535

Family Maltreatment and Military Deployment

Chapter 32

family maltreatment and 

military deployment

RENÉ J. ROBICHAUX, PhD, LCSW,* and JAMES E. McCARROLL, PhD, MPH†

INTRODUCTION

THE ARMY FAMILY ADVOCACY PROGRAM

MILITARY LIFE AND FAMILY MALTREATMENT

Spouse Maltreatment

Child Maltreatment

EFFeCT OF WAR ON FAMILIES

THE ARMY’S RESPONSE TO FAMILY STRESS AND DEPLOYMENT

Summary

*Colonel, US Army (Retired); Social Work Programs Manager, Behavioral Health Division, US Army Medical Command, 2050 Worth Road, Fort Sam 

Houston, Texas 78234; formerly, Chief, Department of Social Work, Brooke Army Medical Center, Fort Sam Houston, Texas 

†

Colonel, US Army (Retired); Psychologist, Center for the Study of Traumatic Stress and Department of Psychiatry, Room B3068, Uniformed Services 

University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814; formerly, Psychologist, Walter Reed Army Institute of Research, 

Silver Spring, Maryland
536

Combat and Operational Behavioral Health

INTRODUCTION

The relationship between family maltreatment (a 

term used to describe child abuse and neglect, and 

domestic violence between married or unmarried 

partners) and military deployment encompasses a 

subset of issues related to the effect of war on families—soldiers, spouses, and children. There have been 

numerous studies describing the effects of deployment on soldiers and families prior to Operation Iraqi 

Freedom and Operation Enduring Freedom.1

 There 

are many factors involved in a military deployment, 

both positive and negative.2 However, the stresses of 

the deployment of a service member are timeless. For 

example, those noted during World War II still occur 

today: uncertainty, separation, privations, bombing in 

noncombat areas, isolation, climate, danger, fatigue, 

differences in status and privilege among ranks and 

services, the length of the deployment, the degree of 

security (which may not allow adequate communication with family members or friends), boredom, and 

interruption of future plans.3

In addition to understanding the psychological 

effect of combat and operational stress on soldiers, 

the military has begun to more fully appreciate war’s 

impact on family members. Families experience many 

stressors that affect soldiers along with their own sets 

of stressors during deployment. Among these are 

managing physical illnesses of the spouse and children, 

pregnancy,4 affective conditions (depression, anger, 

loneliness), marital adjustment, maintaining the home 

and car, assuming sole responsibility for family life, 

playing a dual role as parent, and readjusting following the service member’s return from the deployment.5

Other stressors on families during deployments are the 

threat of soldiers being killed or injured in combat, parenting responsibilities of families in which the mother 

deploys,6 single parents,7,8 the effects of father absence 

on children,9–11 elevated symptoms of depression in 

parents and in children,12 and stress-related problems 

referred to healthcare workers.13 Finally, for both soldiers and spouses there are the issues of infidelity and 

marital trust.2,14

The ability to communicate under most circumstances is an important morale factor for both spouses 

and soldiers.15 During extended conflicts such as World 

War II, Korea, and Vietnam, communication was 

limited to letters. More rapid communication during 

deployment has become possible due to recent technological developments. At the present time, soldiers and 

families have access to a variety of media depending 

on their location and mission. The Internet, cellular 

phones, and e-mail have made virtually instantaneous 

communication possible, but can also produce emotional turmoil and frustration through system failures 

and inability to complete conversations.16

Army wives who had the most difficulty coping 

with the absence of their soldier husbands during the 

1991 Persian Gulf War were younger women with husbands in the lower ranks.17 Attempts to reach younger 

wives in the military community are among the most 

difficult tasks of Army family assistance workers. 

