Adolescents who experience the deployment of a family member in the U.S. military may face an increased risk of depression, suggests a new study.

Ninth- and eleventh-grade students in California public schools with two or more deployment experiences over the past decade were 56 percent more likely to feel sad or hopeless compared with their non-military-family peers, the researchers found.

The same kids were 34 percent more likely to have suicidal thoughts.

The study is one of very few that compare students from military families to their non-military peers, said Julie Cederbaum, an assistant professor of social work at the University of Southern California in Los Angeles, who led the study.

“One of the goals of our research was to highlight kids’ experiences, which have been unintentionally ignored in the past,” Cederbaum told Reuters Health.

Past research in this area has mostly been conducted in clinical settings or at summer camps designed specifically for military families, Cederbaum and her colleagues write in the Journal of Adolescent Health.

Less than one percent of the U.S. population has been on active duty at any point in time since the attacks of September 11, 2001, according to the Pew Research Center in Washington, D.C.

Kids in military families may feel isolated with so few peers who can share and understand their experiences, Cederbaum’s team points out in their report.

For their study, the researchers tacked on an extra questionnaire to a statewide survey administered every two years to public schools in California. The researchers chose to give the military questionnaire to eight public school districts in the southern part of the state. Nearly half of all respondents were Hispanic, followed by white, mixed race, Asian and black, and students could complete the paper-and-pencil survey in English or Spanish.

Of the 14,300 students surveyed, less than 14 percent reported having a connection with the military.

For their deployment analysis, the researchers narrowed their focus to the ninth and eleventh grades only, which included about 9,300 students from both military and non-military families.

The researchers found that kids with a family member in the military had higher rates of depression, hopelessness and suicidal thoughts than non-military peers.

When they adjusted for a variety of factors, it turned out that the differences seemed to be largely driven by the number of deployments kids experienced.

Comparing just the teens with military connections, they found those with one deployment in the family were 15 percent more likely to feel depressed than kids with no deployment experiences, and those with two or more deployments were 41 percent more likely to report symptoms of depression..

“There is the stress of being concerned and worried about the parent or sibling who has been deployed,” Cederbaum said. “While contact has improved drastically, you don’t always know how well they are doing.”

Comparing the overall results to recent statistics for U.S. teens in general, Cederbaum’s team writes that 28.5 percent of teens report feeling sad or hopeless, for example, while 33.7 percent of kids with a parent in the military and 35.3 percent with a sibling in the military reported sadness or hopelessness in the new study.

They also found that 24.8 percent of kids with a parent in the military and 26.1 percent with a sibling in the military reported having had suicidal thoughts. That compares to a rate of about 15 percent in the general population of teens.

“This study collected data a little further away from the height of the wars,” Commander Dr. Gregory Gorman said. “It shows us that these are persistent symptoms.”

Gorman is a Navy pediatrician at the Walter Reed National Military Medical Center and teaches at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. He was not involved with the new study.

Pediatricians and family doctors need to be aware of the risks this population faces because up to two-thirds of contact with children in military families is done in civilian doctor’s offices, Gorman said.

He suggested that non-military doctors, especially in states like California with a large military presence, can simply ask young patients if they live in a military family. “Just asking simple questions leads to more questions and answers,” Gorman explained.

“Schools are taking these findings very seriously,” Cederbaum said.

Before the researchers approached school officials in order to collect data specific to military connectivity, few districts had numbers on how many students lived in military families, she added.

Cederbaum said there are things that parents and school officials can do. For example, school officials in one southern California district celebrated a school-wide event when a student’s parent returned home. Other schools have conducted service events, like collecting food for troops.

“Part of the experience of depression can be isolation. Kids need to be able to connect with one another and know that others feel the way they do,” Cederbaum said.

The researchers acknowledge several weaknesses with their current study, for example, the kids’ self-reports of depression and suicidal thoughts were not cross-checked against another source such as physician records. Also, the study gathered data from a single point in time, rather than follow the subjects for a period to detect mental health fluctuations.

Gorman stressed an important finding from the study is that only deployments appear connected with increased sadness, suicidal thoughts and depression, not the circumstance of merely living in a military family.

“This speaks to the resilience of military families. They are a very unique culture in America,” he said.

SOURCE: Journal of Adolescent Health, online November 18, 2013

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Well-Being and Suicidal Ideation of Secondary School Students From Military Families

Results

More than 13% of the sample had a parent or sibling in the military. Those with military connections were more likely to report depressive symptoms and suicidal ideation. Controlling for grade, gender, and race/ethnicity, reporting any familial deployment compared with no deployments was associated with increasing odds of experiencing sadness or hopelessness, depressive symptoms, and suicidal ideation.
Conclusions

Findings emphasize the increased risk of mental health issues among youth with parents (and siblings) in the military. Although deployment-related mental health stressors are less likely during peace, during times of war there is a need for increased screening in primary care and school settings. Systematic referral systems and collaboration with community-based mental health centers will bolster screening and services.

Julie A. Cederbaum, Tamika D. Gilreath, Rami Benbenishty, Ron A. Astor, Diana Pineda, Kris T. DePedro, Monica C. Esqueda, Hazel Atuel
Journal of Adolescent Health - 18 November 2013 (10.1016/j.jadohealth.2013.09.006)