Impact of the Military Lifestyle on the Behavioral

Health of Children

Vanessa Venezia, MD

Military Unique Experience Deployment Cycle Children’s response to deployment SM’s response to re-deployment Words from fathers Special circumstances to consider

Please interrupt/ask questions at any time

Agenda

Frequent moves

School change Non-AD parental employment

Limited access to extended family Military schooling Deployment

Military Unique Experience

In 2009, 2.2 million AD SM 58% have family 40% have 2 or more children

40% 5 or younger 33% age 6-11 25% teen

2 million children affected by deployment 15 mth deployment 6-12 reset Relocation during deployment or after

Deployment

Predeployment SM

Leave, training, NTC, Medical treatment, last hoorah

FM

Withdrawn, apathy, regression

Deployment Cycle

Early Deployment SM

Sleep wake cycle, right seat left seat, learning new expectations, routine established

FM Overwhelmed, sad, anxiety, clingy, somatic,

aggression

Deployment Cycle

Deployment Cycle

Mid cycle SM

Boredom, routine, experience trauma/losses, FM less “needy”, strengthening of peer relations

FM Symptoms resolve,

increased independence, responsibility, “little man of the house.”

Reunification Excitement Fantasy Anticipation Relief Physical exhaustion Block leave

Deployment Cycle

Reunification part 2 Role confusion Helpful vs bossy “little man of the house”

Oedipal Bed sharing

Conflict Substance use

Deployment Cycle

32% “high risk” for psychosocial morbidity vs

13% non-deployers (Pediatric Stress index) 35 item parent reported 3 item likert scale Validated tool

42% “high risk” for parental stress (Parent Stress Index) 36 item self report with 5 item likert scale Validated tool

Children’s experience

Development of child psychosocial stress/pathology

Sleep trouble Academic achievement Aggression/acting out

Positive predictor Parental stress and Parental

Education level Increased reported morbidity Increased diagnosed morbidity

Children’s Experience

Not predictive

Rank Child gender Age Race Ethnicity Employment Length of time with unit Number of moves in past 5 years

Children’s experience

Identity as parent Role determination/co parenting Balance of work/home responsibilities

Parental Developmental Stages

Child development at deployment vs

redeployment Change in parental approach based on child

developmental stage Execution of duties despite environment vs

child centered rearing Flexible Patience

Hiccups

“There’s times that, like when [my partner] goes to work at night, that

[my daughter] just wants [her mother], and no matter what I do, she just

sits there and she screams, for you know, 3 or 4 hours straight, and no

matter what I do all she does is sit there and scream. [I feel like] Pulling my

hair out . . . like I’mdoing something wrong . . . [and] there’s notmuch that I can do. . . . I try and hold her, that doesn’t work, I try to let her run free throughout the house, that doesn’t work, I try and give her snacks, that doesn’twork, I try to play with her, that doesn’twork. . . . [at these

times] I just don’t know how to deal with her.”

A father’s experience

“Well, it all revolves around when she throws her tantrums . . . and no matter what I do all she does is sit there and just scream and scream

and scream. . . . It’s hurtful for me as a parent ‘cause no matter what I do

I can’t comfort my own child . . . [and] with that I don’t know who I’m angry at. I don’t know if I’m angry at her for the way she’s acting or if

I’m angry at myself for being upset for the way she’s acting. So I don’t

know where the anger lies with that. [Because of this] it’s almost like I feel

a loss inside. And because of the loss, I feel almost like a sorrow

inside.”

A Father’s experience

“[reflecting on his deployments and then being back home] I mean

[during battle] you just, you deal with these idiots that wanna kill ya, and so

your immediate [response] is just overwhelming force . . . and by force I

don’t mean words you know or physical force . . . sometimes it’s just like

your body posture . . . and so for me it’s like I’m terrified because I don’t

want, I don’t wanna treat my kids like I treated some guy that I just pulled out

of his house and you know he’s got 500 RPGs [rocket propelled grenades] in there that been hitting our convoys for weeks.:

A father’s experience

National Guard/Reservists Parental PTSD Infidelity Suicide

Special Considerations

Questions?