Exploring the Role of Social Connectedness Among Military Youth: Perceptions from Youth, Parents, and School Personnel

Maladaptive coping among military-connected adolescents: Examining combined risk using QCA

Introduction

Military-connected students in public schools face a unique set of stressors that may impact their wellbeing and academic functioning.

Methods

Twenty-four youth in the 7th to 12th grades who had an active-duty parent (mother or father) serving in the U.S. Armed Forces were interviewed. Participants completed a qualitative interview while actively completing a Life History Calendar (LHC) to mark deployment and family military service milestones and discuss how they impacted the youth respondent. This study used Qualitative Comparative Analysis (QCA) to explore the interplay and combination of specific stressors related to relocation and deployment experiences among adolescents, and to determine key factors associated with maladaptive outcomes.

Results

The results of the QCA analysis identified bullying experiences and negative experiences with other military-connected youth as conditions that are associated with maladaptive coping.

Discussion

Chronic and acute stressors in adolescence are established risk factors for mental, emotional, and behavioral problems in the short and long-term including suicidality, substance use and abuse, and substance use disorders. Through qualitative inquiry we were able to identify specific contextual details related to maladaptive coping that can be used to further refine areas of focus for research, prevention, and interventions for military-connected adolescents.

Depression and mental health service use among 12-17 year old U.S. adolescents: Associations with current parental and sibling military service

Objective

To examine whether having a parent and/or a sibling currently serving in the military is associated with major depression and use of mental health services among 12-17 year old adolescents in the United States.

Method

Descriptive and multivariate logistic regression analyses are conducted using pooled data from the 2016-2019 National Survey of Drug Use and Health (NSDUH). Analyses are weighted and standard errors are adjusted for the complex sampling design.

Results

Adolescents are more likely to have a sibling than a parent currently serving in the military. Having a sibling currently in the military increases the likelihood of having a lifetime and a past-year major depressive episode (MDE), but not a past-year MDE with severe role impairment or use of mental health services. Having a parent in the military is not associated with any measure of MDE, but increases use of specialty outpatient, specialty inpatient/residential, and non-specialty mental health services net of MDE and sociodemographic controls.

Conclusion

Considerable attention has focused on risk and resilience among the dependent children of current service members. A better understanding of how the current military service experiences of siblings, as well as parents, influences related adolescents' mental health, mental health care service use, substance use, and health behaviors has the potential to contribute to programs and interventions that can enhance the well-being of youth with intra-generational, as well as inter-generational, connections to the military. Adolescents who have a sibling currently serving in the military are an at-risk population for MDE and potentially other mental and behavioral health problems.

Permanent change of station moves and disordered-eating attitudes and behaviors in prevention-seeking adolescent military-dependents

OBJECTIVE

Military-dependent youth appear to be at greater risk for disordered-eating than their civilian counterparts. Permanent change of station moves (PCS-moves), typically occurring every 2-3 years, are commonly experienced by adolescent military-dependents. However, the links between PCS-moves and disordered-eating in this population have not been explored. We hypothesized that stress arising from PCS-moves may contribute to the development and/or exacerbation of disordered-eating.

METHODS

One-hundred-forty-nine adolescent military-dependents with overweight or obesity (59.7% female; 46.3% non-Hispanic White; 14.4±1.5 years; BMI-z: 1.9±0.4) completed measures before commencing an adulthood obesity and binge-eating disorder prevention trial for adolescents at-risk for both conditions due to BMI percentile ≥85th and loss-of-control (LOC)-eating and/or elevated anxiety symptoms. Disordered-eating attitudes and LOC-eating were assessed by semi-structured interview, and emotional eating was self-reported. Adjusting for relevant covariates, multiple linear regressions examined the unique association of PCS-move frequency with disordered-eating attitudes and disinhibited-eating behaviors.

RESULTS

PCS-move frequency was not significantly associated with either LOC-eating frequency (β = 0.09, p = .27) or emotional eating (β = -0.04, p = .62). However, PCS-move frequency was positively associated with disordered-eating attitudes (β = 0.17, p = .04), which appeared to be primarily driven by shape concerns (β = 0.21, p = .01).

DISCUSSION

Findings indicate that frequency of PCS-moves is related to disordered-eating attitudes, but not behaviors. Longitudinal research is needed to understand if PCS-moves prospectively relate to the onset and/or exacerbation of disordered-eating, and the relevance of disordered-eating attitudes as opposed to disinhibited-eating behaviors.

Retention in Outpatient Child Behavioral Health Services Among Military and Civilian Families

Retention in treatment for children with behavior problems is critical to achieve successful outcomes, and clinical evidence suggests the behavioral health needs and retention of military-connected and civilian families differ meaningfully. Military and civilian children in outpatient behavioral treatment were compared in terms of presenting problems as well as appointment adherence (n = 446 children and their parents). Demographics and rates of externalizing behavior were similar across the two groups. More military than civilian children had internalizing problems. Military parents had more parenting distress and depressive symptoms. Fewer military families dropped out of treatment early. Within-military comparisons demonstrated that children whose parent had recently deployed were more likely to have internalizing problems and poor adaptive skills. Although retention was better among military families, the early treatment drop-out proportions (20-30%) for both groups highlight a barrier to effective behavioral intervention.

