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Home Front: Post-Deployment Mental Health and Divorces

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Demography

Abstract

Since 2003, about 14 % of U.S. Army soldiers have reported symptoms of posttraumatic stress disorder (PTSD) following deployments. In this article, we examine how post-deployment symptoms of PTSD and of other mental health conditions are related to the probability of divorce among married active-duty U.S. Army soldiers. For this purpose, we combine Army administrative individual-level longitudinal data on soldiers’ deployments, marital history, and sociodemographic characteristics with their self-reported post-deployment health information. Our estimates indicate that time spent in deployment increases the divorce risk among Army enlisted personnel and that PTSD symptoms are associated with further increases in the odds of divorce. Although officers are generally less likely to screen positive for PTSD than enlisted personnel, we find a stronger relationship between PTSD symptoms and divorces among Army officers who are PTSD-symptomatic than among enlisted personnel. We estimate a larger impact of deployments on the divorce risk among female soldiers, but we do not find a differential impact of PTSD symptoms by gender. Also, we find that most of the effect of PTSD symptoms occurs early in the career of soldiers who deploy multiple times.

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Notes

  1. A more formal discussion is provided in the theoretical model of formation and dissolution of military families in the face of deployments, developed in Negrusa et al. (2014).

  2. The randomness of deployments is essential for the identification of the impact of deployments on divorces in general, but it is not critical for estimating the impact of PTSD symptoms on divorce.

  3. The PC-PTSD has been shown to have a sensitivity of 0.91 and specificity of 0.72, meaning that 91 % of cases of PTSD are correctly identified, although 28 % of those without PTSD screen positive for the disorder (Prins et al. 2004).

  4. The divorce rate in Fig. 2 is constructed as the ratio between the number of divorces that occur over a given year and the number of married soldiers serving at the beginning of that year. Similarly, we define the annual PTSD rate as the number of deploying soldiers who report PTSD symptoms in a given year on a PDHA form, relative to the total number of soldiers who deployed at least once and also completed a PDHA form in that year.

  5. The PDHA’s two stem questions for depression are modified from a validated instrument widely used in primary care settings, the two-item Patient Health Questionnaire (Hoge et al. 2006). The depression indicator takes the value of 1 if the service member answers in the affirmative to one of the two questions: “felt down, depressed, or hopeless” or “little interest or pleasure in doing things.”

  6. The “any mental health concern” indicator takes the value of 1 if the soldier answers positively to any of the eight criteria: little interest or pleasure (a lot); feeling down (a lot); interest in receiving help for stress, emotional distress, family problems (yes); thoughts of hurting self (some or a lot); PTSD screen positive; thoughts of serious conflicts with others (yes); thoughts of hurting someone or sense of a loss of control with others (yes); and have sought or intend to seek care for mental health (yes).

  7. This may reflect a lack of family problems or that soldiers are unaware of them at interview time.

  8. All models are estimated using robust standard errors clustered by individual.

  9. To construct this interaction term, we assign nondeployers the value of zero for months deployed and the PTSD variable.

References

  • Ananat, E. O., & Michaels, G. (2008). The effect of marital breakup on the income distribution of women with children. The Journal of Human Resources, 43, 611–629.

    Article  Google Scholar 

  • Angrist, J. D., & Johnson, J. H., IV. (2000). Effects of work-related absences on families: Evidence from the Gulf War. Industrial and Labor Relations Review, 54, 41–58.

    Article  Google Scholar 

  • Autor, D., Duggan, M. G., & Lyle, D. S. (2011). Battle scars? The puzzling decline in employment and rise in disability receipt among Vietnam era veterans. American Economic Review, 101, 339–344.

    Article  Google Scholar 

  • Bartel, A., & Taubman, P. (1986). Some economic and demographic consequences of mental illness. Journal of Labor Economics, 4, 243–256.

    Article  Google Scholar 

  • Becker, G. S. (1973). A theory of marriage: Part I. Journal of Political Economy, 81, 813–846.

    Article  Google Scholar 

  • Becker, G. S. (1974). A theory of marriage: Part II. Journal of Political Economy, 82, S11–S26.

    Article  Google Scholar 

  • Becker, G. S., Landes, E. M., & Michael, R. T. (1977). An economic analysis of marital instability. Journal of Political Economy, 85, 1141–1187.

