Home Front: Post-Deployment Mental Health and Divorces

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. 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. 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. 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. 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. 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. 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. 7.

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

  8. 8.

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

  9. 9.

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

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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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Keywords

  • Divorce
  • Unanticipated deployment shocks
  • Mental health