Residential Mobility Among Elementary School Students in Los Angeles County and Early School Experiences: Opportunities for Early Intervention to Prevent Absenteeism and Academic Failure

School connectedness is closely linked to academic success: students who are engaged at school have better attendance and academic performance, and are less likely to drop out. Residential mobility – having moved homes – can increase the risk of a negative academic trajectory (e.g., absenteeism and academic failure). Increasing housing instability in the United States due to rising housing costs, especially in urban areas, has made residential mobility a growing concern. While existing research has examined residential mobility among students and its connection to long-term consequences such as absenteeism and academic failure, less is known about how residential mobility relates to potential intermediate school experiences (e.g., school disconnectedness, low perceived academic ability, and experiences with school violence and harassment) that contribute to a negative academic trajectory. This study examines associations between residential mobility in elementary school and school experiences in a large urban jurisdiction. Data were collected from a sample of public elementary school students in Los Angeles County (5th grade, n = 5,620) via the California Healthy Kids Survey (2013–2014). Descriptive, Chi-square, multiple logistic regression analyses, and predicted probabilities were performed to examine the relationships between past-year residential mobility and indicators of school connectedness and school-based relationships, perceived academic performance, and exposure to violence and harassment. More than a third (36.6%) of students in the analysis sample moved at least once in the past year. After adjusting for neighborhood and family factors, a higher number of past-year moves was significantly associated with poorer school experiences, including lower odds of school connectedness for high-movers (2+ moves) [adjusted odds ratio (AOR) = 0.77; 95% confidence interval (CI) = 0.68–0.86], compared to non-movers. Movers had lower odds of perceived academic ability (1 move: AOR = 0.72; CI = 0.63–0.83; 2+ moves: AOR = 0.55; CI = 0.44–0.69), but higher odds of exposure to violence and harassment as a victim (1 move: AOR = 1.26, CI = 1.17–1.37; 2+ moves: AOR = 1.34, CI = 1.17–1.54), and as a perpetrator (1 move: AOR = 1.21, CI = 1.08–1.36; 2+ moves: AOR = 1.54, CI = 1.24–1.92). These results highlight the value of developing and implementing strategies that can identify and support students who move at young ages, to prevent student disengagement and promote attendance and academic success early in their life trajectory.

Behavioral Health Service Use by Military Children During Afghanistan and Iraq Wars

Medical claims were analyzed from 2810 military children who visited a civilian emergency department (ED) or hospital from 2000 to 2014 with behavioral health as the primary diagnosis and TRICARE as the primary/secondary payer. Visit prevalence was estimated annually and categorized: 2000-2002 (pre-deployment), 2003-2008 (first post-deployment), 2009-2014 (second post-deployment). Age was categorized: preschoolers (0-4 years), school-aged (5-11 years), adolescents (12-17 years). During Afghanistan and Iraq wars, 2562 military children received 4607 behavioral health visits. School-aged children's mental health visits increased from 61 to 246 from pre-deployment to the second post-deployment period. Adolescents' substance use disorder (SUD) visits increased almost 5-fold from pre-deployment to the first post-deployment period. Mental disorders had increased odds (OR = 2.93, 95% CI 1.86-4.61) of being treated during hospitalizations than in EDs. Adolescents had increased odds of SUD treatment in EDs (OR = 2.92, 95% CI 1.85-4.60) compared to hospitalizations. Implications for integrated behavioral health and school behavioral health interventions are discussed.

The Context of Sexual Decisions and Intrapersonal and Interpersonal Factors Related to Sexual Initiation Among Female Military-Dependent Youth

Despite the sizable population of military-dependent youth (MDY) in the United States and the military stressors they experience (e.g., relocations, parental deployment), little is known about MDY's sexual behavior, especially about the perceived role that military stressors play in their sexual decisions, such as the decision to initiate sex. We conducted 25 semistructured, in-depth interviews with sexually experienced female MDY aged 15 to 19 years to (a) describe MDY's general perceptions of military life and (b) identify intrapersonal and interpersonal characteristics related to MDY's sexual initiation, including the perceived impact of military stressors. We analyzed life history grids and transcripts to identify common and unique themes across participants' experiences. Most participants reported having positive experiences related to military life, and most did not believe that military stressors influenced their decision to initiate sex. Common intrapersonal and interpersonal characteristics related to sexual initiation were having an older first sexual partner, being in a dating relationship, receiving sexual health education prior to their first sexual experience, and discussing sex with a parent prior to their first sexual experience. These intrapersonal and interpersonal characteristics should be considered when developing sexual health programs for MDY, which should focus on building supportive peer and parental relationships.

