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and psychological findings were not expected, as there has not Disclaimer
been any strong evidence connecting chronic physiological The opinions and assertions expressed herein are those of the
16
findings and anxiety. The only statistically significant finding author(s) and do not necessarily reflect the official policy or
was a diminishing MAP. Exercise equipment is often widely position of the Uniformed Services University of the Health
available and encouraged on military installations and may Sciences or the Department of Defense.
have contributed to this finding. A clear physiological finding
that correlated with psychiatric symptom frequency or severity Disclosures
was not identified. A larger study of a population may identify No financial support was provided for this research. This re-
other interesting deployment effects and be able to remove the search protocol was reviewed and approved by the Eglin Air
confounder of improved physical fitness during deployment. Force Base Institutional Review Board (IRB) in accordance
with all applicable Federal regulations governing human pro-
The COVID-19 pandemic began during this deployment and tections in research. This work was prepared by military or
its effects would be reflected in the results. COVID-19 had a civilian employees of the US Government. The authors nor
negligible direct effect within the area of the team during the their family members have a financial interest in any com-
time period. However, actions taken by the military to mitigate mercial product, service, or as part of the individual’s official
spread occurred during this period and may have had an ef- duties. Therefore, it is in the public domain and does not pos-
17
fect. The uncertainty of an unfolding pandemic, and the abil- sess copyright protection (public domain information may
ity of other units to rotate into theater on time to replace them, be freely distributed and copied; however, as a courtesy it is
may have contributed to the mental health symptom severity requested that the applicable institutions and the authors be
and frequency that may not be seen in other cohorts given an appropriate acknowledgment).

The study data are from a limited population. The twice- Conflict of Interest
weekly PHQ-9 survey proved to be an expedient and effective The authors have no conflicts of interest to report.
way of tracking symptoms but may not be an ideal method
of serially tracking these data. A prospective study of a large, References
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The individual stressors were not recorded. However, with a 7. Department of Defense. (2014). Stages of Deployment. Mili-
small population, they may have played a significant part in tary & Family Life Counselors. https://www.magellanmflc.org/
the results. media/26485/stages_of_deployment_-_military_v2.pdf. Accessed
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Conclusion cle of deployment: military family perspective. Military.com. 2021.
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Author Contributions 12. Bernert RA, Kim JS, Iwata NG, Perlis ML. Sleep disturbances as
AH conceived the study, collected data, and wrote the man- an evidence-based suicide risk factor. Curr Psychiatry Rep. 2015;
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and provided critical revision. All authors read and approved 13. Bachmann S. Epidemiology of suicide and the psychiatric per-
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