The way how young soldiers and their spouses cope with deployment
The mental and emotional problems of U.S. soldiers deployed to the conflicts in Iraq and Afghanistan are well documented (see for example The Invisible Wounds of War). However, there is evidence that military families suffer as well, particularly from the stress of multiple and prolonged deployments. However, relatively little is known about the impact of military deployment on the emotional well-being of military families.
To address these knowledge gaps, the RAND research team conducted a longitudinal study of a sample of youth from military families and their caregivers. The study is one of the first to examine how these groups live during a long war. The study population was selected from applicants to Operation Purple® Camp, a free summer camp for children from military families sponsored by the National Military Family Association.
From the Operation Purple® applicants, 1,507 youths aged 11-17, as well as each youth's non-deployed caregiver, were randomly selected to approximate the composition of service and deployment participants based on the most recent data available at the time (November 2007). The survey consisted of telephone interviews with a young family and their coach on three occasions during the year: in the summer of 2008, six months later in the winter of 2009, and in the summer of 2009 at the end of the year. A total of 1127 young couples and their caregivers participated in at least the baseline and 12-month follow-up surveys.
The survey addressed three key questions:
- How are youth from military families who applied to participate in Operation Purple doing emotionally, socially, and academically?
- What problems do these youth report during and after their parents' deployment?
- What is the status of their non-custodial parents, including their placement?
The study also determined which subgroups reported the most difficulties and identified factors associated with these difficulties.
Youth in the study may have more emotional difficulties and anxiety symptoms than average
The study examined youth functioning in five areas:
Emotional difficulties. Caregivers were asked about their child's emotional health, including the extent to which the youth had difficulty interacting with peers and family members or was sad. Caregiver reports showed that 34% of youth aged 11 to 14 had moderate to severe emotional and behavioral problems, compared with 19% in the national sample of all youth (Figure 1). About one-third of caregivers of children ages 11 to 17 reported at baseline that their children had moderate or severe emotional difficulties. At the 6- and 12-month interviews, caregivers reported slightly fewer difficulties for adolescents, but still approached one-third of the sample analyzed.
Caregivers reported more moderate to severe emotional difficulties for study youth than for the national population sample.
Symptoms of anxiety. Youth in the sample were asked a series of questions designed to assess current anxiety symptoms. These questions included anxiety for no reason or difficulty sleeping. Thirty percent of these youth reported high anxiety symptoms, suggesting the need for further assessment, compared with 15% in other youth surveys. The proportion with heightened anxiety symptoms decreased over the study period, but remained around one-third of the study population.
Peer and family functioning. Caregivers and youth were also asked about peer functioning, such as how often youth had problems getting along with other children, making friends, or being bullied, and family functioning, such as how often youth had problems participating in family activities, carrying out responsibilities, getting along with their families, and talking to their parents about personal feelings or problems. Caregivers' reports of youth functioning in these areas were comparable to levels found in other surveys of youth in the United States. Peer functioning scores improved slightly over the study year; family functioning scores did not change.
Academic Participation. Youth were asked questions about academic engagement, such as whether they did their homework on time or came to class prepared. Overall, the self-reported academic engagement of surveyed youth was comparable to other studies of youth in the United States. Over the study period, self-reported school engagement improved significantly between the 6-month and 12-month studies.
Risky behavior. Youth in the study were asked about their involvement in risky or problematic behaviors, such as fighting with peers, getting into trouble at school, or using alcohol or other drugs. Overall, youth in the sample reported risky behaviors at levels similar to other U.S. surveys. The level of risk behavior reported by youth did not change over the survey year.
Longer cumulative duration of parental placement was associated with more difficulties for the youth in the study.
The research team also looked at problems specifically related to parental placement and reintegration among study youth.
Youth in the study reported problems related to placement.
Youth surveyed also reported problems during the integration process.
Problems with deployment. As shown in Figure 2, youth in the sample reported that the most difficult challenges during deployment were adjusting without a deployed parent (68%) and helping a non-deployed caregiver without a deployed parent (68%). Another widely cited concern was that people in the community did not understand what deployment meant (45%).
During the study period, youth whose parents had been in placement for several months together prior to the study period reported more difficulties than those whose parents had been in placement for fewer months prior to the study period, regardless of whether they had a placement experience during the study period.
Integration difficulties. As shown in Figure 3, we also asked youth about the challenges of returning home as a deployed soldier. Two challenges were most commonly cited by youth: adjusting to the home routines of the returning parent (54%) and concerns about the upcoming deployment (47%). There were no significant changes in integration difficulties over the study period, even among youth whose parent returned during this period.
We also identified subgroups of youth who were more likely to experience problems upon deployment or return:
- Older youth (ages 15-17) in the study were more likely to report difficulties with school and peers during deployment.
