Amen DG, Jellen L, Merves E, Lee RE. Minimizing the impact of deployment separation on military children: Stages, current preventive efforts, and system recommendations. Military Medicine Vol 153(9) Sep 1988, 441-446 1988.
Discusses factors that most influence the adjustment of the child to parent absence in military families. Interactional patterns between family members that affect children (preschoolers to adolescents) during the predeployment, deployment, and postdeployment stages are delineated. Preventive measures that have been found to be helpful for parents to use to minimize the negative effects of parent absence are given. How the military could further minimize the impact of deployment separation on children is examined. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Barker LH, Berry KD. Developmental issues impacting military families with young children during single and multiple deployments. Mil Med. 2009 Oct;174(10):1033-40.
Recent years have seen a dramatic increase in war time deployments for military service members. How have young children been affected by single and multiple Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) deployments? We found young children with a deployed parent showed increased behavior problems during deployment and increased attachment behaviors at reunion compared with children whose parents had not experienced a recent deployment. Child behavior problems were related to many individual child and family characteristics, such as child age and temperament, length of the deployment, total time deployed
parent was absent, number of moves, and number of stressors reported by parent. Child attachment behaviors were related to the length of the deployment, number of deployments, and the number of stressors faced by the parent. Soldiers and spouses of soldiers who chose not to re-enlist more often described themselves as depressed, and had children with many more behavior problems at reunion.
Blount BW, Curry A, Jr., Lubin GI. Family separations in the military. Military Medicine 1992;157(2):76-80.
Family separations are an intrinsic part of military life. The temporary loss of a family member through deployment brings unique stresses to a family in three different stages: predeployment, survival, and reunion. Most families adapt to these stresses well. In families without adequate coping skills, however, these stresses can lead to problems which the family presents to the health care system. Health care providers must be aware of these stresses, the high-risk families, their clinical manifestations, and techniques for preventing and treating them. This article provides some help for health care providers dealing with these issues.
Cabrera OA, Hoge CW, Bliese PD, Castro CA, Messer SC. Childhood adversity and combat as predictors of depression and post-traumatic stress in deployed troops. American Journal of Preventive Medicine 2007;33(2):77-82.
BACKGROUND: Previous studies have shown a relationship between childhood adversity and health outcomes in adulthood. The military represents a segment of the young working population that faces unique hazards that may be worsened by previous adverse life experiences. To date, no comprehensive studies of childhood adversity have been conducted with military samples that have included combat troops before and after a combat deployment. METHODS: Surveys were administered in 2003 to 4529 male soldiers who had not deployed to Iraq , and in 2004 to a separate group of 2392 male soldiers 3 months after returning from Iraq . The main predictor was adverse childhood experiences, an aggregated construct representing incremental exposure to six types of traumatic childhood experiences. This construct correlated with depression and post-traumatic stress disorder rates, as well as symptom scores. For the post-Iraq sample, analyses were conducted to assess whether individuals with childhood trauma were affected differently by exposure to combat. RESULTS: The likelihood of screening positive for depression and post-traumatic stress disorder was significantly higher for individuals reporting exposure to two or more categories of childhood adversity. Core analyses showed that adverse childhood experiences were a significant predictor of mental health symptoms, beyond the expected contribution of combat. CONCLUSIONS: This study confirms the high prevalence of adverse childhood experiences and the association of these experiences with key mental health outcomes. In addition, the results highlight the importance of considering pre-enlistment childhood traumatic experiences as well as the level of combat exposure in the treatment of military personnel returning from combat operations. (1)
Cafferty TP, Davis KE, Medway FJ, O'Hearn RE, Chappell KD. Reunion dynamics among couples separated during Operation Desert Storm: An attachment theory analysis: Bartholomew, Kim (Ed); Perlman, Daniel (Ed); 1994.
Present evidence from an ongoing study of marital partners who as members of National Guard or military reserve units were separated from their spouses and deployed overseas during Operation Desert Storm (1)
Costello M, Phelps L, Wilczenski F. Children and military conflict: Current issues and treatment implications. School Counselor Vol 41(3) Jan 1994, 220-225 1994.
Reviews literature that covers the impact of war on children and developmental factors, gender differences, familial issues, and media effects. The evidence indicates that children feel the effects of war even if it is in another country. They may suffer from deployment of loved ones, and they may suffer greater turmoil from the impact of war than other stressful life events. Recommendations are given for helping children deal with their fears through art or drawing therapy, role playing, and journal writing. Individual counseling is seen as more appropriate than group therapy in highly stressed individuals. Moral issues may also need to be addressed. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (1)
Cozza SJ, Guimond JM, McKibben JB, Chun RS, Arata-Maiers TL, Schneider B, Maiers A, Fullerton CS, Ursano RJ. Combat-injured service members and their families: the relationship of child distress and spouse-perceived family distress and disruption. . J Trauma Stress. 2010 Feb;23(1):112-5.
Combat injury in military service members affects both child and family functioning. This preliminary study examined the relationship of child distress postinjury to preinjury deployment-related family distress, injury severity, and family disruption postinjury. Child distress postinjury was assessed by reports from 41 spouses of combat-injured service members who had been hospitalized at\two military tertiary care treatment centers. Families with high preinjury deployment-related family distress and high family disruption postinjury were more likely to report high child distress postinjury. Spouse-reported injury severity was unrelated to child distress. Findings suggest that early identification and intervention with combat-injured families experiencing distress and disruption may be warranted to support family and child health, regardless of injury severity.
Cozza SJ, Chun RS, Polo JA. Military families and children during operation Iraqi Freedom. Psychiatric Quarterly Vol 76(4) Dec 2005, 371-378 2005.
The general public has become increasingly interested in the health and well being of the children and families of military service members as the war in Iraq continues. Observers recognize the potential stresses or traumas that this population might undergo as a result of the military deployment or the possible injury or death of military family members. While such concern is welcomed, it is sometimes misplaced. Not infrequently, conclusions that are drawn are fraught with misunderstanding and bias based upon lack of understanding of the military community or a preconceived notion of the vulnerabilities of the population. This problem is compounded by the paucity of scientific study. In this article the authors review the strengths of military families as well as the unique challenges that they face. The authors also highlight parental deployment, parental injury and parental death as unique stresses to military children and families. Available and pertinent scientific information is reviewed. Clinical observations of children and families during the ongoing war in Iraq are presented. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract). (1)
Chandra A, Lara-Cinisomo S, Jaycox LH, Tanielian T, Burns RM, Ruder T, Han B. Children on the homefront: the experience of children from military families. Pediatrics. 2010 Jan;125(1):16-25. Epub 2009 Dec 7.
OBJECTIVE: Although studies have begun to explore the impact of the current wars on child well-being, none have examined how children are doing across social, emotional, and academic domains. In this study, we describe the health and well-being of children from military families from the perspectives of the child and nondeployed parent. We also assessed the experience of deployment for children and how it varies according to deployment length and military service
component.
PARTICIPANTS AND METHODS. Data from a computer-assisted telephone interview with military children, aged 11 to 17 years, and nondeployed caregivers (n = 1507) were used to assess child well-being and difficulties with deployment. Multivariate regression analyses assessed the association between family characteristics, deployment histories, and child outcomes.
RESULTS: After controlling for family and service-member characteristics, children in this study had more emotional difficulties compared with national samples. Older youth and girls of all ages reported significantly more school-, family-, and peer-related difficulties with parental deployment (P < .01). Length of parental deployment and poorer nondeployed caregiver mental health were significantly associated with a greater number of challenges for children both
during deployment and deployed-parent reintegration (P < .01). Family characteristics (eg, living in rented housing) were also associated with difficulties with deployment.
CONCLUSIONS: Families that experienced more total months of parental deployment may benefit from targeted support to deal with stressors that emerge over time. Also, families in which caregivers experience poorer mental health may benefit from programs that support the caregiver and child.
Chartrand MM, Frank DA, White LF, Shope TR. Effect of parents' wartime deployment on the behavior of young children in military families. Arch Pediatr Adolesc Med. 2008 Nov;162(11):1009-14.
OBJECTIVE: To describe the effect of wartime military deployments on the behavior
of young children in military families.
DESIGN: Cross-sectional study.
SETTING: Childcare centers on a large Marine base.
PARTICIPANTS: Parents and childcare providers of children aged 1(1/2) to 5 years
enrolled in on-base childcare centers. Main Exposure Parental deployment.
OUTCOME MEASURES: Mean externalizing, internalizing, and total symptom scores on
the Child Behavior Checklist (CBCL) (1(1/2)-5 years) and the CBCL-Teacher Report
Form (TRF) (1(1/2)-5 years).
RESULTS: One hundred sixty-nine of 233 consenting families (73%) participated.
Nonresponders did not differ from responders in their child's age or TRF scores.
Fifty-five children (33%) had a deployed parent. Parents with children aged 3
years or older and a deployed spouse had significantly higher depression scores
than those without a deployed spouse. There were no differences in the
demographic characteristics between groups. After controlling for respondent's
age, stress and depressive symptoms, deployed service member's rank, and total
number of children in the home, we found an age by deployment interaction:
children aged 3 years or older with a deployed parent had significantly higher
CBCL externalizing and total scores (externalizing, 48.50 vs 43.31, P < .05;
total, 47.71 vs 42.68, P < .05) and externalizing and total TRF scores
(externalizing, 50.21 vs 45.62, P < .05; total, 48.54 vs 43.73, P < .05) compared
with same-aged peers without a deployed parent.
