Publication year
2017
Citation Title
The impact of deployment and traumatic brain injury on the health and behavior of children of US military service members and veterans.
Journal Name
Clinical Child Psychology and Psychiatry
Page Numbers
1-17
DOI
10.1177/1359104517740405
Summary
The U.S. military has been involved in conflicts since 2001 in the Middle East; resulting in an increase of Service members and Veterans reintegrating with their families after experiencing a traumatic brain injury (TBI). This study examined the impact of a Service member or Veteran's traumatic brain injury on the health and behavior of his or her children. Results showed that a significant number of the children of Service members or Veterans diagnosed with a TBI experienced a decrease in overall health in five domains: School grades, behavior, medical health, emotional health, and social participation).
Key Findings
Approximately 41.7%-79.1% of children experienced a decline in overall health following the TBI of a parent who is a Service member or Veteran.
Most declines in child health occurred within the first two years post-TBI (68.8%-75.5%).
Approximately 16.9%-26.5% of children experienced two declines in health; after the Service member or Veteran's deployment and following the TBI.
Although most of the children experienced a decline in health and behavior following the TBI of a parent who is a Service member or Veteran, only a minority of the sample reported declines in all five examined domains.
Implications for Program Leaders
Offer workshops during reintegration to help Service members, spouses, and children adjust following a TBI
Disseminate information regarding the possible effects a Service member's TBI may have on the overall health of their children
Offer pre and post-deployment support groups for military spouses focused on mitigating the effects of their partners' TBI on the health of their children
Implications for Policy Makers
Continue to develop and support programs that address the unique challenges Service members and their families may face after a TBI
Promote reintegration programs for spouses and children of Service members to help them adjust to the Service member's return following a TBI
Recommend education for community providers and professionals regarding the possible effects a Service member's TBI may have on the overall health of their children
Methods
Participants were spouses of Service members or Veterans recruited at the Walter Reed National Military Medical Center and through caregiver community outreach initiatives (e.g., conferences, organizations, social media, and snowball sampling).
Inclusion in the study required that participants are 18 years of age, able to comprehend English, and caring for a Service member or Veteran who sustained a TBI after October 2001.
Spouses completed the Children's Health and Behavior Questionnaire, a 20-item caregiver-related questionnaire designed to measure how a child's health is affected by a parent's TBI. The questionnaire was completed independently for each child.
Researchers analyzed the data at three time intervals to identify changes in the child's overall health. The intervals were: prior to first deployment, within the first two years of TBI, and two or more years post-TBI.
Participants
Participants were 104 spouses of U.S. Military Service members or Veterans diagnosed with a TBI.
All participants were female and the sample was 92.3% White.
Each household had an average of two children. The mean child's age at the time of the TBI was 6.7 years.
Limitations
Parental rating of a child could be influenced by their own emotional status (e.g., depression or anxiety), which was not accounted for, resulting in possible report bias.
The study did not include clinical evaluations of the child's health (e.g., learning disabilities or mental illness) which may have confounded results.
The sample was 100% female and 92.3% White, thus limiting generalizability to males and spouses of different races/ethnicities.
Avenues for Future Research
Include the clinical evaluations of spouses and children in order to determine if those have a greater impact on the child's overall health than the Service member or Veteran parent's TBI
Conduct a longitudinal study to explore how caregiver health and family functioning influence or explain some of the findings
Collect a sample with racial and gender diversity to increase the generalizability of results
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
This study examined the impact of service member/veteran (SMV) combat deployment and traumatic
brain injury (TBI) on the health and behavior of his or her children. Participants were 104 female
spouse caregivers of US SMVs who had sustained a mild, severe, or penetrating TBI. Participants
completed the Children’s Health and Behavior Questionnaire (CHBQ; r=.758 to .881) that evaluates
school grades, behavior, medical health, emotional health, and social participation: (a) prior to the
first combat deployment, (b) in the month prior to the TBI, (c) within 2years after the TBI, and (d)
2 or more years after the TBI. A substantial number of children experienced a decline in health and
behavior following the TBI (41.7%–79.1%). Of those who declined (a) 68.8%–75.5% declined within
the first 2years post-injury, followed by improvement or stabilization; (b) 6.7%–15.6% declined only
after 2 or more years post-injury; (c) 15.6%–25.0% declined within the first 2years post-injury and
then again 2 or more years post-injury; and (d) 16.9%–26.5% experienced a decline as a result of
deployment, followed by an additional decline after the SMV’s TBI. Services are required for children
of SMVs following TBI and deployment, particularly children at risk for poor outcome.
brain injury (TBI) on the health and behavior of his or her children. Participants were 104 female
spouse caregivers of US SMVs who had sustained a mild, severe, or penetrating TBI. Participants
completed the Children’s Health and Behavior Questionnaire (CHBQ; r=.758 to .881) that evaluates
school grades, behavior, medical health, emotional health, and social participation: (a) prior to the
first combat deployment, (b) in the month prior to the TBI, (c) within 2years after the TBI, and (d)
2 or more years after the TBI. A substantial number of children experienced a decline in health and
behavior following the TBI (41.7%–79.1%). Of those who declined (a) 68.8%–75.5% declined within
the first 2years post-injury, followed by improvement or stabilization; (b) 6.7%–15.6% declined only
after 2 or more years post-injury; (c) 15.6%–25.0% declined within the first 2years post-injury and
then again 2 or more years post-injury; and (d) 16.9%–26.5% experienced a decline as a result of
deployment, followed by an additional decline after the SMV’s TBI. Services are required for children
of SMVs following TBI and deployment, particularly children at risk for poor outcome.
Abstract Document
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