title: Differential Child Maltreatment Risk Across Deployment Periods of US Army Soldiers.
abstract: OBJECTIVE
  We described the risk for maltreatment among toddlers of US Army soldiers over different deployment cycles to develop a systematic response within the US Army to provide families appropriate supports.
  
  
  METHODS
  We conducted a person-time analysis of substantiated maltreatment reports and medical diagnoses among children of 112,325 deployed US Army soldiers between 2001 and 2007.
  
  
  RESULTS
  Risk of maltreatment was elevated after deployment for children of soldiers deployed once but not for children of soldiers deployed twice. During the 6 months after deployment, children of soldiers deployed once had 4.43 substantiated maltreatment reports and 4.96 medical diagnoses per 10,000 child-months. The highest maltreatment rate among children of soldiers deployed twice occurred during the second deployment for substantiated maltreatment (4.83 episodes per 10,000 child-months) and before the first deployment for medical diagnoses of maltreatment (3.78 episodes per 10,000 child-months).
  
  
  CONCLUSIONS
  We confirmed an elevated risk for child maltreatment during deployment but also found a previously unidentified high-risk period during the 6 months following deployment, indicating elevated stress within families of deployed and returning soldiers. These findings can inform efforts by the military to initiate and standardize support and preparation to families during periods of elevated risk.
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Taylor
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Ross
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Wood
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Griffis
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Gerlinde C
authors.initials: GC
authors.lastname: Harb
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Lanyu
authors.initials: L
authors.lastname: Mi
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Lihai
authors.initials: L
authors.lastname: Song
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Douglas
authors.initials: D
authors.lastname: Strane
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Lynch
authors.affiliation: Christine M. Taylor, Joanne N. Wood, Heather M. Griffis, Douglas Strane, and David M. Rubin are with PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA. Michelle E. Ross and Kevin G. Lynch are with the Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. Sarah M. Frioux is with 42nd Brigade, 1st Armored Division, US Army at Fort Bliss, TX. Joanne N. Wood and David M. Rubin are also with Division of General Pediatrics, The Children's Hospital of Philadelphia. Gerlinde C. Harb is with The Philadelphia Veterans Affairs Medical Center, Philadelphia. Lanyu Mi and Lihai Song are with Healthcare Analytics Unit, The Children's Hospital of Philadelphia. David M. Rubin is also with Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.
authors.forename: David M
authors.initials: DM
authors.lastname: Rubin
mesh_terms: D002649:Child Abuse / Q000706:statistics & numerical data*; D003130:Combat Disorders / Q000453:epidemiology / Q000523:psychology*; D005195:Family Relations / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology