{"id":"https://openalex.org/W4409986458","doi":"https://doi.org/10.1093/milmed/usaf156","title":"Confronting the Mental Health Challenges of Large-Scale Combat Operations","display_name":"Confronting the Mental Health Challenges of Large-Scale Combat Operations","publication_year":2025,"publication_date":"2025-04-11","ids":{"openalex":"https://openalex.org/W4409986458","doi":"https://doi.org/10.1093/milmed/usaf156","pmid":"https://pubmed.ncbi.nlm.nih.gov/40305340"},"language":"en","primary_location":{"id":"doi:10.1093/milmed/usaf156","doi":"https://doi.org/10.1093/milmed/usaf156","is_oa":false,"landing_page_url":"https://doi.org/10.1093/milmed/usaf156","pdf_url":null,"source":{"id":"https://openalex.org/S207859457","display_name":"Military Medicine","issn_l":"0026-4075","issn":["0026-4075","0096-6827","1930-613X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"public-domain","license_id":"https://openalex.org/licenses/public-domain","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Military Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5073696832","display_name":"Rebekah Cole","orcid":"https://orcid.org/0000-0003-2628-8658","observed_orcids":["https://orcid.org/0000-0003-2628-8658"]},"institutions":[{"id":"https://openalex.org/I148314036","display_name":"Uniformed Services University of the Health Sciences","ror":"https://ror.org/04r3kq386","country_code":"US","type":"education","lineage":["https://openalex.org/I148314036"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Rebekah Cole","raw_affiliation_strings":["Department of Health Professions Education, Uniformed Services University , Bethesda, MD 20814,","Department of Military and Emergency Medicine, Uniformed Services University , 4301, Bethesda, MD 20814,"],"raw_orcid":"https://orcid.org/0000-0003-2628-8658","affiliations":[{"raw_affiliation_string":"Department of Health Professions Education, Uniformed Services University , Bethesda, MD 20814,","institution_ids":["https://openalex.org/I148314036"]},{"raw_affiliation_string":"Department of Military and Emergency Medicine, Uniformed Services University , 4301, Bethesda, MD 20814,","institution_ids":["https://openalex.org/I148314036"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5057143820","display_name":"Mason H Remondelli","orcid":"https://orcid.org/0009-0004-9559-7272","observed_orcids":["https://orcid.org/0009-0004-9559-7272","https://orcid.org/0000-0002-3362-7622"]},"institutions":[{"id":"https://openalex.org/I148314036","display_name":"Uniformed Services University of the Health Sciences","ror":"https://ror.org/04r3kq386","country_code":"US","type":"education","lineage":["https://openalex.org/I148314036"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mason H Remondelli","raw_affiliation_strings":["School of Medicine, Uniformed Services University , Bethesda, MD 20814,"],"raw_orcid":"https://orcid.org/0000-0002-3362-7622","affiliations":[{"raw_affiliation_string":"School of Medicine, Uniformed Services University , Bethesda, MD 20814,","institution_ids":["https://openalex.org/I148314036"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5073696832"],"corresponding_institution_ids":["https://openalex.org/I148314036"],"apc_list":{"value":4748,"currency":"USD","value_usd":4748},"apc_paid":null,"fwci":10.1651,"has_fulltext":false,"cited_by_count":9,"citation_normalized_percentile":{"value":0.98521661,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":94,"max":99},"biblio":{"volume":"191","issue":"3-4","first_page":"40","last_page":"43"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10242","display_name":"Posttraumatic Stress Disorder Research","score":0.9829000234603882,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10242","display_name":"Posttraumatic Stress Disorder Research","score":0.9829000234603882,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10762","display_name":"Migration, Health and Trauma","score":0.005900000222027302,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10168","display_name":"COVID-19 and Mental Health","score":0.0026000000070780516,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/large-scale-combat-operations","display_name":"large-scale combat operations","score":1.0},{"id":"https://openalex.org/keywords/military-mental-health","display_name":"military mental health","score":0.9269999861717224},{"id":"https://openalex.org/keywords/posttraumatic-stress-disorder","display_name":"post-traumatic stress disorder","score":0.9869999885559082},{"id":"https://openalex.org/keywords/depression","display_name":"depression","score":0.878000020980835},{"id":"https://openalex.org/keywords/moral-injury","display_name":"moral