Positive and Negative Consequences of a Military Deployment

Transcription

1 VOLUME 170 OCTOBER 2005 NUMBER 10 ORIGINAL ARTICLES Authors lone re responsible for opinions expressed in the contribution nd for its clernce through their federl helth gency, if required. MILITARY MEDICINE, 170, 10:815, 2005 Positive nd Negtive Consequences of Militry Deployment Gurntor: John H. Newby, DSW Contributors: John H. Newby, DSW* ; Jmes E. McCrroll, PhD*; R.J. Ursno, MD*; Zizhong Fn, MPH*; Jun Shigemur, MD*; COL Yvonne Tucker-Hrris, MSC USA This study determined the perception by 951 U. S. Army soldiers of positive nd negtive consequences of pecekeeping deployment to Bosni. Seventy-seven percent reported some positive consequences, 63% reported negtive consequence, nd 47% reported both. Written comments were lso provided. Of the 951 soldiers, 478 wrote t lest one positive comment nd 403 t lest one negtive comment. Single soldiers were more likely thn mrried soldiers to report positive consequences (82% vs. 72%). Mrried soldiers were more likely thn single soldiers to report negtive consequences (70% vs. 55%). Positive consequences included mking dditionl money, self-improvement, nd time to think. Negtive consequences included the militry chin of commnd, being wy from home, nd deteriortion of mritl/significnt other reltionships. Introduction he number nd durtion of militry deployments by U.S. T service members hve incresed significntly over the pst decde. Deployment ffects both soldiers nd their fmilies. A number of stressors re common to most deployments. Mny of these were identified during World Wr II, including uncertinty, seprtion, isoltion, dnger, ftigue, nd differences in sttus nd privilege mong rnks nd services. 1 Descriptions of militry fmilies during World Wr II noted crises nd levels of disorgniztion they experienced resulting from the soldier s bsence. 2 In the post-cold Wr, the time nd loction of deployments cn rnge from brief periods for trining exercises to extended periods ssocited with combt, humnitrin, or pecekeeping *Deprtment of Psychitry, Uniformed Services University of the Helth Sciences, 4301 Jones Bridge Rod, Bethesd, MD Reprints: John H. Newby, DSW, Deprtment of Psychitry, Uniformed Services University of the Helth Sciences, 4301 Jones Bridge Rod, Bethesd, MD 20814; e-mil: jnewby@usuhs.mil. U. S. Army Hedqurters, Deprtment of the Army 4700 King Street Alexndri, VA This mnuscript ws received for review in June 2004 nd ccepted for publiction in August missions. In ddition, the degree of security (which my limit communiction with fmily members or friends), boredom, nd interruption of future plns re common prt of present dy deployments. 3 A vriety of fctors increse stress before, during, nd fter the soldier s bsence. 4,5 Recently, incresed stressors on Army fmilies include the possibility of extended nd recurring deployments s well s terrorism on the home front tht could ffect the sfety of the soldiers fmilies. It is importnt to know how deployment stressors ffect soldiers reltive to postdeployment personl nd socil djustments. Accordingly, the reltionship between deployment stressors nd postdeployment rections nd interpersonl functioning hs been subject of considerble interest. Pecekeeping missions pose new nd different chllenges to combttrined soldiers. Post-trumtic stress disorder nd psychitric symptoms fter pecekeeping deployments hve been ssocited with wr stressors, frustrtion with pecekeeping tsks, nd life events fter the deployment. 6 8 Negtive consequences hve been seen fter numerous stressful life experiences, including dissters, child nd spouse buse nd mltretment, exposure to ded bodies, nd more common events such s utomobile ccidents. There is lso growing body of literture tht individuls exposed to trumtic experiences my, t times, perceive some benefit from their encounter with the experience. 9 Self-concept chnges nd benefits, personlity resiliency, nd the positive potentil for growth hve lso been reported ) Growth, perceived benefit, nd positive trnsformtions following trum or situtions of extreme stress indicte tht even in the fce of extreme stressful life experiences positive s well s negtive effects my occur. 11,13 15 Personl nd socil trnsformtions in the lives of survivors of stressful nd trumtic experiences hve been described. 16 The dynmics of such trnsformtions re defined s post-trumtic growth, referring to the tendency of some individuls to report chnges in self-perceptions, reltionships with others, 815

