Deployment-Related Stress & Support Needs

Research Paper Title

“This is not your Life…and it becomes your Life”: A Qualitative Exploration of Deployment-related Stress and Support needs in National Guard and Reserve spouses who are Mothers of Young Children.

Background

The adverse effects of deployment-related stress (DRS) on military service members, spouses, and children are well documented.

Findings from a recent Consensus Report on Military Families by the National Academies of Science, Engineering, and Medicine (2019) underscore the priority of gaining a more comprehensive understanding of the diversity of today’s military families and their needs and well-being.

While social support is generally regarded as helpful during times of stress, it has not been studied extensively in National Guard/Reserve spouses who are parents of young children.

Methods

This qualitative study of 30 women examines the unique ways in which DRS affects women who are National Guard/Reserve spouses and mothers of young children, as well as the processes through which they encountered support to manage these stressors.

Salient themes spanned experiences involving deployment cycle phases of separation and reintegration and included both anticipated and unanticipated changes in family-related division of labour, dynamics, and communication patterns.

These were complicated by geographic, social, and cultural isolation and misguided efforts to support spouses initiated by civilians.

Conclusions

Women managed these stressors primarily through seeking, acquiring, and repurposing existing sources of informal social support for themselves and formal supports for their children, with varying degrees of success.

Reference

Ross, A.M., DeVoe, E.R., Steketee, G., Spencer, R. & Richter, M. (2020) “This is not your Life…and it becomes your Life”: A Qualitative Exploration of Deployment-related Stress and Support needs in National Guard and Reserve spouses who are Mothers of Young Children. Family Process. doi: 10.1111/famp.12622. Online ahead of print.

Suicidal Ideation: Linking the Role of Major Depressive Disorder & Noncombat Trauma

Research Paper Title

Factors Associated With Suicide Ideation in US Army Soldiers During Deployment in Afghanistan.

Background

Understanding suicide ideation (SI) during combat deployment can inform prevention and treatment during and after deployment.

Therefore the purpose of this study was to examine associations of sociodemographic characteristics, lifetime and past-year stressors, and mental disorders with 30-day SI among a representative sample of US Army soldiers deployed in Afghanistan.

Methods

In this survey study, soldiers deployed to Afghanistan completed self-administered questionnaires in July 2012. The sample was weighted to represent all 87 032 soldiers serving in Afghanistan. Prevalence of lifetime, past-year, and 30-day SI and mental disorders was determined. Logistic regression analyses examined risk factors associated with SI. Data analyses for this study were conducted between August 2018 and August 2019.

The main outcomes and measures were suicide ideation, lifetime and 12-month stressors, and mental disorders were assessed with questionnaires. Administrative records identified sociodemographic characteristics and suicide attempts.

Results

A total of 3,957 soldiers (3473 [weighted 87.5%] male; 2135 [weighted 52.6%] aged ≤29 years) completed self-administered questionnaires during their deployment in Afghanistan.

Lifetime, past-year, and 30-day SI prevalence estimates were 11.7%, 3.0%, and 1.9%, respectively. Among soldiers with SI, 44.2% had major depressive disorder (MDD) and 19.3% had posttraumatic stress disorder in the past 30-day period.

A series of analyses of the 23 grouped variables potentially associated with SI resulted in a final model of sex; race/ethnicity; lifetime noncombat trauma; past 12-month relationship problems, legal problems, and death or illness of a friend or family member; and MDD.

In this final multi-variable model, white race/ethnicity (odds ratio [OR], 3.1 [95% CI, 1.8-5.1]), lifetime noncombat trauma (OR, 2.1 [95% CI, 1.1-4.0]), and MDD (past 30 days: OR, 31.8 [95% CI, 15.0-67.7]; before past 30 days: OR, 4.9 [95% CI, 2.5-9.6]) were associated with SI.

Among the 85 soldiers with past 30-day SI, from survey administration through 12 months after returning from deployment, 6% (5 participants) had a documented suicide attempt vs 0.14% (6 participants) of the 3872 soldiers without SI.

Conclusions

This study suggests that major depressive disorder and noncombat trauma are important factors in identifying SI risk during combat deployment.