injury","score":1.0},{"id":"https://openalex.org/keywords/compassion-fatigue","display_name":"compassion fatigue","score":0.9990000128746033},{"id":"https://openalex.org/keywords/psychological-warfare","display_name":"psychological warfare","score":0.7990000247955322},{"id":"https://openalex.org/keywords/cyber-warfare","display_name":"cyber warfare","score":0.8309999704360962},{"id":"https://openalex.org/keywords/russia-ukraine-war","display_name":"Russian invasion of Ukraine","score":0.7099999785423279},{"id":"https://openalex.org/keywords/veterans","display_name":"veterans","score":0.6539999842643738},{"id":"https://openalex.org/keywords/civilian-mental-health","display_name":"civilian mental health","score":0.7799999713897705},{"id":"https://openalex.org/keywords/displacement","display_name":"displacement","score":0.48500001430511475},{"id":"https://openalex.org/keywords/psychological-distress","display_name":"psychological distress","score":0.49300000071525574}],"concepts":[{"id":"https://openalex.org/C134362201","wikidata":"https://www.wikidata.org/wiki/Q317309","display_name":"Mental health","level":2,"score":0.763171911239624},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.6714227795600891},{"id":"https://openalex.org/C2778119281","wikidata":"https://www.wikidata.org/wiki/Q18391161","display_name":"Moral injury","level":2,"score":0.500342845916748},{"id":"https://openalex.org/C2779072820","wikidata":"https://www.wikidata.org/wiki/Q47064","display_name":"Military personnel","level":2,"score":0.4974067509174347},{"id":"https://openalex.org/C526869908","wikidata":"https://www.wikidata.org/wiki/Q3298118","display_name":"Suicide prevention","level":3,"score":0.46420034766197205},{"id":"https://openalex.org/C2778755073","wikidata":"https://www.wikidata.org/wiki/Q10858537","display_name":"Scale (ratio)","level":2,"score":0.4604339003562927},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.45380452275276184},{"id":"https://openalex.org/C137176749","wikidata":"https://www.wikidata.org/wiki/Q4105337","display_name":"Psychological resilience","level":2,"score":0.4439469575881958},{"id":"https://openalex.org/C3017944768","wikidata":"https://www.wikidata.org/wiki/Q1450463","display_name":"Poison control","level":2,"score":0.42005911469459534},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.41822394728660583},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.3993538022041321},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.2833144962787628},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.19640350341796875},{"id":"https://openalex.org/C77805123","wikidata":"https://www.wikidata.org/wiki/Q161272","display_name":"Social psychology","level":1,"score":0.14488813281059265},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0},{"id":"https://openalex.org/C121332964","wikidata":"https://www.wikidata.org/wiki/Q413","display_name":"Physics","level":0,"score":0.0},{"id":"https://openalex.org/C62520636","wikidata":"https://www.wikidata.org/wiki/Q944","display_name":"Quantum mechanics","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008603","descriptor_name":"Mental Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D008603","descriptor_name":"Mental Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D008889","descriptor_name":"Military Personnel","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D008889","descriptor_name":"Military Personnel","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D013313","descriptor_name":"Stress Disorders, Post-Traumatic","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D013313","descriptor_name":"Stress Disorders, Post-Traumatic","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D013313","descriptor_name":"Stress Disorders, Post-Traumatic","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":false},{"descriptor_ui":"D013313","descriptor_name":"Stress Disorders, Post-Traumatic","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014728","descriptor_name":"Veterans","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":false},{"descriptor_ui":"D014728","descriptor_name":"Veterans","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":false},{"descriptor_ui":"D014857","descriptor_name":"Warfare","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D014857","descriptor_name":"Warfare","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1093/milmed/usaf156","doi":"https://doi.org/10.1093/milmed/usaf156","is_oa":false,"landing_page_url":"https://doi.org/10.1093/milmed/usaf156","pdf_url":null,"source":{"id":"https://openalex.org/S207859457","display_name":"Military