THE ARMY FAMILY ADVOCACY PROGRAM

Since the beginning of military operations in Afghanistan and the subsequent clustering of domestic 

violence fatalities at Fort Bragg, North Carolina in July, 

2002, there has been intense interest in identifying 

deployment stressors that may contribute to increased 

domestic violence. The Family Advocacy Program 

(FAP) is the Army’s mechanism for substantiating 

incidents of maltreatment and caring for victims. The 

Army FAP was formally established in 1976 following 

the enactment of the Federal Child Abuse Prevention 

and Treatment Act of 1974, as amended,18,19 although 

less formal programs existed prior to that time.20 The 

Army FAP is currently regulated by Department of 

Defense Directive 6400.121 and Army Regulation 608-

18.22 The objectives of the FAP are to prevent abuse, encourage the reporting of all instances of abuse, ensure 

the prompt assessment and investigation of all abuse 

cases, protect victims, and treat all family members 

affected by abuse. The Army is required to investigate 

all credible reports of family maltreatment.23

Incidents of abuse may come to the attention of 

the FAP from a variety of military and civil sources 

including law enforcement, medical and dental services, command authorities, and other agencies. When 

incidents of alleged abuse are reported to an Army installation (regardless of whether the incident occurred 

on or off the post), a multidisciplinary case review 

committee at the medical treatment facility on each 

major Army installation reviews them. Substantiated 

incidents of child maltreatment may be categorized as 

one or more of four possible types of maltreatment: (1) 

deprivation of necessities (neglect), (2) physical abuse, 

(3) sexual abuse, and (4) emotional abuse. Substantiated domestic violence can be categorized as physical, 

emotional, or sexual abuse.

If the incident is substantiated, case information is 

forwarded to the Army Central Registry (ACR), a confidential database of demographic and incident data 

on all substantiated child and spouse abuse victims 

and offenders. ACR records are maintained on child 
537

Family Maltreatment and Military Deployment

victims 17 years of age and younger and on married 

soldiers and their spouses. Recently the military services expanded their definition of domestic violence 

to include violence toward a person of the opposite 

sex who is a current or former spouse, a person with 

whom the abuser shares a child, or a current or former 

intimate partner with whom the abuser shares or has 

shared a common domicile.24

MILITARY LIFE AND FAMILY MALTREATMENT

Spouse Maltreatment 

Spouse abuse rates in the ACR have steadily declined from 6.3/1,000 in 2001 to 4.4/1,000 in 2007.25

This decrease is difficult to interpret. Many soldiers 

have deployed for several tours during this period, 

thereby decreasing the number of married persons at 

risk for domestic violence. 

It is broadly believed, at least in the media,26 that 

the stress of military life contributes to family maltreatment. Is there a difference in military and civilian spouse abuse rates of domestic violence? These 

populations have not been directly compared, but 

one study27 compared a reasonably representative 

sample of Army couples to previously collected civilian prevalence data of the US national population.28

The male soldier self-reports of moderate husbandto-wife spousal aggression were not significantly different—11% for the soldiers and 10% for the civilians. 

However, there was a small, but statistically significant 

difference in severe aggression in the Army sample 

(2.5%) compared to the civilian sample (0.7%). The 

authors concluded that the higher Army rates were 

mostly due to differences in age and race and not to 

abuse propensity. 

Military deployment has been suggested as a possible cause of domestic violence,13,25 but little information supports such a claim. Using data from the 

Heyman and Neidig study,27 a secondary analysis 

was performed studying the relationship between the 

length of deployment and spousal aggression. In this 

study, using a large-scale database (n = 26,835), with 

demographic variables controlled, deployment contributed a small, but statistically significant increase 

in the probability of self-reported severe husband-towife violence over a 1-year period.29 The probability 

increased from 4% with no deployment to 5% with 

deployment of 6 to 12 months. The frequency of moderate and severe violence increased with the number 

of weeks deployed.

Two other studies examined the relationship between deployment and domestic violence. Active duty 

deployed (n = 313) and nondeployed (n = 712) male 

soldiers were surveyed after returning from a 6-month 

peacekeeping deployment to Bosnia.30 Postdeployment domestic violence by male soldiers was predicted 

by youthful age and the existence of predeployment 

domestic violence, but not by deployment. Nonwhite 

race and off-post residence also contributed to the 

prediction. The predicted probability of postdeployment domestic violence for a deployed 20-year-old, 

nonwhite soldier living on the military installation 

with a history of predeployment domestic violence 

was 0.20. For the soldier without a history of predeployment domestic violence it was 0.05.30

A second study of the relationship between domestic violence and deployment was conducted on wives 

of male soldiers who deployed to Bosnia.31 Soldiers 

in the previous survey30 and spouses in this survey 

were not matched because surveys were anonymous; 

however, both reported their experiences relative to 

the same deployment. There were 368 wives of soldiers 

who had been deployed and 528 wives of nondeployed 

soldiers who retrospectively provided domestic 

violence data for both the pre- and postdeployment 

periods. There were no significant differences in the 

frequency of domestic violence between the deployed 

and nondeployed groups for pre- or postdeployment 

time periods. Deployment was not a significant predictor of domestic violence during the first 10 months of 

the postdeployment period, but younger wives and 

those who were victims of predeployment domestic 

violence were more likely to report postdeployment 

domestic violence than older wives and those who had 

not been identified as victims during predeployment. 

Anecdotal reports suggest that abuse is most likely to 

occur several months after the soldier’s return from 

deployment, but there are no studies to support this 

observation.

As a result of these latter two studies, it was concluded that prevention and intervention programs 

for postdeployment domestic violence should target 

younger families, persons with a domestic violence 

history, and those who live off post. Increased opportunities for counseling these groups on the risk of 

postdeployment domestic violence may be helpful. 

Such programs might emphasize increased awareness 

of personal risk for domestic violence, self-monitoring, 

and early help-seeking.

Child Maltreatment 

In 1990, prior to the Persian Gulf War (1990–1991), 

the child victim maltreatment rate was 6.9/1,000 

children. After a steady decrease of child maltreatment rates through the 1990s, the rates increased 
538

Combat and Operational Behavioral Health

from 5.2/1,000 in 2000 to 6.2/1,000 in 2004, and then 

decreased to 5.0/1,000 in 2007. Child neglect is the type 

of maltreatment most affected by the deployments. 

Neglect rates decreased from a high in 1991 (3.6/1,000) 

to a low in 2000 (2.7/1,000), an overall decline of 25%. 

By 2004, however, the rates had increased to 4.5/1,000, 

which is above the 1991 level. The neglect rates were 

3.5/1,000 in 2005, 3.3/1,000 in 2006, and 3.7/1,000 

in 2007. Neglect rates were highest for the youngest 

children and decreased as age increased. The rates of 

child physical abuse decreased from 3.1/1,000 in 1990 

to 1.0/1,000 in 2007.25

A study of child maltreatment cases in military 

families living in Texas between 2000 and 2003 found 

that both departure to and return from an operational 

deployment impose stresses on military families and 

are likely to increase the rate of child maltreatment.32

For each 1% increase in the percentage of active duty 

personnel departing to or returning from deployment, 

there was approximately a 30% increase in the rate of 

child maltreatment.32

A second study found approximately a 40% increased rate of child maltreatment when the soldier 

parent was deployed.33 The rates of child neglect 

were nearly twice as high during deployment. 

However, the rate of physical abuse was less during 

deployment. The rate of neglect by female civilian 

spouses was almost 4 times greater during deployment and the rate of physical abuse was almost twice 

as great. The authors speculate that the increased 

risk of child maltreatment may be a function of 

deployments creating a situation similar to that of 

single parents in the general population, for whom 

the research has demonstrated an increased risk for 

child maltreatment due to limited financial resources 

and greater levels of physical exhaustion. Finally, a 

study of trends in child maltreatment cases recorded 

in the ACR from 1990 to 2004 indicated that child 

neglect rates increased during the Middle East wars 

(in the Persian Gulf War [1990–1991] and Operation Iraqi Freedom/Operation Enduring Freedom 

[2002–2004]).34 

Earlier research demonstrated little or no relationship between deployment and domestic violence.29–31

This research, however, was performed during deployments (Bosnia in 1998–1999 and earlier) that were of 

relatively short duration and did not involve extensive 

combat operations. These deployments, thus, represent 

an entirely different scenario for soldiers and families 

compared to the current conflicts in Iraq and Afghanistan. Recent research has shown a probable effect of 

lengthy deployment on child maltreatment.32–34

EFFECT OF WAR ON FAMILIES

Clinical depression of the nondeployed spouse may 

contribute substantially to the observed increase in 

the child neglect rates during combat deployments. 

