Child Maltreatment in Enlisted Soldiers' Families During Combat-Related Deployments

Gibbs, Deborah; Martin, Sandra L.; Kupper, Lawrence L.; Johnson, Ruby

doi:10.1001/jama.298.5.528

Cited by 229 publications

(154 citation statements)

References 25 publications

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“…3 Military families are at risk for child maltreatment, particularly at times of deployment. 44,45 Specific family and community preventive factors mitigate some of the risks, including parental resilience, parent knowledge of child development and parenting, concrete support in times of need, social connections, and a child's ability to form positive relationships. 46,47 The presence of safe, stable, nurturing relationships and environments prevent maltreatment and are essential for healthy childhood.…”

Section: Impact Of Physical Abuse On Pediatric and Adult Healthmentioning

confidence: 99%

The Evaluation of Suspected Child Physical Abuse

Christian¹

2015

Pediatrics

450

301

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Child physical abuse is an important cause of pediatric morbidity and mortality and is associated with major physical and mental health problems that can extend into adulthood. Pediatricians are in a unique position to identify and prevent child abuse, and this clinical report provides guidance to the practitioner regarding indicators and evaluation of suspected physical abuse of children. The role of the physician may include identifying abused children with suspicious injuries who present for care, reporting suspected abuse to the child protection agency for investigation, supporting families who are affected by child abuse, coordinating with other professionals and community agencies to provide immediate and long-term treatment to victimized children, providing court testimony when necessary, providing preventive care and anticipatory guidance in the office, and advocating for policies and programs that support families and protect vulnerable children.

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Section: Impact Of Physical Abuse On Pediatric and Adult Healthmentioning

confidence: 99%

The Evaluation of Suspected Child Physical Abuse

Christian¹

2015

Pediatrics

450

301

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“…7,8 Keenan et al 8 demonstrated an increase in both AHT and noninflicted TBI after Hurricane Floyd. Results of a study by Gibbs et al 9 suggested an effect of prolonged stress on child maltreatment in military families.…”

mentioning

confidence: 99%

Abusive Head Trauma During a Time of Increased Unemployment: A Multicenter Analysis

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Abusive head trauma (AHT) is the leading cause of death from child abuse. Poverty and stress are recognized risk factors for abuse. No studies to date have evaluated whether there is a relationship between the economy and rates of AHT. WHAT THIS STUDY ADDS:Results of this study demonstrate a relationship between an economic recession and the rate of AHT. Given the high morbidity and mortality rates for children with AHT, these results are highly concerning. abstract OBJECTIVE: To evaluate the rate of abusive head trauma (AHT) in 3 regions of the United States before and during an economic recession and assess whether there is a relationship between the rate of AHT and county-level unemployment rates. RESULTS: During the 5 1 ⁄ 2-year study period, a total of 422 children were diagnosed with AHT in a 74-county region. The overall rate of AHT increased from 8.9 in 100 000 (95% confidence interval [CI]: 7.8 -10.0) before the recession to 14.7 in 100 000 (95% CI: 12.5-16.9) during the recession (P Ͻ .001). There was no difference in the clinical characteristics of subjects in the prerecession versus recession period. There was no relationship between the rate of AHT and county-level unemployment rates. METHODS: CONCLUSIONS:The rate of AHT increased significantly in 3 distinct geographic regions during the 19 months of an economic recession compared with the 47 months before the recession. This finding is consistent with our understanding of the effect of stress on violence. Given the high morbidity and mortality rates for children with AHT, these results are concerning and suggest that prevention efforts might need to be increased significantly during times of economic hardship.

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“…10 Child maltreatment rates are also increased during deployment. 18 The effects of deployment can also differ depending on the gender of the deployed parent. 19 These observations, however, have not directly linked parental deployment to clinically significant pediatric mental or behavioral health disorders.…”

mentioning

confidence: 99%

Wartime Military Deployment and Increased Pediatric Mental and Behavioral Health Complaints

2010

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WHAT'S KNOWN ON THIS SUBJECT:Military deployment of a parent influences children's behavior in a variety of settings. The clinical significance of these deployment-associated behavior changes has not been determined. WHAT THIS STUDY ADDS:Children experiencing separation from a parent due to wartime military deployment have an 11% increase in outpatient visits for mental and behavioral health complaints, which contrasts with a general deploymentassociated decrease in health care visits in all other diagnostic categories.abstract BACKGROUND: Children of military personnel face stress when a parent deploys. OBJECTIVE: Our goal was to determine the effect of parental military deployment on the relative rate of outpatient visits for mental and behavioral health disorders in children aged 3 to 8 years. METHODS:This was a retrospective cohort study. Records of children of active-duty personnel during fiscal years 2006 and 2007 were linked with their parent's deployment records. Mental and behavioral health visits were identified by using International Classification of Diseases, Ninth Revision, codes. The incidence rate ratio (IRR) of visits per year according to parental deployment status was determined with random-effects negative binomial regression modeling with longitudinal data analysis. RESULTS: A total of 642 397 children aged 3 to 8 years and 442 722 military parents were included. Mean child age was 5.0 years (SD: 1.9 years); 50.6% were male, and 68.0% were white. Ninety percent of the parents were male, and 90.5% were married; 32.0% of the parents were deployed during the study. There were 1 049 081 person-years with 611 115 mental and behavioral health visits (0.6 visit per year). The IRR of mental and behavioral health visits for children with a deployed parent compared with when a parent was home was 1.11 (95% confidence interval [CI]: 1.07-1.14; P Ͻ .001). IRRs of pediatric anxiety, behavioral, and stress disorders when a parent deployed were 1.14 (95% CI: 0.98 -1.32; P ϭ .095), 1.19 (95% CI: 1.07-1.32; P Ͻ .001), and 1.18 (95% CI: 1.10 -1.26; P Ͻ .001), respectively. Older children and children with military fathers and married parents had larger increases in rates of mental and behavioral health visits during parental deployments. In contrast, the overall outpatient rate and rates of visits for other diagnoses decreased when a parent was deployed. CONCLUSIONS: Mental and behavioral health visits increased by 11% in these children when a military parent deployed; behavioral disorders increased 19% and stress disorders increased 18%. Rates especially increased in older children and children of married and male military parents.

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Child Maltreatment in Enlisted Soldiers' Families During Combat-Related Deployments

Cited by 229 publications

References 25 publications

The Evaluation of Suspected Child Physical Abuse

The Evaluation of Suspected Child Physical Abuse

Abusive Head Trauma During a Time of Increased Unemployment: A Multicenter Analysis

Wartime Military Deployment and Increased Pediatric Mental and Behavioral Health Complaints

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