CONCLUSIONS: This study is the first to show that children aged 3 years or older
with a deployed parent exhibit increased behavioral symptoms compared with peers
without a deployed parent after controlling for caregiver's stress and depressive
symptoms.
Darwin JL, Reich KI. Reaching Out to the Families of Those Who Serve: The SOFAR Project. [Article]: Professional Psychology - Research & Practice October 2006;37(5):481-484; 2006. Families of those in the U.S. Army Reserves represent a population at risk for mental health problems. Strategic Outreach to Families of All Reservists (SOFAR) is a pro bono outreach program serving families with soldiers deployed in Afghanistan , Iraq , and Kuwait . Program components include prevention, intervention, and the production of educational materials. SOFAR negotiated with the reserves (a hierarchical system wary of mental health), recruited pro bono therapists, and oriented them to the needs of reservists' families. During the pilot phase, SOFAR participated in support services, direct services, and psychoeducation. The project is a pilot for a national program., (C) 2006 by the American Psychological Association (1)
Durand DB. Army Wife, Army Mother. Castro, Carl Andrew (Ed); Adler, Amy B (Ed); Britt, Thomas W (Ed). (2006).
Military life: The psychology of serving in peace and combat (Vol. 3): The military family; 2006.
The author was an Army wife for almost 25 years so she experienced separations, frequent moving, living overseas, and, because her husband had two Vietnam tours, she also experienced the fear of his injury or death. She feels as though she dealt quite well with all those demands the Army made; in fact, she had a really enjoyable time while her husband was in the military. Then two of their four daughters joined the Army and she found it more difficult to cope when these same demands were placed upon them. It was particularly difficult when they were deployed. These were her "babies," and she wanted them safely in the nest, not involved in wartime scenarios. Why the distinction? She feels that in part it is because these women soldiers are her children, but it is also due to the fact that the Army policies and culture have considerably changed over her lifetime and even though the demands are the same, they are presented differently and responded to differently. The author illustrates this by relating how it was with her husband and how it has been with her children during their deployment experiences. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (1)
Eide M, Gorman G, Hisle-Gorman E. Effects of parental military deployment on pediatric outpatient and well-child visit rates. Pediatrics. 2010 Jul;126(1):22-7. Epub 2010 Jun 7. OBJECTIVE: The objective of this study was to determine whether parental deployment affected the rates at which children of military parents accessed health care within the military health system. METHODS: We linked outpatient health care claims data for military service members' children <2 years of age from fiscal year 2007 to the parental deployment history during the same period. Incidence rate ratios (IRRs) for all visits and well-child visits were determined according to parental deployment status. RESULTS: A total of 169,986 children were identified, with 1,772,703 outpatient visits. Of those children, 32% had a parent deployed during the study period. Well-child visits constituted 27% of all outpatient visits. The unadjusted visit rates for all visits and well-child visits were 10.4 and 2.8 visits per year, respectively. Children of single parents had decreased rates of outpatient visits (IRR: 0.84 [95% confidence interval [CI]: 0.80-0.89]; P < .001) and well-child visits (IRR: 0.88 [95% CI: 0.84-0.93]; P < .001) during deployment. Children of married parents, however, had increased rates of both outpatient visits (IRR: 1.08 [95% CI: 1.03-1.09]; P < .001) and well-child visits (IRR: 1.08 [95% CI: 1.07-1.09]; P < .001) during deployment. There was interaction between parental marital status and deployment, which was most significant among parents <24 years of age and consistently decreased with increasing parental age. CONCLUSIONS: Children of young, single, military parents are seen less frequently for acute and well-child care when their parent is deployed, whereas children of married parents are seen more frequently in the military health system.
Fitzsimons VM, Krause-Parello CA. Military children: when parents are deployed overseas. J Sch Nurs. 2009 Feb;25(1):40-7.
Members of the Armed Services and Reserve Unit Members, both male and female, are being deployed to distant lands for long periods of time, disrupting family life and causing stressful times for the adults and children in the family. Traditionally, the mother of the military family was left to be the caregiver after the deployment of the husband/father. Today, extended family members as well as mothers or fathers are asked to serve as caregivers for dependent children of deployed servicemen and servicewomen. This article provides information about the challenges families face and the psychosocial developmental needs of children and families during the five stages of military deployment: predeployment, deployment, sustainment, redeployment, and postdeployment. School nurses can offer children and families support and link them with available resources and networks that will assist them with their needs.
Flake EM, Davis BE, Johnson PL, Middleton LS. The psychosocial effects of deployment on military children. J Dev Behav Pediatr. 2009 Aug;30(4):271-8.
OBJECTIVE: The impact of the Global War on Terror on two million U.S. military children remains unknown. The purpose of this study was to describe the psychosocial profile of school age children during parental deployment utilizing standardized psychosocial health and stress measures, and to identify predictors of children at "high risk" for psychosocial morbidity during wartime deployment.
METHODS: Army spouses with a deployed service member and a child aged 5-12 years completed a deployment packet consisting of demographic and psychosocial questions. The psychosocial health measures included the Pediatric Symptom Checklist (PSC), the Parenting Stress Index-Short Form and the Perceived Stress Scale-4.
RESULTS: Overall, 32% of respondents exceeded the PSC cut off score for their child, indicating "high risk" for psychosocial morbidity and 42% reported "high risk" stress on the Parenting Stress Index-Short Form. Parenting stress significantly predicted an increase in child psychosocial morbidity (odds ratio 7.41, confidence interval 2.9-19.0, p < 0.01). Parents utilizing military support reported less child psychosocial morbidity (odds ratio 0.32, confidence interval
0.13-0.77, p < 0.01) and parental college education was related to a decrease in child psychosocial morbidity (odds ratio 0.33, confidence interval 0.13-0.81, p < 0.02). The effects of military rank, child gender, child age, and race or ethnic background did not reach statistical significance.
CONCLUSION: Families in this study experiencing deployment identified one-third of military children at "high risk" for psychosocial morbidity. The most significant predictor of child psychosocial functioning during wartime deployment was parenting stress. Military, family and community supports help mitigate family stress during periods of deployment.
Flake E. Identifying Children at Risk Prior to Parental Military Deployment: Abstract 35 Increasing levels of stress in the daily lives of adolescents is an important health concern. Adolescents experience a variety of stressful situations and use a wide range of coping strategies to help effectively manage stress. Recent research on adolescent coping with stressful situations is reviewed. Findings support an association between coping and adolescent health problems, chronic physical illness, and mental health. More research is needed to investigate the long-term benefits of coping with stress on adolescent health and well-being. Specific recommendations for helping adolescents cope with stressful situations are discussed. Health care providers are encouraged to assess how adolescents cope with acute and chronic stressors and provide adolescents with information about coping with stressful situations.
Gahm GA, Lucenko BA, Retzlaff P, Fukuda S. Relative impact of adverse events and screened symptoms of posttraumatic stress disorder and depression among active duty soldiers seeking mental health care. Journal of Clinical Psychology 2007;63(3):199-211.
Symptoms of depression and posttraumatic stress are among the most studied psychological difficulties among soldiers. Such symptoms have been linked to a history of adverse events among both civilians and combat veterans. There is a paucity of research on this topic that can be applied to an active duty clinical population. Intake screening data were reviewed for 1,626 soldiers presenting to an outpatient mental health clinic to identify variables, including history of potentially traumatic experiences, associated with screened symptoms of posttraumatic stress disorder (PTSD) and depression. Demographics such as age, gender, and military rank, as well as number of adverse childhood experiences were significant predictors of screened PTSD and depression. A history of deployment to a combat zone predicted screened PTSD, but not depression. The role of childhood abuse as a risk factor is discussed and highlighted in the etiology of symptoms for soldiers seeking mental health care. (c) 2007 Wiley Periodicals, Inc. (1)
Gibbs DA, Martin SL, Kupper LL, Johnson RE. Child maltreatment in enlisted soldiers' families during combat-related deployments. JAMA: Journal of the American Medical Association Vol 298(5) Aug 2007, 528-535 2007.