Impact of Social Networking Sites on Children in Military Families

Youth in military families experience a relatively unique set of stressors that can put them at risk for numerous psychological and behavior problems. Thus, there is a need to identify potential mechanisms by which children can gain resiliency against these stressors. One potential mechanism that has yet to be empirically studied with military youth is social networking sites (SNSs). SNSs have gained significant popularity among society, especially youth. Given the significance of these communication tools in youths' lives, it is important to analyze how SNS use may affect military youth and their ability to cope with common military life stressors. The current review examines the potential positive and negative consequences associated with SNS use in coping with three common stressors of youth in military families: parent deployment, frequent relocation, and having a family member with a psychological or physical disability. By drawing from SNS and military literature, we predict that SNS use can be a positive tool for helping children in military families to cope with stressors. However, certain SNS behaviors can potentially result in more negative outcomes. Recommendations for future research are also discussed.

Suicidality among military-connected adolescents in California schools

Previous research indicates that suicidal ideation is higher among military-connected youth than non military-connected youth. This study extends prior work by examining suicidal ideation, plans, and attempts in military-connected and non military-connected adolescents. Data were gathered from 390,028 9th and 11th grade students who completed the 2012-2013 California Healthy Kids Survey. Bivariate comparisons and multivariate logistic analyses were conducted to examine differences in suicidal ideation, plans, attempts, and attempts requiring medical attention between military and not military-connected youth. In multivariate logistic analyses, military-connected youth were at increased risk for suicidal ideation (OR = 1.43, 95 % CI = 1.37-1.49), making a plan to harm themselves (OR = 1.19, CI = 1.06-1.34), attempting suicide (OR = 1.67, CI = 1.43-1.95), and an attempted suicide which required medical treatment (OR = 1.71, CI = 1.34-2.16). These results indicate that military-connected youth statewide are at a higher risk for suicidal ideation, plans, attempts, and attempts requiring medical care because of suicidal behaviors. It is suggested that policies be implemented to increase awareness and screening among primary care providers, school personnel, and military organizations that serve military-connected youth.

Well-being and suicidal ideation of secondary school students from military families

BACKGROUND

The mental health of children is a primary public health concern; adolescents of military personnel may be at increased risk of experiencing poorer well-being overall and depressive symptoms specifically. These adolescents experience individual and intrafamilial stressors of parental deployment and reintegration, which are directly and indirectly associated with internalizing behaviors.

PURPOSE

The present study sought to better understand the influence of parental military connectedness and parental deployment on adolescent mental health.

METHODS

Data from the 2011 California Healthy Kids Survey examined feeling sad or hopeless, suicidal ideation, well-being, and depressive symptoms by military connectedness in a subsample (n = 14,299) of seventh-, ninth-, and 11th-grade California adolescents. Cross-classification tables and multiple logistic regression analyses were used.

RESULTS

More than 13% of the sample had a parent or sibling in the military. Those with military connections were more likely to report depressive symptoms and suicidal ideation. Controlling for grade, gender, and race/ethnicity, reporting any familial deployment compared with no deployments was associated with increasing odds of experiencing sadness or hopelessness, depressive symptoms, and suicidal ideation.

CONCLUSIONS

Findings emphasize the increased risk of mental health issues among youth with parents (and siblings) in the military. Although deployment-related mental health stressors are less likely during peace, during times of war there is a need for increased screening in primary care and school settings. Systematic referral systems and collaboration with community-based mental health centers will bolster screening and services.

Adolescents in wartime US military families: a developmental perspective on challenges and resources

Adolescents in wartime US military families are a unique group of young people who are experiencing the usual milestones of adolescent development, including establishing their identities and becoming autonomous, while they face the challenges of military life such as multiple frequent moves, relocation, and parent deployment to combat settings. This paper reviews research on adolescents in wartime US military families, within the context of adolescent development, to identify their behavioral, emotional and academic risk status, and challenges and resources. Recommendations for future research and interventions to foster the healthy development of these adolescents are also provided.

Prevalence and correlates of victimization and weapon carrying among military- and nonmilitary-connected youth in Southern California

OBJECTIVES

The present analysis sought to explore the normative rates and correlates of school victimization and weapon carrying among military-connected and nonmilitary-connected youth in public schools in Southern California.

METHODS

Data are from a sub-sample of the 2011 California Healthy Kids Survey (N=14,512). Items to assess victimization and weapon carrying were separated into three categories: physical acts (e.g., being pushed or shoved), nonphysical acts (e.g., having rumors spread about them) and weapon carrying.

RESULTS

The bivariate results indicate that youth with a military-connected parent had higher rates of physical victimization (56.8%), nonphysical victimization (68.1%), and weapon carrying (14.4%) compared to those with siblings serving (55.2%, 65.2%, and 11.4%, respectively) and nonmilitary-connected (50.3%, 61.6%, and 8.9%, respectively) youth. Having a parent in the military increased the odds of weapon carrying by 29% (Odds Ratio=1.29, 95% confidence interval=1.02-1.65). Changing schools and a larger number of family member deployments in the past 10years were associated with significant increases in the likelihood of victimization and weapon carrying.

CONCLUSIONS

The results of this analysis warrant a focus on school supports for youth experiencing parental military service, multiple relocations and deployments of a family member.