When a parent goes to war: Effects of parental deployment on very young children and implications for intervention

American Journal of Orthopsychiatry

Volumn 80, Issue 4, 2010, Pages 610-618

  Paris, Ruth ^a   DeVoe, Ellen R ^a   Ross, Abigail M ^a   Acker, Michelle L ^a  

^a BOSTON UNIVERSITY   (United States)

Author keywords

Combat stress; Development; Ecological approach; Evidence based approach; Family based services; Intervention; Military families; Parent child interaction; Parental deployment; Separation; Trauma; United States; War; Young children

Indexed keywords

ARTICLE; BEHAVIOR CHANGE; CHILD DEVELOPMENT; CHILD GROWTH; CHILD PARENT RELATION; ECOLOGY; EMOTION; HOME MENTAL HEALTH CARE; HUMAN; MENTAL HEALTH; MILITARY DEPLOYMENT; PARENTAL STRESS;

CHILD PSYCHOLOGY; CHILD WELFARE; CHILD, PRESCHOOL; COMBAT DISORDERS; HUMANS; INFANT; MENTAL HEALTH; MILITARY PERSONNEL; PARENTING; PARENTS; UNITED STATES; VETERANS;

EID: 77958465095     PISSN: 00029432     EISSN: 19390025     Source Type: Journal    
DOI: 10.1111/j.1939-0025.2010.01066.x     Document Type: Article

References (83)

