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MacDermid Wadsworth SM, Topp D, Lester P, Stander V, Christ SL, Whiteman S, Knobloch L. Long-term consequences of mothers' and fathers' wartime deployments: Protocol for a two-wave panel study. PLoS One 2024; 19:e0295007. [PMID: 38498486 PMCID: PMC10947692 DOI: 10.1371/journal.pone.0295007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/13/2023] [Indexed: 03/20/2024] Open
Abstract
Multiple adjustment difficulties have been associated with children's exposure to recent parental wartime military deployments, but long-term consequences have not yet been systematically studied. This investigation will assess direct and indirect relationships between exposures to parental deployments early in life and later youth adjustment. Parents' psychological health and family processes will be examined as mediators, and parents' and children's vulnerability and support will be examined as moderators. Archival data will be combined with new data gathered from two children and up to two parents in families where children will be aged 11 to 16 at the first data collection and will have experienced at least one parental deployment, for at least one child prior to age 6. Data are being gathered via telephone interviews and web-based surveys conducted twice one year apart. Outcomes are indicators of children's social-emotional development, behavior, and academic performance. Notable features of this study include oversampling of female service members, inclusion of siblings, and inclusion of families of both veterans and currently serving members. This study has potentially important implications for schools, community organizations and health care providers serving current and future cohorts of military and veteran families.
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Affiliation(s)
- Shelley M. MacDermid Wadsworth
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, United States of America
| | - Dave Topp
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, United States of America
| | - Patricia Lester
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States of America
| | - Valerie Stander
- Naval Health Research Center, San Diego, California, United States of America
| | - Sharon L. Christ
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, United States of America
| | - Shawn Whiteman
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, United States of America
| | - Leanne Knobloch
- Department of Communication, University of Illinois, Urbana, Illinois, United States of America
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DuBois D, Richmond R, Stephanie Roberts L, Mahar A, Fear N, Gill K, Samantha Leroux J, Cramm H. A scoping review of military and Veteran families within international suicidality and suicide prevention research. Prev Med Rep 2023; 33:102206. [PMID: 37223562 PMCID: PMC10201831 DOI: 10.1016/j.pmedr.2023.102206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 04/09/2023] [Accepted: 04/10/2023] [Indexed: 05/25/2023] Open
Abstract
The impacts of suicidality on families are well known, which is particularly relevant in at-risk populations, such as active duty military personnel and Veteran communities. This scoping review describes how military and Veteran families have been conceptualized within suicide prevention research. A systematic, multi-database search was conducted, and 4,835 studies were screened. All included studies underwent quality assessment. Bibliographic, participant, methodological, and family-relevant data was extracted and descriptively analyzed into Factors, Actors, and Impacts. In total, 51 studies (2007 - 2021) were included. Most studies focused on suicidality rather than suicide prevention. Factor studies described family constructs as a suicidality risk or protective factor for military personnel or Veterans. Actor studies described families' roles or responsibilities to act in relation to the suicidality of military personnel or Veterans. Impacts studies described the impacts of suicidality on military and Veteran family members. The search was limited to English language studies. There were few studies on suicide prevention interventions for or including military and Veteran family members. Family was typically considered peripheral to the military personnel or Veteran experiencing suicidality. However, there was also emerging evidence of suicidality and its consequences in military-connected family members.
