Parents' wartime deployment associated with children's behavior problems

Children ages 3 to 5 with a parent deployed to a war zone appear to exhibit more behavior problems than their peers whose parents are not deployed, according to a report in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. More than 2 million U.S. children have had parents deployed to Iraq or Afghanistan during the wars there, according to background information in the article. About 40 percent of these children are younger than 5. "Recent policy statements from the American Psychological Association and the Department of Defense Task Force on Mental Health have called for research on the effect of wartime deployments on children in military families," the authors write.

Molinda M. Chartrand, M.D., of the Boston University School of Medicine and Boston Medical Center, and colleagues studied 169 families with children age 1½ to 5 who were enrolled in military childcare centers at a large Marine base in 2007. Parents and childcare providers each completed a behavior problem assessment that analyzed both internalizing (such as anxiousness, depression and withdrawal) and externalizing (such as attention problems and aggression) behaviors in the children. Parents also completed a questionnaire to measure their own level of depression. Caregivers provided information about the rank and deployment status of the parent in the service, as well as family composition and both parents' age, education and ethnicity.

Of the 169 families, 55 (33 percent) had a deployed parent, with an average deployment length of 3.9 months. Children age 3 and older who had a deployed parent had significantly higher scores on measures of externalizing and overall behavior problems than children of the same age without a deployed parent. "Such reported differences might be dismissed as distorted perceptions of the child by the distressed non-deployed parent; however, the association remained after controlling for parental stress and depressive symptoms," the authors write. In addition, childcare providers reported similarly elevated scores.

"Larger, longitudinal studies are needed to ascertain whether there are changes in children's behavior from the time before parental deployment, during parental deployment and at the time of reunification," the authors write. "This information is necessary to provide clinicians serving military families with evidence-based anticipatory guidance and clinical interventions. Finally, the needs of the children of deployed parents in the National Guard and Reserves also warrant urgent further elucidation."

(Arch Pediatr Adolesc Med. 2008;162[11]:1009-1014. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by the Joel and Barbara Alpert Foundation and the Society for Developmental and Behavioral Pediatrics. Support in the form of books was provided by Reach Out and Read. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Changes in Policy and Services Needed

"The decision to send troops into war is never taken lightly, and the sacrifices experienced by the soldiers, their families and their country are heavy burdens that may be considered intrinsic to war itself," write David J. Schonfeld, M.D., and Robin Gurwitch, Ph.D., of the Cincinnati Children's Hospital Medical Center, in an accompanying editorial. "However, our country's policies must be based on efforts to take all reasonable steps to minimize known negative effects; thus, these research results, which are unlikely to be surprising to pediatricians and other child health care providers, are nonetheless timely and important."

"Findings from this study highlight the need for increased attention to the mental health concerns of young children of deployed soldiers as well as the mental health concerns of the soldiers and non-deployed spouses," they continue. "They raise questions of how to best determine deployment length and what preventive measures can be taken to reduce stress and distress to the non-deployed spouses and children left behind."

(Arch Pediatr Adolesc Med. 2008;162[11]:1094-1095. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.

Source: JAMA and Archives Journals