Since 2001, armed conflicts have required extraordinary sacrifices by U.S. military service members and their families. Literature on the impact of the military lifestyle between 2001 and 2021 suggests frequent relocation and deployment have consequences for children. Limited research on the subpopulation of children and youth with special health care needs contains evidence these military families face complex issues, amplifying stressors of military life. The results of this review identified challenges in continuity of care in education, health care, and family support resulting from frequent relocations, plus notable gaps in research. These findings are important because of their potential impact on military readiness, recruitment, and retention. This review appears to be the only peer-reviewed systematic literature review on military-connected children with special health care needs and their families.
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1 - 12 of 121 Military-connected children with special health care needs and their families: A literature review
Military-connected children with special health care needs and their families: A literature review
APA Citation:
Hill, A. Toni, & Blue-Banning, M. (2023). Military-connected children with special health care needs and their families: A literature review. Armed Forces & Society. Advance online publication. https://doi.org/10.1177/0095327X231197992
Focus:
Children
Parents
Programming
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
School age (6 - 12 yrs)
Adolescence (13 - 17 yrs)
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Research & Summary
Hill, Antoinette “Toni”; Blue-Banning, Martha
2023
Love is not all you need: Understanding the association between relationship status and relationship dysfunction with self-directed violence in veterans
APA Citation:
Weber, D. M., Halverson, T. F., Daruwala, S. E., Pugh, M. J., Calhoun, P. S., Beckham, J. C., & Kimbrel, N. A. (2023). Love is not all you need: Understanding the association between relationship status and relationship dysfunction with self-directed violence in veterans. Archives of Suicide Research. Advance online publication. https://doi.org/10.1080/13811118.2023.2237097
Focus:
Veterans
Couples
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
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Research & Summary
Weber, Danielle M.; Halverson, Tate F.; Daruwala, Samantha E.; Pugh, Mary Jo; Calhoun, Patrick S.; Beckham, Jean C.; Kimbrel, Nathan A.
2023
Introduction Research indicates that being married is associated with reduced risk of suicide and self-directed violence (SDV) relative to being divorced. Simultaneously, difficulties within relationships predict poorer health outcomes. However, research on relationship status rarely examines relationship functioning, obfuscating the joint contribution of these variables for SDV risk.Method Veterans (N = 1,049) completed a survey that included assessment of relationship status, relationship functioning, and SDV history. Logistic regression models tested how (a) relationship status, (b) relationship dysfunction, and (c) being divorced compared to being in a low- or high-dysfunction relationship were associated with SDV, controlling for several intrapersonal risk factors.Results Veterans in a relationship did not differ in SDV history compared to divorced/separated veterans. However, more dysfunction within relationships was associated with greater odds of a history of SDV and suicidal cognitions. Finally, SDV histories were more likely among veterans endorsing high-dysfunction relationships compared with (a) low-dysfunction relationships and (b) divorced veterans.Conclusion It may be insufficient to only consider relationship status when evaluating interpersonal risk factors for SDV. A single item assessing relationship dysfunction was associated with enacted SDV and suicidal cognitions over and above intrapersonal risk factors. Integrating such single-item measures into clinical practice could improve identification and subsequent tailored intervention for veterans at greater risk for SDV.
Mental health, alcohol use, and associations with pre-deployment family functioning in active-duty service members
APA Citation:
Jia-Richards, M., Morissette, S. B., Ellor, J. W., Myers, D. R., Crow, J., Whitacre, J., & Dolan, S. L. (2023). Mental health, alcohol use, and associations with pre-deployment family functioning in active-duty service members. Military Behavioral Health. Advance online publication. https://doi.org/10.1080/21635781.2023.2246899
Focus:
Substance use
Mental health
Deployment
Branch of Service:
Army
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Jia-Richards, M.; Morissette, S. B.; Ellor, J. W.; Myers, D. R.; Crow, J.; Whitacre, J.; Dolan, S. L.
2023
As service members prepare to deploy, poor mental health and increased alcohol use associated with the difficulties of the pre-deployment period may negatively impact service members’ family functioning. The etiology of poor family functioning may also differ for men and women serving in the military. The current study recruited U.S. military service members (N = 343, 28% women, 59% White) preparing to deploy to Iraq or Afghanistan to examine the effects of symptoms of depression, anxiety, stress, post-traumatic stress (PTS), and alcohol use (frequency and quantity) on family functioning. We also sought to identify whether those effects differed between genders. Across participants, PTS was the only factor significantly associated with worse family functioning (β = .01, SE = .00, t(251.99) = 2.03, p = .043), however the effect of depression was similar in magnitude and trending toward significance (β = .01, SE = .00, t(297.49) = 1.96, p = .051). Interactions between gender, mental health, and alcohol use were non-significant. Findings suggest that addressing service members’ PTS and depression symptoms pre-deployment could improve family functioning. Gender may not be a major factor for pre-deployment mental health and family functioning, although more research is warranted. Contrary to expectations, alcohol use was unrelated to family functioning. Future studies should consider using measures of drinking that capture alcohol-related problems in addition to consumption. As service members prepare to deploy, it is important to understand which factors are most impactful on family functioning as this may help target preventative interventions during the pre-deployment stage.