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Affiliation(s)
- Denise DuBois
- Families Matter Research Group, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, Ontario K7L 3N6, Canada
| | - Rachel Richmond
- Families Matter Research Group, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, Ontario K7L 3N6, Canada
| | - Lauren Stephanie Roberts
- Families Matter Research Group, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, Ontario K7L 3N6, Canada
| | - Alyson Mahar
- Max Rady College of Medicine, Community Health Sciences, University of Manitoba, Winnipeg, Ontario R3E 3P5, Canada
| | - Nicola Fear
- Department of Military Mental Health, Institute of Psychiatry, King’s College London, London WC2R 2LS, England, United Kingdom
| | - Kamaldeep Gill
- Families Matter Research Group, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, Ontario K7L 3N6, Canada
| | - Janette Samantha Leroux
- Families Matter Research Group, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, Ontario K7L 3N6, Canada
| | - Heidi Cramm
- Families Matter Research Group, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, Ontario K7L 3N6, Canada
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Gilreath TD, Montiel Ishino FA, Sullivan KS, Okoror TA. Maladaptive coping among military-connected adolescents: Examining combined risk using QCA. Front Psychol 2022; 13:948474. [PMID: 36600698 PMCID: PMC9806339 DOI: 10.3389/fpsyg.2022.948474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Tamika D. Gilreath
- Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, TX, United States,*Correspondence: Tamika D. Gilreath,
| | | | | | - Titilayo A. Okoror
- Department of Africana Studies, Binghamton University, Binghamton, NY, United States
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Sullivan KS, Hawkins SA, Gilreath TD, Castro CA. Mental Health Outcomes Associated with Risk and Resilience among Military-Connected Youth. FAMILY PROCESS 2021; 60:507-522. [PMID: 32981035 PMCID: PMC7997811 DOI: 10.1111/famp.12596] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The present study aimed to describe patterns of risk and protective factors affecting U.S. Army families and their association with mental health diagnoses among military-connected children. Wartime military service is associated with increased adverse outcomes for military-connected youth, but few studies have explored the impact of concurrent risk and access to protective factors. Using big data methods to link existing datasets, protective factors (e.g., marital and family functioning) were drawn from a voluntary survey completed by 1,630 US Army spouses. Risk factors (e.g., parent mental health, family moves, deployment) were drawn from Department of Defense (DoD) archival data. Rates of mental health diagnoses among youth were derived from DoD healthcare records. Using the three-step method of latent profile analysis, five profiles emerged with variability across risk and protective factors. The largest group (40% of the sample) had considerable protective factors and limited risk exposure. Statistically significant differences in the prevalence of mental health diagnoses among military-connected youth were observed across profiles (χ2 = 30.067, df = 4, p < .001), with the highest rates (31.1% and 30.5%) observed in the two profiles with the lowest protective factors. Findings suggest most military families are faring well and highlight the importance of a thorough assessment that evaluates both the stressors military families face and the strengths they possess.
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Affiliation(s)
| | - Stacy Ann Hawkins
- Research Facilitation Laboratory, Army Analytics Group, Monterey, CA, USA
| | - Tamika D Gilreath
- Department of Health and Kinesiology, Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, TX, USA
| | - Carl A Castro
- Center for Innovation and Research on Veterans and Military Families, University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
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Rossiter AG, Ling CG. Building resilience in US military families: why it matters. BMJ Mil Health 2021; 168:91-94. [PMID: 33785586 DOI: 10.1136/bmjmilitary-2020-001735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 11/03/2022]
Abstract
Service members and their families have endured significant stressors over the past 19 years in support of the nation's engagement in the wars in Iraq and Afghanistan. 'Resilience' is the term most commonly used to describe the military spouse and military-connected child. However, due to a paucity of research on military families, little is known about the impact of spousal/parental military service on the military family. The ability of the healthcare provider is critical to ensuring the success of the military spouse and military-connected child. Providers can support the physical and psychological health needs of military families through (1) identification of military family members in clinical practice and (2) providing culturally competent care that correlates the unique lifestyle and physical and psychological health exposures associated with spousal/parental military service. Historically, in the United States, there has been a proud legacy of generational military service in families-upwards of 80% of new recruits have a family member who has served in the military. The leading factor associated with retention of the service member on Active Duty or in the Reserve or National Guard is the satisfaction of the at-home spouse. Disenfranchising the military spouse and lack of services and support for military-connected children could create a gap in meeting recruitment goals creating a threat to national security in the United States.
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Affiliation(s)
| | - C G Ling
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Abstract
Suicide is a preventable health problem. Multiple definitions and inconsistent use of the term suicidality can result in failure to properly recognize suicide risk and behavior and confuses suicide research. Clarification of the suicidality concept is needed to facilitate the care for individuals at risk for suicide. Using Rodgers' evolutionary concept analysis method, this analysis describes the breadth and scope of the suicidality concept. Findings indicate suicidality covers a spectrum of suicidal risk and levels of emotional suffering and intent. The analysis does not draw definite conclusions, but outlines a direction for further research.
