic highlights of the report findings can be found here. “MOAA is very honored to be able to present statistically reliable and informative data about military spouse employment that will help provide the basis for future decision and policy making regarding the well-being of military families,” MOAA President Vice Adm. Norb Ryan said
Credit Newswise — The fact that many veterans ultimately leave their initial post-military job is well known, but the reasons behind this attrition and the ways employers can best increase retention have yet to be quantified. In order to gather the necessary data, VetAdvisor® and the Institute for Veterans and Military Families at Syracuse University (IVMF) today launched a nationwide Veterans Job Retention Survey. The Veterans Job Retention Survey focuses on determining the reasons why veterans leave their initial post-military jobs. Because this data has not been previously captured, the survey will provide insight into how organizations can best structure their veteran-centric employee programs. All interested veterans and service members are encouraged to participate in the survey. “Better understanding the causes for veteran attrition, and programs and policies that can improve retention, aligns with the mission of IVMF,” states James Schmeling, IVMF Managing Director and Co-Founder. “Our goal is to develop employment-focused programs in collaboration with industry, government, NGOs and the veteran community, to address the primary economic and public policy concerns of our nation’s servicemen and women such as employee retention and career development.” The IVMF is committed to forging enduring partnerships with stakeholders like VetAdvisor® that are committed to supporting transitioning service members, veterans and their families. “We’re thrilled to partner with the IVMF in conducting this nationwide survey of veterans and employers,” says VetAdvisor® CEO Dan Frank. “Developing programs in support of veteran employees is crucial both for organizations interested in retaining the talent they have invested in recruiting, but also for enhancing the career development paths of veterans entering the workforce.” The Veterans Retention Work Survey is part of a continuing effort by VetAdvisor® to develop programs to support veterans as they transition to civilian life. As part of its though leadership in the reintegration issues faced by veterans, VetAdvisor® partnered with the Johns Hopkins School of Medicine in 2012 to conduct the National Veteran Sleep Survey in order to better understand the underlying causes of and possible treatments for veteran sleep disorders. The Veterans Job Retention Work Survey will be conducted online at with a goal of recruiting 5,000 participants.
Credit Newswise —  The U.S. Senate has approved legislation that will improve the delivery of benefits to America's veterans, bringing them one step closer to gaining further access to the essential services provided by doctors of chiropractic (DCs) at major Department of Veterans Affairs (VA) medical centers. S. 1203, the 21st Century Veterans Benefits Delivery Act, passed under unanimous consent and has been referred to the U.S. House of Representatives, where it awaits action. Section 102 of the Act, titled "Expansion of Provision of Chiropractic Care and Services to Veterans," calls for the chiropractic benefit to be carried out at a minimum of two additional medical centers or clinics per Veterans Integrated Service Network (VISN) no later than two years after enactment of the bill, with the program being implemented at no less than 50 percent of all medical centers in each VISN within three years of enactment. There are nearly 160 VA treatment facilities nationwide. Currently, DCs serve at 66 treatment facilities across the country. Especially important to note in the bill is the further integration of chiropractic services available to veterans, which was broadened to include services provided by DCs under the Preventive Health Services and Medical categories in addition to the existing coverage area of Rehabilitative Services, placing DCs in service categories previously closed to them. "For the past several years, veterans have enjoyed only limited access to the essential services provided by doctors of chiropractic throughout the VISN," said American Chiropractic Association (ACA) President Anthony Hamm, DC. "ACA has worked closely with our congressional allies, such as Sens. jerry Moran and Richard Blumenthal, on behalf of our nation's heroes and in support of this important bill." "I am especially proud that the member institutions that comprise the Association of Chiropractic Colleges (ACC) will play a pivotal role in preparing the next generation of DCs to serve our military veterans throughout the United States and overseas," said David O'Bryon, JD, CAE, ACC president. "It is important for us to assist with veterans care."The provision comes after a VA report published in June 2015, stated that more than 61 percent of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans who sought health care from the VA over a 13-year period were treated for musculoskeletal ailments. Sen. Moran (R-Kansas), a senior member of the Senate VA Committee, and Sen. Blumenthal (D-Conn.), ranking member of the committee, championed this provision, after introducing S. 398, the "Chiropractic Care Available to all Veterans Act of 2015," from which the pro-chiropractic provisions of the recently passed legislation were derived. Sens. Moran and Blumenthal have been strong supporters of further integrating the essential services provided by DCs to veterans and worked closely with ACA in securing support for this provision in the Senate.ACA believes that the inclusion of services provided by DCs in the VA health care system will speed the recovery of many veterans, especially those returning from operations in Iraq and Afghanistan. The services provided by DCs have been proven to be a cost-effective and beneficial treatment option. In fact, a 2010 study published in Clinical Rehabilitation found that spinal manipulation provided better short- and long-term functional improvement and more pain relief in follow-up assessments than other physiotherapy interventions. Furthermore, a 2003 study published in the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications.Prior to congressional intervention over a dozen years ago, no DCs served on the staff of any VA treatment facility. The availability of chiropractic care for eligible veterans was limited to VA "referrals" to DCs serving in private practice outside the VA system. Such referrals were so rare that chiropractic care was essentially non-existent within the VA system.