4 Incidence of postpartum depression decreases after initial expansion of military maternity leave
Incidence of postpartum depression decreases after initial expansion of military maternity leave
APA Citation:
Herrick, M. S. R., & Chai, W. (2023). Incidence of postpartum depression decreases after initial expansion of military maternity leave. Military Medicine, Article usad354. https://doi.org/10.1093/milmed/usad354
Focus:
Mental health
Programming
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Herrick, Minette S. R.; Chai, Weiwen
2023
Postpartum depression impacts 1 in 8 women in the United States. Research has indicated maternity leave duration, and compensation can have an impact on postpartum depression symptoms. The U.S. military increased their maternity leave provision from 6 to 12 weeks in 2016. The aim of this study was to expand upon current literature on the role of maternity leave on postpartum depression by analyzing objective data from 2011 to 2019 utilizing military health records.All deliveries to active duty women in the Military Health System from 2011 to 2019 were considered for analysis. A total of 60,746 women met inclusion criteria. Active duty women were stratified by year of delivery to identify if they had 6 weeks (2011–2015) or 12 weeks (2016–2019) of maternity leave. International Classification of Disease (ICD)-9 and ICD-10 codes were used for the identification of postpartum depression diagnosis. Logistic regression models were used to assess the association between maternity leave provision and postpartum depression diagnosis adjusting for covariates.Overall, 4.8% of the women were diagnosed with postpartum depression. Active duty women who were allotted 12 weeks (2016–2019) of maternity leave had higher odds of postpartum depression diagnosis than those allotted 6 weeks (2011–2015) (12 weeks vs. 6 weeks of leave: odds ratio [OR] = 1.29; 95% confidence interval [CI] = 1.20–1.39, P < 0.0001). However, there was a 50% reduction in odds of postpartum depression during 2016–2017 (the 2 years following the 12-week leave implementation) in comparison to 2011–2015 (OR = 0.50; 95% CI = 0.43–0.57, P < 0.0001). The trends were similar across military branches. Additionally, between 2011 and 2019, the lowest rates of postpartum depression were observed during 2016–2017, but the rates significantly increased starting 2018. Overall, women with lower military ranks had higher postpartum depression rates than those with higher ranks.Our results indicate increasing paid maternity leave in the military from 6 to 12 weeks did initially lower the odds of postpartum depression diagnosis among active duty women from immediately after policy implementation (2016) and prior to the release of the Veterans Affairs and Department of Defense Clinical Practice Guidelines on Pregnancy Management (2018). Later, increased odds of depression (2018–2019) are likely due to increased depression screening protocols at the Military Treatment Facilities in the perinatal period.
5 Challenges and opportunities to maximize mental health among shipboard sailors: A qualitative study
Challenges and opportunities to maximize mental health among shipboard sailors: A qualitative study
APA Citation:
Schmied, E. A., Harrison, E. M., Englert, R. M., Thomsen, C. J., & Glassman, L. H. (2023). Challenges and opportunities to maximize mental health among shipboard sailors: A qualitative study. Military Behavioral Health. Advance online publication. https://doi.org/10.1080/21635781.2023.2258785
Focus:
Mental health
Branch of Service:
Navy
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Schmied, Emily A.; Harrison, Elizabeth M.; Englert, Robyn M.; Thomsen, Cynthia J.; Glassman, Lisa H.