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Affiliation(s)
- Tamara Pike Keefner
- Nursing, South Dakota State University - College of Nursing, Rapid City, South Dakota, USA
| | - Thomas Stenvig
- Graduate Nursing, South Dakota State University - College of Nursing, Brookings, Rapid City, South Dakota, USA
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Gribble R, Mahar AL, Keeling M, Sullivan K, McKeown S, Burchill S, Fear NT, Castro CA. Are we family? A scoping review of how military families are defined in mental health and substance use research. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2020. [DOI: 10.3138/jmvfh-2019-0054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: While some families may experience poor mental health, substance use, and poor school performance due to service life, the usefulness and applicability of these research findings may be affected by how representative study participants are of the broader population. This article aims to examine how research on mental health and substance use defines a “military family” to understand if the current body of evidence reflects the increasing diversity of this population. Methods: A systematic search of academic articles was conducted in Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, Ebsco CINAHL and ProQuest PILOTS using database-specific subject headings and keyword searches for ‘military’, ‘family’, ‘mental health’ and ‘substance use’. Sociodemographic and military characteristics of study participants were extracted to identify who was and was not included. Results: The most commonly represented family structure was the traditional, heteronormative family comprised of a male service member married to a female civilian with whom they have children. Military couples without children, dual-serving couples, families of LGBTQ personnel, unmarried and new relationships, single parents, male spouses/partners, Veterans not seeking Veterans Affairs (VA) services, and families with additional challenges were regularly not reflected in the research due to implicit or explicit exclusion from studies. Discussion: Research on mental health and substance use among the family members of service personnel continues to reflect the traditional, heteronormative family. Future studies should consider more inclusive definitions of family and creative approaches to recruitment to ensure research in this area reflects the experiences, needs, and strengths of an increasingly diverse military community.
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Affiliation(s)
- Rachael Gribble
- King’s Centre for Military Health Research (KCMHR), Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Alyson L. Mahar
- Manitoba Centre for Health Policy, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mary Keeling
- Center for Innovation and Research on Veterans and Military Families, University of Southern California, Los Angeles, California, USA
- Centre for Appearance Research, University of the West of England, Frenchay Campus, Bristol, United Kingdom
| | - Kate Sullivan
- Center for Innovation and Research on Veterans and Military Families, University of Southern California, Los Angeles, California, USA
- Silver School of Social Work, New York University, New York, New York, USA
| | - Sandra McKeown
- Bracken Health Sciences Library, Queen’s University, Kingston, Ontario, Canada
| | - Susan Burchill
- Manitoba Centre for Health Policy, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nicola T. Fear
- King’s Centre for Military Health Research (KCMHR), Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Carl A. Castro
- Center for Innovation and Research on Veterans and Military Families, University of Southern California, Los Angeles, California, USA
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Collateral Damage: Mitigating Toxic Stress Secondary to Parental Military Service in Post-9/11 Military-Connected Children. Adv Pediatr 2020; 67:1-13. [PMID: 32591053 DOI: 10.1016/j.yapd.2020.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
Adolescence is the transitional bridge between childhood and adulthood; it encompasses developmental milestones that are unique to this age group. Healthy cognitive, physical, sexual, and psychosocial development is both a right and a responsibility that must be guaranteed for all adolescents to successfully enter adulthood. There is consensus among national and international organizations that the unique needs of adolescents must be addressed and promoted to ensure the health of all adolescents. This policy statement outlines the special health challenges that adolescents face on their journey and transition to adulthood and provides recommendations for those who care for adolescents, their families, and the communities in which they live.
