Association Between Childhood Behavioral Problems and Parental Military Active Duty Status: A Cross-Sectional Analysis of the 2017-2021 National Survey of Children's Health.

Introduction Children of military families face unique stressors, including frequent relocations and parental deployments, which can disrupt stability and influence behavioral development. These experiences may also contribute to conduct problems and challenges in social interactions, including bullying victimization and perpetration. However, limited research exists specifically examining behavioral risks in military-connected children. Objective To assess whether children with at least one parent with current or prior military service have increased behavioral problems or a history of being bullied. Methodology We performed secondary data analysis of U.S. children aged 0-17 years who participated in the National Survey of Children's Health (NSCH) from 2017 to 2021. The independent variable was parental military-duty status categorized as at least one parent with (1) current or (2) prior active-duty service in the U.S. Armed Forces, Reserves, or the National Guard, and (3) parents never in military duty (reference group). Outcomes assessed included (1) history of child behavioral or conduct problems and (2) history of being bullied. Outcomes were assessed independently. Confounding variables included demographic factors, family poverty ratio, deployment status, child's general health, and a history of physical abuse and of living with mentally ill relatives. Logistic regression was used to estimate crude and adjusted associations. Results We analyzed data from 140,542 children: 4,919 (3.5%) had parents in active service, and 13,914 (9.9%) had parents with prior military service. A total of 10,681 (7.6%) reported a history of behavioral problems. Among those with information available regarding bullying (n = 81,382), 35,808 (44%) reported having ever been bullied. Children of currently active-duty parents were not associated with increased odds of behavioral problems (adjusted OR 0.89, 95% confidence interval (CI) 0.73-1.10, = 0.289) but had higher odds of reporting being bullied (adjusted OR 1.30, 95% CI 1.07-1.58, = 0.008), even after adjustment for selected covariates. Lastly, children of parents with prior military service had increased odds of both behavioral problems (adjusted OR 1.36, 95% CI 1.19-1.57) and being bullied (adjusted OR 1.19, 95% CI 1.08-1.31). Conclusions Parental military service was associated with increased risks of behavioral problems and risk of being bullied in U.S. children. Although we are unable to determine causation from this analysis, our findings support current literature highlighting the need for further research aimed at understanding the mechanisms and potential long-term health impacts of military service on child behavior. Behavioral health screening and early intervention programs could help to address emerging psychological and emotional challenges in this vulnerable population.
Mental Health
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Authors

Haydon Haydon, Kady Kady, Lamy Lamy, Varella Varella
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