2023
Recent reports show U.S. sailors have the highest rates of self-reported psychological health symptoms of any service, perhaps in part due to the unique challenges of serving in a shipboard environment. Resources are available to maximize the psychological health of sailors while at sea, though no empirical research is available regarding sailors’ perspectives on what strategies, services, and programs they find most helpful and accessible. To address this knowledge gap, thirteen focus groups were conducted with sailors from two different ships (n = 86) to determine how they manage stress and maximize psychological health while underway. Content analysis of focus group transcripts conducted by two independent reviewers identified themes within three content areas: strategies and resources to manage stress and maximize psychological health; challenges to accessing supportive services and resources; and opportunities to improve psychological health. Five themes emerged for managing stress underway, the most common of which was engaging in physical fitness. Others included participating in organized social events, general comradery and social support, seeking help from medical, and communicating with Chaplains. Social and logistical barriers to seeking psychological healthcare were identified, including stigma, fear of adverse career repercussions, and too few providers/long wait times. Suggestions for improving psychological health at sea included improving sleep health, changes to workload and scheduling, increased shipboard providers trained in psychological healthcare, and increased social support. Specific interventions that may benefit shipboard sailors are sleep health education, improvements to berthing areas, adoption of circadian watchbills, telemedicine, and an increased number of social events aboard ships.
Fathers’ marital conflict and children’s socioemotional skills: A moderated-mediation model of conflict resolution and parenting
APA Citation:
Gong, Q., Kramer, K. Z., & Tu, K. M. (2023). Fathers’ marital conflict and children’s socioemotional skills: A moderated-mediation model of conflict resolution and parenting. Journal of Family Psychology, 37(7), 1048–1059. https://doi.org/10.1037/fam0001102
Focus:
Parents
Children
Mental health
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Gong, Qiujie; Kramer, Karen Z.; Tu, Kelly M.
2023
Marital conflict is common in many families. The effects of marital conflict may often spill over to parent–child dyads and affect children’s development via their parenting practices. However, couples handle their marital conflict in different ways, and conflict resolution strategies may play a role in children’s outcomes. Although mother-reported marital conflict has been a primary focus in most prior studies, little is known about fathers’ perspectives. To that end, we examined the mediating effect of fathers’ parenting in the association between the frequency of marital conflict and mother-reported children’s socioemotional skills in preschool, as well as the moderating role of father constructive conflict resolution frequency in the association between father reports of the frequency of the marital conflict and parenting. Results indicate that father parenting warmth and parenting stress mediated the association between the frequency of marital conflict and children’s socioemotional skills. We also found that father reports of the frequency of the marital conflict was positively associated with involvement and negatively associated with warmth at higher levels of constructive conflict resolution frequency. Fathers who reported higher constructive conflict resolution frequency showed higher father involvement and warmth. Finally, the moderated-mediation analysis revealed that, after accounting for mothers’ parenting variables, father warmth was the moderated mediator, such that there was a negative indirect effect between the frequency of marital conflict and children’s socioemotional skills through father warmth at average and higher levels of constructive conflict resolution frequency. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
7 Examining food parenting practices in military families
Examining food parenting practices in military families
APA Citation:
Roys, B. E., & Balantekin, K. N. (2023). Examining food parenting practices in military families. Appetite, 185, Article 106545. https://doi.org/10.1016/j.appet.2023.106545
Focus:
Parents
Children
Other
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Roys, Brooke E.; Balantekin, Katherine N.
2023
Food parenting practices impact child eating and weight outcomes. While there are currently no data examining food parenting practices among military families, research on general parenting has shown that military families are more likely to engage in authoritarian parenting practices. In addition, psychological well-being affects food parenting, and the military lifestyle is defined by how frequently they experience stressful demands such as deployment and relocation. The study objectives were to describe food parenting practices among military families by: (1) comparing food parenting practices between military families and civilian families; and (2) exploring associations between military (total military years, deployments, relocation) and psychological (stress, anxiety, depression) factors and food parenting practices. Participants includes 358 parents (103 military, 255 civilian) of children between the ages of five and 13 years. There were no significant differences in food parenting practices between military and civilian families. However, within military families, both total number of military parent and having more than one military parent were associated with increased structure-based food parenting practices. Having more than one military relocation was associated with more frequent pressure to eat and coercive control. While stress was associated with more frequent restriction, there were no associations between anxiety or depression and food parenting practices. These findings suggest that although food parenting practices of military families are similar to those of their civilian counterparts, there are specific psychological and military life factors that impact food parenting practices in this population.
8 Veteran caretaker perspectives of the need for childcare assistance during health care appointments
Veteran caretaker perspectives of the need for childcare assistance during health care appointments
APA Citation:
Shepherd-Banigan, M., Cannedy, S., Rodriguez, A. N., Burns, M., Woolson, S., Hamilton, A., Quiroz, I., Matthews, H., Garber-Cardwell, D., Byrd, K. G., Brown, A., & Goldstein, K. M. (2024). Veteran caretaker perspectives of the need for childcare assistance during health care appointments. Women's Health Issues, 34(1), 98-106. https://doi.org/10.1016/j.whi.2023.08.005
Focus:
Veterans
Programming
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Shepherd-Banigan, Megan; Cannedy, Shay; Rodriguez, Adelmira N.; Burns, Madison; Woolson, Sandra; Hamilton, Alison; Quiroz, Ismael; Matthews, Hanh; Garber-Cardwell, Diane; Byrd, Kaileigh G.; Brown, Adrian; Goldstein, Karen M.
