Military Veterans' Psychological Distress Associated with Problematic Pornography Viewing
Abstract: Problematic pornography use represents a common feature reported by those with compulsive sexual behavior disorder. While prior research suggests US military veterans may experience disproportional rates of problematic pornography use, few comparative studies exist. Moreover, no measurement invariance analyses between veterans and non-veterans exist on measures designed to assess problematic pornography use. The purposes of the present report were to explore whether differences exist between veteran and non-veteran men on indices of problematic pornography use, determine whether veteran status is associated with an exacerbation of psychological distress in conjunction with problematic pornography use, and establish measurement invariance psychometric data between veteran and non-veteran men on the Brief Pornography Screen (Kraus et al., 2020). We analyzed data drawn from a nationally representative panel of men from the USA (N = 658 non-veterans, N = 186 veterans). When adjusting for age, veteran men experienced significantly more problematic pornography use compared to non-veteran men. A substantial moderation effect was also evident, with veterans experiencing significantly more psychological distress associated with their problematic pornography use (β = .65) compared to non-veterans (β = .29), while adjusting for age and pornography use frequency. The Brief Pornography Screen demonstrated residual invariance (i.e., measurement equivalence of factor structure, loadings, intercepts, and errors) between veteran and non-veteran men. Clinicians working with veterans should explore how pornography use is related to their mental health. The Brief Pornography Screen is an effective tool to assess problematic pornography viewing in veteran and non-veteran men.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.