Credit Newswise — Nearly 100 members of The University of Texas Health Science Center at Houston (UTHealth) community and visitors celebrated the opening of the UTHealth Veterans’ Bachelor of Science in Nursing (VBSN) program in Jan. They welcomed the first three VBSN students, who were admitted to the new program this semester. A three-year federal grant from the Health Resources and Services Administration and a grant from the Vivian L. Smith Foundation are helping launch the program, which will facilitate the transition of United States military veterans into professional nursing by providing an opportunity for up to 10 veterans per semester to receive academic credit for prior military training and experience. To help address the unique needs of veterans, each VBSN student will be matched with a mentor from the U.S. Veteran’s Initiative and will work with a case manager to help them adjust to the rigors and challenges of nursing school. On their dark blue scrubs, U.S. Navy retiree Jason Crume, U.S. Army veteran Laterria Anderson and retired U.S. Air Force master sergeant Robert Duran wore “Veteran” patches provided by the PARTNERS organization and its chair, Roberta Prazak, B.S.N., R.N. Special guest Georgeann McRaven, wife of The University of Texas System Chancellor Bill McRaven, spoke about the importance of “helping veterans continue to serve in civilian life.” She expressed admiration for UTHealth’s “dedication to the welfare and advancement of our vets,” as exemplified by the VBSN program and noted that “education is the absolute key to making a successful transition to civilian life.” As a military spouse for 37 years and mother of a serving Air Force officer, McRaven talked about her “appreciation, respect and reverence for nursing” and the “intangible attributes” that veterans offer employers. McRaven was introduced by UTHealth President Giuseppe N. Colasurdo, M.D., who called the VBSN program “another milestone in the university’s mission to support veterans.” After recognizing special guests, UTHealth School of Nursing Dean Lorraine Frazier, Ph.D., R.N., said “none of us would be here without the generosity of our donors who supported us and helped make this program a reality.” Frazier noted that, in 2013, UTHealth School of Nursing became a member of the national “Joining Forces” initiative to increase access to education for veterans and their families. As a result of that commitment, the VBSN program was developed. VBSN program director Bridgette R. Pullis, Ph.D., R.N., associate professor of clinical nursing in the Department of Nursing Systems at the School of Nursing, described the two-year effort to bring the program to reality. She promised “wrap-around service” to support the success of current and future VBSN students, which is planned to reach a total of 60 students in three years. Pullis said that in her own clinical work – much of it at the Michael E. DeBakey VA Medical Center – she sees the healing power of the “veteran-to-veteran connection in nursing care.” “When a nursing student is caring for a veteran and the veteran finds out that the student is also a veteran, the air in the room changes, a common bond enables trust and hope,” she said. Veterans interested in the VBSN program can find more information at
Credit Newswise — The Virtual Soldier Research Program at the University of Iowa has been awarded a $2.6 million grant from the Office of Naval Research to create a simulation program to predict and prevent musculoskeletal injuries in U.S. Marines—one of the leading medical problems impeding military readiness. Using the UI’s virtual human male and female models, Santos and Sophia, the researchers will develop software allowing the Marines to use an individual soldier’s characteristics—such as height, weight, strength, and aerobic capacity—to complete virtual simulations in different training environments. The program then will accurately predict injuries and recommend training modifications based on the individual soldier and activity. "Typically, you would have to test hundreds of Marines to get that kind of data,” says Kevin Kregel, UI professor of human physiology and co-principal investigator on the project. “Using our innovative approach, we can do the modeling and predictions by testing a lot fewer human subjects.” Santos and Sophia are part of the UI’s Virtual Soldier Research Program, established in 2003 by Karim Abdel-Malek, professor of biomedical and mechanical engineering and principal investigator on the project. Since the program’s inception, Santos and Sophia have attracted partnerships with U.S. military and private industry, generating $38 million in external research funding for the UI. “Being at the University of Iowa is wonderful because we have an amazing pool of talent and very high ethics of work,” Abdel-Malek says. “Our history of partnering with the U.S. military is evidence that they trust our work and continue to build upon the Santos capabilities.” The Virtual Soldier Research team for this project includes Abdel-Malek; Kregel; Jasbir Arora, professor of civil, environmental and mechanical engineering; Rajan Bhatt, associate director of the program; and Landon Evans, assistant strength and conditioning coach for UI Olympic Sports and adjunct lecturer in physiology. For the first time, this interdisciplinary group will give Santos and Sophia new capabilities in strength and conditioning, such as the ability to grow stronger over time or to experience less muscle weakness with sustained activity. “With these individualized simulations, the soldiers can become more resilient because we know that if they can mitigate themselves against the risk factors of training, the likelihood of reducing injuries increases,” Evans says. In addition, researchers predict soldiers who are injured fewer times during their service would be less likely to suffer from musculoskeletal disorders later in life, a leading cause of health problems in veterans. T­he UI findings could also have broader implications beyond the military. Kregel says the virtual human technology could help rehabilitate people of all ages—particularly older adults—with musculoskeletal injuries. And Evans says the UI athletics department is keeping a close eye on the project for its potential use among student athletes, who could benefit from the customized training recommendations and insight.
