The Impact Of Military Parents’ Injuries On The Health And Well-Being Of Their Children

Abstract

Parental injuries and illnesses affect child and family life. We hypothesized that military parental injury would adversely affect children's preventive care, injuries, maltreatment, mental health care, and psychiatric medication prescriptions. Visit and prescription data of 485,002 military-connected children ages 2-16 were tracked for two years before and two years after the injury of a parent in the period 2004-14. Adjusted negative binomial regression compared pre-and post-injury visit and prescription rates. Children with injured parents had decreased rates of preventive care visits and increased rates of visits for injuries, maltreatment, and mental health care, as well as increased psychiatric medication use, following their parent's injury. Across all categories of care, children of parents with posttraumatic stress disorder (PTSD), both alone and with traumatic brain injury, appeared to have more pronounced changes in care patterns. Parental injury and illness are associated with changes in children's health care use, and PTSD in a parent increases the effect. Severe parental injury or illness can affect family functioning and limit parents' capacity to care for children. Studies in civilian populations and burgeoning military-focused research illustrate how parental injury and illness can negatively affect multiple domains of children's health and well-being. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Research that explores the effects of parental illness or injury on children often focuses on associations between parental health problems and children's behavioral and mental health. Poor parental mental health has been linked with numerous indicators of behavioral and mental health problems in children, including suicidal ideation, eating disorders, attention deficit hyperactivity disorder, internalizing and externalizing behaviors, depression, conduct disorder, behavioral problems, and psychopathology. [3][4][5][6][7][10][11][12][15][16][17] Parental physical health problems have been associated with children's depression, coping difficulties, behavior problems, anxiety, sleeping problems, compulsive behaviors, stress, internalizing and externalizing behaviors, conduct problems, and substance use. 14,[18][19][20][21][22][23] Children's health issues worsen with parental depression and distress, 24,25 and increased parental distress has been associated with poor overall family functioning. 26 Children of brain-injured parents have an increased likelihood of experiencing posttraumatic stress symptoms, emotional and behavioral problems, psychiatric disorders, developmental disorders, depression, substance abuse, and poor social coping. [27][28][29][30][31][32] Spouses of individuals with brain injury also have increased stress, which affects children. 33 Parental injury is associated with child distress, and family disruption and pre-injury family problems increase child distress. 34 An emerging literature has linked other indicators of child health and family functioning

Pre- and Perinatal Risk Factors for Child Maltreatment in Military Families Across the First Two Years of Life

“…Parental trauma exposure, substance use, and poorer mental health are associated with perpetration of maltreatment (Ayers et al, 2019; Chemtob et al, 2011; Hammond et al, 2017; Wolf & Freisthler, 2016). Parents’ physical health has received less attention (Stith et al, 2009), but studies conducted with military samples suggest that parental physical injuries may increase maltreatment risk (Hisle-Gorman et al, 2019). Though evidence is mixed (Stith et al, 2009), child and birth-related factors, including premature birth, male infant sex, and birth defects, may also increase risk (Gumbs et al, 2013; Van Horne et al, 2015).…”

Impact of parental injury on adolescent sleep

“…17,18 Beyond effects on behavioral and mental health, parental injury has been found to increase the use of psychoactive medication use by children. 1,[19][20][21] Children of parents treated for unintentional injury were more likely to report posttraumatic stress and depressive symptoms postinjury. 1 Parental TBI has been associated with emotional and behavioral difficulties in children, including depressive symptoms.…”