2 816 Consequences of Militry Deployment nd perceptions of the world resulting from the trum, dversity, or extremely stressful situtions. Militry deployments re generlly viewed s negtive events with potentilly hrmful effects. However, there is vrition mong soldiers nd their fmily members reltive to the beneficil or detrimentl effects of deployments. The consequences of militry deployment for soldiers nd their fmilies my lso not lwys be perceived s being detrimentl to soldier nd fmily functioning. The positive or negtive perceptions of the deployment experience my be linked to positive chnges in the soldiers personl or introspective experiences nd beliefs, their socil or interpersonl reltionships, nd their view of the world. The purpose of this study ws to explore soldiers perception of the positive nd negtive consequences of pecekeeping deployment. Knowledge of such consequences my fcilitte more ccurte definition of the deployment environment for soldiers nd ssist in the structuring of interventions for soldiers nd their fmilies. This study ws conducted s prt of lrger study on the effects of deployment on domestic violence. 17 Methods The Army identified representtive smple of 2,460 ctive duty men nd women, deployed nd nondeployed, by ge, rnk, nd mritl sttus to study the effect of deployment on domestic violence. This group included 951 mle nd femle soldiers who hd been deployed to Bosni nd hd returned to their home instlltion during the previous 3 to 5 months. Soldiers were given the option of prticipting. Surveys were dministered in person. The study ws pproved by our Institutionl Review Bord. All responses were nonymous nd no records of prticiption were collected. Of the 951 soldiers, 519 were mrried nd 432 were unmrried (Tble I). Ninety-two percent of the soldiers were men nd pproximtely 7% were women. The mjority (49.2%) reported hving some college or higher eduction. Almost 56% were Cucsin, 25% were Africn Americn, nd 12% were Hispnic. Approximtely 56% were in the rnk group of E1 E4 nd 8.4% were officers. More soldiers (54%) lived off post compred to 46% who lived on post. The deployed soldiers were sked to respond yes or no to two questions: whether nything positive or nything negtive hd come out of their deployment to Bosni. Prticipnts were lso sked to write comments bout wht they experienced s positive nd negtive consequences of the deployment. Comments were reviewed nd then independently clssified by three doctorl level investigtors. Seven positive (Tble II) nd six negtive (Tble III) themtic ctegories were identified. The rters greed on 88.2% of ll positive comments nd 89.6% of ll negtive comments. Disgreements were resolved by consensus. A totl of 1.9% of the positive comments nd 1% of the negtive comments ws considered too vgue to clssify nd were excluded from the nlysis. Results Consequences of the Deployment Of the 951 deployed soldiers, 77.0% (n 732) reported tht there were positive consequences of the deployment nd 63.0% TABLE I DEMOGRAPHY OF SOLDIER PARTICIPANTS A (N 951) Sex Mle 876 (92.7%) Femle 69 (7.3%) Rnk E1 E4 529 (55.9%) E5 E6 292 (30.9%) E7 E9 45 (4.8%) Chief Wrrnt Officer 8 (0.85%) O1 O3 68 (7.2%) O4 O6 4 (0.42%) Eduction Less thn high school 23 (2.4%) High school or Generl Eductionl Development 358 (37.6%) Some college 469 (49.3%) Bchelor s degree 92 (9.7%) Grdute degree 9 (0.95%) Rce/ethnic Cucsin 518 (54.9%) Africn Americn 223 (23.6%) Hispnic 112 (11.9%) Asin/Pcific Islnder 28 (3.0%) Ntive Indin 16 (1.7%) Other 46 (4.9%) Loction of residence On Post 438 (46.1%) Off Post 512 (53.9%) The totl number for ech ctegory my slightly vry due to missing vlues. (n 599) reported negtive consequences (Tble IV). Both positive nd negtive consequences of the deployment were reported by 46.9% (n 446). Only positive consequences of the deployment were reported by 30.1% (n 286) nd only negtive consequences were reported by 16.1% (n 153). Single soldiers were more likely thn mrried soldiers to report positive consequences of the deployment (82% vs. 72%), , df 1, p Mrried soldiers were more likely thn single soldiers to report negtive consequences of the deployment (70% vs. 55%), , df 1, p Of the mrried soldiers, 23% (n 123) reported only positive consequences nd 21% (n 109) reported only negtive consequences. Among the single soldiers, 37.7% (n 