- Girls were more likely than boys to report difficulties during deployment.
- Child participants with higher self-perceived emotional well-being than their caregivers fared better during and after deployment. 15% of children in the study had higher self-perceived emotional well-being than their caregivers.
- In addition, two key factors – longer cumulative parental placement (13 months or more since 2001) and lower caregiver emotional well-being – were associated with greater difficulties in youth emotional and social functioning during the study period. This finding applied across all units and components.
- Caregivers' emotional well-being had an impact
Previous research has shown that caregivers who live away from home, including their children, can have significant deployment-related difficulties.
- We assessed caregivers' emotional well-being and also asked questions about deployment-specific topics, such as household management issues, the relationship with the deployed spouse, and the relationship between caregivers and children.
Overall, caregivers' self-reported emotional well-being in our study was comparable to well-being reported in other studies of adults in the United States. Caregivers in our sample cited two issues that were most challenging during deployment: coping with life without a deployed parent (72%) and the burden of new household responsibilities (57%). Caregivers reported that the most difficult challenge during deployment was adjusting to the parent's routine back home (62%).
- However, the level of challenges reported by caregivers varied across subgroups, with some factors associated with more challenges than others. Reservist caregivers (National Guard and Reservists) reported poorer mental well-being and more problems at home.
- Reservist caregivers and all currently deployed caregivers reported more problems in their relationship with their deployed parent.
- Good family communication quality-defined as a sense of empathy and understanding between parents and children-was associated with fewer problems at home, and these problems decreased on average, wave by wave, over the study period as family communication quality improved.
- Caregivers of boys reported greater parenting problems than did caregivers of girls; caregivers who were deployed at the time of the study reported greater problems than those who were not deployed.
- Caregivers' emotional well-being was most strongly associated with children's social, academic, and emotional outcomes. In addition, lower emotional well-being among caregivers was associated with greater problems in household management, relationships, and child rearing.
- When one parent returned from deployment, self-reported emotional difficulties among noncaregivers decreased. However, difficulties did not decrease when the surrogate parent was absent for the entire study period.
Conclusions and Implications
Overall, the results showed that young campers and their caregivers reported difficulties related to emotional functioning, household management, and relationships. Specifically, six subgroups of camp enrollees reported greater difficulties: (1) those whose caregivers had poorer emotional well-being, (2) those whose parent had more cumulative months of deployment, (3) older youth coping with their parent's deployment, (4) girls coping with demobilization, (5) caregivers and children with poorer communication skills, and (6) caregivers of reservists.
These findings are an important step in understanding the relationship between parental and military deployment and family well-being. The findings also have implications for how military family support programs might be targeted to better address the subgroups that benefit most.
Consider screening for emotional problems in families. Our findings on the well-being of young, non-deployed family caregivers suggest that ongoing assessment of family members' health and well-being before and after deployment may be warranted. This could help identify those most at risk and direct them to appropriate treatment or support programs. Although the assessment cannot be mandatory, it could be incorporated into routine visits and service delivery.
Target support to families facing several months of cumulative parental deployment. Some camp applicants appeared to be struggling with issues that did not abate over time. At the time of this report, military organizations do not have a systematic plan for guiding and managing youth whose families face several months of cumulative deployment. Our findings also suggest that older youth (ages 15-17), and girls in particular, can benefit from initiatives in this area.
Implementation of support programs throughout the placement period, including at discharge. Given the strong correlation between the length of placement and the challenges faced by the youth in our sample and their caregivers, specific initiatives may be needed for families who have been in placement for several months.
Programs focused on the quality of family interaction. For the families in the sample, higher quality family communication was associated with greater well-being and functioning of the child and caregiver, both during and after placement. Therefore, it may be important to consider incorporating evidence-based strategies into programs aimed at improving the quality of caregiver-youth and caregiver-foster parent interactions. This could include pre- and post-placement interventions that focus on whole family interactions and aim to improve empathy for each family member.
Ensure adequate resources to support caregivers, especially those in the National Guard and Reserves. Our survey results show that National Guard and Reserve caregivers in our sample reported greater challenges. Because military and Reserve families may have difficulty accessing services (for example, because they do not live near a military installation or have easy access to military resources), they may need better resources.
Evaluate programs in light of available research findings. Since the start of the conflicts in Iraq and Afghanistan, military family support programs have grown rapidly, but few have been thoroughly evaluated. These programs need to be systematically evaluated, particularly to determine how well their content meets the needs of families.
The results will also influence future research. The results highlight the challenges faced by military and non-military caregivers in their self-selected population. Broadening and deepening our understanding of the issues facing military families by examining additional samples of military youth is essential for military organizations to understand and appropriately address family needs. In addition, future studies would benefit from including comparable civilian samples to understand how the emotional well-being of military personnel and caregivers compares to the general population.
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.