2024
Purpose In 2020, Congress passed legislation to establish the national Veterans Child Care Assistance Program (VCAP) targeting eligible veterans receiving care through the Veterans Health Administration (VA). This needs assessment describes the childcare needs of veteran caretakers of young children and explores the implications of inadequate childcare on health care engagement. Methods Survey data were collected from 2,000 VA users with dependent children; data were analyzed using standard descriptive statistics. Qualitative data were collected from 19 veterans through focus groups and analyzed using rapid thematic analysis. Findings More than 75% of veterans surveyed indicated that they required childcare assistance during health care appointments and 73% reported barriers to finding childcare. Prominent barriers included the high cost of childcare and not having a trusted source of childcare. Nearly 58% of survey respondents reported missed or canceled VA health care appointments due to childcare challenges. Furthermore, 35% of surveyed veterans reported that their children had accompanied them to an appointment in the past year. Among these veterans, 59% brought their children into the exam room. Focus group participants discussed how having children present during their health care appointments hampered communication with health care providers. Conclusions Veterans report that lack of childcare keeps them from attending and remaining focused on the provider during their health care visits, which could compromise quality of care. As one of the only health systems in the United States that will offer childcare assistance, VCAP presents an opportunity to improve health care access and quality by reducing missed appointments and suboptimal care.
Trauma-informed parenting intervention for veterans: A preliminary uncontrolled trial of Strength at Home–Parents
APA Citation:
Creech, S. K., Pearson, R., Saenz, J. J., Braciszewski, J. M., Riggs, S. A., & Taft, C. T. (2023). Trauma-informed parenting intervention for veterans: A preliminary uncontrolled trial of Strength at Home–Parents. Journal Of Family Psychology, 37(8), 1294-1302. https://doi.org/10.1037/fam0001131
Focus:
Programming
Veterans
Mental health
Parents
Branch of Service:
Multiple branches
Military Affiliation:
Veteran
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Creech, Suzannah K.; Pearson, Rahel; Saenz, Jeremy J.; Braciszewski, Jordan M.; Riggs, Shelley A.; Taft, Casey T.
2023
Trauma exposure and posttraumatic stress disorder (PTSD) are highly prevalent in military and veteran populations and are associated with parenting difficulties. Unfortunately, there is a lack of accessible, trauma-informed, and evidence-based parenting support interventions within the Department of Veterans Affairs (VA). Strength at Home–Parents (SAHP) is a trauma-informed psychotherapy group that aims to improve parenting behaviors and overall parent–child and family functioning among U.S. military veterans with PTSD symptoms. SAHP was developed to maximize ease of use by VA providers and accessibility for parents. Here we report data from an uncontrolled trial of SAHP delivered using synchronous video technology in a sample of veterans using VA care (N = 53) who met the criteria for PTSD and parent–child functioning difficulties. Enrollment and retention rates met study goals and suggest feasibility and acceptability of study methods. Significant pre- to postintervention improvements were observed in measures of dysfunctional discipline, parenting stress, general family functioning, child psychosocial functioning, and parental PTSD and depression symptoms. Coupled with high satisfaction ratings, findings support further study of the intervention, including in an efficacy trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
10 Exploring the lived experiences of pain in military families: A qualitative examination
Exploring the lived experiences of pain in military families: A qualitative examination
APA Citation:
Noyek, S., Lund, T., Jordan, A., Hoppe, T., Mitchell, R., Mitchell, R., Stinson, J., & Noel, M. (2023). Exploring the lived experiences of pain in military families: A qualitative examination. The Journal of Pain, 24(12), 2340-2351. https://doi.org/10.1016/j.jpain.2023.07.016
Focus:
Physical health
Children
Parents
Veterans
Branch of Service:
International Military
Multiple branches
Military Affiliation:
Veteran
Population:
Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Noyek, Samantha; Lund, Tatiana; Jordan, Abbie; Hoppe, Tom; Mitchell, Rebekah; Mitchell, Ryan; Stinson, Jennifer; Noel, Melanie
2023
Chronic pain in Canadian Veterans is twice that of the general population and the prevalence of their related mental health concerns is alarmingly high. This likely puts their children at an increased risk of developing pain and mental health problems that can pervasively impact daily life and persist into adulthood. Pain care and military culture of (acute and chronic) pain has been identified as a top priority of Canadian Veterans. This study aimed to gain an in-depth understanding of the pain experiences of Canadian Armed Forces (CAF) families. Thirty-five semi-structured qualitative interviews were conducted. Demographic information was collected; age, gender, and ethnicity were reported. Twelve CAF members/Veterans, 17 youth, and six spouses were interviewed. Ninety-two percent of Veteran participants reported chronic pain. Reflexive thematic analyses generated four themes: i) Military mindset: herd culture and solider identity, ii) The culture of pain within military families, iii) Inseparability of mental health and pain, iv) Breaking the cycle and shifting the military mindset. Military culture and identity create a unique context within which pain expression and experience is integrally shaped within these families. This study sheds light on how pain is experienced and perceived within military families and can inform research on and efforts to foster resilience in these families. Perspective This is the first qualitative study to explore the lived experiences of pain in Canadian military families. Findings underscore the key role that military culture and identity plays in how pain is experienced and perceived in all family members.
