MONDAY, Nov. 8 (HealthDay News) -- Mental and behavioral
problems cause children of U.S. soldiers deployed to Iraq,
Afghanistan and other war zones to need considerably more
outpatient medical visits than those with non-deployed parents, a
new study suggests.
Researchers examined the medical records of more than 640,000
military children between the ages of 3 and 8, and found that those
separated from deployed parents sought treatment 11 percent more
often for cases of mood, anxiety and adjustment disorders. Visits
for conditions such as autism and attention-deficit disorder, whose
causes are not linked to deployment, also increased.
The study, reported online Nov. 8 and in the December issue of
Pediatrics, also revealed larger increases in mental and behavioral visits among older children, children with military fathers and children of married military parents.
"It's statistically significant, but I also think it's clinically significant," said lead researcher Dr. Gregory Gorman, an assistant professor of pediatrics at Uniformed Services University of the Health Sciences in Bethesda, Md. "These are also probably the worst cases."
Gorman said he was surprised to find that while these types of
medical visits went up, the rates of visits for all other medical
"I have no direct evidence, but we hypothesize that when a parent is deployed . . . and the other parent has to do all of the duties, they may want to handle other problems at home," Gorman said. "These parents who remain at home need to multi-task even more."
Gorman and his team studied records of children of active duty
personnel during 2006 and 2007 that were linked with their parent's
deployment records. Children from ages 3 to 8 were chosen in part
because they were at the developmental stage in which Gorman had
observed an increase in behavioral concerns at his pediatric
Children of deployed military face numerous stressors, including
frequent moves, prolonged parental absences and the risk of a
parent's death, the study noted. Beyond that, the multiple,
successive deployments many soldiers have faced in recent years
hits their children especially hard, said Rick Olson, a retired
Army general and director of strategic communications for the
Child, Adolescent and Family Behavioral Health Proponency in Fort
"There are statistics that show how multiple and extended deployments are causing increased problems in terms of the behavioral health of our kids," said Olson, whose organization supports behavioral health care for military children and their families. "We hear that all the time from our commanders."
"Those kids are growing up . . . without a family member, so that causes a lot of problems," Olson added. "The re-integration process gets harder every time, because the kids get used to the parent not being there, and when they come back, they interrupt patterns that have been set. And then mom or dad leaves again."
In Gorman's study, the most frequent primary diagnosis during
mental and behavioral health visits was attention-deficit disorder
(ADD). Adjustment and autistic disorders came next, while farther
down the list were mood and anxiety disorders, oppositional defiant
disorder, developmental delays, post-traumatic stress disorder,
bedwetting and separation anxiety.
In the cases of ADD and autism, Gorman thinks outpatient visits
increased because those conditions may worsen during the deployed
parent's absence and/or become harder to manage for the remaining
Finding that visits rose among children with deployed fathers,
Gorman believes that in many families the mother "might be the
primary caregiver and might be more attuned to the children's
behaviors and changes, subtle as they may be," he said.
Children of single military parents, who had lower rates of
mental and behavioral visits during their parent's deployment,
usually stay with relatives or others, Gorman said. Their visits
may have dropped, he noted, because guardians didn't know how to
access health care for the child or were not familiar with the
child's normal behavior, making changes harder to detect.
There have been 5,473 American casualties and 38,076 service
members wounded in action from October 2001 to May 2010, the study
noted. Among children whose parents are in combat areas, the
ever-present fear of them being killed is particularly hard to
bear, Olson said. He noted that Gen. George W. Casey Jr., chief of
staff of the Army, is focusing on reducing multiple, successive
tours of duty among soldiers because he understands their dramatic
impact on family members.
"The Army can make [the deployment process] more predictable so that parents have an opportunity to work with their kids, prepare them for deployment, to know when they're leaving and when they're coming back," Olson said. "When we're talking about kids, it's a ticking time bomb effect. The problems are building, but they don't become critical until they get down the road a bit. So it's not just now when the wars are on, it's five to 10 years from now."
Gorman said he hopes his research will raise awareness among
pediatricians and other health professionals serving children,
since it may not be obvious that their young patients -- who could
be seeking care for routine issues such as ear infections and the
like -- are under stress from a parent's deployment.
About 65 percent of mental and behavioral health services for
military children are provided by civilian pediatricians and other
professionals, the study found.
"One of the routine questions we ask children is, 'Do you have a parent deployed right now?'" Gorman said. In the study, he noted that this should be followed up with: "How are you feeling?" This simple step, he said, "should help [pediatricians] to anticipate, screen and ask about it so they can help parents know what to expect."
Find out more about this issue at the
U.S. Department of Veterans Affairs.
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