The majority of the neglect complaints received by the 

Army FAP involved both a lack of child supervision 

and dirty homes, which present a health risk to children. Caretakers who are depressed have little energy 

to both maintain a house and provide suitable activities for young children. The Army Medical Command 

(MEDCOM) has published written guidance for its 

healthcare providers to increase screening for depression in family member spouses. New policy changes 

encouraging social workers to leave their clinic offices 

and aggressively reach out to isolated and depressed 

mothers has underscored the MEDCOM’s desire to 

intervene early and avoid serious negative family 

outcomes due to depression.

Military spouses have reported their belief that 

military stress increases the number of divorces.35,36

If military stress contributes to marital conflict and 

marital dissolution, deployment should increase both 

these outcomes. Soldiers have reported that deterioration of a marital or romantic relationship is one of the 

negative consequences of deployment.2

 Several studies have addressed this point. Spouses of nearly 400 

enlisted soldiers who deployed to Somalia in 1992 to 

1993 reported that difficulties encountered during the 

soldier’s deployment, such as pregnancy, loneliness, 

death of a friend or relative, or having problems communicating with the soldier spouse have less impact 

on marital satisfaction, and are less stressful than is 

often assumed.5

 A study of over 800 enlisted soldiers 

who participated in Operations Desert Shield/Storm 

(1990–1991) found no significant overall change in 

marital satisfaction.37

The “stress hypothesis” is commonly cited to 

explain the observed increases in divorce rates 

among military couples and predicts that soldiers 

who are deployed will experience higher rates of 

divorce compared to soldiers who do not deploy.38

Additionally, the hypothesis suggests that longer 

deployments will be more damaging to marriages 

than shorter deployments. After correlating deployment histories with personnel records for marital 

status and controlling for variables such as gender, 

race, and age at marriage, the opposite outcome was 

found. For enlisted soldiers, the longer that a service 

member was deployed while married, the lower the 

subsequent risk of marital dissolution. The same effect 

was also observed for soldiers in the Army Reserve 

and Army National Guard. One of the overall conclusions was that deployment appears to enhance the 
539

Family Maltreatment and Military Deployment

stability of the marriage. It follows from an analysis 

of the number of days deployed and its relationship 

to marital dissolution that the longer the deployment, 

the greater the benefit to the marriage. However, the 

effects of military service and deployment in particular on marital stability are complex and are affected by 

service member factors such as gender, race/ethnicity, 

age at marriage, and children.38

In addition to the stress hypothesis is the selection 

factor present in service recruitment.38 Military marriages may be at increased risk for dissolution because 

the various military services recruit from relatively 

high-risk populations and provide incentives such 

as healthcare, housing allowances, separate rations, 

moving expenses, and survivors’ benefits that encourage marriage. Recent challenges to meeting recruiting goals may lead to waivers of some standards for 

recruitment; these modified standards may lead to a 

vulnerable group of recruits. In fiscal year 2007, more 

than 11% of Army recruits were given waivers. Waivers were given to some enlistees for medical problems, 

drug and alcohol issues, and criminal backgrounds.39

Although the group with waivers is considered the 

most vulnerable based on factors associated with 

impulsivity, anger control, and substance abuse, the 

remaining 88% are also considered to be vulnerable 

to marital problems based on age, ethnicity, and potential for career advancement in the civilian labor 

market.40 Thus, soldiers marry younger and have 

children sooner than their civilian counterparts, both 

of which are associated with increased risk of divorce 

and marital conflict.38

THE ARMY’S RESPONSE TO FAMILY STRESS AND DEPLOYMENT

The Army has responded to its many deploymentrelated challenges by increasing the number of human 

service workers to help soldiers and families in the 

high-tempo environment of repeated deployments 

to the Middle East. By 2004, the Army had placed 70 

clinical social workers at various installations that 

regularly deployed large numbers of soldiers (power 

projection platforms) to support soldiers and family 

members adjusting to the psychological challenges 

associated with deployment. Additionally, the Department of Defense has provided on contract over 84 

military and family life consultants, who arrive at an 

installation for temporary duty during peak periods 

of deployment activity, to assist with education and 

consultation related to deployment stress issues. These 

contracted master’s- and doctoral-level social workers and psychologists have been particularly active in 

support of Army National Guard and Army Reserve 

units during their redeployment activities.

