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ABSTRACT: Deployment represents a significant potential strain on military families. The impact of postdeployment stresses may be increased if family coping resources are diminished by returning service members' physical injuries, mental health issues, or substance abuse. This article examines the health and mental health correlates of self-reported concerns regarding interpersonal conflict among married soldiers following return from deployment and the likelihood that soldiers acknowledging such concerns are referred to counseling services. Among 20,166 married Army soldiers completing Post-Deployment Health Reassessments, 18% reported having experienced serious interpersonal conflict with their spouse, family members, close friends, or coworkers. Results indicate that interpersonal conflict was more common among those who reported health problems, depression, post-traumatic stress disorder, and alcohol abuse. Among soldiers reporting interpersonal conflict and not already receiving services, 11% were referred to service. Findings support the need to communicate with soldiers and their spouses about the availability of services following return from deployment and to continue efforts to reduce stigma associated with seeking treatment.
Military medicine 10/2012; 177(10):1178-83. · 0.92 Impact Factor
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ABSTRACT: Stigma associated with substance abuse is less understood than stigma of mental health. Moreover, neither issue has been studied in depth within the military. We conducted focus groups with soldiers at six installations to explore how perceptions regarding substance abuse and mental health issues influenced attitudes toward treatment of these issues. Analyses indicate that negative attitudes toward treatment for alcohol abuse are based on their association with infractions that precipitate treatment and acceptance for soldiers with deployment-related mental health issues. However, the military context appears to moderate the influence of perceived responsibility and danger on stigmatization. Our data suggest several strategies that may useful in reducing stigma associated with alcohol abuse treatment in the military.
Military Psychology 01/2011; 23(1):36-51. · 0.72 Impact Factor
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ABSTRACT: Combat exposure and other factors associated with military service may place soldiers at increased risk of substance use and mental health issues. We examine the importance of soldier characteristics and risk for alcohol abuse and mental health issues in predicting entry into treatment for alcohol abuse and treatment for mental health issues among active duty soldiers (n = 43,342). Results indicated that soldiers were more likely to be referred for mental health issues than alcohol abuse issues and that marital status, race/ethnicity, and pay grade were predictive of the likelihood of entering treatment. We discuss the implications of our findings with regard to the referral and treatment of alcohol abuse and mental health issues within the military environment.
Military Psychology 01/2011; 23(1):22-35. · 0.72 Impact Factor
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ABSTRACT: Few studies have compared persons in treatment to those not in treatment with regard to perceived stigma. We surveyed soldiers to examine differences in stigma perceptions among those in treatment for substance abuse and/or mental health problems (n = 470) and those not in treatment (n = 966). Analyses revealed that soldiers in treatment perceived greater stigma regarding mental health treatment compared with soldiers not in treatment. These findings support the notion that personnel most in need of treatment perceive greater stigma associated with these services and as a result may be less likely to pursue them. We discuss the implications of our findings for theory, research, and practice.
Military Psychology 01/2011; 23(1):52-64. · 0.72 Impact Factor
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ABSTRACT: Data on 7,424 soldier spouse abuse offenders were analyzed to determine the prevalence of substance use during abusive incidents, and to examine differences between substance-using and non-substance-using offenders. Results showed that 25% of all offenders used substances during abusive incidents, with males and non-Hispanic Whites being more likely to hav e used substances. Substance-using offenders were more likely to perpetrate physical spouse abuse and more severe spouse abuse. These findings underscore the importance of educating military personnel (including commanders) about links between substance use and domestic violence, and of coordinating preventive and therapeutic substance abuse and violence-related interventions.
Violence Against Women 11/2010; 16(11):1295-310. · 1.33 Impact Factor
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ABSTRACT: Child maltreatment (CM) and intimate partner violence (IPV) take a tremendous toll on communities around the world. Despite the impact of CM and IPV, data on their incidence are drawn from disparate sources of varying quality. To improve data resources in these areas, the Centers for Disease Control and Prevention's (CDC) Division of Violence Prevention funded state-based IPV and CM surveillance activities in nine states between 1994 and 2005. This article describes reported outcomes of these surveillance programmes; assesses factors affecting their sustainability; and provides recommendations for similar programmes through document review and interviews with state representatives. Findings indicate that states achieved outcomes with these surveillance initiatives; however, states noted concerns with sustaining systems because of a lack of resources and ineffective collaborations. Highlighted in this article are several lessons that other countries can learn from the experiences of these states in testing CM and IPV surveillance systems.
International Journal of Injury Control and Safety Promotion 04/2010; 17(3):177-85. · 0.67 Impact Factor
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ABSTRACT: Army data from 2000 to 2004 were used to compare two groups of married, male, Army soldier, first-time family violence offenders: 760 dual offenders (whose initial incident included both child maltreatment and spouse abuse) and 2,209 single offenders (whose initial incident included only child maltreatment). The majority (81%) of dual offenders perpetrated physical spouse abuse; however, dual offenders were less likely than single offenders to perpetrate physical child abuse (16% vs. 42%) or sexual child abuse (1% vs. 11%), but they were more likely to perpetrate emotional child abuse (45% vs. 12%). These findings may be, at least in part, explained in light of the Army Family Advocacy Program policy, which considers spouse offenders as also being emotional child abuse offenders since children may be traumatized by exposure to spouse abuse.