11 Gender role reversal: Civilian husbands of U.S. military servicewomen as tied-migrant workers
Gender role reversal: Civilian husbands of U.S. military servicewomen as tied-migrant workers
APA Citation:
Dowling, L. E., Jackson, J. B., & Landers, A. L. (2024). Gender role reversal: Civilian husbands of U.S. military servicewomen as tied-migrant workers. Family Relations, 73(1), 441-465. https://doi.org/10.1111/fare.12936
Focus:
Mental health
Other
Branch of Service:
Multiple branches
Army
Marine Corps
Air Force
Navy
Military Affiliation:
Active Duty
Population:
Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Dowling, L. Emily; Jackson, Jeffrey B.; Landers, Ashley L.
2024
Objective This qualitative study examined the experiences of male spouses of female service members in the U.S. military (civilian husbands of servicewomen) in their positions as tied-migrant workers. Background Employment of civilian husbands of servicewomen is frequently affected when they geographically relocate due to their wives' military service. Because societal norms for husbands as primary breadwinners in marriages persist and the majority of military couples consist of male service members married to female civilian spouses, civilian husbands of servicewomen may experience a gender role reversal in their identities as a spouse and as a provider within their relationships and military culture. Method Semistructured interviews were conducted with 22 civilian husbands who experienced at least one geographic relocation due to their wife's military service. Descriptive phenomenological analysis was used to discover the essence of participants' experiences. Results Themes around defining masculinity, minority experiences in the military, and nontraditional gender provider roles as tied-migrant workers emerged. Participants experienced a gender role reversal as tied-migrant workers and as military spouses, and they had some difficulties integrating into military communities. Participants expanded their masculine identities to include performing traditionally feminine tasks and valuing egalitarianism in their spousal relationships when they experienced barriers to breadwinning. Conclusion Findings indicated the importance of emotional support as civilian husbands navigate their masculine identities and relationships both with spouses and as gender minorities in their communities. Implications Clinical recommendations for psychotherapists are provided with an emphasis on using emotionally focused therapy with couples consisting of civilian husbands and servicewomen.
12 Post-traumatic stress symptoms and parenting in military families: A systematic integrative review
Post-traumatic stress symptoms and parenting in military families: A systematic integrative review
APA Citation:
Gupta, A., Gewirtz, A. H., & Borden, L. M. (2023). Post-traumatic stress symptoms and parenting in military families: A systematic integrative review. Journal of Family Theory & Review, 15(4), 822-844. https://doi.org/10.1111/jftr.12530
Focus:
Parents
Mental health
Branch of Service:
Multiple branches
Military Affiliation:
Active Duty
Population:
Young adulthood (18 - 29 yrs)
Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
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Research & Summary
Gupta, Aditi; Gewirtz, Abigail H.; Borden, Lynn M.
2023
Post-traumatic stress disorder (PTSD) among service members portends substantial impairments not only for the affected individual but also for their families. However, the association between PTSD symptoms and specific parenting domains remains understudied. Drawing upon the Military Family Stress Model and the Cognitive Behavioral Interpersonal Theory of PTSD, this systematic review provides an overview and synthesis of the literature on PTSD symptoms and parenting in military families with the objective to examine associations between parental PTSD symptoms and key parenting domains. Following PRISMA guidelines, 27 empirical studies were reviewed. Five distinct parenting domains emerged across studies. The findings indicated that greater PTSD symptoms were generally associated with adverse parenting outcomes with some variation across different parenting domains, such that some parenting outcomes showed more consistent negative associations with parental PTSD symptoms than others. These results have significant implications for research and practice, providing insight for family-focused intervention/prevention studies.