163) reported only positive consequences nd 10% (n 44) reported only negtive consequences. Comments bout the Deployment Of the 951 deployed soldiers, 478 wrote t lest one positive comment nd 403 wrote t lest one negtive comment. Single nd mrried soldiers differed on the reporting of positive nd negtive consequences. See Tbles V nd VI for exmples of positive nd negtive consequences of the deployment. Positive Comments The most frequently cited positive comment for ll soldiers ws mde dditionl money. Single soldiers, more often then mrried soldiers reported mde dditionl money (22.0% nd 13.5%, respectively; , df 1, p ). More single soldiers (13.9%) thn mrried soldiers (9.2%) lso commented tht positive benefit of the deployment ws: self-

3 Consequences of Militry Deployment 817 TABLE II POSITIVE COMMENTS OF SINGLE AND MARRIED SOLDIERS Ctegory Totl (N 951) Single (N 432) Mrried (N 519) Mde dditionl money 165 (17.4%) 95 (22.0%) 70 (13.5%)** Self-improvement 108 (11.4%) 60 (13.9%) 48 (9.2%)* Time to think 102 (10.7%) 54 (12.5%) 48 (9.2%) Improved mritl/significnt other reltionship 54 (5.7%) 5 (1.2%) 49 (9.4%)** Helped the people of Bosni 48 (5.0%) 16 (3.7%) 32 (6.2%) Trvel to nother culture 44 (4.6%) 26 (6.0%) 18 (3.5%) Sw how good we hve it in the United Sttes 43 (4.5%) 24 (5.6%) 19 (3.7%) Comprison of single nd mrried soldiers:, p 0.05;, p TABLE III NEGATIVE COMMENTS OF SINGLE AND MARRIED SOLDIERS Ctegory Totl (N 951) Single (N 432) Mrried (N 519) Disppointed with militry/chin of commnd 131 (13.8%) 62 (14.4%) 69 (13.3%) Awy from fmily/missed importnt events 107 (11.3%) 27 (6.3%) 80 (15.4%)** Deteriortion of mritl or romntic reltionship 86 (9.0%) 26 (6.0%) 60 (11.6%)* Personl chnge for the worse 50 (5.3%) 26 (6.0%) 24 (4.6%) No reson for the mission 32 (3.4%) 11 (2.5%) 21 (4.0%) Lost/wsted/mismnged money 30 (3.2%) 7 (1.6%) 23 (4.4%)* Comprison of single nd mrried soldiers:, p 0.05;, p TABLE IV POSITIVE AND NEGATIVE CONSEQUENCES OF DEPLOYMENT Positive Consequences Negtive Consequences Totl (N 951) Single Soldiers (N 432) Mrried Soldiers (N 519) Only positive Yes No 286 (30.1%) 163 (37.7%) 123 (23.7%) Only negtive No Yes 153 (16.1%) 44 (10.2%) 109 (21.0%) Both positive nd negtive Yes Yes 446 (46.9%) 193 (44.7%) 253 (48.8%) Neither positive nor negtive No No 66 (6.9%) 32 (7.4%) 34 (6.6%) improvement ( , df 1, p ) nd more mrried soldiers (9.4%) thn single soldiers (1.2%) reported tht there hd been n improvement in their mritl/significnt other reltionship ( , df 1, p ). For ech of the seven positive comment ctegories, except improved mritl/ significnt other reltionship nd helped the Bosnin people, the percentge of single soldiers mking positive comments ws higher thn the percentge of mrried soldiers. The rnk order of positive comments ws similr between the single nd mrried soldiers. First in priority for ll soldiers ws mde dditionl money followed bout evenly by the ctegories of self-improvement nd time to think (Tble II). Negtive Comments Single nd mrried soldiers differed slightly in their reporting of severl ctegories of negtive comments. The most common ctegory of negtive comments for ll of the soldiers ws chin of commnd issues. There ws no difference between the mrried nd single soldiers on this ctegory. Of the mrried soldiers, 15.4% reported the negtive deployment result of: wy from fmily/missed importnt events compred to 6.3% of the single soldiers, ( , df 1, p.0.001). Mrried soldiers (11.6%) were more likely thn single soldiers (6.0%) to report deteriortion in mritl/significnt other reltionship ( , df 1, p ). Also, more mrried soldiers (4.4%) thn single soldiers (1.6%) reported tht they lost or mismnged money during the deployment, ( , df 1, p ). For ll soldiers, chin of commnd issues ws the most frequently reported negtive consequence followed by wy from fmily/missed importnt events nd then deteriortion of mritl/significnt other reltionship. Mrried nd single soldiers differed somewht on the rnk order of the negtive consequences. The most reported negtive consequence for mrried soldiers ws wy from fmily/missed importnt events, followed by chin of commnd issues nd then deteriortion of mritl/significnt other reltionship. For the single soldiers, the most reported ctegory of negtive consequence ws chin of commnd issues, followed by wy from fmily/ missed importnt events nd then tie between deteriortion of mritl/significnt other reltionships nd personl chnge for the worse (Tble III). Discussion Our dt indicte tht positive s well s negtive consequences result from militry pecekeeping deployment. Importntly, substntil number of deployed soldiers (63%) reported t lest some positive consequences of deployment nd 16.1% reported only negtive consequences. Positive conse-

4 818 Consequences of Militry Deployment TABLE V EXAMPLES OF POSITIVE COMMENTS BY SOLDIERS Soldier mde dditionl money Pid ll my bills off nd sved $5,000. I m out of debt. I becme finncilly stble. Finncil sitution got better. Improvement in reltionship with spouse or significnt other My mrrige becme stronger. A chllenging test of my reltionship which resulted positive. I relized how much I love my wife nd tht she will lwys be there. In the end, I feel like I m closer to my wife. The shred experience of seprtion hs united us. Soldier sw how good we hve it in the United Sttes Seeing wht we s country tke for grnted. Relity check nd thnkfulness for wht you hve nd where you live. It showed me how bd country cn be without strong government. It tught me wht the world is like nd how precious life is. Soldier did something to help the people of Bosni We helped the people in res of Bosni tht we visited. Just being there mde me feel I ws helping the people of Bosni through their struggle. It ws rel world mission, with fr-reching impct, therefore worthwhile. Felt like we mde difference. Soldier mde new or improved reltionships in the militry More friends. More knowledge of the world. I got to know everyone little better, nd lso I found one gret role model. Greter bond with buddies. Closer friendships, experience, the chnce to see different plce, different culture. Trvel I got to see things I ve never seen before. Sw nother country. Exposure to nother culture. Building temwork in the unit. Doing something positive within very negtive sitution. I hve prtied in Budpest, seen Bosni, tlked to locls nd lerned bout being soldier. Soldier reported personl improvement Being in Bosni mde me relize tht I could hndle nything thrown t me. The stress ws unberble nd when returning home, stress t home seemed less significnt. My physicl ppernce relly improved nd my spouse ws impressed. I lerned lot bout myself nd who you cn count on. Higher self-confidence. I enjoyed doing my job in rel-life crisis scenrio. I lerned better how the bttlion opertes. quences of the deployment included (1) mde dditionl money, (2) experienced self-improvement, nd (3) hd time to think. Negtive consequences included (1) issues pertining to the chin of commnd, (2) being wy from fmily/missing importnt events, nd (3) the deteriortion of mritl/significnt other reltionships. The comments provided by the soldiers describe fctors relted to the deployment tht tend to define the deployment experience for both soldiers nd their fmily members. Single soldiers were more likely to report chin of commnd issues s negtive consequence of the deployment wheres mrried TABLE VI EXAMPLES OF NEGATIVE COMMENTS BY SOLDIERS Awy from fmily nd friends or missed importnt events Continued fmily seprtion. I hve been wy from spouse 20 of lst 30 months. Unble to support my wife during miscrrige. Not being ble to be round for my grndfther s funerl. Being wy from fmily, especilly during the holidys. Deteriortion in soldier s view of the militry Not trusting the chin of commnd where your fmily is concerned. Using U.S. soldiers for personl gin. You got to relly see how some people don t cre for nybody but themselves. People mke me sick trying to plese other people. We were there to keep the pece, not be on disply s the best cmp. Mritl or romntic reltionship deteriorted or ws lost or other fmily problem My girlfriend strted sleeping with other men. Me nd my wife re going through tough times becuse of me being gone for so long. Fincé left me. Divorce. Soldier thought Bosni mission ws not worthwhile Got to see how we put our nose in nother country s business where it don t belong nd how the country htes us. Whose country re we defending? It sure isn t ours. The United Sttes didn t cre bout where we go nd who they hurt. Negtive feelings towrd other members of NATO, but lso Serbs nd Muslims. Soldier lost, wsted, or mismnged money Upon return to the Sttes, spent more money thn I should hve on redjusting. I wsn t s creful with my money s I would hve liked. Pln on filing bnkruptcy very soon. Wife left me nd clened out the