Army chaplains have increased their outreach 

to couples struggling in their marriages against a 

backdrop of multiple deployments. A program entitled “Strong Bonds” combines elements of marriage 

preparation and marriage enrichment and is generally 

delivered in a group setting to both the active and reserve components. Family life chaplains also provide 

traditional couples’ counseling to individual families 

seeking to improve communication, goal setting, and 

problem resolution skills.

Funds have recently been set aside to hire approximately 1,000 family readiness support assistants to 

organize the family support activities centered at the 

battalion level. Pilot projects have attested to the enormous advantage that can accrue from the networking 

and outreach efforts provided by the addition of these 

funded positions. They have succeeded in improving 

the flow of information between the military unit and 

the individual family as well as encouraging support 

between families. Their activities have served to mitigate the feelings of isolation and alienation reported 

by the wives of young soldiers during the Persian Gulf 

War (1990–1991). 

The FAP is directed by the US Army Family and 

Morale, Welfare, and Recreation Command. Among 

the many FAP services provided to families is the New 

Parent Support Program (NPSP). The NPSP can conduct home visits for high-risk families as well as many 

educational programs for parents of young children. 

The FAP currently provides 52 NPSP home visitors and 

plans to add an additional 100 in support of families 

who are coping with parenting young children amidst 

the added stress of multiple deployments.

In July 2006 MEDCOM directed that all parents 

(both military and civilian spouses) of children born 

in Army medical treatment facilities and civilian hospitals receive briefings designed to reduce and avoid 

injuries inflicted in response to children’s uncontrolled 

crying. The Center for Health Promotion and Preventive Medicine has developed materials to educate new 

parents in understanding the causes of inconsolable 

crying and offer solutions for them. The Department 

of Defense, in partnership with the National Center 

on Shaken Baby Syndrome, has launched a campaign 

directed at service families to raise awareness while 

offering sources of help to address this problem.

Drawing from lessons learned from the 2003 and 

2004 Fatality Review Board findings, the Army MEDCOM has also directed that when healthcare providers 

identify high-risk families, their cases be assessed by 

a team and managed by an identified social worker 

case manager until the risk is determined to be sufficiently reduced.
540

Combat and Operational Behavioral Health

Child development centers at various power projection platforms have, since the war’s inception, offered 

hours of free respite care for parents of children while 

the other parent is deployed. Those installations where 

this service has been most highly used have seen fewer 

referrals to the FAP for child neglect.

The programs outlined here represent a broad first 

effort to manage the psychological stressors associated 

with high personnel and operational tempo, but more 

needs to be learned about the effectiveness of these 

programs. As the Army increases its capacity to address 

the psychological consequences of deployment for the 

active force and its relation to family conflict and family 

maltreatment, a significant benefit would accrue from 

having trained marriage and family therapists as part 

of any increased behavioral health workforce. There are 

about 60 such therapists currently on staff in various 

hospitals across the Army. They have demonstrated 

their value in a number of substantive ways. Pre- and 

postintervention outcome self-report questionnaires 

indicate clinically significant improvements in distress 

symptoms. At those installations where marriage and 

family therapists provided couples’ counseling to 

identified domestic violence cases, the couples were 

significantly more likely to successfully complete the 

required treatment. For many soldiers struggling with 

the need to seek help for depression and posttraumatic 

stress, family therapy has proven to be extremely efficacious in breaking through denial and rationalizations that may have precluded individual therapy. It is 

believed that participating as a family in therapy can 

be helpful to all. War disrupts everyone’s lives; therapy 

with a family can be less threatening than identifying 

an individual as “damaged” or “broken.”

