Military deployment: the impact on children and family adjustment and the need for care.
OBJECTIVE
Over a million children and their families have now experienced the stress of the deployment of a family member during the recent wars in Iraq and Afghanistan. Whereas there is an extensive clinical literature about the developmental challenges facing children and issues of family adjustment, there is a lack of systematic research. This review summarizes the findings of recent publications.


RESULTS
Some veterans develop posttraumatic stress disorder as a consequence of their experiences. This condition drives many of the adverse changes in the families of returning veterans through the effects on intimacy and nurturance in their families of withdrawal, numbing and irritability that are components of posttraumatic stress disorder. There is the more general challenge that all families and children face when a partner/parent deploys of role ambiguity consequent on anxiety that is provoked by the threat that deployed family members experience. A study of Kuwaiti military showed that mothers' anxiety had the greatest impact on the children of deployed fathers, although absence of posttraumatic stress disorder in mothers could mitigate the effects of their fathers' posttraumatic stress disorder. Intervention programs are described, but there is a poverty of their evaluation.


CONCLUSIONS
A substantial advantage of focusing on family adjustment is that it can facilitate access to mental healthcare for veterans while assisting families' positive adaptation.
University of Adelaide, The Centre for Military and Veterans' Health, Adelaide, South Australia. alexander.mcfarlane@adelaide.edu.au
Alexander C
AC
McFarlane
D000223:Adaptation, Psychological; D000293:Adolescent; D055826:Afghan Campaign 2001-; D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data / Q000628:therapy; D002667:Child Reactive Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D002675:Child, Preschool; D003130:Combat Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D054541:Family Conflict / Q000523:psychology*; D005196:Family Therapy; D006801:Humans; D054542:Iraq War, 2003-2011; D008889:Military Personnel / Q000523:psychology*; D011157:Population Dynamics; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D014481:United States; D014728:Veterans / Q000523:psychology*