Context: Parental stress is believed to play a critical role in child maltreatment, and deployment is often stressful for military families. Objective: To examine the association between combat-related deployment and rates of child maltreatment in families of enlisted soldiers in the US Army who had 1 or more substantiated reports of child maltreatment. Design and Setting: Descriptive case series of substantiated incidents of parental child maltreatment in 1,771 families of enlisted US Army soldiers who experienced at least 1 combat deployment between September 2001 and December 2004. Main Outcome Measures: Conditional Poisson regression models were used to estimate rate ratios (RRs) that compare rates of substantiated child maltreatment incidents during periods of deployment and nondeployment. Results: A total of 1,858 parents in 1,771 different families maltreated their children. In these families, the overall rate of child maltreatment was higher during the times when the soldier-parents were deployed compared with the times when they were not deployed (942 incidents and 713,626 days at risk during deployments vs 2,392 incidents and 2.6 million days at risk during nondeployment; RR, 1.42 [95% confidence interval {CI}, 1.31 - 1.54]). During deployment, the rates of moderate or severe maltreatment also were elevated (638 incidents and 447,647 days at risk during deployments vs 1421 incidents and 1.6 million days at risk during nondeployment; RR, 1.61 [95% CI, 1.45-1.77]). The rates of child neglect were nearly twice as great during deployment (761 incidents and 470,657 days at risk during deployments vs 1407 incidents and 1.6 million days at risk during nondeployment; RR, 1.95 [95% CI, 1.77-2.14]); however, the rate of physical abuse was less during deployments (97 incidents and 80,033 days at risk during deployments vs 451 incidents and 318,326 days at risk during nondeployment; RR, 0.76 [95% CI, 0.58-0.93]). Among female civilian spouses, the rate of maltreatment during deployment was more than 3 times greater (783 incidents and 382,480 days at risk during deployments vs 832 incidents and 1.2 million days at risk during nondeployment; RR, 3.33 [95% CI,-2.98-3.67]), the rate of child neglect was almost 4 times greater (666 incidents and 303,555 days at risk during deployments vs 605 incidents and 967,362 days at risk during nondeployment; RR, 3.88 [95% CI, 3.43-4.34]), and the rate of physical abuse was nearly twice as great (73 incidents and 18,316 days at risk during deployments vs 141 incidents and 61,105 days at risk during nondeployment; RR, 1.91 [95% CI, 1.33-2.49]). Conclusions: Among families of enlisted soldiers in the US Army with substantiated reports of child maltreatment, rates of maltreatment are greater when the soldiers are on com bat-related deployments. Enhanced support services may be needed for military families during periods of increased stress. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract). (1)
Gorman GH, Eide M, Hisle-Gorman E. Wartime military deployment and increased pediatric mental and behavioral health complaints. Pediatrics. 2010 Dec;126(6):1058-66. Epub 2010 Nov 8. BACKGROUND: Children of military personnel face stress when a parent deploys. OBJECTIVE: Our goal was to determine the effect of parental military deployment on the relative rate of outpatient visits for mental and behavioral health disorders in children aged 3 to 8 years. METHODS: This was a retrospective cohort study. Records of children of active-duty personnel during fiscal years 2006 and 2007 were linked with their parent's deployment records. Mental and behavioral health visits were identified by using International Classification of Diseases, Ninth Revision, codes. The incidence rate ratio (IRR) of visits per year according to parental deployment status was determined with random-effects negative binomial regression modeling with longitudinal data analysis. RESULTS: A total of 642,397 children aged 3 to 8 years and 442,722 military parents were included. Mean child age was 5.0 years (SD: 1.9 years); 50.6% were male, and 68.0% were white. Ninety percent of the parents were male, and 90.5% were married; 32.0% of the parents were deployed during the study. There were 1,049,081 person-years with 611,115 mental and behavioral health visits (0.6 visit per year). The IRR of mental and behavioral health visits for children with a deployed parent compared with when a parent was home was 1.11 (95% confidence interval [CI]: 1.07-1.14; P < .001). IRRs of pediatric anxiety, behavioral, and stress disorders when a parent deployed were 1.14 (95% CI: 0.98-1.32; P = .095), 1.19 (95% CI: 1.07-1.32; P < .001), and 1.18 (95% CI: 1.10-1.26; P < .001), respectively. Older children and children with military fathers and married parents had larger increases in rates of mental and behavioral health visits during parental deployments. In contrast, the overall outpatient rate and rates of visits for other diagnoses decreased when a parent was deployed. CONCLUSIONS: Mental and behavioral health visits increased by 11% in these children when a military parent deployed; behavioral disorders increased 19% and stress disorders increased 18%. Rates especially increased in older children and children of married and male military parents.
Haas DM, Pazdernik LA, Olsen CH. Cross-Sectional Survey of the Relationship Between Partner Deployment and Stress in Pregnancy During Wartime. Women's Health Issues Vol 15(2) Mar-Apr 2005, 48-54 2005.
Objective: The objective of this study was to determine if having a partner deployed during wartime increased the stress levels in pregnant women and altered their attitudes toward pregnancy. Methods: We administered a cross-sectional survey of all military and civilian women attending the antenatal clinic at Naval Hospital Camp Lejeune . We collected the anonymous surveys in May 2003. The survey measured demographics, self-reported stress level, and other attitudes toward the pregnancy and deployment; blood pressure was recorded. Data were compared by partner deployment status and reported stress levels using chi-square, t-tests, and logistic regression analysis. Results: Two hundred seventy-nine surveys were returned, representing 93.3% of those distributed. An almost equal number of patients had a partner deployed as nondeployed (49.1% versus 50.9%). Women with deployed partners were older, more had children at home, more often reported both significantly higher stress levels and a severe impact of the deployment on their stress, had a lower systolic blood pressure, more often reported changed eating habits, and reported that media coverage of the war worsened their stress than those whose partners were not deployed. Logistic regression analysis of stress found that partner deployment, having more than one child at home, and being active-duty were associated with reporting higher stress levels (odds ratio [OR] = 2.27, p = .013; OR = 3.11, p = .042; and OR = 4.03, p = .01, respectively). Conclusions: Pregnant women with deployed partners and those with more than one child already at home report higher stress levels than their peers with partners present. Increased stress in pregnant women with deployed partners may lead to adverse pregnancy outcomes. Further study is warranted to assess the impact of deployment on pregnancy and family life to better support homeland pregnant partners of deployed military members during wartime. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract). (1)
Hardaway T. Treatment of Psychological Trauma in Children of Military Families. Webb, Nancy Boyd (Ed). (2004). Mass trauma and violence: Helping families and children cope; 2004. Approximately 1.8 million children in the United States live in military families. Evaluating and treating these families requires knowledge of the unique culture and military command systems in which they are embedded and in which they function. Therapists must understand the military related issues in order to make recommendations that are realistic and relevant to such families. Similarly, therapists must understand the nature of the various stressors in the lives of military children in order to perform meaningful and helpful assessments, and to formulate effective treatment plans. The nature and severity of stressors can be divided into the following categories: 1. Routine stressors: frequent moves; changes in school and social milieus; and routine separations from military parents, who often must go into the field or to sea to train for up to months at a time. 2. Acute, severe stressors: wartime deployment of military parents; negative reactions from the surrounding civilian social structure regarding the work that a military child's parent is doing; and possible or actual injury to or death of the military parent. 3. Chronic, recurring, and severe stressors: living in remote, sometimes hostile foreign areas; accompanying threats or occurrences of terrorism. 4. Complicating factors: effects of mental health problems such as attention-deficit
Hardaway T. Treatment of Psychological Trauma in Children of Military Families. Webb, Nancy Boyd (Ed). (2004). Mass trauma and violence: Helping families and children cope; 2004. Hyperactivity disorder, oppositional defiant disorder, and depression, as well as developmental delays and physical abnormalities, upon already stressed military families. This chapter reviews the most common examples of each of these stressors in the lives of military families, the effects of these stressors upon their children, and the influence of these stressors on assessments and treatments by therapists who work with this population. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Hobson TA. The impact of deployment on the stay-behind spouse of active duty navy women: Hobson, Tony A.: Walden U. , US ; 2006.
Although researchers have documented the psychological and physiological ramifications military-induced separation has had on the family members of military men, little is known about the effects of such separations on men married to navy women, an increasing phenomenon as the numbers of women in active-duty military swells. This research describes the experiences of 5 men who are the caretakers of their children when their wife is deployed. Using phenomenological methodology, interview transcripts were analyzed by identifying recurrent themes relevant to the experience of being the sole caregiver. Themes were then used to develop individual and group descriptions of their experience. Interviews with these men suggested that military-induced separation from their Navy wives meant developing strengthened paternal bonds with their children and embracing their roles as primary caretakers. The men needed to adjust to the additional stress of single parenting and develop a more rigid structure and routine. They also expressed less role strain than expected. The men in this study redefined masculinity in a community that is composed of traditional male and female roles and illuminated the reconstruction or redefinition of what contemporary masculinity means. Traditionally, family support systems within military communities have catered to the needs of the female spouse and children. The results of this study can be used to heighten awareness of a growing need to recognize and implement supports for an underserved male population (stay-at-home spouses of deployed Navy wives). Understanding the experience of the stay-behind male will provide the directors of the military support systems and community counselors with the understanding they will need to assist these males and their families. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (2)
Horton D. Consultation With Military Children and Schools: A Proposed Model. Consulting Psychology Journal: Practice and Research Vol 57(4) Fal 2005, 259-265 2005.
Military children face situations that are unique. Their parents may be deployed at any time, causing separations and reorganization of the family. How to assist these children lead their lives despite constant change and threat to the family is an understudied area. This article presents a potential consultation model to assist military children to remain in school and to stay motivated. By supporting the mental and emotional health of the children, the academic work could be more consistent. A consultee-centered approach is reviewed. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract). (1)
Horton D. The impact of deployment on children in military families: Horton, Denise: Walden U. , US ; 2007.
Current military conflicts have increased the deployment of military personnel, most of whom are married. Little research has been conducted examining the effects of deployment on children. The purpose of the study was to determine whether there were any differences in the level of internal distress and personal adjustment in children from military families who has a parent deployed as compared to children whose parent is not currently deployed. Cognitive appraisal theory and the theory of fear acquisition guided the study. Participants (ages 9-10) included 31 children from Army families and 11 children from Air Force families. Standardized instruments used include the Behavior Assessment System for Children, Second Edition (BASC-2), the Life Events Checklist (LEC), and the Draw a Person: Screening Procedure for Emotional Disturbance (DAP: SPED). Data were analyzed using independent T tests and correlations. The results suggested that the two groups did not differ statistically on the three measures used. The children in both groups endorsed clinical and developmental indicators of distress on the critical items on the BASC-2. There was a significant correlation between parent and child scores on the Internalizing Problems scale from the BASC-2. On the LEC, the overall sample of children noted that deployment is a negative life event and that the current environment is highly stressful. Implications for social change include improved prevention programming that is coordinated between existing military family support services and schools. By better serving these children who are potentially at risk for emotional problems, the military, as well as the families who serve, would be strengthened. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Jensen PS, Bloedau L, Davis H. Children at risk: II. Risk factors and clinic utilization. Journal of the American Academy of Child & Adolescent Psychiatry 1990;29(5):804-12.