Credit Newswise — As social media has grown to become a ubiquitous part of contemporary American culture, scholars are studying its capacities for both good and ill. Lisa Ellen Silvestri, assistant professor of communication studies at Gonzaga University, explores how Facebook and YouTube have transformed soldiers’ experiences at the frontlines of war in her book, “Friended at the Front: Social Media in the American War Zone” (2015, University Press of Kansas). In a major shift in the wartime experience of American soldiers, their loved ones and the public, Facebook and other social media now offer troops the ability to instantly communicate to their networks of family and friends that they are alive, notes Silvestri, who earned a Ph.D. in communication studies from the University of Iowa. Informed by in-person interviews and online fieldwork with Marines, Silvestri’s book documents how new media have impacted the attitudes and behaviors of troops on the ground in Iraq and Afghanistan. The book also reviews the military’s developing guidelines for social media use – including some of its complications – and explores the current relationship between American soldiers and their social media pages from the frontlines of war. Silvestri grew up in Philadelphia, the daughter of a Vietnam War veteran who was drafted in 1966. “I grew up in that stereotypical Vietnam household where we just didn’t really talk about it,” said Silvestri, whose research centers on American politics and popular culture with a special focus on war and emergent communication technologies. “But it was something you could feel.” Her brother Jason enlisted in ROTC at Penn State University, graduated in 1999 as an officer, and received a scholarship to attend medical school. He was deployed to Iraq in 2005 and Afghanistan in 2013. Through some of the experiences of her father and brother, Silverstri developed a deep interest in war and how communication impacts military personnel. She interviewed 30 Marines from bases in Okinawa, Japan and Camp Pendleton in San Diego, California, and studied the Facebook pages of nine Marines. Through her interactions with American soldiers both at home and overseas, Silvestri learned that turning a human story into a book is both difficult and emotionally taxing. “The emotional toll of working with people is really hard,” Silvestri said. “People are so messy and unpredictable, and also they are so fragile and beautiful. To try and represent them in 12 point Times New Roman is really difficult to do.” At Gonzaga, Silvestri brings her expertise in social media and the digital age to her students – encouraging them to find their “unique voice” through the growing array of digital tools to present and analyze their ideas. “We’re all journalists to some degree with our cameras,” said Silvestri, who combines her experience with communication theories to teach students how to become proficient consumers and creators of quality digital information. “It comes directly out of my experience of writing this book, because I know that I had something unique, and that gave me a unique perspective and a unique voice. And it helped me write. So I’m trying to get my students to embrace that as well,” she said. During her students’ finals presentations last semester, Silvestri saw everything from the ways in which emoticons stifle emotional vocabulary to examples of how the Dark Knight and Batman reflect political policies on terrorism. She is pleased to see her students find their perspective through trial and error, much like she has done. She’s especially proud to see them looking for ways to use their skills and education to help others – in the centuries-old Jesuit tradition. “The students here are so invested, and they don’t just want to succeed, they really want to understand it so they can be men and women for others,” said Silvestri.
Credit Newswise — Research conducted by Dr. Taylor Plumb and Dr. Diane Zelman from the California School of Professional Psychology at Alliant International University shows high rates of disturbed sleep and indicators of possible sleep disorders experienced by current and former military personnel who served in Afghanistan or Iraq during Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF). These findings highlight the need to provide regular and detailed assessment of sleep among individuals who have been deployed in OIF/OEF, and the need to adapt and evaluate behavioral treatments for insomnia and nightmares to address sleep disturbances among OEF and OIF personnel and veterans.   The research was conducted as a part of Dr. Plumb's doctoral dissertation, under Dr. Zelman's supervision. They surveyed the types, severity and correlates of sleep disturbances experienced by 375 current or former military personnel (84.7% male) who served in Afghanistan or Iraq during Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF). The participants had returned from deployment over the last five years. A high percentage of military personnel reported disrupted sleep, even many months following deployment. 56.3% of participants reported their sleep as "bad" or "very bad" within the last month. Participants reported experiencing delayed sleep onset (40.5%) and middle of the night awakenings (58.6%) at least 3 times a week. Other reported sleep symptoms experienced at least once a week included feelings of general nervousness (46.1%), anxiety/panic (26.7%), and nightmares (trauma related: 30.2%, not trauma related: 26.9%). A large percentage of military personnel reported sleep onset, sleep efficiency, and total sleep time at levels similar to those of persons with sleep disorders (45.4%, 55.9% and 21.4% respectively). Although sleep problems were considerably more common and severe among individuals who scored over clinical cut-points for PTSD, depression and anxiety, sleep problems were also extremely common (30- 42%) among those who did not exceed cut-points for any of these disorders. Greater combat exposure, female gender, divorced or widowed status, lower education and lower rank was associated with significantly greater sleep problems.