Medicine","issn_l":"0026-4075","issn":["0026-4075","0096-6827","1930-613X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"public-domain","license_id":"https://openalex.org/licenses/public-domain","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Military Medicine","raw_type":"journal-article"},{"id":"pmid:40305340","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40305340","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Military medicine","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9537000060081482,"id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":26,"referenced_works":["https://openalex.org/W1984065858","https://openalex.org/W1988492248","https://openalex.org/W2036475917","https://openalex.org/W2100549246","https://openalex.org/W2116577406","https://openalex.org/W2193416543","https://openalex.org/W2754052532","https://openalex.org/W4281684156","https://openalex.org/W4294204706","https://openalex.org/W4297502272","https://openalex.org/W4308834640","https://openalex.org/W4319317566","https://openalex.org/W4378172788","https://openalex.org/W4380785265","https://openalex.org/W4388609414","https://openalex.org/W4390511238","https://openalex.org/W4396494585","https://openalex.org/W4396762891","https://openalex.org/W4400232695","https://openalex.org/W4400926700","https://openalex.org/W4401547463","https://openalex.org/W4403552345","https://openalex.org/W4405285927","https://openalex.org/W4406967748","https://openalex.org/W4407774178","https://openalex.org/W4409969189"],"related_works":["https://openalex.org/W2260842574","https://openalex.org/W4407398420","https://openalex.org/W2086616525","https://openalex.org/W2014696941","https://openalex.org/W2237087163","https://openalex.org/W2603103134","https://openalex.org/W1967302349","https://openalex.org/W2092438568","https://openalex.org/W4401994564","https://openalex.org/W2002076882"],"abstract_inverted_index":{"The":[0],"Department":[1],"of":[2,34,62,92,163],"Defense":[3],"predicts":[4],"that":[5],"future":[6],"conflicts":[7,23,76],"will":[8],"involve":[9,83],"large-scale":[10,164],"combat":[11],"operations":[12],"(LSCOs)":[13],"characterized":[14],"by":[15,184],"high-intensity":[16],"warfare":[17],"between":[18],"technologically":[19],"advanced":[20],"nations.":[21],"These":[22],"may":[24,82,122,151],"result":[25],"in":[26,56,72,77,148],"prolonged":[27,84],"exposure":[28,155],"to":[29,109,129,156,175,193],"violence,":[30],"increasing":[31],"the":[32,54,59,112,159],"risk":[33],"severe":[35],"mental":[36,106,114,133,167,186],"health":[37,107,115,134,168,187],"consequences":[38],"for":[39,139],"military":[40],"personnel,":[41],"veterans,":[42,201],"and":[43,49,69,79,89,94,131,136,141,154,171,202],"civilians.":[44,203],"Research":[45],"on":[46,198],"past":[47],"wars":[48],"ongoing":[50,166],"conflicts,":[51],"such":[52],"as":[53],"war":[55],"Ukraine,":[57],"demonstrates":[58],"heightened":[60],"risks":[61],"post-traumatic":[63],"stress":[64],"disorder,":[65],"depression,":[66],"moral":[67,143],"injury,":[68],"compassion":[70],"fatigue":[71],"LSCOs.":[73,119],"Unlike":[74],"previous":[75],"Iraq":[78],"Afghanistan,":[80],"LSCOs":[81],"deployments,":[85],"limited":[86],"medical":[87],"evacuations,":[88],"greater":[90],"use":[91],"cyber":[93],"psychological":[95,98,161,196],"warfare,":[96,165],"exacerbating":[97],"distress.":[99],"Given":[100,158],"these":[101,181],"anticipated":[102,113],"threats,":[103],"we":[104],"urge":[105],"professionals":[108,188],"proactively":[110],"address":[111],"challenges":[116,182],"associated":[117],"with":[118],"Preemptive":[120],"strategies":[121],"include":[123],"predeployment":[124],"resilience":[125],"training,":[126],"increased":[127],"access":[128],"deployable":[130],"telehealth":[132],"resources,":[135],"targeted":[137],"interventions":[138,192],"preventing":[140],"mitigating":[142],"injury.":[144],"Additionally,":[145],"civilian":[146],"populations":[147],"conflict":[149],"zones":[150],"experience":[152],"displacement":[153],"violence.":[157],"long-term":[160],"impact":[162],"program":[169],"development":[170],"evaluation":[172],"is":[173],"needed":[174],"support":[176],"affected":[177],"populations.":[178],"By":[179],"anticipating":[180],"posed":[183],"LSCOs,":[185],"can":[189],"implement":[190],"strategic":[191],"mitigate":[194],"their":[195],"burden":[197],"service":[199],"members,":[200]},"counts_by_year":[{"year":2026,"cited_by_count":7},{"year":2025,"cited_by_count":2}],"updated_date":"2026-10-16T09:59:22.235173","created_date":"2025-10-10T00:00:00"}