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Affiliation(s)
- Elizabeth M Alderman
- Division of Adolescent Medicine, Department of Pediatrics, Albert Einstein College of Medicine and The Children's Hospital at Montefiore, Bronx, New York; and
| | - Cora C Breuner
- Division of Adolescent Medicine, Departments of Pediatrics and Orthopedics and Sports Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington
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10
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Kranke D, Barmak S, Weiss E, Dobalian A. The Application of a Self-Labeling Approach among Military-Connected Adolescents in a Public School Setting. HEALTH & SOCIAL WORK 2019; 44:193-201. [PMID: 30839058 DOI: 10.1093/hsw/hlz007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/15/2018] [Accepted: 10/11/2018] [Indexed: 06/09/2023]
Abstract
The contextual factors and individual responses to the labeling of military-connected adolescents as "being in a military family" is an understudied yet important phenomenon. Minimal research construes the experience of being in a military family as a label applied to military-connected populations by people in society. However, social environmental factors associated with school setting among military-connected adolescents being in a military family have common components to the process of self-labeling. This article seeks to explore the concept and application of self-labeling by (a) providing a literature review of self-labeling among military-connected adolescents and (b) relying on modified labeling theory to identify any consistencies or potential nuances. The analysis of the process is strictly hypothetical, but could help to account for widely varying responses, sequence of events, and underlying reasons for the behaviors among some military-connected adolescents identified in the literature review and in light of the U.S. protracted military involvement in Iraq and Afghanistan. Authors conclude by highlighting the need for future research to assess the adequacy of this self-labeling framework to ensure the healthy development of military-connected youths.
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Affiliation(s)
- Derrick Kranke
- Veterans Emergency Management Evaluation Center, U.S. Department of Veterans Affairs, Plummer Street, North Hills, CA
| | | | - Eugenia Weiss
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| | - Aram Dobalian
- Veterans Emergency Management Evaluation Center, U.S. Department of Veterans Affairs, North Hills, CA
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Abstract
OBJECTIVE Childhood psychiatric disorders affect current functioning and predispose individuals to more severe adult mental health problems. Provider survey research has suggested that children's mental health problems are increasing; observed changes may be due to increased illness or improved access to care. The authors sought to quantify trends in the prevalence of diagnosed and treated mental health conditions, outpatient treatment, and psychiatric medication prescriptions in a large population of children who were continuously insured. METHODS The authors performed a retrospective trend study of diagnosed mental health conditions, treatment, and psychiatric medication prescriptions from 2003 to 2015 in children ages 2-18 who were military dependents (N=1,798,530). Poisson regression analyses and Cochran-Armitage tests determined trends in the prevalence of treated psychiatric diagnoses overall and by subcategory, rates of outpatient mental health visits, and psychiatric medication use overall and by specific class. RESULTS From 2003 to 2015, the prevalence of children with diagnosed mental health conditions increased from 9.2% to 15.2% (rate ratio=1.04, 95% confidence interval=1.04-1.05, p<0.001). Identified suicidal ideation prevalence increased by 20% a year. Mental health care visits increased by 2% a year, and psychiatric medication prescriptions increased by 3% a year between 2003 and 2015, with larger increases seen among older children. Prescriptions for children with identified mental health conditions did not increase. CONCLUSIONS Diagnosed mental health conditions, pharmaceutical treatment, and outpatient visits all increased across a diverse U.S. pediatric population from 2003 to 2015. Results suggest that use of psychiatric medications kept pace with the increased number of diagnoses and that older children are most affected.
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Affiliation(s)
- Elizabeth Hisle-Gorman
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland (all authors); Walter Reed National Military Medical Center, Bethesda (Gorman)
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland (all authors); Walter Reed National Military Medical Center, Bethesda (Gorman)
| | - Gregory H Gorman
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland (all authors); Walter Reed National Military Medical Center, Bethesda (Gorman)
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Goldman-Mellor S, Kwan K, Boyajian J, Gruenewald P, Brown P, Wiebe D, Cerdá M. Predictors of self-harm emergency department visits in adolescents: A statewide longitudinal study. Gen Hosp Psychiatry 2019; 56:28-35. [PMID: 30553125 PMCID: PMC6353680 DOI: 10.1016/j.genhosppsych.2018.12.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/29/2018] [Accepted: 12/06/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study investigated patient- and area-level characteristics associated with adolescent emergency department (ED) patients' risk of subsequent ED visits for self-harm. METHOD Retrospective analysis of adolescent patients presenting to a California ED in 2010 (n = 480,706) was conducted using statewide, all-payer, individually linkable administrative data. We examined associations between multiple predictors of interest (patient sociodemographic factors, prior ED utilization, and residential mobility; and area-level characteristics) and odds of a self-harm ED visit in 2010. Patients with any self-harm in 2010 were followed up over several years to assess predictors of recurrent self-harm. RESULTS Self-harm patients (n = 5539) were significantly more likely than control patients (n = 16,617) to have prior histories of ED utilization, particularly for mental health problems, substance abuse, and injuries. Residential mobility also increased risk of self-harm, but racial/ethnic minority status and residence in a disadvantaged zipcode decreased risk. Five-year cumulative incidence of recurrent self-harm was 19.3%. Admission as an inpatient at index visit, Medicaid insurance, and prior ED utilization for psychiatric problems or injury all increased recurrent self-harm risk. CONCLUSIONS A range of patient- and area-level characteristics observable in ED settings are associated with risk for subsequent self-harm among adolescents, suggesting new targets for intervention in this clinical context.