Violence and Victims 02/2009; 24(4):458-68. · 1.28 Impact Factor
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ABSTRACT: Although empowerment evaluation has gained widespread currency, few reports have described its outcomes. This article combines perspectives of participants and technical assistance providers to describe the process and outcomes of the Evaluation Assistance for Sexual Violence Programs project. Participating programs reported substantial enhancements in evaluation capacity, resources devoted to evaluation, and the extent and sophistication of their evaluation practice, as well as numerous examples of the application of evaluation findings to program improvement. Experiences from evaluation technical assistance providers identified aspects of the process that were particularly useful in achieving these outcomes, including investing in collaborative relationships, maximizing participation among program staff, tailoring the content and form of technical assistance to program preferences, and combining structured learning with program-specific technical assistance.
Health Promotion Practice 01/2009; 10(1 Suppl):38S-44S.
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ABSTRACT: Although substance abuse has consistently been linked to child maltreatment, no study to date has described the extent of substance abuse among child maltreatment offenders within the military. Analysis of U.S. Army data on all substantiated incidents of parental child maltreatment committed between 2000 and 2004 by active duty soldiers found that 13% of offenders were noted to have been abusing alcohol or illicit drugs at the time of their child maltreatment incident. The odds of substance abuse were increased for offenders who committed child neglect or emotional abuse, but were reduced for child physical abuse. The odds of offender substance abuse nearly tripled in child maltreatment incidents that also involved co-occurring spouse abuse. Findings include a lack of association between offender substance abuse and child maltreatment recurrence, possibly because of the increased likelihood of removal of offenders from the home when either substance abuse or spouse abuse were documented.
Child Maltreatment 09/2008; 13(3):259-68. · 2.77 Impact Factor
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ABSTRACT: This study compared the occurrence of child maltreatment in military and nonmilitary populations. Data came from the National Child Abuse and Neglect Data System. All cases of child maltreatment substantiated from January 1, 2000 through December 31, 2002, in the state of Texas were analyzed. The rate of occurrence of substantiated maltreatment was lower for children in military families compared with children in nonmilitary families (5.05 vs. 7.89 per 1000 person-years). A greater proportion of caretakers of children in nonmilitary families compared with military families reportedly had financial problems (18.7% vs. 5.2%) and received public assistance (28.2% vs. 8.9%). The rate of occurrence of substantiated child maltreatment appears to be lower in military than nonmilitary families. The proportion of families with financial problems and public assistance is lower in military than nonmilitary families, suggesting that these factors may increase stress in families and the risk of maltreatment.
Military medicine 07/2008; 173(6):515-22. · 0.92 Impact Factor
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ABSTRACT: Parental stress is believed to play a critical role in child maltreatment, and deployment is often stressful for military families.
To examine the association between combat-related deployment and rates of child maltreatment in families of enlisted soldiers in the US Army who had 1 or more substantiated reports of child maltreatment.
Descriptive case series of substantiated incidents of parental child maltreatment in 1771 families of enlisted US Army soldiers who experienced at least 1 combat deployment between September 2001 and December 2004.
Conditional Poisson regression models were used to estimate rate ratios (RRs) that compare rates of substantiated child maltreatment incidents during periods of deployment and nondeployment.
A total of 1858 parents in 1771 different families maltreated their children. In these families, the overall rate of child maltreatment was higher during the times when the soldier-parents were deployed compared with the times when they were not deployed (942 incidents and 713 626 days at risk during deployments vs 2392 incidents and 2.6 million days at risk during nondeployment; RR, 1.42 [95% confidence interval {CI}, 1.31-1.54]). During deployment, the rates of moderate or severe maltreatment also were elevated (638 incidents and 447 647 days at risk during deployments vs 1421 incidents and 1.6 million days at risk during nondeployment; RR, 1.61 [95% CI, 1.45-1.77]). The rates of child neglect were nearly twice as great during deployment (761 incidents and 470 657 days at risk during deployments vs 1407 incidents and 1.6 million days at risk during nondeployment; RR, 1.95 [95% CI, 1.77-2.14]); however, the rate of physical abuse was less during deployments (97 incidents and 80 033 days at risk during deployments vs 451 incidents and 318 326 days at risk during nondeployment; RR, 0.76 [95% CI, 0.58-0.93]). Among female civilian spouses, the rate of maltreatment during deployment was more than 3 times greater (783 incidents and 382 480 days at risk during deployments vs 832 incidents and 1.2 million days at risk during nondeployment; RR, 3.33 [95% CI, 2.98-3.67]), the rate of child neglect was almost 4 times greater (666 incidents and 303 555 days at risk during deployments vs 605 incidents and 967 362 days at risk during nondeployment; RR, 3.88 [95% CI, 3.43-4.34]), and the rate of physical abuse was nearly twice as great (73 incidents and 18 316 days at risk during deployments vs 141 incidents and 61 105 days at risk during nondeployment; RR, 1.91 [95% CI, 1.33-2.49]).