SUMMARY

Deployments place additional stresses on military 

families. Research conducted prior to the wars in 

Iraq and Afghanistan showed little or no significant 

relationship between deployment and domestic violence. More recent research has shown increases in 

child maltreatment, especially child neglect, during 

the deployment periods. The Army has responded 

with many new and expanded efforts to address the 

many challenges of soldiers and families associated 

with repeated deployments. The results of some research, such as the effect of deployment on military 

marriages, have been counterintuitive, showing 

increased strength of such marriages. However, this 

finding is not without significant caveats. Much more 

needs to be learned to address problems encountered 

in the various phases of deployment: how to prepare 

soldiers and families for deployment, which services 

are most helpful to family members while the soldier 

is deployed, and how to facilitate resumption of postdeployment family life.

REFERENCES

1. McCarroll JE, Hoffman KJ, Grieger TA, Holloway HC. Psychological aspects of deployment and reunion. In: Kelley PW, ed. Military Preventive Medicine: Mobilization and Deployment. In: Lounsbury DE, Bellamy RF, eds. Textbook of 

Military Medicine. Washington, DC: Department of the Army, Office of The Surgeon General, Borden Institute; 2005: 

1395–1424.

2. Newby JH, McCarroll JE, Ursano RJ, Fan Z, Shigemura J, Tucker-Harris Y. Positive and negative consequences of a 

military deployment. Mil Med. 2005;170:815–819.

3. Menninger WC. Psychiatry in a Troubled World. New York, NY: MacMillan; 1948.

4. Haas DM, Pazdernik LA, Olsen CH. A cross-sectional survey of the relationship between partner deployment and 

stress in pregnancy during wartime. Women’s Health Issues. 2005;15:48–54.

5. Schumm WR, Bell DB, Knott B, Rice RE. The perceived effect of stressors on marital satisfaction among civilian wives 

of enlisted soldiers deployed to Somalia for Operation Restore Hope. Mil Med. 1996;161:601–606.

6. Kelley ML, Herzog-Simmer PA, Harris MA. Effects of military-induced separation on the parenting stress and family 

functioning of deploying mothers. Mil Psychol. 1994;6:125–138.

7. Bowen GL. Single fathers for the defense. Soc Casework: J Contemp Soc Work. 1987;6:339–344.

8. Schumm WR, Rice RE, Bell DB, Perez MMV. Trends in single parenting in the Army. Psychol Reports. 1996;78:1311–

1328.
541

Family Maltreatment and Military Deployment

9. Jensen PS, Grogan D, Xenakis SN, Bain MW. Father absence: effects on child and maternal psychopathology. J Am 

Acad Child Adolesc Psychiatry. 1989;28:171–175.

10. Jensen PS, Lewis RL, Xenakis SN. The military family in review: context, risk, and prevention. J Am Acad Child Psychiatry. 1986;25:225–234.

11. Amen DG, Jellen L, Merves E, Lee RE. Minimizing the impact of deployment separation on military children: stages, 

current preventive efforts, and system recommendations. Mil Med. 1988;153:441–446.

12. Jensen PS, Martin D, Watanabe H. Children’s response to parental separation during Operation Desert Storm. J Am 

Acad Child Adolesc Psychiatry. 1996;35;433–441.

13. Blount BW, Curry A Jr, Lubin GI. Family separations in the military. Mil Med. 1992;157:76–80.

14. van Vranken EW, Jellen LK, Knudson KH, Marlowe DH, Segal M. 82nd Airborne Division Sinai MFO Deployment Family 

Health Study I-IV. The Impact of Deployment Separation on Army Families. Washington, DC: Walter Reed Army Institute 

of Research; 1983.

15. Schumm WR, Bell DB, Ender MG, Rice RE. Expectations, use, and evaluation of communication media among deployed 

peacekeepers. Armed Forces Soc. 2004;30:649–662.

16. Ross BJ. The emotional impact of e-mail on deployment. US Naval Institute Proceedings. 2001;127:85–86.

17. Rosen LR, Westhuis DJ, Teitelbaum JM. Patterns of adaptation among Army wives during Operations Desert Shield 

and Desert Storm. Mil Med. 1994;159:43–47.

18. Child Abuse Prevention and Treatment Act, 42 USC §5101 et seq (1989).

19. Child Abuse Prevention and Treatment Act Amendments of 1996, 42 USC §5116 et seq.

20. Wichlacz CR, Randall DH, Nelson JH, Kempe CH. The characteristics and management of child abuse in the US 

Army-Europe. Clin Pediatr (Phila). 1975;14:545–548.