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Affiliation(s)
- Sidra Goldman-Mellor
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA 95343, USA.
| | - Kevin Kwan
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA 95343, USA.
| | - Jonathan Boyajian
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA 95343, USA.
| | - Paul Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA 94612, USA.
| | - Paul Brown
- Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA 95343, USA.
| | - Deborah Wiebe
- Department of Psychology, School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA 95343, USA.
| | - Magdalena Cerdá
- Violence Prevention Research Program, University of California, Davis, Sacramento, CA 95817, USA.
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Williamson V, Stevelink SAM, Da Silva E, Fear NT. A systematic review of wellbeing in children: a comparison of military and civilian families. Child Adolesc Psychiatry Ment Health 2018; 12:46. [PMID: 30443263 PMCID: PMC6220523 DOI: 10.1186/s13034-018-0252-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/12/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Children in military families have uniquely different childhood experiences compared to their civilian peers, including a parent in employment and a stable familial income, frequent relocations, indirect exposure to and awareness of conflict, and extended separation from parents or siblings due to deployment. However, whether children from military families have poorer wellbeing than non-military connected children is not well understood. METHOD We conducted a systematic review to explore the relationship between military family membership (e.g. parent or sibling in the military) and child wellbeing compared to non-military connected controls. Searches for this review were conducted in September 2016 and then updated in February 2018. RESULTS Nine studies were identified, eight were cross-sectional. All studies utilised self-report measures administered in US school settings. On the whole, military connected youth were not found to have poorer wellbeing than civilian children, although those with deployed parents and older military connected children were at greater risk of some adjustment difficulties (e.g. substance use, externalising behaviour). Although only assessed in two studies, having a sibling in the military and experiencing sibling deployment was statistically significantly associated with substance use and depressive symptoms. CONCLUSIONS This study is unique in its direct comparison of military and non-military connected youth. Our results highlight the need to examine the impact of military service in siblings and other close relatives on child wellbeing. Given the adverse impact of poor mental health on child functioning, additional research is needed ensure appropriate, evidence-based interventions are available for youth in military families.
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Affiliation(s)
- Victoria Williamson
- Kings Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Sharon A. M. Stevelink
- Kings Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Eve Da Silva
- Kings Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
| | - Nicola T. Fear
- Kings Centre for Military Health Research, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
- Academic Department for Military Mental Health, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK
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I Serve 2: Identifying and caring for military-connected children in civilian primary care settings. J Am Assoc Nurse Pract 2018; 30:614-618. [DOI: 10.1097/jxx.0000000000000084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Benbenishty R, Astor RA, Roziner I. A School-Based Multilevel Study of Adolescent Suicide Ideation in California High Schools. J Pediatr 2018; 196:251-257. [PMID: 29544883 DOI: 10.1016/j.jpeds.2017.12.070] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 12/05/2017] [Accepted: 12/21/2017] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To assess the between-school variation in suicide ideation and to estimate the contribution of school-level attributes, student-level characteristics, and 2 cross-level interactions (school by student) to student suicide ideation. STUDY DESIGN A secondary analysis of the California Healthy Kids Survey in 2 large and representative samples of California high schools and students: 2009-2011 and 2011-2013. This is a population sample of all public high school students (grades 9 and 11) in California. Analyses were first conducted on surveys administered in the 2011-2013 academic years to 790 schools with 345 203 students and replicated on surveys administered in 2009-2011 to 860 schools with 406 313 students. RESULTS School-level suicide ideation rates ranged between 4% and 67%, with a median of 19.3% and mean of 20.0% (SD, 5.7%). Student suicide ideation was explained by student-level characteristics (R2 = .20) and to a larger extent by school-level attributes (R2 = .55). Student-level characteristics predictive of suicide ideation included, sex, ethnic and racial affiliation, victimization, and perceptions of school climate. In both samples, school size and average level of academic achievement were not associated with rates of school suicide ideation. Schools with a larger number of girls and higher levels of victimization had higher rates of suicide ideation in both samples. The hypotheses regarding cross-level interactions were not confirmed. CONCLUSIONS Differences among schools in student suicide ideation are meaningful. The findings suggest an emphasis on the role of schools in prevention programs, public health campaigns to reduce suicide, multilevel research, and theory development.