Using a strategy involving multiple raters and instruments, the authors compared 134 clinic subjects with controls matched on sex, age, and socioeconomic status to determine how various risk factors are related to clinic utilization apart from their effects on children's symptomatology. Parental psychopathology, family size, and marital status were most predictive of children's symptom levels, while stress levels, family size, and marital status were most predictive of clinic utilization. Although children's total symptom levels explained 27.6% of the variance in clinic utilization, other factors (family size, family history of divorce, stress, and parental psychopathology) explained an additional 13.2% of the variance. Findings indicate that clinicians and health care planners must carefully assess variables other than children's symptom levels in order to better understand children's mental health services utilization, develop more robust models of risk, and increase the effectiveness of our efforts directed towards prevention and intervention.
Jensen PS, Bloedau L, DeGroot J, Ussery T, Davis H. Children at risk: I. Risk factors and child symptomatology. Journal of the American Academy of Child & Adolescent Psychiatry 1990;29(1):51-9.
The authors compared 134 6- to 12-year-old children from a military psychiatric clinic with a control sample to determine the salience of various risk factors in predicting levels of child psychopathology. Parents provided demographic information and completed standardized questionnaires on themselves and their children, while children completed two self-report symptom inventories. Results indicated that all hypothesized risk factors mediated effects on child psychopathology, but the effects of various risk factors differed as a function of the rater and type of psychopathological construct being measured. Generally, parental psychopathology and life stress mediated the greatest effects on overall child symptoms levels. Furthermore, the clinical and community samples differed in the presence and extent of risk factors. Results indicate the need for caution in studies of child psychopathology using only clinical samples and may suggest the importance of therapies based on environmental manipulations for a substantial proportion of patients seeking child psychiatric assistance. (1)
Jensen PS, Grogan D, Xenakis SN, Bain MW. Father absence: effects on child and maternal psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry 1989;28(2):171-5.
The effects of fathers' absences during the previous year on 213 military children were examined, using multiple measures of children's functioning and psychiatric symptoms. Children whose fathers had been absent 1 or more months during the previous 12 months experienced significantly higher self-reported depression and anxiety, but these symptoms were not apparent to adult observers (parents and teachers). These effects were not demonstrated when maternal psychiatric symptoms and intercurrent family stressors were controlled. Thus, the effects of father absence under routine conditions in relatively healthy samples may exert no significant effects independent of intervening family stressors or maternal psychopathology. Clinic referrals of children during times of father absence may partly be due to an effect of additional stressors impacting on the mother during the absence of the father. (1)
Jensen PS, Martin D, Watanabe H. Children's response to parental separation during Operation Desert Storm. Journal of the American Academy of Child & Adolescent Psychiatry Vol 35(4) Apr 1996, 433-441 1996.
Studied the effects of Operation Desert Storm on military children and their parents by having 383 children of military personnel and their remaining caretaking parent complete self- and parent-report instruments concerning child and family functioning and life stressors. Children of deployed and nondeployed personnel were compared cross-sectionally, as well as longitudinally, using data collected prior to any knowledge of Operation Desert Storm. Children of deployed personnel experienced elevated self-reported symptom levels of depression, as did their parents. Likewise, families of deployed personnel reported significantly more intervening stressors, compared with children and families of nondeployed personnel. However, deployment per se rarely provoked pathological levels of symptoms in otherwise healthy children. Boys and younger children appeared to be especially vulnerable to deployment effects. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Jensen PS, Xenakis SN, Wolf P, Bain MW. The "military family syndrome" revisited: "by the numbers". Journal of Nervous & Mental Disease 1991;179(2):102-7.
Because concerns have been raised about high levels of psychopathology in military children, the authors used standardized psychopathology rating scales to survey 213 six-to twelve-year-old children of military parents and their parents. Results from children's symptom self-reports, as well as from teachers' ratings of children, indicated that children's symptom levels were at levels consistent with national norms. In contrast, parents' (especially mothers') ratings of children were significantly higher than national norms, as were parents' ratings of their own symptoms. Also, parents' own symptom reports showed somewhat stronger relationships with life stressors presumably affecting the child than did the children's and teachers' reports. Results suggest that parents' reports of children's symptoms may be mediated by the effects of military life stressors on the parents, but these stressors do not necessarily result in higher symptoms in the children. Overall results do not support the notion that levels of psychopathology are greatly increased in children of military parents. Further studies of military families should address the effects of rank and socioeconomic status, housing, and the current impact of life stressors on the parents as well as the children in order to avoid drawing erroneous conclusions about parts or all of the military community.
Kelley ML, Herzog-Simmer PA, Harris MA. Effects of military-induced separation on the parenting stress and family functioning of deploying mothers. Military Psychology Vol 6(2) 1994, 125-138 1994.
Examined the responses of 118 US Navy deploying mothers on the Parenting Stress Index, the Maternal Separation Anxiety Scale, the Parenting Dimensions Inventory, and on 2 subscales of the Family Environment Scale. Parenting and family functioning were affected by point in the mothers' deployment cycle and marital status. Women anticipating a deployment reported significantly higher levels of parenting stress and more sensitivity to children than those who had recently returned from deployment. Single mothers reported more separation anxiety, less family cohesiveness, and less family organization than did married mothers. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (1)
Kelley ML, Hock E, Bonney JF, Jarvis MS, Smith KM, Gaffney MA. Navy mothers experiencing and not experiencing deployment: Reasons for staying in or leaving the military. Military Psychology Vol 13(1) 2001, 55-71 2001.
71 Navy mothers (aged 20-47 yrs) of 6-mo- to 8-yr-olds were interviewed before and after a scheduled deployment. Overall intentions to reenlist did not differ between the 2 groups. Results show that women who experienced deployment are more likely than women in the nondeploying control group to report commitment to a Navy career as a reason for planning to stay in the Navy. Women in the control group, however, more often report dissatisfaction with the Navy as a reason for planning to leave the military. Women in both groups are less likely to report commitment to a Navy career as a rationale for reenlistment intentions in the time between the initial and final assessment. Commitment to a Navy career, satisfaction with benefits, and a perception that workday separations may benefit children predict intentions to reenlist at the initial assessment. Dissatisfaction with the Navy, concerns about balancing a Navy career with family responsibilities, and higher commitment to the motherhood role predict intentions to leave the military. Significant predictors of reenlistment intentions at the final assessment were Time 1 reenlistment intentions, commitment to a Navy career, satisfaction with benefits, work-family concerns, and dissatisfaction with the military. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Kelley ML, Hock E, Smith KM, Jarvis MS, Bonney JF, Gaffney MA. Internalizing and externalizing behavior of children with enlisted Navy mothers experiencing military-induced separation. Journal of the American Academy of Child & Adolescent Psychiatry Vol 40(4) Apr 2001, 464-471 2001.
Examined whether children with Navy mothers exhibit higher levels of internalizing and externalizing behavior than children in civilian families and whether deployment affects children's internalizing and externalizing behavior. Navy mothers (aged 20-47 yrs) who experienced deployment completed a measure assessing children's (aged 8 mo to 8 yrs) internalizing and externalizing behavior before and after a deployment (and at similar intervals for the Navy and civilian comparison groups). Data collection took place between 1996 and 1998. Navy children with deployed mothers exhibited higher levels of internalizing behavior than children with nondeployed Navy mothers. Navy children whose mothers experienced deployment were more likely to exhibit clinical levels of internalizing behavior than Navy children with nondeployed mothers or civilian children. Group differences, however, were modest and overall mean scores were in the normal range. Findings do not suggest greater pathology in children of Navy mothers; however, findings do indicate we should be particularly attentive of deployed mothers and their children. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Kelley ML. Single Military Parents in the New Millennium. Castro, Carl Andrew (Ed); Adler, Amy B (Ed); Britt, Thomas W (Ed). (2006).
Military life: The psychology of serving in peace and combat (Vol. 3): The military family; 2006.
Military service requires a commitment that extends beyond the work environment. A military career involves hectic and indeterminate schedules, temporary separations due to training, deployments with little or no notice, frequent and sometimes undesired relocations, and threats to the military member's safety. As Bowen (1989) notes, there are few civilian organizations that require a similar level of dedication to duty and such an extent of commitment from their employees. Although both single and married military parents cope with extraordinary work demands, for single military parents, the requirements of a military career may require more complex strategies to meet these demands. By tailoring research and programs to meet the needs of single military parents, the military organization can more effectively support the individual service members, their children, and, indirectly, the functioning of their units. Single military parents are, on average, a particularly committed group of individuals who must balance the demands of single parenthood with the demands of the military while accessing resources and solving day-to-day problems without much support from another parent--all skills that are likely to be valued in any military organizational setting. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (2)
Kelley ML. Military-induced separation in relation to maternal adjustment and children's behaviors. Military Psychology Vol 6(3) 1994, 163-176 1994.
61 mothers (mean age 32.5 yrs) with 5-13 yr old children completed measures of depressive behavior, dysphoria, self-esteem, and children's behavior before, during, and after a peacetime or wartime military-induced separation from their husbands. Mothers of younger children reported lower self-esteem than did mothers of older children. Maternal depressive behavior significantly decreased over time during a routine separation. Maternal adjustment and child behavior differed for wartime and peacetime deployments. Women whose husbands were deployed during the Persian Gulf War reported more dysphoria than did a matched sample of 14 women from the peacetime group. Internalizing and externalizing behavior decreased over time for children whose fathers experienced a routine deployment but stayed the same for children whose fathers were deployed during the Persian Gulf War. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (1)
Kelley ML. The effects of military-induced separation on family factors and child behavior Children's reactions to the Desert Storm deployment: Initial findings from a survey of Army families Uniforms and youth: The military child and his or her family. Minimizing the impact of deployment separation on military children: Stages, current preventive efforts, and system recommendations. 1994:Springer Publishing Co.
Data from 61 mothers of school-age children (5-13 yrs old) were examined before, during, and after military deployment of their husbands. Mothers completed 3 self-report instruments: the Family Adaptability and Cohesion Evaluation Scale (FACES III), the Parenting Dimensions Inventory, and the Child Behavior Checklist. Separations resulted in temporary disruptions in families' reported ability to maintain supportive relationships. Wives of servicemen sent to the Persian Gulf War reported less nurturance and family cohesiveness, and more internalizing and externalizing in children, than did those whose husbands' deployment was routine. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Kelley MLPD, Hock EPD, Smith KMBS, Jarvis MSMS, Bonney JFMS, Gaffney MAMS. Internalizing and Externalizing Behavior of Children With Enlisted Navy Mothers Experiencing Military-Induced Separation. [Article]: Journal of the American Academy of Child & Adolescent Psychiatry April 2001;40(4):464-471; 2001.
Objectives: To examine whether children with Navy mothers exhibit higher levels of internalizing and externalizing behavior than children in civilian families and whether deployment affects children's internalizing and externalizing behavior., Method: Navy mothers who experienced deployment completed a measure assessing children's internalizing and externalizing behavior before and after a deployment (and at similar intervals for the Navy and civilian comparison groups). Data collection took place between 1996 and 1998., Results: Navy children with deployed mothers exhibited higher levels of internalizing behavior than children with nondeployed Navy mothers. Navy children whose mothers experienced deployment were more likely to exhibit clinical levels of internalizing behavior than Navy children with nondeployed mothers or civilian children. Group differences, however, were modest and overall mean scores were in the normal range., Conclusions: Findings do not suggest greater pathology in children of Navy mothers; however, findings do indicate we should be particularly attentive of deployed mothers and their children., Copyright 2001 (C) American Academy of Child and Adolescent Psychiatry (1)
Kennedy CH. Understanding One of Our Nation's Greatest Assets: Military Personnel 1. [Book or Media Review]: PsycCRITIQUES September 20, 2006;51(38); 2006.
Reviews the book, Military Life: The Psychology of Serving in Peace and Combat (Vols. 1-4) edited by Thomas W. Britt, Amy B. Adler, and Carl Andrew Castro (see records 2006-01631-000, 2006-01725-000, 2006-01726-000, 2006-01728-000). This four-volume set provides a framework for the psychological aspects of serving in the military and serves to enhance our understanding of our fighting forces, to optimize their functioning both personally and occupationally, and to put forth needed future research directions to advance the effectiveness of our service personnel. The volumes are divided into four loosely defined areas: military performance, operational stress, the military family, and military culture. Volume 1: Military Performance includes a hodgepodge of topics such as combat stress; a literature review of disaster response with a brief focus on terrorist attacks; a futuristic chapter on the potential uses of augmented cognition; and chapters on morale, on group cohesion, and with a discussion of modern-day American psychological operations, which is quite an interesting read. But the most important chapters in this volume address the here-and-now performance issues of sleep loss and decision making under stress. Volume 2: Operational Stress looks at the service member's experience from initial indoctrination and training, then addresses deployment issues related to combat stress and prisoners of war, and concludes with chapters on selected organizational responses and topics. The chapters on the Code of Conduct and the psychology of captivity, combat stress, and posttraumatic stress disorder (PTSD) were all exceptionally well written. More recently, we have become better attuned to needs of military families, particularly in the context of a changing military force (e.g., increasing numbers of women, single parents, and dual military couples) and Volume 3: The Military Family addresses these salient issues. This entire volume is a must read for anyone providing mental health care or any form of counseling to family members or service members with family responsibilities, as well as for individuals engaged in policy development that affects military families. The volume is essentially a primer on concerns and problems that may arise, as well as the continuous family-related issues that may affect the service member's functioning on a day-to-day basis. Volume 4: Military Culture tackles some of the most difficult challenges that the military faces, such as cultural differences, quality of life, and the impact of recent technological advances, which have resulted in immediate access to news and communication, unheard of in past wars. This volume also addresses some of the more controversial issues faced by the military today, such as women's roles in the military and the issue of homosexuality and military service. Together, these volumes provide a highly useful resource and successfully tackle many of the psychological aspects of military service. These books will enhance the collection of any military library, and they are an excellent overview of many of the major topics in military psychology, particularly for those individuals new to the field. In addition to presenting information related to the current state of military psychology, the four volumes collectively provide for exciting and innovative research directions. (PsycINFO Database Record (c) 2006 APA, all rights reserved), (C) 2006 by the American Psychological Association (1)
La Bash HA, Vogt DS, King LA, King DW. Deployment stressors of the Iraq War: insights from the mainstream media. J Interpers Violence. 2009 Feb;24(2):231-58. Epub 2008 May 8.
A comprehensive understanding of the stressors of the Iraq War is needed to ensure appropriate postdeployment assessments and to inform empirical inquiries. Yet we are unaware of any published studies that address the range of stressors experienced by this cohort. Thus, in the present study, we report the results of an interpretive literature review of mainstream media reports published from the beginning of the Iraq War in March 2003 to March 2005. This literature revealed a combination of stressors associated with traditional combat, insurgency warfare, and peacekeeping operations. The increasing deployment of National
Guard/Reservist personnel, older soldiers, and women highlights additional stressors associated with sexual harassment and assault, preparedness and training, and life and family disruptions. This is a cause for concern as war-zone stressors have been implicated in postdeployment health outcomes, including intimate partner violence and child maltreatment, immediate physical
and mental health, and long-term adjustment.
Lester P, Peterson K, Reeves J, Knauss L, Glover D, Mogil C, Duan N, Saltzman W, Pynoos R, Wilt K, Beardslee W. The long war and parental combat deployment: effects on military children and at-home spouses. J Am Acad Child Adolesc Psychiatry. 2010 Apr;49(4):310-20.
OBJECTIVE: Given the growing number of military service members with families and the multiple combat deployments characterizing current war time duties, the impact of deployments on military children requires clarification. Behavioral and emotional adjustment problems were examined in children (aged 6 through 12) of an active duty Army or Marine Corps parent currently deployed (CD) or recently returned (RR) from Afghanistan or Iraq.
METHOD: Children (N = 272) and their at-home civilian (AHC) (N = 163) and/or recently returned active duty (AD) parent (N = 65) were interviewed. Child adjustment outcomes were examined in relation to parental psychological distress and months of combat deployment (of the AD) using mixed effects linear models.
RESULTS: Parental distress (AHC and AD) and cumulative length of parental combat-related deployments during the child's lifetime independently predicted increased child depression and externalizing symptoms. Although behavioral adjustment and depression levels were comparable to community norms, anxiety was significantly elevated in children in both deployment groups. In contrast, AHCparental distress was greater in those with a CD (vs. RR) spouse.
CONCLUSIONS: Findings indicate that parental combat deployment has a cumulative effect on children that remains even after the deployed parent returns home, and that is predicted by psychological distress of both the AD and AHC parent. Such data may be informative for screening, prevention, and intervention strategies.
Levai M, Kaplan S, Ackermann R, Hammock M. The effect of father absence on the psychiatric hospitalization of Navy children. Military Medicine Vol 160(3) Mar 1995, 104-106 1995.
Examined whether prolonged parental deployment is associated with a particular marker of psychiatric morbidity: the admission of a child to a psychiatric hospital. Demographic, medical history, family history, and history of child abuse and social stress data were gathered from 103 Navy and 103 civilian children (aged 4-12 yrs) and adolescents (aged 13-17 yrs). Deployment of the father placed Navy Ss at risk for psychiatric hospitalization, but mainly in non-intact families (59 of 103) where step-parents and single parents were present. Deployment may strain an already vulnerable family structure in selected Navy families. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (1)
Lincoln A, Swift E, Shorteno-Fraser M. Psychological adjustment and treatment of children and families with parents deployed in military combat.J Clin Psychol. 2008 Aug;64(8):984-92.
The effects of the military deployment of parent-soldiers on children and families need to be understood in the context of military culture as well as from developmental risk for maladjustment. Although research addressing such effects is limited in both scope and certainty, we can identify several key factors that relate to psychological risk, adjustment, and outcome. Most children are resilient to the effects of deployment of at least one of their parents, but
children with preexisting psychological conditions, such as anxiety and depression, may be particularly vulnerable, as well as children with specific risk factors, such as child abuse, family violence, or parental substance abuse. A series of case vignettes illustrate the psychological adjustment and treatment implications for children with parents deployed in support of military combat operations.
McFarlane AC. Military deployment: the impact on children and family adjustment and the needfor care. Curr Opin Psychiatry. 2009 Jul;22(4):369-73.
PURPOSE OF REVIEW: Over a million children and their families have now experienced the stress of the deployment of a family member during the recent wars in Iraq and Afghanistan. Whereas there is an extensive clinical literature about the developmental challenges facing children and issues of family adjustment, there is a lack of systematic research. This review summarizes the findings of recent publications.
RECENT FINDINGS: Some veterans develop posttraumatic stress disorder as a consequence of their experiences. This condition drives many of the adverse changes in the families of returning veterans through the effects on intimacy and nurturance in their families of withdrawal, numbing and irritability that are components of posttraumatic stress disorder. There is the more general challenge that all families and children face when a partner/parent deploys of role ambiguity consequent on anxiety that is provoked by the threat that deployed family members experience. A study of Kuwaiti military showed that mothers' anxiety had the greatest impact on the children of deployed fathers, although absence of posttraumatic stress disorder in mothers could mitigate the effects of their fathers' posttraumatic stress disorder. Intervention programs are described, but there is a poverty of their evaluation.
SUMMARY: A substantial advantage of focusing on family adjustment is that it can facilitate access to mental healthcare for veterans while assisting families' positive adaptation.
McNulty PAF. Does deployment impact the health care use of military families stationed in Okinawa , Japan ? Military Medicine 2003;168(6):465-70.
Military families are placed under a great deal of stress while serving in the armed forces. In Okinawa , Japan , marines deploy regularly at 3-month intervals throughout the year, leaving behind 7,924 dependents in a single-parent home environment. The purpose of this study was to investigate the health care needs of families in a deployed and nondeployed status in Okinawa , Japan . Families enrolled were studied over a 6-month period for levels of self-reliance, coherence, social support, well-being, adaptation, coping, anxiety, and health care visits. The tools that were used included the Family Index of Regenerativity and Adaptation-Military tools and the State Trait Anxiety Inventory. There were 299 families enrolled, of which 80% were marine spouses. A total of 28% of those surveyed were regarded as "high risk" based on the responses received on the surveys. Of these 85 families, 35% (n = 30) were nondeployed (ND), and 65% (n = 55) were from the deployed group (p = 0.03). After phone intervention, 40% of the deployed group and 17% of the ND were classified as stable; however, psychiatric consults were accepted by 29% of deployed group spouses compared with 23% of ND spouses who were identified as high-risk families. Typology change over time identified family dysfunction at 1% in the ND group alone. This study sheds new light on the stressors and subsequent health care needs of both deployed and nondeployed families in an isolated overseas duty location. (1)
McNulty PAF. Reported stressors and health care needs of active duty Navy personnel during three phases of deployment in support of the war in Iraq . Military Medicine 2005;170(6):530-5. Literature has generously documented the stress of military members and their families during deployments in noncombat periods. Deployment has been shown to increase the needs of family members for health care, both physical and psychological. The purpose of this study was to describe the health care needs and perceived stressors of active duty members deployed to Iraq during the predeployment, mid-deployment, and postdeployment phases. Active duty Navy service members deployed on three aircraft carriers during Operation Enduring Freedom and Operation Iraqi Freedom in 2002-2003 were randomly selected to participate in an anonymous study that evaluated member well-being, adaptation, coping, anxiety, stress, and health care needs during three phases of deployment. Data were obtained from 474 Navy members in predeployment, 445 in mid-deployment, and 276 in postdeployment. Logistic regression analyses indicated that many variables predicted extreme anxiety during deployment, including mid-deployment phase, age of under 25 years, being childless, nonattendance at church, being enlisted, zero- or one-deployment history; no high school education, and being currently in counseling. Active duty members in all phases of deployment had equally disturbing levels of anxiety. All phases reported suicidal ideation at alarming rates (2.4% in predeployment, 4.9% in mid-deployment, and 3% in postdeployment). This study sheds new light on the stressors and subsequent health care needs of active duty members on carriers during war and provides valuable information for the prevention of high-risk anxieties and subsequent health risks for all service members during similar deployments. (1)
Medway FJ, Davis KE, Cafferty TP, Chappell KD, et al. Family disruption and adult attachment correlates of spouse and child reactions to separation and reunion due to Operation Desert Storm. Journal of Social & Clinical Psychology Vol 14(2) Sum 1995, 97-118 1995.
Conducted 2 studies to examine the impact of separation disruptiveness on spouses' personal distress, their ratings of child behavior, and how perceived distress is influenced by social supports and attachment style among 117 19-54 yr old wives (Study 1, conducted just following the cessation of fighting) and 154 wives (Study 2, conducted 6 mo after reunion) of South Carolina Reserve and National Guard members deployed during Operation Desert Storm. Ss completed measures of relationship satisfaction, personal distress, life disruption, parent-child relations, child behavior, and military group support. In Study 1, separation was correlated with emotional distress for spouses and internalizing-type behavior problems in children. In Study 2, as in Study 1, distress was related to family disruption and attachment style, and maternal distress was highly related to children's behavior during deployment and at reunion.
Mitchum NT . The effects of group counseling on the self-esteem, anxiety, and behavior of children with deployed parents: Mitchum, Nancy Taylor: Old Dominion U , US ; 1999.
Independent variables were control group, child gender and age. Dependent variables were self-esteem, anxiety, and behavior as measured by the Coopersmith Self-Esteem Inventory (SEI), the State-Trait Anxiety Inventory for Children (STAIC), the Child Behavior Checklist for Parents (CBCL), and the Child Behavior Checklist - Teacher's Report Form (TRF). Children were administered the SEI and the STAIC by their elementary school counselors before and after the CDP-Group (and at similar intervals for the control group). Mothers and teachers of participating children completed the CBCL or the TRF, respectively, before and after the counseling program (and at similar intervals for children in the control group). Mothers completed the Beck Depression Inventory and a background information questionnaire at midpoint. Analyses of variance (ANOVAs) determined that children's functioning did not differ by gender or by age. Functioning of children who attended the counseling sessions did not differ from the control group over time. Although group counseling did not appear to effect children's functioning over time, children's externalizing behavior was predicted by mother's current participation in counseling, the father's level of education, the number of years the child's parents had been married, father's paygrade, and the number of years the father had been in the military. The child's self-esteem was predicted by the child's level of trait anxiety; state anxiety was predicted by the mother's self-reported level of depressive affect. Teacher's reports of the child's level of internalizing behavior was predicted by the mother's current participation in counseling, maternal depression, state anxiety, and trait anxiety.
Mitchum NT . The effects of group counseling on the self-esteem, anxiety, and behavior of children with deployed parents: Mitchum, Nancy Taylor: Old Dominion U , US ; 1999.
The purpose of this study was to examine the effectiveness of a six-session group counseling intervention for children who had a parent experiencing military-induced deployment. Participants were 65 children (30 boys, 35 girls) of enlisted military personnel attending elementary schools near the Norfolk Naval Base. Elementary school counselors facilitated the counseling groups.
Murray JS. Helping children cope with separation during war. Journal for Specialists in Pediatric Nursing Vol 7(3) Jul-Sep 2002, 127-130 2002.
Notes that children from military families increasingly are facing separation from a significant other as their parents are deployed to military or war situations around the world. This article contains some common childhood emotional responses to separation based on the developmental level of the child (infants, toddlers, preschoolers, school-age children, and adolescents). Some nursing and other interventions individuals can implement to help children of all ages adjust to separations from their parents are described. Along with specific suggestions, the article lists some broad concepts such as helping children to express their feelings, supporting the remaining parent or caregiver, and encouraging family members to keep lines of communication open. The article closes with some suggestions for mental health services or preventive services. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Paden LB, Pezor LJ. Uniforms and youth: The military child and his or her family: Kaslow, Florence Whiteman (Ed); 1993.
Describes the debate over whether or not military children and military families have a greater incidence of psychopathology than their civilian counterparts (from the chapter) current services and future needs
Park N. Military children and families: Strengths and challenges during peace and war. Am Psychol. 2011 Jan;66(1):65-72.
Throughout history, military children and families have shown great capacity for adaptation and resilience. However, in recent years, unprecedented lengthy and multiple combat deployments of service members have posed multiple challenges forU.S. military children and families. Despite needs to better understand the impact of deployment on military children and families and to provide proper support for them, rigorous research is lacking. Programs exist that are intended to help, but their effectiveness is largely unknown. They need to be better coordinated and delivered at the level of individuals, families, and communities.Research and programs need to take a comprehensive approach that is strengths based and problem focused. Programs for military children and families oftenfocus on the prevention or reduction of problems. It is just as important to recognize their assets and to promote them. This article reviews existing research on military children and families, with attention to their strengths as well as their challenges. Issues in need of further research are identified,especially research into programs that assist military children and families.Military children and families deserve greater attention from psychology.
(PsycINFO Database Record (c) 2010 APA, all rights reserved).
Paris R, DeVoe ER, Ross AM, Acker ML. When a parent goes to war: effects of parental deployment on very young children and implications for intervention. Am J Orthopsychiatry. 2010 Oct;80(4):610-8.
Young children (birth through 5 years of age) are disproportionately represented in U.S. military families with a deployed parent. Because of their developmental capacity to deal with prolonged separation, young children can be especially vulnerable to stressors of parental deployment. Despite the resiliency of many military families, this type of separation can constitute a developmental crisis for a young child. Thus, the experience may compromise optimal child growth and development. This article reviews what is known about the effects of the military
deployment cycle on young children, including attachment patterns, intense emotions, and behavioral changes and suggests an ecological approach for supporting military families with infants, toddlers, and preschoolers. Specifically, home-based family focused interventions seem to warrant the most serious consideration.