checking ccount nd did not py the bills. Soldier reported personl chnge for the worse or helth deteriorted My wife doesn t understnd why I ve chnged so much nd tht I m still not the sme. Being prt of this unit hs chnged me for the worst s fr s my ttitudes nd physiclly. I don t sleep sound t night. I wke up in the night lot now. I found it esier to instntly become cold, hertless, nd unemotionl. soldiers were more likely to report tht being wy from fmily/ missing importnt events s the most negtive consequence of deployment. Our findings suggest tht deployments hve differentil impct upon soldiers depending on whether the soldiers re mrried or single. Some soldiers nd their fmily members my not be ble to overcome the effects of deployment. These results indicte the potentil for positive outcomes tht some soldiers in the ftermth of deployment experience. Historiclly, the deployment experience for soldiers nd fmilies hs been defined nd rected to within context of negtive expecttions. Interventions re routinely designed to ddress potentil problems or the dverse effects of deployments. The potentil for positive outcomes of deployment suggest the need for fresh perspective in the design nd implementtion of

5 Consequences of Militry Deployment 819 deployment nd postdeployment-relted interventions. Accordingly, it would require shift from the deficit- or problem-focused prdigm of deployment-relted interventions to strength prdigm grounded in such concepts s coping, hrdiness, resiliency, nd positive chnge. Deployed soldiers nd their fmily members would not be viewed s being broken by the deployment experience nd in need of fixing but s lso hving benefited from the deployment, re resilient, nd expected to bounce bck from ny dverse effects of the deployment. This study is limited by our use of self-report dt. We did not hve long-term follow-up design to determine whether there ws reltionship between the prticipnt s positive or negtive perceptions of the deployment nd postdeployment individul nd fmily functioning. Additionlly, the ctegoriztion of the positive nd negtive comments ws inferred from the soldiers written comments. Further reserch is needed to focus on res of positive nd negtive consequences of deployment nd on intervention progrms tht my build on positive outcomes s well s negtive consequences. References 1. Menninger WC: Psychitry in Troubled World, pp New York, McMilln, Hill R: Fmilies Under Stress, pp New York, Hrper & Row, McCrroll JE, Hoffmn KJ, Grieger TA, Hollowy HC: Psychologicl spects of deployment nd reunion. In: Militry Preventive Medicine: Mobiliztion nd Deployment. Edited by Kelley PW. Wshington, DC, The Borden Institute nd the Office of the Surgeon Generl of the Army (in press). 4. Wsileski M, Cllghn-Chffee ME, Chffee RB: Spousl ggression in militry homes: n initil survey. Milit Med, 1982; 147: Blount BW, Curry A.,: Lubin: GI. Fmily seprtions in the militry. Milit Med 1992; 157: Orsillo SM, Roemer L, Litz BT, Ehlich P, Friedmn MJ: Psychitric symptomtology ssocited with contemporry pecekeeping: n exmintion of post-mission functioning mong pecekeepers in Somli. J Trum Stress 1998; 11: Litz BT, Orsillo SM, Friedmn M, Ehlich, P, Btres, A: Posttrumtic stress disorder ssocited with pecekeeping duty in Somli for U. S. militry personnel. Am J Psychitry 1997;154: 2, Mehlum L, Weiseth L: Predictors of posttrumtic stress rections in Norwegin U.N. pecekeepers 7 yers fter service. J Trum Stress 2002; 15: Tedeschi G. Clhoun LG: The posttrumtic growth inventory: mesuring the positive legcy of trum. J Trum Stress 1996; 9: Sledge WH, Boydstun JA, Rhe AJ: Self-concept chnges relted to wr cptivity. Arch Gen Psychitry 1980; 37: Afflect G, Tennen H: Construing benefits from dversity: dpttionl significnce nd dispositionl underpinnings. J Pers 1996; 64: Singer M: Viet Nm prisoners of wr, stress, nd personlity resiliency. Am J Psychitry 1981; 138: Elder GH. Clipp CC: Combt experience nd emotionl helth: impirment nd resilience in lter life. J Pers 1989; 57: Joseph S, Willims R, Yule W: Chnges in outlook following disster: the preliminry development of mesure to ssess positive nd negtive responses. J Trum Stress 1993; 6: McMillen JC, Smith EM, Fisher RH: Perceived benefit nd mentl helth fter three types of disster. J Consult Clin Psychol 1997; 65: Tedeschi RG: Violence trnsformed: Posttrumtic growth in survivors nd their societies. Aggress Violence Behv 1999; 4: