U.S. Military Children and the Wartime Deployments of Family Members

Being a parent of a soldier is a challenging experience - stress, anxiety, and depression among parents of Israeli soldiers

At any given moment, a notable proportion of parents worldwide have at least one child serving in the military. The aim of this study is to assess the prevalence of depression, anxiety, and stress in the sample of parents of Israeli soldiers and to assess the difference in this prevalence by type of service (combat vs. non-combat) and other demographic characteristics of parents and soldiers. A cross-sectional study of a convenience sample of 202 Israeli parents who were interviewed during January-September 2023. Depression Anxiety Stress Scale (DASS-21) was used to measure the emotional states of depression, anxiety, and stress (with cut-off points of ≥5, ≥4, and ≥8, respectively). Having depression, anxiety, or stress was defined as psychological distress. Parents' demographics and child's service characteristics were included in the multivariable logistic regression model, with psychological distress as a dependent variable. Almost a quarter (22.8%) of parents experienced distress, defined as having high depression, anxiety, or stress score. In a multivariable model, combat service (vs. non-combat) was significantly associated with distress: parents of combat soldiers were four times more likely to report distress than parents of non-combat soldiers (OR = 3.9; 95% CI: 1.3-11.8). Highly classified service preventing the child from sharing information with the parents was significantly associated with distress (OR = 2.6; 95% CI: 1.2-5.3). Most distressed parents (78.3%) did not seek professional help, with the vast majority of those seeking assistance were female. Given the substantial proportion of parents suffering from mental distress found in this study, especially parents of combat soldiers and those serving in highly classified positions, healthcare professionals should be aware of parents' difficulties, be proactive in gathering information about their mental well-being, and be prepared to provide professional help.

Geographical access to specialized behavioral health treatment programs for U.S. active duty service members and military families from military installations

Active duty service members and their families have unique behavioral health care service needs. The purpose of this study is to determine geographical access to specialized behavioral health programs tailored to active duty U.S. service members and military families from military installations. This study generated network distance measures between active duty military installations and licensed substance use disorder (SUD) treatment facilities and mental health treatment facilities for 2015-2018 using data from national surveys administered by the Substance Abuse and Mental Health Services Administration and coordinates for active duty military installations from the Defense Installation Spatial Data Infrastructure Program. Using regression analysis, we calculated the share of installations that are at-risk of being remote from behavioral healthcare services. Separately, we calculated the share of treatment facilities accepting military insurance that offer specialized programs for active duty service members and/or military families within a 30-minute drive to an installation. Three out of 10 installations were at-risk of being remote from a behavioral health treatment facility. About 25 percent of behavioral health treatment facilities accepting military insurance within a 30-minute drive to an installation offered a specialized treatment program for active duty military or military families. Lack of a specialized treatment programs could suggest facilities may not be equipped to manage stressors unique to being in the military, and as a consequence, could adversely impact the health and well-being of this population. Further research is necessary to understand what specialized treatment programs for military populations entail.

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.

Cultivating knowledge of resiliency and reintegration among military youth through a national youth leadership program

Youth in military families are frequently challenged by the adjustment demands associated with the deployment and reintegration of a parent. A positive youth development approach was undertaken by the Boys and Girls Clubs of America to develop and implement a Military Teen Ambassadors (MTA) training for youth in military families that would facilitate knowledge of resiliency and reintegration and foster leadership skills to build assets for themselves as well as their peers within their local communities. To determine if MTA was functioning as intended and to refine future programming, this preliminary formative study assessed perceived participant learning outcomes associated with MTA on variables pertaining to knowledge acquisition, perceived skill acquisition, and community needs awareness. Data were collected prior to the training, immediately following the training, and 6 months after the training. Repeated measures analysis indicated significant mean increases over time in knowledge and awareness of resiliency and reintegration; perceived leadership skills; and community awareness. Qualitative findings provided triangulation in the aforementioned areas. These findings strengthen the body of knowledge on resiliency by demonstrating that the 7 Cs model may be an effective strategy to incorporate into leadership development programs seeking to build knowledge of resiliency among military youth. Study limitations, lessons learned, and recommendations for further research are delineated.

