Association of Parental Status and Diagnosis of Posttraumatic Stress Disorder Among Veterans of Operations Iraqi and Enduring Freedom

Authors
Janke-Stedronsky, S. R. Greenawalt, D. S. Stock, E. M. Tsan, J. Y. MacCarthy, A. A. MacCarthy, D. J. Copeland, L. A.
Publication year
2015
Citation Title
Association of parental status and diagnosis of posttraumatic stress disorder among veterans of Operations Iraqi and Enduring Freedom.
Journal Name
Psychological Trauma: Theory, Research, Practice, and Policy
Journal Volume
8
Issue Number
1
Page Numbers
72-79
DOI
10.1037/tra0000014
Summary
Service members who are parents may have additional concerns during deployment about their family’s well-being than non-parent Service members. The relationship between having dependent children and receiving a diagnosis of posttraumatic stress disorder (PTSD) was examined among OEF/OIF Veterans who used the Veterans Affairs (VA) department’s care during 2006-2009. Veterans with dependent children were significantly more likely to have a PTSD diagnosis than those without children.
Key Findings
After controlling for mental health care utilization, parents of dependent children were almost 50% more likely to be diagnosed with PTSD than non-parents.
The association between parenthood and PTSD was stronger for men than women.
White race and Hispanic ethnicitiy were associated with an increased risk of PTSD.
Among men, younger age was associated with higher odds of having PTSD.
Implications for Program Leaders
Offer parenting classes for Service members living with PTSD
Provide education and support groups for military parents living with PTSD (e.g., websites, brochures, mobile apps) to empower them as parents
Offer classes for military youth whose parent has PTSD, providing information about the symptoms of PTSD and how children can cope during difficult times
Implications for Policy Makers
Continue to support military family programs, including programs for Service members with PTSD
Recommend collaboration among child care providers and other community providers to allow Service members who are parents to access mental health appointments more easily
Support programs in providing child-appropriate spaces (e.g., play areas, waiting rooms with children’s books) to make it easier for parents to bring children to appointments
Methods
Administrative records of OEF/OIF Veterans who used VA services between 2006 and 2009 were used to select those with dependent children.
As a control group, Veterans without children were matched on age, gender, and demobilization month.
Records were used to examine the associations between disability status, medical comorbidity, stress-related care, and mental health service use among Veterans.
Participants
Participants included 72,688 Veterans with an average age of 31.8 years (SD = 8.3); 50% had dependent children, 92% were male, and 29% were married.
Veterans identified as 76% White, 19% Black, and 5% Asian American.
The majority of the participants had a history of multiple deployments (53%).
Limitations
Due to the cross-sectional nature of the study, causal conclusions cannot be drawn.
Births of new children were not recorded; some of the non-parents likely became parents during the course of the study.
Other unmeasured variables (e.g., combat exposure, treatment outside the VA) may have impacted the findings.
Avenues for Future Research
Investigate the association between motherhood and PTSD diagnoses using a larger sample of female Service members
Examine mediating factors that contribute to the observed relationship between parenthood and PTSD
Explore the experiences and needs of offspring of military parents living with PTSD
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Research indicates that concerns about disruption of family relationships during military service may be associated with greater posttraumatic stress symptomatology. The current study sought to extend previous findings by examining the relative odds of a posttraumatic stress disorder (PTSD) diagnosis among Operations Enduring and Iraqi Freedom (OEF/OIF) veterans with dependent children versus veterans without dependent children. Administrative databases were queried to identify 36,334 OEF/OIF veterans with dependent children seeking care in the Veterans Health Administration (VA) during fiscal years 2006–2009. These veterans were matched 1:1 on age, gender, and demobilization date to veterans without dependent children (N = 72,668). In unconditional analyses, OEF/OIF veterans with dependent children versus those without were significantly more likely to incur a PTSD diagnosis (44% vs. 28%). After controlling for demographic variables, mental health utilization, and other serious mental illness, OEF/OIF veterans with dependent children were about 40% more likely to carry a diagnosis of PTSD. The association was stronger for men than for women. It may be of value for clinicians to consider parental status when assessing and treating veterans with PTSD. In-depth study of OEF/OIF veterans is needed to determine whether disruption of family relationships leads to increased psychological stress or parents are more likely than nonparents to seek VA mental health services for PTSD symptoms.
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