The rate of child maltreatment in families of enlisted soldiers was 42
percent higher when military spouses were off at war than when they were at
home, according to a study covering all substantiated reports of child
maltreatment among U.S. Army families worldwide between September 2001 and
"The findings confirm the need for supportive and preventive services
for Army families during times of deployment," wrote Deborah Gibbs,
M.S.P.H., of the child and families program at RTI International in Research
Triangle Park, N.C., and colleagues in the August 1 Journal of the
American Medical Association. The U.S. Army Medical Research and Materiel
Command provided funding for the study.
The study linked Army human-resource data with information from the Army
Central Registry on confirmed incidents of child maltreatment or spousal abuse
reported by Army medical, social-service, educational, and law-enforcement
personnel. Overall, there are 1.1 million children younger than age 18 in U.S.
military families. During the 40 months covered by the study, 1,858 parents in
1,771 families of enlisted soldiers neglected or abused their children, in a
total of 3,334 incidents involving 2,968 children. Of those, 942 incidents
occurred during deployments.
Among the families excluded from the study because of likely differences in
families' experiences of deployment and small sample size were 156 families in
which the soldier and civilian parent were not married.
During deployments, rates of child maltreatment rose for female civilian
parents but not for male civilians, and rates were greater for non-Hispanic
whites than for blacks or Hispanics, said the researchers. Children between
the ages of 2 and 12 were more likely to be mistreated during deployment than
those younger or older.
Female civilian parents were twice as likely to abuse a child physically
and almost four times more likely to neglect a child when male soldiers were
deployed than at other times, said Gibbs and colleagues. Sexual abuse rates
remained almost the same.
"We see here the classic profile of child neglect," Gibbs told
Psychiatric News. "Parents who are suffering from depression
and need help the most are the least likely to seek help or accept
The researchers found similar increases in maltreatment rates in both lower
and higher (sergeant or above) enlisted pay grades.
The study did not measure initial rates of maltreatment, only the
difference between families who were dealing with deployment and those who
Both single and multiple deployments affected child maltreatment rates, but
more than one deployment did not appear to be associated with worse rates of
maltreatment beyond those seen in families with soldiers deployed once.
That may suggest some resiliency, if validated by future research, said
Stephen Cozza, M.D., associate director of the Center for Traumatic Stress and
a professor of psychiatry at the Uniformed Services University of the Health
Sciences in Bethesda, Md., in an interview.
"This is the first piece of data-driven analysis I've seen that looks
at the effects of multiple deployments," he said. "However, based
upon the statistical measures used, we cannot draw any conclusions about the
relative change in risk of child maltreatment between families in which a
single or multiple deployment has occurred. Many variables could be impacting
Not only deployment but the increased pressures of training and other
operations in shorthanded units during wartime also create stresses for
families, said Cozza.
The late-2004 cutoff of Gibbs's study should prompt caution regarding the
impact of multiple deployments, said Joyce Raezer, M.A., chief operating
officer of the National Military Families Association.
"I suspect that at that time, increased deployments, extended tours
of duty in Iraq, and diminished time at home had not yet had a major effect on
Army units, as they do now," said Raezer, in an interview. "From
every measure I have, things are more difficult for families now than in
Gibbs's study supports findings of an earlier study of child maltreatment
rates in military families in Texas. That study found that while maltreatment
rates were historically lower in military households than in comparable
civilian families from 2000 to 2002, they began to rise as war approached and
commenced, wrote E. Danielle Rentz, Ph.D., and colleagues (including Gibbs) in
the May 15 American Journal of Epidemiology. Rentz was then in the
Department of Epidemiology at the University of North Carolina, Chapel Hill,
and is now an epidemic intelligence service officer with the Centers for
Disease Control and Prevention in Atlanta.
Rentz and colleagues looked at files from the National Child Abuse and
Neglect Data System (NCANDS) for the state of Texas, which was chosen because
it had a large military population and the most complete information on the
military family status of child victims. They compared 1,399 children in
military families with 146,583 in civilian families. Child maltreatment
included physical abuse, sexual abuse, emotional abuse, and neglect.
Rates of maltreatment in civilian families remained stable throughout the
study period, January 2000 to June 2003, said Rentz. Military families had
lower rates than among civilians until the last six months of 2002. However,
as service members were deployed to war zones in late 2002 and early 2003,
rates of maltreatment in military families rose above those of civilian
The child maltreatment rate in military families after October 2002 was
double the rate before that time, while civilian rates remained the same.
Arguments can be made in both directions for risk and protective factors
when comparing civilian and military populations. On the one hand, military
families face stresses like repeated relocations, separations caused by
deployments, and a dangerous work environment. On the other hand, troops must
meet educational, psychological, and physical health standards upon
enlistment. They receive housing, health care, and both formal and informal
family psychosocial support. Drug and severe alcohol abuse is not
The threshold for tolerating child maltreatment is probably lower in
military settings, but those thresholds haven't changed, said Cozza, and he
believes the rate is indeed going up.
"These studies indicate the need for more scientific understanding of
the impact of deployment on families and children," said Cozza.
Raezer agreed. "We're doing a good job capturing what's happening
with deployed service members, but not as good a job with their
families," she said. "There should be more research because
there's a lot we don't know."
Better outreach, increased resources, and more effective services would
help families left behind during a spouse's tour of duty, said Gibbs. The Army
does have the Family Advocacy Program, family readiness support groups, and
family assistance centers to help. The service has also instructed all primary
care providers to ask patients about deployment in the family, screen for
depression, and refer if needed, she said.
"The Army is doing more now to help than in 2002, but it's still not
enough," said Raezer. "Nobody's doing enough. We need ongoing
research and ongoing support."
However, further studies on this dataset depend on Congressional funding,
which has not yet been authorized.
"Given the increased deployment tempo and casualties, I would really
like to know what is happening," said Gibbs.
An abstract of "Child Maltreatment in Enlisted Soldiers'
Families During Combat-Related Deployments" is posted at<http://jama.ama-assn.org/cgi/content/abstract/298/5/528>.▪