1. Achenbach, T., & Rescorla, L. (2000). Child behavior checklist for ages 1 1/2 to 5. Burlington: University of Vermont.
2. American Psychological Association Presidential Task Force on Military Deployment Services for Youth Families and Service Members. (2007). The psychological needs of U.S. military service members and their families: A preliminary report. Washington, DC: American Psychological Association.
3. Appleyard, K., & Osofsky, J. D. (2003). Parenting after trauma: Supporting parents and caregivers in the treatment of children impacted by violence. Infant Mental Health Journal, 24, 111-125.
4. Bagner, D. M., & Eyberg, S. M. (2007). Parent-child interaction therapy for disruptive behavior in children with mental retardation: A randomized controlled trial. Journal of Clinical Child and Adolescent Psychology, 36, 418-429.
5. Barker, L., & Berry, K. (2009). Developmental issues impacting military families with young children during single and multiple deployments. Military Medicine, 174, 1033.
6. Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55, 83-96.
7. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.
8. Burlingham, D., & Freud, A. (1942). Young children in wartime. London, UK: Allen & Unwin.
9. Caselli, L. T., & Motta, R. W. (1995). The effect of PTSD and combat level on Vietnam veterans' perceptions of child behavior and marital adjustment. Journal of Clinical Psychology, 51, 4-12.
10. Chandra, A., Lara-Cinisomo, S., Jaycox, L. H., Tanielian, T., Burns, R. M., Ruder, T. & Han, B. (2010). Children on the homefront: The experience of children from military families. Pediatrics, 125, 16-25.
11. Chartrand, M. M., Frank, D. A., White, L. F., & Shope, T. R. (2008). Effect of parents' wartime deployment on the behavior of young children in military families. Archives of Pediatric Adolescent Medicine, 162, 1009-1014.
12. Cicchetti, D., Rogosch, A., & Toth, S. (2000). The efficacy of toddler-parent psychotherapy for fostering cognitive development in offspring. Journal of Abnormal Child Psychology, 28, 135-148.
13. Cohen, J. A., & Mannarino, A. P. (1993). A treatment model for sexually abused preschoolers. Journal of Interpersonal Violence, 8, 115-131.
14. Cohen, J. A., & Mannarino, A. P. (1996). A treatment outcome study for sexually abused preschool children: Initial findings. Journal of the Academy of Child and Adolescent Psychiatry, 35, 42-50.
15. Cohen, J., Mannarino, A., Berminger, L., & Deblinger, E. (2000). Trauma-focused cognitive behavioral therapy for children and adolescents: An empirical update. Journal of Interpersonal Violence, 15, 1202-1223.
16. Cooper, P., & Murray, L. (1997). Prediction, detection, and treatment of postnatal depression. Archives of Disease in Childhood, 77, 97-99.
17. Cozza, S., Chun, R. S., & Polo, J. A. (2005). Military families and children during operation Iraqi freedom. Psychiatric Quarterly, 76, 371-378.
18. Cozza, S., & Lieberman, A. (2007). The young military child: Our modern Telemachus. Zero to Three, 27(6), 27-33.
19. Davidson, A., & Mellor, D. (2001). The adjustment of children of Australian Vietnam veterans: Is there evidence for the transgenerational transmission of the effects of war-related trauma? Australian and New Zealand Journal of Psychiatry, 35, 345-351.
20. Davidson, J., Smith, R., & Kudler, H. (1989). Familial psychiatric illness in chronic posttraumatic stress disorder. Comprehensive Psychiatry, 30, 339-345.
21. De Arellano, M. A., Ko, S. J., Danielson, C. K., & Sprague, C. M. (2008). Trauma-informed interventions: Clinical and research evidence and culture-specific information project. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
22. Diaz, J., Oshana, D., & Harding, K. (2004). Healthy families America: 2003 annual profile of program sites. Chicago, IL: Prevent Child Abuse America.
23. Elder, G., & Clipp, E. (2006). Combat experience and emotional health: Impairment and resilience in later life. Journal of Personality, 57, 311-341.
24. Eyberg, S. M., & Matarazzo, R. G. (1980). Training parents as therapists: A comparison between individual parent-child interaction training and parent group didactic training. Journal of Clinical Psychology, 36, 492-499.
25. Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based treatments for child and adolescent disruptive behavior disorders. Journal of Clinical Child and Adolescent Psychology, 37, 213-235.
26. Faber, A. J., Willerton, E., Clymer, S. R., MacDermid, S. M., & Weiss, H. M. (2008). Ambiguous absence, ambiguous presence: A qualitative study of military reserve families in wartime. Journal of Family Psychology, 22, 222-230.
27. Fitzsimmons, V., & Krause-Parello, C. (2009). Military children: When parents are deployed overseas. Journal of School Nursing, 25, 40-48.
28. Fonagy, P. (1998). An attachment theory approach to treatment of the difficult patient. Bulletin of the Menninger Clinic, 62, 147-169.
29. Fonagy, P., Steele, H., Steele, M., Leigh, T., Kennedy, R., Mattoon, G. et al. (1995). Attachment, the reflective self, and borderline states: The predictive specificity of the Adult Attachment Interview and pathological emotional development. In S. Goldberg, R. Muir & J. Kerr (Eds.), Attachment theory: Social, developmental, and clinical perspectives (Vol. 64, pp. 233-278). New York, NY: Analytic Press.
