vanessa venezia, md. military unique experience deployment cycle children’s response to...
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Impact of the Military Lifestyle on the Behavioral
Health of Children
Vanessa Venezia, MD
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Military Unique Experience Deployment Cycle Children’s response to deployment SM’s response to re-deployment Words from fathers Special circumstances to consider
Please interrupt/ask questions at any time
Agenda
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Frequent moves
School change Non-AD parental employment
Limited access to extended family Military schooling Deployment
Military Unique Experience
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In 2009, 2.2 million AD SM 58% have family 40% have 2 or more children
40% 5 or younger 33% age 6-11 25% teen
2 million children affected by deployment 15 mth deployment 6-12 reset Relocation during deployment or after
Deployment
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Predeployment SM
Leave, training, NTC, Medical treatment, last hoorah
FM
Withdrawn, apathy, regression
Deployment Cycle
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Early Deployment SM
Sleep wake cycle, right seat left seat, learning new expectations, routine established
FM Overwhelmed, sad, anxiety, clingy, somatic,
aggression
Deployment Cycle
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Deployment Cycle
Mid cycle SM
Boredom, routine, experience trauma/losses, FM less “needy”, strengthening of peer relations
FM Symptoms resolve,
increased independence, responsibility, “little man of the house.”
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Reunification Excitement Fantasy Anticipation Relief Physical exhaustion Block leave
Deployment Cycle
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Reunification part 2 Role confusion Helpful vs bossy “little man of the house”
Oedipal Bed sharing
Conflict Substance use
Deployment Cycle
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32% “high risk” for psychosocial morbidity vs
13% non-deployers (Pediatric Stress index) 35 item parent reported 3 item likert scale Validated tool
42% “high risk” for parental stress (Parent Stress Index) 36 item self report with 5 item likert scale Validated tool
Children’s experience
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Development of child psychosocial stress/pathology
Sleep trouble Academic achievement Aggression/acting out
Positive predictor Parental stress and Parental
Education level Increased reported morbidity Increased diagnosed morbidity
Children’s Experience
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Not predictive
Rank Child gender Age Race Ethnicity Employment Length of time with unit Number of moves in past 5 years
Children’s experience
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Identity as parent Role determination/co parenting Balance of work/home responsibilities
Parental Developmental Stages
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Child development at deployment vs
redeployment Change in parental approach based on child
developmental stage Execution of duties despite environment vs
child centered rearing Flexible Patience
Hiccups
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“There’s times that, like when [my partner] goes to work at night, that
[my daughter] just wants [her mother], and no matter what I do, she just
sits there and she screams, for you know, 3 or 4 hours straight, and no
matter what I do all she does is sit there and scream. [I feel like] Pulling my
hair out . . . like I’mdoing something wrong . . . [and] there’s notmuch that I can do. . . . I try and hold her, that doesn’t work, I try to let her run free throughout the house, that doesn’t work, I try and give her snacks, that doesn’twork, I try to play with her, that doesn’twork. . . . [at these
times] I just don’t know how to deal with her.”
A father’s experience
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“Well, it all revolves around when she throws her tantrums . . . and no matter what I do all she does is sit there and just scream and scream
and scream. . . . It’s hurtful for me as a parent ‘cause no matter what I do
I can’t comfort my own child . . . [and] with that I don’t know who I’m angry at. I don’t know if I’m angry at her for the way she’s acting or if
I’m angry at myself for being upset for the way she’s acting. So I don’t
know where the anger lies with that. [Because of this] it’s almost like I feel
a loss inside. And because of the loss, I feel almost like a sorrow
inside.”
A Father’s experience
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“[reflecting on his deployments and then being back home] I mean
[during battle] you just, you deal with these idiots that wanna kill ya, and so
your immediate [response] is just overwhelming force . . . and by force I
don’t mean words you know or physical force . . . sometimes it’s just like
your body posture . . . and so for me it’s like I’m terrified because I don’t
want, I don’t wanna treat my kids like I treated some guy that I just pulled out
of his house and you know he’s got 500 RPGs [rocket propelled grenades] in there that been hitting our convoys for weeks.:
A father’s experience
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National Guard/Reservists Parental PTSD Infidelity Suicide
Special Considerations
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Questions?