    Article  Google Scholar 

  • Bergstrom, T. C. (1997). A survey of theories of the family. In M. R. Rosenzweig & O. Stark (Eds.), Handbook of population and family economics (Vol. 1, pp. 21–79). Amsterdam, The Netherlands: Elsevier.

    Chapter  Google Scholar 

  • Carroll, E. M., Rueger, D. B., Foy, D. W., & Donahoe, C. P. (1985). Vietnam combat veterans with posttraumatic stress disorder: Analysis of marital and cohabitating adjustment. Journal of Abnormal Psychology, 94, 329–337.

    Article  Google Scholar 

  • Castro, C. A. (2008, January 15). 10 unpleasant facts about combat and what leaders can do to change them (Briefing). Silver Spring, MD: Walter Reed Army Institute of Research.

  • Cesur, R., Sabia, J. J., & Tekin, E. (2013). The psychological costs of war: Military combat and mental health. Journal of Health Economics, 32, 51–65.

    Article  Google Scholar 

  • Charles, K. K., & Stephens, M., Jr. (2004). Disability, job displacement and divorce. Journal of Labor Economics, 22, 489–522.

    Article  Google Scholar 

  • Chemtob, C. M., Hamada, R. S., Roitblat, H. L., & Muraoka, M. Y. (1994). Anger, impulsivity, and anger control in combat-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 62, 827–832.

    Article  Google Scholar 

  • Cherlin, A. J., Chase-Lansdale, P. L., & McRae, C. (1998). Effects of parental divorce on mental health throughout the life course. American Sociological Review, 63, 239–249.

    Article  Google Scholar 

  • Conlin, D., & Heerwig, J. (2011). The war at home: Effects of Vietnam-era military service on post-war household stability (NBER Working Paper No. 16671). Cambridge, MA: National Bureau of Economic Research.

  • Costa, D. L., & Kahn, M. E. (2010). Health, wartime stress, and unit cohesion: Evidence from Union Army veterans. Demography, 47, 45–66.

    Article  Google Scholar 

  • Dao, J. (2012, January 2). Acting out war’s inner wounds. New York Times, p. A1.

  • Davila, J., Karney, B. R., Hall, T. W., & Bradbury, T. N. (2003). Depressive symptoms and marital satisfaction: Within-subject associations and the moderating effects of gender and neuroticism. Journal of Family Psychology, 17, 557–570.

    Article  Google Scholar 

  • Doiron, D., & Mendolia, S. (2012). The impact of job loss on family dissolution. Journal of Population Economics, 25, 367–398.

    Article  Google Scholar 

  • Engel, R. C., Gallagher, L. B., & Lyle, D. S. (2010). Military deployments and children’s academic achievement: Evidence from Department of Defense Education Activity Schools. Economics of Education Review, 29, 73–82.

    Article  Google Scholar 

  • Gimbel, C., & Booth, A. (1994). Why does military combat experience adversely affect marital relations? Journal of Marriage and the Family, 56, 691–703.

    Article  Google Scholar 

  • Heaton, P., Loughran, D. S., & Miller, A. R. (2012). Compensating wounded warriors: An analysis of injury, labor market earnings, and disability compensation among veterans of the Iraq and Afghanistan Wars. Santa Monica, CA: RAND Corporation.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Hosek, J. R., Kavanagh, J., & Miller, L. (2006). How deployments affect service members. Santa Monica, CA: RAND Corporation.

    Google Scholar 

  • Hosek, J. R., & Martorell, F. (2009). How have deployments during the war on terror affected reenlistment? Santa Monica, CA: RAND Corporation.

    Google Scholar 

  • Jordan, B. K., Marmar, C. R., Fairbank, J. A., Schlenger, W. E., Kulka, R. A., Hough, R. L., & Weiss, D. S. (1992). Problems in families of male Vietnam veterans with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 60, 916–926.

  • Karney, B. R., & Crown, J. S. (2007). Families under stress. An assessment of data, theory, and research on marriage and divorce in the military. Santa Monica, CA: RAND Corporation.

    Google Scholar 

  • Keith, V. M., & Finlay, B. (1988). The impact of parental divorce on children’s educational attainment, marital timing, and likelihood of divorce. Journal of Marriage and the Family, 50, 797–809.

    Article  Google Scholar 

  • Kessler, R. C., Walters, E. E., & Forthofer, M. S. (1998). The social consequences of psychiatric disorders, III: Probability of marital stability. American Journal of Psychiatry, 155, 1092–1096.