Among families of enlisted soldiers in the US Army with substantiated reports of child maltreatment, rates of maltreatment are greater when the soldiers are on combat-related deployments. Enhanced support services may be needed for military families during periods of increased stress.
JAMA The Journal of the American Medical Association 09/2007; 298(5):528-35. · 30.03 Impact Factor
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ABSTRACT: War has a profound emotional impact on military personnel and their families, but little is known about how deployment-related stress impacts the occurrence of child maltreatment in military families. This time-series analysis of Texas child maltreatment data from 2000 to 2003 examined changes in the occurrence of child maltreatment in military and nonmilitary families over time and the impact of recent deployment increases. The rate of occurrence of substantiated maltreatment in military families was twice as high in the period after October 2002 (the 1-year anniversary of the September 11th attacks) compared with the period prior to that date (rate ratio = 2.15, 95% confidence interval: 1.85, 2.50). Among military personnel with at least one dependent, the rate of child maltreatment in military families increased by approximately 30% for each 1% increase in the percentage of active duty personnel departing to (rate ratio = 1.28, 95% confidence interval: 1.20, 1.37) or returning from (rate ratio = 1.31, 95% confidence interval: 1.16, 1.48) operation-related deployment. These findings indicate that both departures to and returns from operational deployment impose stresses on military families and likely increase the rate of child maltreatment. Intervention programs should be implemented to mitigate family dysfunction in times of potential stress.
American Journal of Epidemiology 06/2007; 165(10):1199-206. · 5.22 Impact Factor
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ABSTRACT: This study analyzed data collected by the U.S. Army’s Family Advocacy Program, the group primarily responsible for family
violence prevention, identification, evaluation, treatment, and follow-up on Army installations. Patterns of spouse abuse
and child abuse perpetrated within a five year period (2000–2004) were examined in a sample of 10,864 Army Soldiers who were
substantiated for family violence offenses. Three groups of family violence offenders were compared: (1) those who perpetrated
spouse offenses only; (2) those who perpetrated child offenses only; and (3) those who perpetrated both spouse and child offenses.
Results showed that the majority of substantiated family violence offenders were spouse offenders who had not committed child
abuse (61%), followed by child offenders who had not committed spouse abuse (27%), and finally those who committed both spouse
and child offenses (12%). The three groups of family violence offenders differed in terms of the types of abuse they perpetrated
(neglect of children, emotional abuse, physical abuse, and sexual abuse), their experiences of being a spouse abuse victim,
and sociodemographic characteristics. Twelve percent of all spouse abusers committed multiple spouse abuse incidents, and
10% of all child abusers committed multiple child abuse incidents.
Journal of Family Violence 01/2007; 22(7):587-595. · 1.17 Impact Factor
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ABSTRACT: Family violence, including both child maltreatment and spouse abuse, is a public health concern in both military and civilian populations. However, there is limited knowledge concerning violence in military families relative to civilian families. This literature review critically reviews studies that examine child maltreatment and spouse abuse among military families and compares family violence in military versus nonmilitary populations. Physical abuse and neglect compose the majority of the reported and substantiated cases of child maltreatment in military families, followed by sexual abuse and emotional abuse. On the other hand, physical abuse represents more than 90% of all substantiated cases of spouse abuse in military families, followed by emotional abuse, neglect, and sexual abuse. Mixed results were found when comparing military and nonmilitary families in terms of child maltreatment and spouse abuse, in part because of a lack of consistency in policies and practices between military and civilian agencies.
Trauma Violence & Abuse 05/2006; 7(2):93-108. · 3.27 Impact Factor
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ABSTRACT: This study analyzed data collected by the U.S. Army's Family Advocacy Program, the group primarily responsible for family violence prevention, identification, evaluation, treatment, and follow-up on Army installations. Patterns of spouse abuse and child abuse perpetrated within a five year period (2000–2004) were examined in a sample of 10,864 Army Soldiers who were substantiated for family violence offenses. Three groups of family violence offend-ers were compared: (1) those who perpetrated spouse of-fenses only; (2) those who perpetrated child offenses only; and (3) those who perpetrated both spouse and child offenses. Results showed that the majority of substantiated family violence offenders were spouse offenders who had not committed child abuse (61%), followed by child offend-ers who had not committed spouse abuse (27%), and finally those who committed both spouse and child offenses (12%). The three groups of family violence offenders differed in terms of the types of abuse they perpetrated (neglect of children, emotional abuse, physical abuse, and sexual abuse), their experiences of being a spouse abuse victim, and sociodemographic characteristics. Twelve percent of all spouse abusers committed multiple spouse abuse inci-dents, and 10% of all child abusers committed multiple child abuse incidents.
