Children's Response to Parental Separation during Operation Desert Storm

Jensen, Peter S.; Martin, David; Watanabe, Henry K.

doi:10.1097/00004583-199604000-00009

Cited by 170 publications

(126 citation statements)

References 18 publications

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“…19 These observations, however, have not directly linked parental deployment to clinically significant pediatric mental or behavioral health disorders. 20,21 Changes in behavior that lead a caregiver to seek medical attention for a child signal a more significant impact of parent-child separation than crosssectional measurements or surveys of child behavior. Studies that have examined the effect of parental deployment on inpatient psychiatric hospitalization have been small and provided differing results.…”

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confidence: 99%

Wartime Military Deployment and Increased Pediatric Mental and Behavioral Health Complaints

2010

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WHAT'S KNOWN ON THIS SUBJECT:Military deployment of a parent influences children's behavior in a variety of settings. The clinical significance of these deployment-associated behavior changes has not been determined. WHAT THIS STUDY ADDS:Children experiencing separation from a parent due to wartime military deployment have an 11% increase in outpatient visits for mental and behavioral health complaints, which contrasts with a general deploymentassociated decrease in health care visits in all other diagnostic categories.abstract 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 Ͻ .001). IRRs of pediatric anxiety, behavioral, and stress disorders when a parent deployed were 1.14 (95% CI: 0.98 -1.32; P ϭ .095), 1.19 (95% CI: 1.07-1.32; P Ͻ .001), and 1.18 (95% CI: 1.10 -1.26; P Ͻ .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.

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confidence: 99%

Wartime Military Deployment and Increased Pediatric Mental and Behavioral Health Complaints

2010

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“…[4][5][6][7] Interestingly, increased stressors during parental deployment among children of military service members were not shown to result in increased levels of symptoms of depression, compared with children of nondeployed parents. 8 According to a Defense Manpower Data Center survey, 20% of military spouses reported increases in problem behavior exhibited by their children at home in response to parental deployment, and 21% reported increased levels of fear and anxiety among their children during deployment. 9 Also, 39% of respondents reported having problems managing child care or child schedules while their spouse was deployed, which might infringe on their ability to schedule appropriate well-child visits for their children.…”

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confidence: 99%

Effects of Parental Military Deployment on Pediatric Outpatient and Well-Child Visit Rates

2010

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WHAT'S KNOWN ON THIS SUBJECT:Military members and their families experience unique stressors, particularly during wartime deployments. Increased pediatric outpatient visit rates may be associated with family demographic features, and parental deployment has been shown to have emotional and behavioral effects on children. WHAT THIS STUDY ADDS:The objective of this study was to determine whether parental military deployment affected the rates at which children of military parents accessed health care, particularly regarding preventive well-child visits, within the military health system. abstract 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 Ͻ2 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 Ͻ .001) and well-child visits (IRR: 0.88 [95% CI: 0.84 -0.93]; P Ͻ .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 Ͻ .001) and well-child visits (IRR: 1.08 [95% CI: 1.07-1.09]; P Ͻ .001) during deployment. There was interaction between parental marital status and deployment, which was most significant among parents Ͻ24 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.

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“…The Sesame Workshop materials for families dealing with wounds and injuries aimed to bolster the resilience of children and their caregivers, using principles from Bandura's Social Learning theory (18,19) and parental stress theory (10). Targeted areas were caregivers' own well-being, their ability to be responsive to the child, their ability to help the child to cope, and their access to social support.…”

Section: Theory Model and Materialsmentioning

confidence: 99%

“…The development of young children may be especially susceptible to stress in the parent-child system (8). Because children's reactions to stressors are strongly related to those of at-home-caregivers (9)(10)(11), parents who model effective coping are more likely to create conditions for their children to cope well and to help them to develop their resilience. Parents that are functioning well are unlikely to be socially isolated or show symptoms of depression and are more likely to help their children to cope and to show them sensitivity.…”

Section: Introductionmentioning

confidence: 99%