    Google Scholar 

  • Lindo, J. M., & Stoecker, C. F. (2012). Drawn into violence: Evidence on “what makes a criminal” from the Vietnam draft lotteries (NBER Working Paper No. 17818). Cambridge, MA: National Bureau of Economic Research.

  • Lyle, D. S. (2006). Using military deployments and job assignments to estimate the effect of parental absences and household relocations on children’s academic achievement. Journal of Labor Economics, 24, 319–350.

    Article  Google Scholar 

  • Mansfield, A. J., Kaufman, J. S., Marshall, S. W., Gaynes, B. N., Morrissey, J. P., & Engel, C. C. (2010). Deployment and the use of mental health services among U.S. Army wives. New England Journal of Medicine, 362, 101–109.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Negrusa, S., Negrusa, B., & Hosek, J. R. (2014). Gone to war: Have deployments increased divorces? Journal of Population Economics, 27, 473–496.

    Article  Google Scholar 

  • Omalu, B., Hammers, J. L., Bailes, J., Hamilton, R. L., Kamboh, M. I., Webster, G., Fitzsimmons, R. P. (2011). Chronic traumatic encephalopathy in an Iraqi War Veteran with posttraumatic stress disorder who committed suicide. Neurosurgical Focus, 31, E3. doi:10.3171/2011.9.FOCUS11178

  • Pavalko, E. K., & Elder, G. H. (1990). World War II and divorce: A life-course perspective. American Journal of Sociology, 95, 1213–1234.

    Article  Google Scholar 

  • Prins, A., Ouimette, P., Kimerling, R., Camerond, R. P., Hugelshofer, D. S., Shaw-Hegwer, J., . . . Sheikh, J. I. (2004). The Primary Care PTSD Screen (PC–PTSD): Development and operating characteristics. Primary Care Psychiatry, 9, 9–14.

  • Rohlfs, C. (2010). Does combat exposure make you a more violent or criminal person? Evidence from the Vietnam draft. Journal of Human Resources, 45, 271–300.

    Article  Google Scholar 

  • Singer, J. D., & Willett, J. B. (1993). It’s about time: Using discrete-time survival analysis to study duration and the timing of events. Journal of Educational and Behavioral Statistics, 18, 155–195.

    Article  Google Scholar 

  • Smith, T. C., Ryan, M. A. K., Wingard, D. L., Slymen, D. J., Sallis, J. F., & Kritz-Silverstein, D. (2008). New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: Prospective population based U.S. military cohort study. British Medical Journal, 336, 366–371.

    Article  Google Scholar 

  • Tanielian, T., & Jaycox, L. H. (Eds.). (2008). Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND Corporation.

    Google Scholar 

  • Teitler, J. O., & Reichman, N. E. (2008). Mental illness as a barrier to marriage among unmarried mothers. Journal of the Marriage and Family, 70, 772–782.

    Article  Google Scholar 

  • Weiss, Y., & Willis, R. (1997). Match quality, new information, and marital dissolution. Journal of Labor Economics, 15, S293–S329.

    Article  Google Scholar 

  • Whisman, M. A. (2001). The association between depression and marital dissatisfaction. In S. R. H. Beach (Ed.), Marital and family processes in depression: A scientific foundation for clinical practice (pp. 3–24). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • White House. (2011). Strengthening our military families: Meeting America’s commitment (Report). Retrieved from http://www.defense.gov/home/features/2011/0111_initiative/strengthening_our_military_january_2011.pdf

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Acknowledgments

This research was conducted while the authors were affiliated with the RAND Corporation. The authors gratefully acknowledge the funding and support from the Office of the Undersecretary of Defense. We especially thank Beth Asch, James Hosek, Juergen Maurer, Amalia R. Miller, Sonia Oreffice, Climent Quintana-Domeque, Rajeev Ramchand, Terri Tanielian, and John T. Warner for their valuable suggestions and comments. We thank Adria Jewell and Arthur Bullock, whose contributions were critical in developing the data set that was used in the empirical analysis. We also thank Audrey L. Luken, Program Manager in the U.S. Army Medical Command, for her assistance in obtaining the PDHA and PDHRA data for this project. This study does not reflect the official position of the Department of Defense. All opinions, as well as any remaining errors, belong solely to the authors.

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Correspondence to Sebastian Negrusa.

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Negrusa, B., Negrusa, S. Home Front: Post-Deployment Mental Health and Divorces. Demography 51, 895–916 (2014). https://doi.org/10.1007/s13524-014-0294-9

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