Publication year
2012
Citation Title
Prospective evaluation of mental health and deployment experience among women in the U.S. Military.
Journal Name
American Journal of Epidemiology
Journal Volume
176
Issue Number
2
Page Numbers
135-145
DOI
10.1093/aje/kwr496
Summary
Data from the Millennium Cohort Study were used to examine military women's mental health outcomes (depression, anxiety, and posttraumatic stress disorder [PTSD]) following deployment. Women with combat exposure, Active Duty women, and mothers with young children had greater odds of reporting mental health symptoms.
Key Findings
Service women who reported prior combat exposure had 1.83-2.74 times greater odds of reporting symptoms of mental health disorders than women who did not report prior combat exposure.
Deployment was significantly associated with PTSD and anxiety disorders, but not depression.
Active Duty women and mothers of young children had increased odds of mental health disorders. Higher stress levels, problem drinking, and a history of mental illness were also significantly associated with an increased risk of later mental health conditions.
Implications for Program Leaders
Develop curricula specific to female Service members about mental health conditions, with particular attention paid to the impact of multiple deployments and prior combat exposure on mental health
Offer courses for military families whose Service members has been diagnosed with a mental health condition, including information about how to best support the Service member
Disseminate information regarding possible mental health issues related to deployment for female Service members
Implications for Policy Makers
Recommend professional development for program staff regarding gender differences in mental health conditions
Continue to support programs that offer services to Service members with mental health concerns and their families
Continue to support pre- and post-deployment workshops that help Service members prepare for deployment and re-adjust following deployment
Methods
Data for this study included self-report data collected from the Millennium Cohort questionnaire (2001-2008) and electronic military records provided by the Defense Manpower Data Center.
All participants had completed a baseline survey and one (n = 8,551) or two (n = 8,930) follow-up surveys.
Analyses were conducted on the deployed subgroup (n = 4,906) to determine which specific mental health outcomes (PTSD, depression, or anxiety disorders) were most influential.
Participants
Seventeen thousand four hundred eighty-one military women participated, including 48% Army, 31% Air Force, 18% Navy, 3% Marine Corps; 51% Active Duty, 49% Reserve/National Guard; 76% enlisted, 24% officers.
Sixteen percent were 34 years or younger, 29% were 35-44 years, 36% were 45-54 years, 19% were 54 years or older.
Sixty-six percent of participants were White.
Limitations
Female Service members included in the Milennuim Cohort data may not be representative of all female Service members, limiting generalizability of results.
Self-report survey data can under- or over-represent the true prevalence of an exposure or outcome, biasing the results.
The use of standardized instruments for screening for mental health issues may have resulted in some misclassifications, thereby biasing results.
Avenues for Future Research
Examine the effects of military-induced separation from children on military mothers
Explore the protective factors that positively impact military Service women against negative mental or behavioral outcomes
Explore how deployment (number and length) of military mothers influences a child's emotional, social, and physical development
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Previous research has shown that military women often experience potentially severe health outcomes following deployment. Data from the Millennium Cohort Study, a 21-year longitudinal study examining the health effects of military service, were used to examine this issue. In longitudinal analyses (2001-2008) carried out among US military women (n = 17,481), the authors examined positive screens for depression, anxiety, panic, and posttraumatic stress disorder in relation to deployment in support of the operations in Iraq and Afghanistan, while adjusting for relevant baseline and time-varying covariates. Women who were deployed and reported combat-related exposures had greater odds than nondeployed women of reporting symptoms of a mental health condition (odds ratio = 1.91, 95% confidence interval: 1.65, 2.20), after adjustment for demographic, military, and behavioral covariates. In addition, higher stress, problem drinking, and a history of mental illness were significantly associated with increased risk of later mental health conditions. In contrast, women in the Reserves or National Guard and those with higher education were at decreased risk of mental health conditions (all P 's < 0.01). As the roles and responsibilities of women in the military expand and deployments continue, designing better prevention and recovery strategies specifically for women are critical for overall force health protection and readiness.
Abstract Document
PRTW Document
Attach