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Affiliation(s)
- Rami Benbenishty
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Israel.
| | - Ron Avi Astor
- Suzzane Dworak-Peck School of Social Work University of Southern California, CA
| | - Ilan Roziner
- Sackler Faculty of Medicine, Tel Aviv University, Israel
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MacDermid Wadsworth S, Bailey KM, Coppola EC. U.S. Military Children and the Wartime Deployments of Family Members. CHILD DEVELOPMENT PERSPECTIVES 2016. [DOI: 10.1111/cdep.12210] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rossiter AG, Dumas MA, Wilmoth MC, Patrician PA. "I Serve 2": Meeting the needs of military children in civilian practice. Nurs Outlook 2016; 64:485-90. [PMID: 27477834 DOI: 10.1016/j.outlook.2016.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/23/2016] [Accepted: 05/31/2016] [Indexed: 10/21/2022]
Abstract
The American Academy of Nursing launched the "Have You Ever Served in the Military?" campaign in 2013 in conjunction with the Joining Forces campaign spearheaded by First Lady Michelle Obama and Dr. Jill Biden. The "Have You Ever Served in the Military?" campaign provides guidance and resources for nurses outside the Military Health System and Veterans Health Administration where upwards of 80% of veterans receive care. However, most military personnel do not serve alone. More than half of the 2.2 million active duty, National Guard, and Reserve service members currently serving in the armed forces have families and many military children experience stress and anxiety secondary to parental military service. Although strides have been made to improve identification and treatment of the visible and invisible wounds of war for service members, little to no information exists regarding the impact parental service has on the physical, psychological, and behavioral health of military children. In addition, there is no mechanism in place to identify military children in civilian practice nor resources providing evidence-based best practices when caring for these children.
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Affiliation(s)
| | - Mary Anne Dumas
- Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies, Hofstra University, Hempstead, NY
| | - Margaret C Wilmoth
- Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, GA
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Friedman SL, Sigelman CK, Rohrbeck CA, del Rio-Gonzalez AM. Quantity and quality of communication during parental deployment: Links to adolescents’ functioning. APPLIED DEVELOPMENTAL SCIENCE 2016. [DOI: 10.1080/10888691.2016.1207536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gewirtz AH, DeGarmo DS, Zamir O. Effects of a Military Parenting Program on Parental Distress and Suicidal Ideation: After Deployment Adaptive Parenting Tools. Suicide Life Threat Behav 2016; 46 Suppl 1:S23-31. [PMID: 27094107 PMCID: PMC5113712 DOI: 10.1111/sltb.12255] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Few studies have examined whether parenting prevention programs might mitigate risk for suicidality in parents, yet parent suicidality is a strong risk factor for offspring suicidality. We report results from a randomized controlled trial of a parenting program for deployed National Guard and Reserve families with a school-aged child. Intent-to-treat analyses showed that random assignment to the parenting program (ADAPT) was associated with improved parenting locus of control (LOC). Improved parenting LOC was concurrently associated with strengthened emotion regulation which predicted reductions in psychological distress and suicidal ideation at 12 months postbaseline. Results are discussed in the context of ongoing efforts to reduce suicide rates in military populations.
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Affiliation(s)
- Abigail H. Gewirtz
- Department of Family Social Science & Institute of Child Development, & Institute for Translational Research in Children’s Mental Health, University of Minnesota
| | - David S. DeGarmo
- Prevention Science Institute, Department of Educational Methodology, Policy, and Leadership, University of Oregon
| | - Osnat Zamir
- Institute for Translational Research in Children’s Mental Health, University of Minnesota
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