30. Galovski, T., & Lyons, J. A. (2004). Psychological sequelae of combat violence: A review of the impact of PTSD on the veteran's family and possible interventions. Aggression and Violent Behavior, 9, 477-501.
31. Garmezy, N. (1983). Stressors of childhood. In N. Garmezy & M. Rutter (Eds.), Stress, coping and development in children (pp. 47-85). New York, NY: McGraw-Hill.
32. Gibbs, D. A., MartS. L., Kupper, L. L., & Johnson, R. E. (2007). Child maltreatment in enlisted soldiers' families during combat-related deployments. Journal of the American Medical Association, 298, 528-535.
33. Goff, B. S., Crow, J. R., Reisbig, A. M., & Hamilton, S. (2007). The impact of individual trauma symptoms of deployed soldiers on relationship satisfaction. Journal of Family Psychology, 21, 344-353.
34. Gomby, D., Culross, P., & Behrman, R. (1999). Home visiting: Recent program evaluations: Analysis and recommendations. Future of Children, 9, 4-26.
35. Gorman, L. A., & Fitzgerald, H. E. (2007). Ambiguous loss, family stress, and infant attachment during times of war. Zero to Three, 27, 20-26.
36. Green, B. L., Korol, M., Grace, M. C., Vary, M. G., Leonard, A. C., Gleser, G. C. et al. (1991). Children and disaster: Age, gender, and parental effects on PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 945-951.
37. Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295, 1023-1032.
38. Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351, 13-22.
39. Huebner, A., Mancini, J., Wilcox, R., Grass, S., & Grass, G. (2007). Parental deployment and youth in military families: Exploring uncertainty and ambiguous loss. Family Relations, 56, 112-122.
40. Inouye, J., Cerny, J. E., Hollandsworth, J., & Ettipio, A. (2001). Child abuse prevention program with POTS-based telehealth: A feasibility project. Telemed Journal and E-Health, 7, 325-332.
41. Jacobs, F., Easterbrooks, M., Brady, M., & Mistry, J. (2005). Healthy families Massachusetts final evaluation report. Medford: Massachusetts Healthy Families Evaluation. Retrieved April 17, 2010, from
42. Jaycox, L. (2004). Cognitive-behavioral intervention for trauma in schools. Longmont, CO: Sopris West.
43. Jordan, B. K., Marmar, C. R., Fairbank, J. A., Schlenger, W. E., Kulka, R. A., Hough, R. L. et al. (1992). Problems in families of male Vietnam veterans with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 60, 916-926.
44. Kelley, M., SchwerJ., Farrar, K., & Lane, M. (2006). A participant evaluation of the U.S. Navy Parent Support Program. Journal of Family Violence, 21, 301-310.
45. Kolko, D., & Swenson, C. (2002). Assessing and treating physically abused children and their families: A cognitive behavioral approach. Thousand Oaks, CA: Sage.
46. Laor, N., Wolmer, L., Mayes, L. C., Golomb, A., Silverberg, D. S., Weizman, R. et al. (1996). Israeli preschoolers under Scud missile attacks. A developmental perspective on risk-modifying factors. Archives of General Psychiatry, 53, 416-423.
47. Levy-Shiff, R., Hoffman, R., & Rosenthall, M. (1993). Innocent bystanders: Young children in war. Infant Mental Health Journal, 14, 116-130.
48. Lieberman, A. (2004). Child-parent psychotherapy: A relationship-based approach to the treatment of mental health disorders in infancy and early childhood. In A. J. Sameroff, S. McDonough, & K. L. Rosenblum (Eds.), Treating parent-infant relationship problems (pp. 97-122). New York, NY: Guilford.
49. Lieberman, A., & Van Horn, P. (2005). "Don't hit my mommy!" A manual for child-parent psychotherapy for young witnesses of family violence. Washington, DC: Zero to Three Press.
50. Lieberman, A., Van Horn, P., & Ippen, C. G. (2005). Toward evidence-based treatment: Child-parent psychotherapy with preschoolers exposed to marital violence. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 1241-1248.
51. MacDermid, S. M. (2006). Multiple transitions of deployment and reunion for military families. Retrieved March 17, 2010, from
52. MacDermid, S. M., Olson, T. M., & Weiss, H. (2002). Supporting military families throughout deployment. Retrieved May 1, 2010, from
53. MacDermid, S., Schwarz, R., Faber, A., Adkins, J., Mishkind, M., & Weiss, H. (2005). Military fathers on the front lines. In W. Marsiglio, K. Roy, & G. L. Fox (Eds.), Situated fathering: A focus on physical and social spaces (pp. 209-234). Oxford, UK: Rowman & Littlefield.
54. MacDonald, C., ChamberlaK., Long, N., & Flett, R. (1999). Posttraumatic stress disorder and interpersonal functioning in Vietnam veterans: A mediational model. Journal of Traumatic Stress, 12, 701-707.
55. McDonough, S. (2004). Interaction guidance: Promoting and nurturing the caregiving relationship. In A. J. Sameroff, S. C. McDonough, & K. L. Rosenblum (Eds.), Treating parent-infant relationship problems: Strategies for intervention (pp. 70-96). New York, NY: Guilford.
56. Mental Health Advisory Team V. (2008). Operation Iraqi Freedom 06-08: Iraq and Operation Enduring Freedom Afghanistan. Rockville, MD: Office of the Surgeon General United States Army Medical Command.
57. Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. Journal of the American Medical Association, 298, 2141-2148.
58. Office of the Deputy Under Secretary of Defense. (2008). 2008 Demographics: Profile of the military community. Washington, DC: Department of Defense (Military Community and Family Policy).
59. Olds, D., Robinson, J., Pettitt, L., Luckey, D., Holmberg, J., Ng, R. et al. (2004). Effects of home visits by paraprofessionals and by nurses: Age 4 follow-up results of a randomized trial. Pediatrics in Review, 114, 1560-1568.
60. Paris, R. (2008). "For the dream of being here, one sacrifices...": Voices of immigrant mothers in a home visiting program. American Journal of Orthopsychiatry, 78, 141-151.
61. Raiha, N. K., & Soma, D. J. (1997). Victims of child abuse and neglect in the U.S. army. Child Abuse & Neglect, 21, 759-768.
62. Rentz, E. D., Marshall, S. W., Loomis, D., MartS. L., Casteel, C., & Gibbs, D. A. (2007). Effect of deployment on the occurrence of child maltreatment in military and non-military families. American Journal of Epidemiology, 16, 1199-1206.
63. Rosenblum, K. L., Dayton, C., & Muzik, M. (2009). Infant social and emotional development: Emerging competence in a relational context. In C. H. Zeanah (Ed.), Handbook of infant mental health (3rd ed., pp. 80-103). Toronto, Canada: Guilford.
64. Rosenheck, R., & Nathan, P. (1985). Secondary traumatization in children of Vietnam veterans. Hospital and Community Psychiatry, 36, 538-539.
65. Rosenheck, R., & Thomson, J. (1986). "Detoxification" of Vietnam war trauma: A combined family-individual approach. Family Process, 25, 559-570.
66. Ruscio, A. M., Weathers, F. W., King, L. A., & King, D. W. (2002). Male war-zone veterans' perceived relationships with their children: The importance of emotional numbing. Journal of Traumatic Stress, 15, 351-357.
67. Rutter, M. (1990). Psychosocial resilience and protective factors. In J. Rolf, A. S. Masten, D. Cicchetti, K. N. Neuchterle& S. Weintraub (Eds.), Risk and protective factors in the development of psychopathology (pp. 181-214). Cambridge, UK: Cambridge University Press.
68. Sameroff, A., & Fiese, B. (2000). Models of development and developmental risk. In C. H. Zeanah (Ed.), Handbook of infant mental health (2nd ed., pp. 3-19). New York, NY: Guildford.
69. Saxe, G. N., Ellis, B. H., & Kaplow, J. (2006). Collaborative care for traumatized children and teens: A trauma systems therapy approach. New York, NY: Guilford.
70. Scheeringa, M. S., Salloum, A., Arnberger, R. A., Weems, C. F., Amaya-Jackson, L., & Cohen, J. A. (2007). Feasibility and effectiveness of cognitive-behavioral therapy for posttraumatic stress disorder in preschool children: Two case reports. Journal of Traumatic Stress, 20, 631-636.
71. Scheeringa, M. S., Zeanah, C. H., Drell, M. J., & Larrieu, J. (1995). Two approaches to the diagnosis of posttraumatic stress disorder in infancy and early childhood. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 191-200.
72. Shonkoff, J. (1985). Social support and vulnerability to stress: A pediatric perspective. Pediatric Annals, 14, 550-554.
73. Siefer, R., & DicksteS. (2000). Parental mental illness and infant development. In C. H. Zeanah (Ed.), Handbook of infant mental health (2nd ed., pp. 145-160). New York, NY: Guilford.
74. Slade, A. (1999). Representation, symbolization and affect regulation in the concomitant treatment of a mother and child: Attachment theory and child psychotherapy. Psychoanalytic Quarterly, 19, 797-830.
75. Slade, A., Sadler, L., De Dios-Kenn, C., Webb, D., Ezepchick, J., & Mayes, L. (2005). Minding the baby: A reflective parenting program. Psychoanalytic Study of the Child, 60, 74-100.
76. Steinberg, L., & Avenevoli, S. (2000). The role of context in the development of psychopathology: A conceptual framework and some speculative propositions. Child Development, 71, 66-74.
77. Suchman, N., McMahon, T., & Luthar, S. (2004). Interpersonal maladjustment as predictor of mothers' response to a relational parenting intervention. Journal of Substance Abuse Treatment, 27, 135-143.
78. Thompson, R. (1999). Early attachment and later development. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 265-286). New York, NY: Guilford.
79. Truman, S., Levy, D., & Mayes, L. (2002). Reflective Functioning As a Mediator Between Drug Use, Parenting Stress, and Child Behavior. Paper presented at the College of Drug Dependence, Quebec City, Quebec.
80. U.S. Census Bureau. (2000). United States census 2000. Retrieved May 11, 2010, from
81. U.S. Government Accountability Office. (2006). DOD and the services need to take additional steps to improve mobilization data for the reserve components GAO Publication No. GAO-06-1068. Washington, DC: Author.
82. Veterans Health Administration Office of Public Health and Environmental Hazards. (2008). Analysis of VA Health Care Utilization Among US Global War on Terrorism (GWOT) Veterans. Retrieved March 17, 2010, from
83. Williams, D., & Rose, T. (2007). I say hello; you say good-bye: When babies are born while fathers are away. Zero to Three, 27(6), 13-19.