Survey of Resources in Behavioral Sleep Medicine Across the Department of Defense, Defense Health Agency.

Introduction: Insomnia affects approximately 40% of active duty service members and adversely affects health, readiness, and safety. The VA/DoD Clinical Practice Guideline for the management of insomnia recommends cognitive-behavioral treatment of insomnia (CBTI) or its abbreviated version (brief behavioral treatment of insomnia [BBTI]) as the first-line insomnia treatment. The goal of this study was to assess CBTI/BBTI resources at MTFs, perceived facilitators and barriers for CBTI/BBTI, and gaps in these treatments across the Defense Health Agency.

Sex differences in US military personnel with insomnia, obstructive sleep apnea, or comorbid insomnia and obstructive sleep apnea.

Study Objectives: The aim of this study was to evaluate sex-related differences in symptoms of sleep disorders, sleep-related impairment, psychiatric symptoms, traumatic brain injury, and polysomnographic variables in treatment-seeking military personnel diagnosed with insomnia, obstructive sleep apnea (OSA), or comorbid insomnia and OSA (COMISA).

Methods: Participants were 372 military personnel (46.2% women, 53.

Tobacco quitline performance: Comparing the impacts of early cessation and proactive re-engagement on callers' smoking status at follow-up at 12 months.

Introduction: While tobacco Quitlines are effective in the promotion of smoking cessation, the majority of callers who wish to quit still fail to do so. The aim of this study was to determine if 12-month tobacco Quitline smoking cessation rates could be improved with re-engagement of callers whose first Quitline treatment failed to establish abstinence.

Methods: In an adaptive trial, 614 adult smokers, who were active duty, retired, and family of military personnel with TRICARE insurance who called a tobacco Quitline, received a previously evaluated and efficacious four-session tobacco cessation intervention with nicotine replacement therapy (NRT).

Cohesion and chronic pain: A case for assessing an overlooked process variable.

Chronic pain management services are often provided in group formats, as they are cost effective, increase access to care, and provide unique and needed social support to patients, but mixed outcomes for these groups indicate room for improvement. A small but growing body of research suggests routine assessment of and feedback on group cohesion may improve individual patient outcomes, though this has not been studied among chronic pain groups. Provided in this article is a rationale for assessing group cohesion in pain management programs, along with considerations for how and when to use routine outcome monitoring of cohesion in clinical practice.

Targeting Chronic Pain in Primary Care Settings by Using Behavioral Health Consultants: Methods of a Randomized Pragmatic Trial.

Background: Manualized cognitive and behavioral therapies are increasingly used in primary care environments to improve nonpharmacological pain management. The Brief Cognitive Behavioral Therapy for Chronic Pain (BCBT-CP) intervention, recently implemented by the Defense Health Agency for use across the military health system, is a modular, primary care-based treatment program delivered by behavioral health consultants integrated into primary care for patients experiencing chronic pain. Although early data suggest that this intervention improves functioning, it is unclear whether the benefits of BCBT-CP are sustained.

Relationship Attachment Styles in a Sample of Hypersexual Patients.

Some authors theorize that relationship attachment difficulties play an etiological role in the development of hypersexual behavior. The research in support of this theory is plagued by small sample sizes and analyses that are limited to averages within 4 forced-choice categories of attachment. The present study seeks to further the understanding of relationship attachment styles and hypersexual behavior by analyzing both categorical and dimensional measures of attachment among a large sample of men (N = 136) seeking treatment for excessive sexual behaviors.