The Physiological Regulation of Emotion During Social Interactions: Vagal Flexibility Moderates the Effects of a Military Parenting Intervention on Father Involvement in a Randomized Trial

To make prevention programs more effective and understand "what works for whom," evidence regarding what individual characteristics predict intervention responsiveness is needed. Previous studies have evaluated a military parent training program known as After Deployment Adaptive Parenting Tools/ADAPT, yet less is understood about the program's varying effects for fathers. We tested the physiological regulation of emotion during social interactions as a moderator predicting fathers' responsiveness in a randomized trial of ADAPT, in which emotion regulation was operationally measured through vagal flexibility (VF; dynamic changes in cardiac vagal tone). Families with a child aged between 4 and 13 years for whom physiological data were gathered (n = 145) were randomly assigned to ADAPT (14-week face-to-face group intervention) or a control group (services as usual). Fathers in these families were National Guard/Reserve members who had been deployed to war in Iraq and/or Afghanistan and recently returned. Prior to the intervention, cardiac data was collected in-home throughout a set of family interaction tasks and VF was operationalized as the changes in high frequency (HF) power of heart rate variability (HRV) from a reading task to a problem-solving task. Parenting behaviors were observed and coded based on theory-driven indicators pre-intervention and at 1-year follow-up. Results of structural equation modeling showed that VF significantly moderated fathers' intervention responsiveness, such that fathers with higher vs. lower VF exhibited more effective parenting at 1-year follow-up if they were randomized into ADAPT vs. the control group. This study is the first to demonstrate that parasympathetic vagal functioning may be a biomarker to predict response to a military parenting intervention to enhance parenting in combat deployed fathers. The implications for precision-based prevention are discussed.

Character strengths and performance outcomes among military brat and non-brat cadets

Although many studies have compared military vs. civilian samples on a wide variety of characteristics, few have examined these differences within the context of those who commit a portion of their life to the military. In this study, we explored how West Point cadets with ("military brat cadet") or without ("non-brat cadet") a family military background might differ in terms of their character strengths. Although the cadets shared many similarities, we found that several strengths related to self-control were higher in non-brat cadets than brat cadets and that many of these self-control-related strengths were important predictors of performance for brat cadets (but not non-brat cadets). For non-brat cadets, strengths related to a drive to fully involve themselves and navigate relationships with others were better predictors of performance. In a second study utilizing a different class of cadets, we again found support for the idea that nonmilitary brat cadets possessed more self-control than military brat cadets. Better understanding the unique strengths and weaknesses of those within the military who have vs. don't have a military background may provide important insights for future recruitment, training, and military preparation.

Improving parental emotion socialization in military families: Results of a randomized controlled trial

Prior research indicates that children of deployed parents are at risk for emotional problems, suggesting the utility of preventive efforts for military families. Effective parental socialization of children's emotions is protective for children's development, and parental experiential avoidance may impede parental emotion socialization, yet intervention studies in this area are lacking. This study examined the impact of a parenting program, After Deployment Adaptive Parenting Tools (ADAPT), on parental emotion socialization postintervention (6 months postbaseline) and whether intervention effects were moderated by parental experiential avoidance. The sample included 336 families (294 fathers and 313 mothers) with at least 1 deployed parent and a focal child aged 4-12. Families were randomized into either ADAPT (a 14-week group-based intervention) or control group. Self-reported data on parental emotion socialization and experiential avoidance were analyzed using structural equation modeling. Results showed that mothers who were assigned to the intervention had significant improved supportive emotion socialization and reduced nonsupportive emotion socialization at postintervention compared with controls. Mothers with higher levels of experiential avoidance assigned to the intervention group had higher levels of supportive emotion socialization at postintervention. No significant intervention effects were found in fathers. This study provides support for the effects of the ADAPT program on maternal emotion socialization at 6-month postbaseline, and the role of experiential avoidance as a moderator. We discuss findings in relation to the different parental roles that mothers and fathers play in postdeployed families, as well as implications for personalized intervention programming. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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.