Reference

Ursano, R.J., Mash, H.B.H., Kessler, R.C., Naifeh, J.A., Fullerton, C.S., Aliaga, P.A., Stokes, C.M., Wynn, G.H., Ng, T.H.H., Dinh, H.M., Gonzalez, O.I., Zaslavsky, A.M., Sampson, N.A., Kao, T-C., Heeringa, S.G., Nock, M.K. & Stein, M.B. (2020) Factors Associated With Suicide Ideation in US Army Soldiers During Deployment in Afghanistan. JAMA Network Open. 3(1):e1919935. doi: 10.1001/jamanetworkopen.2019.19935.

Are there Differences in Sources of Help & Barriers to Care in Deployed vs. Post-Deployment Environments?

Research Paper Title

Mental Health Service Utilization and Perceived Barriers to Receiving Care in Deployed Soldiers.

Background

Scant research has examined mental health treatment utilisation and barriers to care in deployed US soldiers.

This study aims to assess mental health treatment utilisation in deployed soldiers, including providers used and barriers to care.

Methods

US Army soldiers (n = 2,412) in a combat environment were surveyed on psychiatric symptoms, mental health help received, sources of care, and perceived barriers to care by Mental Health Advisory teams from 2009 to 2013.

Results

Of the 25% of soldiers at mental health risk, 37% received mental health help, with 18% receiving help from a provider. Non-provider sources of care were utilised significantly more frequently than providers.

Soldiers at mental health risk reported significantly greater anticipated career-related stigma, organisational barriers to care, self-reliance views, and negative attitudes toward care, yet these constructs did not differ between who did or did not receive help.

Soldiers who received help from providers exclusively reported significantly more anticipated career-related stigma and fewer organisational barriers to care than those that received no help.

Soldiers who spent no time living outside the forward operating base and soldiers with six or more types of combat exposures were more likely to receive help.

Conclusions

Prevalence of common psychopathology and receipt of care in a combat environment was similar to previous reports from post-deployment settings.

Non-provider sources of care were more frequently utilised as compared to an in-Garrison report.

Findings suggest important differences exist in sources of help and barriers to care in deployed vs. post-deployment environments.

The hypothesised barriers to care did not preclude receiving any help, however, less than one-half of soldiers at mental health risk received help.

Thus, future research should identify factors that have the greatest influence on help seeking behaviour in both deployed and Garrison settings.

Reference

Nugent, K.L., Riviere, L.A., Sipos, M.L. & Wilk, J.E. (2020) Mental Health Service Utilization and Perceived Barriers to Receiving Care in Deployed Soldiers. Military Medicine. pii: usaa019. doi: 10.1093/milmed/usaa019. [Epub ahead of print].

Is there an Association between Firearm Ownership & Capability for Suicide in Post-Deployment National Guard Service Members?

Research Paper Title

Firearm Ownership and Capability for Suicide in Post-Deployment National Guard Service Members.

Background

National Guard service members demonstrate increased suicide risk relative to the civilian population.

One potential mechanism for this increased risk may be familiarity with and access to firearms following deployment.

This study examined the association between firearm ownership, reasons for ownership, and firearm familiarity with a widely studied suicide risk factor-capability for suicide-among National Guard service members.

Methods

Data were drawn from a cross-sectional survey of National Guard service members conducted immediately post-deployment in 2010. Service members (n = 2,292) completed measures of firearm ownership, firearm familiarity, and capability for suicide.

Results

Firearm ownership and increased firearm familiarity were associated with capability for suicide (d = 0.47 and r = .25, for firearm ownership and familiarity, respectively).

When examined separately based on reason for ownership, owning a firearm for self-protection (d = 0.33) or owning a military weapon (d = 0.27) remained significantly associated with capability for suicide.

In contrast, owning a firearm for hobby purposes did not (d = -0.07).

Conclusions

Our findings support theories emphasising practical aspects of suicide (e.g., three-step theory) and suggest that owning firearms, in particular for self-protection, along with familiarity using firearms may be associated with greater capability for suicide.

Reference

Goldberg, S.B., Tucker, R.P., Abbas, M., Schultz, M.E., Hiserodt, M., Thomas, K.A., Anestis, M.D. & Wyman, M.F. (2019) Firearm Ownership and Capability for Suicide in Post-Deployment National Guard Service Members. Suicide & Life-Threatening Behavior. 49(6), pp.1668-1679. doi: 10.1111/sltb.12551. Epub 2019 Apr 19.