21. US Department of Defense. Family Advocacy Program (FAP). Washington, DC: DoD; 2004. DoD Directive 6400.1.

22. US Department of the Army. The Army Family Advocacy Program. Washington, DC: HQDA; 2007. Army Regulation 

608-18.

23. McCarroll JE, Newby JH, Dooley-Bernard M. Responding to domestic violence in the US Army: the Family Advocacy 

Program. In: Kendall-Tackett KA, Giacomoni SM, eds. Intimate Partner Violence. Kingston, NJ: Civic Research Institute; 

2007: Chap 12.

24. US Department of Defense. Domestic Abuse Involving DoD Military and Certain Affiliated Personnel. Washington, DC: 

DoD; 2007. DoD Instruction 6400.06

25. Spouse and child maltreatement rates in the ACR computed from data compiled by James E. McCarroll, Center for the 

Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, 

Md. 

26. Thompson M. The living room war. Time. 1994;143:48–51.

27. Heyman RE, Neidig PH. A comparison of spousal aggression prevalence rates in US Army and civilian representative 

samples. J Consult Clin Psychol. 1999;67:239–242.

28. Straus MA, Gelles RJ. Physical Violence in American Families: Risk Factors and Adaptations to Violence in 8,145 Families.

New Brunswick, NJ: Transaction; 1990.

29. McCarroll JE, Ursano RJ, Liu X, et al. Deployment and the probability of spousal aggression by US Army soldiers. Mil 

Med. 2000;165:41–44.
542

Combat and Operational Behavioral Health

30. McCarroll JE, Ursano RJ, Newby JH, et al. Domestic violence and deployment in US Army soldiers. J Nerv Ment Dis. 

2003;191:3–9.

31. Newby JH, Ursano RJ, McCarroll JE, Liu X, Fullerton CS, Norwood AE. Postdeployment domestic violence by US 

Army soldiers. Mil Med. 2005;170:643–647.

32. Rentz ED, Marshall SW, Loomis D, Casteel C, Martin SL, Gibbs DA. Effect of deployment on the occurrence of child 

maltreatment in military and nonmilitary families. Am J Epidemiol. 2007;165:1199–1206.

33. Gibbs DA, Martin SL, Kupper LL, Johnson RE. Child maltreatment in enlisted soldiers’ families during combat-related 

deployments. JAMA. 2007;298:528–535.

34. McCarroll JE, Fan Z, Newby JH, Ursano RJ. Trends in US Army child maltreatment reports: 1990–2004. Child Abuse 

Rev. 2008;17:108–118.

35. Rosen LN, Durand DB. Coping with the unique demands of military family life. In: Martin JA, Rosen LN, Sparacino 

LR, eds. The Military Family: A Practice Guide for Human Service Providers. Westport, Conn: Praeger; 2000: 55–72.

36. Rosen LN, Durand DB. Marital adjustment following deployment. In: Martin JA, Rosen LN, Sparacino LR, eds. The 

Military Family: A Practice Guide for Human Service Providers. Westport, Conn: Praeger; 2000: 153–165.

37. Schumm WR, Hemesath K, Bell DB, Palmer-Johnson CE, Elig TW. Did Desert Storm reduce marital satisfaction among 

Army enlisted personnel? Psychol Reports. 1996;78:1241–1242.

38. Karney BR, Crown JS. Families Under Stress: An Assessment of Data, Theory, and Research on Marriage and Divorce in the 

Military. Santa Monica, Calif: RAND National Defense Research Institute; 2007. Report No. DRR-4071-OSD.

39. Madhani A. US Army lowers its recruiting standards: more recruits have criminal records, no high school diploma. Chicago Tribune. October 11, 2007. Available at: http:/archives.chicagotribune.com/2007/oct/11/news/chi-recruit11oct11. 

Accessed December 17, 2008.

40. Bachman JG, Segal DR, Freedman-Doan P, O’Malley PM. Who chooses military service? Correlates of propensity and 

enlistment in the US armed forces. Mil Psychol. 2000;12:1–30.