Rentz ED, Marshall SW, Loomis D, Casteel C, Martin SL, Gibbs DA. Effect of deployment on the occurrence of child maltreatment in military and nonmilitary families. American Journal of Epidemiology 2007;165(10):1199-206.
War has a profound emotional impact on military personnel and their families, but little is known about how deployment-related stress impacts the occurrence of child maltreatment in military families. This time-series analysis of Texas child maltreatment data from 2000 to 2003 examined changes in the occurrence of child maltreatment in military and nonmilitary families over time and the impact of recent deployment increases. The rate of occurrence of substantiated maltreatment in military families was twice as high in the period after October 2002 (the 1-year anniversary of the September 11th attacks) compared with the period prior to that date (rate ratio = 2.15, 95% confidence interval: 1.85, 2.50). Among military personnel with at least one dependent, the rate of child maltreatment in military families increased by approximately 30% for each 1% increase in the percentage of active duty personnel departing to (rate ratio = 1.28, 95% confidence interval: 1.20, 1.37) or returning from (rate ratio = 1.31, 95% confidence interval: 1.16, 1.48) operation-related deployment. These findings indicate that both departures to and returns from operational deployment impose stresses on military families and likely increase the rate of child maltreatment. Intervention programs should be implemented to mitigate family dysfunction in times of potential stress. (1)
Ritchie EC. Combat psychiatry: From the battle front to the home front: Introduction. Psychiatric Quarterly Vol 76(4) Dec 2005, 341-342 2005.
This section hopes to outline the broad range of psychiatry practiced in the military today. This is an enormous and complex subject, and so areas most pertinent for civilian and VA psychiatrists will be highlighted. The specific focus will be on Operation Iraqi Freedom (OIF), soldiers returning from that conflict, and their families. "Treatment of the Stress Casualty during Operation Iraqi Freedom One" is written by two Army psychiatrists who deployed early in OIF. "Psychiatric Interventions with Returning Soldiers at Walter Reed" focuses on the mental health issues of the wounded soldier as they pass through Landstuhl and Walter Reed. "Re-Entry and Reintegration: Returning Home After Combat" is written from the perspective of psychiatrists at Madigan Army Medical Center have been receiving a large contingent of Army troops, active duty, reserve and National Guard. "Military Families and Children During Operation Iraqi Freedom" focuses on families, which have long been recognized as impacted by deployments and war, both because of extended separations and the changes in soldiers when they return. There are numerous Army initiatives attempting to cope with the issues highlighted in these articles. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Robinson R, Davis JD, Krueger M, Gore K, Freed MC, Kuesters P, Dube S, Engel CC. Acceptability of adverse childhood experiences questions for health surveillance in U.S. Armed Forces. Mil Med. 2008 Sep;173(9):853-9.
BACKGROUND: Research has documented a consistent and strong association between adverse childhood experiences (ACE) and negative health outcomes in adulthood. The Department of Defense is expanding health surveillance of military members and considering the inclusion of ACE questions.
OBJECTIVE: To explore the perceptions and attitudes of service members and spouses regarding the use of ACE questions in routine health surveillance.
METHOD: Forty-one active duty service members and spouses were interviewed at two Army troop medical centers. Semistructured qualitative interviews were used to examine their views regarding the use of ACE questions in military health surveillance.
RESULTS: Participants believe there is value in health surveillance; however, they are cautious about providing ACE or other information that may be perceived negatively, without confidentiality reassurances.
CONCLUSION: Successful employment of ACE questions in active duty military health surveillance will depend on the ability of military health officials to ensure confidentiality and to communicate the relevance of ACE to health status.
Roberts KA. Self-efficacy, self-concept, and social competence as resources supporting resilience and psychological well-being in young adults reared within the military community: Roberts, Kristi A.: Fielding Graduate U. , US ; 2007.
Studies examining such concepts as self-efficacy, self-concept, and social competence have provided evidence for how individuals cope with stressful life events, thus maintaining adaptive functioning. Past research has hypothesized the military lifestyle, replete with frequent relocations and separations from a deployed parent, a rigid conforming community, and discrimination from those outside the military community, may be damaging to the psychological well-being of children. Resources such as self-efficacy, self-concept, and social competence have been shown in the research literature to be important in mitigating the negative impact of a stressful environment upon psychological well-being and may be important in the resilience of military children. Participants (N=720, ages 19-22) were recruited from the University of Utah and Hill Air Force Base and were classified into one of four groups: military reared college, military reared non-college, civilian reared college and civilian reared non-college. Participants were asked to complete four questionnaires to measure their current psychological well-being, self-efficacy, self-concept and social competence. Results indicated that significant differences in psychological well-being did not exist between military and civilian reared individuals when they were matched for education. For all four groups, only self-efficacy was found to be significantly associated with psychological well-being. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (2)
Roper LL. Air force single parent mothers and maternal separation anxiety: Roper, Lawanda L.: Capella U. , US ; 2007.
The purpose of this study was to examine the level of maternal separation anxiety and general anxiety of deployed Air Force single parent mothers in relation to military deployment and retention. The study also assessed the affect of deployment on the reenlistment intentions and rationale of Air Force single parent mothers. Sixty-nine Air Force single custodial parent mothers from the Headquarters Air Force Material Command, who had physical custody of their children, were administered Web-based surveys. There were two groups in the study. The first group consisted of 20 Air Force single parent mothers who were scheduled for deployment within 30 to 180 days for a period of six months; the second group consisted of 49 single parent mothers who were not scheduled for deployment. The results of the study indicated there was no significant difference in the level of separation anxiety, separation effects, and employment-related concerns of deploying and non-deploying Air Force single parent mothers. However, Air Force single parent mothers experienced a greater level of separation anxiety and employment related concerns than Army single military fathers, but there were no significant difference in separation effects. The study also suggested that Air Force single parent mothers and Army military fathers had similar emotions and concerns when balancing a career and a family during deployment and separation.
Rosen LN, Teitelbaum JM, Westhuis DJ. Children's reactions to the Desert Storm deployment: Initial findings from a survey of Army families. Military Medicine Vol 158(7) Jul 1993, 465-469 1993.
Studied psychological symptom profiles on 1,601 children of soldiers deployed during Operation Desert Storm (ODS). The profiles were obtained from reports of 1,274 parents who stayed at home with the children. Certain symptoms such as sadness were common, but few parents considered their children's problems serious enough to require counseling. The strongest predictor of children's receiving counseling during ODS was a previous history of being in counseling for emotional problems.
Rotter JC, Boveja ME. Counseling military families. The Family Journal Vol 7(4) Oct 1999, 379-382 1999.
Examined issues of anticipation, separation, and reunion in families with military personnel deployed overseas. Stress traditionally arising from the events of deployment has been compounded in the last 3 decades through an increased prevalence of dual-career military couples, married personnel, personnel with children, and military wives working out of the home. The cases of James, a military serviceman for 29 yrs, and Patricia, experiencing her first overseas deployment, show how the US military has addressed deployment issues through meetings, support groups, newsletters, rumor control, educational programs, telephone trees, chaplain services, and mental health services. Patricia found comfort in expressing her emotions through a spiritual group.
Rush CM, Akos P. Supporting children and adolescents with deployed caregivers: A structured group approach for school counselors. Journal for Specialists in Group Work Vol 32(2) Jun 2007, 113-125 2007.
Children and adolescents of deployed soldiers require preventive and sometimes remedial service from school counselors, because deployment taxes coping skills and exacerbates normal developmental challenges. This article reviews the cultural and developmental context for children with deployed caregivers and outlines a ten session, hybrid psychoeducational-counseling group designed to increase student knowledge (e.g., emotional cycles of deployment), build student competencies (e.g., coping skills, mastery of developmental tasks), and promote a safe environment to express emotions with connected peers.
Russo TJ, Fallon MA. Helping military families who have a child with a disability cope with stress. Early Childhood Education Journal Vol 29(1) Fal 2001, 3-8 2001.
This exploratory study investigates perceived levels of family stress for 253 military families who have a young child with a disability. Two primary areas of study were the sources and levels of stress, and the benefits of resources designed to help families cope. Results of the study indicate an increased level of stress for families when the demands of military life were coupled with the demands of caring for a young child with a disability. Events such as separation from family members, relocation, deployment, and personal safety and health issues emerged as concerns of the military personnel. The importance of coordinating services for these families is discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Ryan-Wenger NAPDRN. Impact of the Threat of War on Children in Military Families. [Miscellaneous]: American Journal of Orthopsychiatry April 2001;71(2):236-244; 2001.
The potential for war is a pervasive threat to the security and family structure of children in military families. This study compared children of active-duty, reserve, and civilian families with respect to their perceptions of war, origin of fears related to war, levels of manifest anxiety, coping strategies, and projection of emotional problems in human figure drawings. Findings regarding the adaptation of children in military families are discussed, and the need for further research from children's perspectives is highlighted., (C) 2001 by the American Psychological Association (1)
Sahni N. Perceptions of those left behind: An exploration of family dynamics within military reservist families during the 2003 Iraq wartime deployment: Sahni, Nameeta: Alliant International U, San Diego , US ; 2005.
This qualitative study investigated the experiences of latency children and their families when a reservist father was deployed during wartime. The study also examined some of the family dynamics that occur in reservist families during a wartime deployment. Data was collected through the use of semi-structured individual interviews with latency boys, ages seven to eleven, and then similar semi-structured interviews with the children's families. Two themes were most salient in both the individual and family interviews. First, the theme emerged that the sons were "little soldiers." The role of "little soldiers" is to keep dynamics status quo, making sure to keep things normal, not add to the chaos and difficulty, follow rules to the best of their ability, and to distract the family in difficult times. Additionally, this theme highlights that the sons in this study were cast into the role of taking care of other members of their family and keeping their own worries and concerns to themselves. Another salient theme related to the use of ritual to maintain balance during the deployment. Each family in this study was able to create a new ritual that involved all remaining members of the household, in an effort to establish a new sense of balance and routine. The theme of sons as little soldiers is consistent with the current literature on active-duty family dynamics. This study also illustrates the lack of identity that these reservist families experienced, feeling caught between the military and civilian worlds. Aspects of their daily experiences mimic experiences of both military and civilian lifestyles. However, the experiences of the families in this study were unique because the military and civilian lifestyles intermingled during the deployment, creating cognitive dissonance around their identity and sense of belonging. The literature does not currently address cognitive dissonance in military reservist families during wartime deployments. Further research in the area of reservist families and their family dynamics is needed. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Schachman KA. Online fathering: the experience of first-time fatherhood in combat-deployed Troops Nurs Res. 2010 Jan-Feb;59(1):11-7.
BACKGROUND: More than 90% of fathers in the United States attend the births of their children. Each year, thousands of fathers are absent during this important life transition because of military deployment in combat regions; however, it is unknown how this population experiences new fatherhood.
OBJECTIVE: The purpose of this study was to explore the lived experience of first-time fatherhood from the unique perspective of military men deployed to combat regions during birth.
METHOD: A phenomenological approach was used. Seventeen men who were stationed in
Okinawa, Japan, and had returned recently from a combat deployment participated
Unstructured, in-depth interviews were conducted 2 to 6 months after the births. Interviews were audiotaped, transcribed, and analyzed using Colaizzi's method.
RESULTS: Disruption of the protector and provider role was a main theme that encompassed four theme clusters: (a) worry-a traumatic and lonely childbirth; (b) lost opportunity; (c) guilt-an absent father; and (d) fear of death and dismemberment-who will be the father? Although their absence interfered with their ability to fulfill the fatherhood role as they perceived it, this was
offset by the theme cluster Communication: The ties that bind, highlighting the role of online communication with their partner (e.g., e-mail, instant messaging, Facebook, blogs, and chat rooms) in restoring balance to the protector and provider role.
DISCUSSION: Insight is provided into the needs of first-time fathers who are combat-deployed during the births of their babies. Understanding these experiences assists nurses in identifying better ways to prepare and to support men in an involved fatherhood role, despite the limitations of a stressful combat environment and geographic separation. This information can set the stage for a healthy reunion, which may take place at military bases and within communities across the globe, and thus is of benefit to all nurses working with military families.
Schumm WR, Bell DB, Knott B. Characteristics of families of soldiers who return prematurely from overseas deployments: an assessment from Operation Restore Hope ( Somalia ). Psychological Reports 2000;86(3 Pt 2):1267-72.
Nearly 500 wives, married to enlisted soldiers who deployed to Somalia for Operation Restore Hope, participated in a postdeployment study in the summer of 1993. About 10% of their husbands had returned early from Somalia for family reasons. Analysis of their wives' reports suggests that early returns were associated most often with childbirth or problematic pregnancies rather than other factors such as inexperience with deployments, negative attitudes towards the military, a lack of support services, or lower coping abilities. However, in hindsight, our results probably reflect compliance with military policy at that time for that deployment, under which pregnancy-related concerns were one of the most legitimate reasons for permitting an early return. The results support sociological theories that highlight the importance of macrosocial factors in influencing the lives of individual families somewhat independently of the microsocial environment of the families. (1)
Thorne B. Children and the 2003 war in Iraq . Childhood: A Global Journal of Child Research Vol 10(3) Aug 2003, 259-263 2003.
This journal article describes the life of children in the wake of the military invasion of Iraq and the troubled Middle East . The article aims to bring into the focus the impact of a war on the minds of children and their childhood. Children across the world should have the rights to physical and emotional safety, health, nutrition, care and education. Since the last decade, children in Iraq have been facing serious jeopardy regarding their basic rights. Before the 1991 Persian Gulf War , Iraq had one of the lowest infant mortality rates in the developing world; by 2003 it had one of the highest. According to 1999 UNESCO surveys, in the south and center of Iraq (home to 85 percent of the population), deaths of children under 5 more than doubled during the 1990s. Many children died of hunger, malnutrition, dysentery and cancer. The usage of depleted uranium bombs, manufactured and deployed by the US and Britain , seriously degraded the environment of Iraq , resulting in the death of many innocent children. The articles in this journal also deal with the issue of child labor. Themes of war, labor, representation and fantasy demonstrate that the subject of children is as broad and complex as human experience itself. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Ursano RJ, Norwood AE. Emotional aftermath of the Persian Gulf War: Veterans, families, communities, and nations. (1996). Emotional aftermath of the Persian Gulf War: Veterans, families, communities, and nations; 1996.
"Emotional Aftermath of the Persian Gulf War" explores the impact of war from a unique perspective--it addresses not only the effect of trauma on soldiers in combat but also the toll war takes on families and communities as a whole. (1)
Ursano RJ, Norwood AE. Emotional aftermath of the Persian Gulf War: Veterans, families, communities, and nations. (1996). Emotional aftermath of the Persian Gulf War: Veterans, families, communities, and nations; 1996.
The authors focus on the experience of servicemembers and of their families in response to deployment, separation, loss, and reintegration after the war. They discuss the treatment of combat casualties, those with and without psychiatric illness, who were rapidly returned home still in the acute stage of their injuries. The authors emphasize providing the best support, both medically and psychologically, for military personnel and their families for the essential mental health and effectiveness of the fighting force and the improved quality of life of individual people. The special needs of families and of reserve and guard members are considered, and models of community outreach programs for coping with the stressors of war are discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved). (1)
Waldron JA, Whittington RR, Jensen S. Children's single-session briefings: Group work with military families experiencing parents' deployment. Social Work with Groups Vol 8(2) Sum 1985, 101-109 1985.
Describes a model developed to ease the crisis situation presented for all family members by forced separation of a parent from the family because of military service. A series of children's single-session briefings involved talking with parents and children in a large group, talking with children in small groups while their parents observed, and a large group discussion with parents. Children were encouraged to express feelings related to separation, and parents were assisted in developing strategies for coping with the family changes resulting from the deployments. Children's briefings were organized pre-, mid-, and post-deployment and utilized lectures, slides, and coloring books. The groups were led by 2 clinical social workers and a chaplain. (27 ref) (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Walker WO, Jr., LaGrone RG, Atkinson AW. Psychosocial screening in pediatric practice: identifying high-risk children.[see comment][erratum appears in J Dev Behav Pediatr 1990 Feb;11(1):43]. Journal of Developmental & Behavioral Pediatrics 1989;10(3):134-8.
The purpose of this study was to evaluate the effectiveness of the Pediatric Symptom Checklist (PSC) as a psychosocial screening instrument. Using the PSC, the researchers screened 212 patients, ages 6-12 years, at a military outpatient pediatric clinic. Twenty-one children with scores in the "high-risk" range were randomly selected and matched with children scoring in the normal, "not-high-risk" range. Two trained interviewers, blind to individual PSC scores, independently interviewed and rated each subject's level of psychosocial functioning on the Children's Global Assessment Scale (CGAS). The Child Behavior Checklist (CBCL), a standardized psychosocial measure, was also completed by each subject's mother. PSC scores were compared to the CGAS and CBCL scores in terms of sensitivity and specificity. Additional analyses compared data from the study sample with that of previous studies. Results suggest that the PSC is a valid pediatric psychosocial screening instrument for multiethnic patient populations. (1)
Weisz JR, Sandler IN, Durlak JA, Anton BS. Promoting and Protecting Youth Mental Health Through Evidence-Based Prevention and Treatment. [Miscellaneous Article]: American Psychologist September 2005;60(6):628-648; 2005.
For decades, empirically tested youth interventions have prevented dysfunction by addressing risk and ameliorated dysfunction through treatment. The authors propose linking prevention and treatment within an integrated model. The model suggests a research agenda: Identify effective programs for a broadened array of problems and disorders, examine ethnicity and culture in relation to intervention adoption and impact, clarify conditions under which programs do and do not work, identify change mechanisms that account for effects, test interventions in real-world contexts, and make tested interventions accessible and effective in community and practice settings. Connecting the science and practice of prevention and treatment will be good for science, for practice, and for children, adolescents, and their families., (C) 2005 by the American Psychological Association (1)
Wexler HK, McGrath E. FAMILY MEMBER STRESS REACTIONS TO MILITARY INVOLVEMENT SEPARATION. [Article]: Psychotherapy: Theory, Research, Practice, Training Fall 1991;28(3):515-519; 1991.
This article describes an exploratory study of stress reactions experienced by adult dependents separated from family members involved in the Persian Gulf War. The majority of respondents reported loneliness and anxiety along with strong feelings of pride and patriotism. Most of the sample reported a strong need for additional support groups. Separation reactions were related to age, ethnicity, education, expected and actual lengths of the current separation, and number and duration of prior military separations., (C) 1991 by the American Psychological Association