Women & Health
ISSN: 0363-0242 (Print) 1541-0331 (Online) Journal homepage: http://www.tandfonline.com/loi/wwah20
The Well-Being of Australian Service Mothers Carol P. Davy PhD, Michelle Lorimer BS, Alexander McFarlane MBBS, MD, FRANZCP, Stephanie Hodson PhD, Samantha Crompvoets PhD, Ellie Lawrence-Wood PhD & Susan J. Neuhaus MBBS, PhD, FRACS, GAICD To cite this article: Carol P. Davy PhD, Michelle Lorimer BS, Alexander McFarlane MBBS, MD, FRANZCP, Stephanie Hodson PhD, Samantha Crompvoets PhD, Ellie Lawrence-Wood PhD & Susan J. Neuhaus MBBS, PhD, FRACS, GAICD (2015) The Well-Being of Australian Service Mothers, Women & Health, 55:7, 737-753, DOI: 10.1080/03630242.2015.1050541 To link to this article: http://dx.doi.org/10.1080/03630242.2015.1050541
Accepted online: 21 May 2015.Published online: 21 May 2015.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=wwah20 Download by: [University of Otago]
Date: 03 October 2015, At: 18:52
Women & Health, 55:737–753, 2015 Copyright © Taylor & Francis Group, LLC ISSN: 0363-0242 print/1541-0331 online DOI: 10.1080/03630242.2015.1050541
The Well-Being of Australian Service Mothers CAROL P. DAVY, PhD South Australian Health and Medical Research Institute; and Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, South Australia, Australia
Downloaded by [University of Otago] at 18:52 03 October 2015
MICHELLE LORIMER, BS Data Management and Analysis Centre, University of Adelaide, Adelaide, South Australia, Australia
ALEXANDER McFARLANE, MBBS, MD, FRANZCP Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, South Australia, Australia
STEPHANIE HODSON, PhD Department of Veterans’ Affairs, Canberra, Australian Capital Territory, Australia
SAMANTHA CROMPVOETS, PhD College of Medicine, Biology and Environment, Australian National University, Canberra, Australia Capital Territory, Australia
ELLIE LAWRENCE-WOOD, PhD and SUSAN J. NEUHAUS, MBBS, PhD, FRACS, GAICD Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, South Australia, Australia
In recent years servicewomen with dependent children have for the first time in history been deployed into conflict zones in support of Australian Defence Force operations. This represents a significant social change, and the implications of deployment on the health of these service mothers are not fully understood. Data from women who participated in the Middle East Area of Operations Census study were analyzed to compare the psychological and physical symptoms reported by service mothers with service women who had no dependent children at the time of deploying to Afghanistan
Received January 18, 2014; revised August 31, 2014; accepted September 17, 2014. Address correspondence to Carol P. Davy, PhD, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, South Australia 5001, Australia. E-mail: carol. [email protected] 737
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and/or Iraq. Of the 921 women who were included in this analysis, 235 had dependent children and 686 had no dependent children (comparison group). Service mothers were significantly older and were more likely to have served in the Air Force than women in the comparison group. Findings demonstrate that serving mothers were not at any significantly higher risk of psychological distress, posttraumatic stress symptoms, alcohol misuse, or reporting of somatic symptoms, than women who had no dependent children. A number of possible explanations for these findings are discussed, including the healthy soldier/mother effect, support from partners and extended family members, and collegial networks. KEYWORDS military health, mothers, psychological well-being, somatic symptoms
INTRODUCTION Recently, Australian service women, including those with dependent children, have been permitted to take on direct combat roles in support of Australian military operations (Australian Humans Rights Commission 2012). In addition to the normal challenges such changes pose, these service mothers must also cope with being separated from, and at the same time support, their children who may be experiencing a range of emotions (McFarlane 2009). While a number of studies have already investigated the impact of deployment on children of service personnel (De Pedro et al. 2011; DeVoe and Ross 2012; Galinsky 2005; Johnson and Ling 2012), and even deployed fathers (Willerton et al. 2011), very few have addressed the emerging issues that may be faced by service mothers who deploy. A number of studies have, however, suggested that, in general, women who deploy may be at greater risk of psychological symptoms compared to men. In a sample of United States (U.S.) National Guard personnel, females (27 percent) were twice as likely to meet clinician-administered diagnostic criteria for depression compared to males (13 percent) (Kehle et al. 2011). A study of 12,605 American/U.S. veterans of the Afghanistan and Iraq conflicts with deployment-related traumatic brain injury also found that women were twice as likely as men to be diagnosed by a clinician with depression and 1.3 times as likely to have a diagnosis of co-morbid post-traumatic stress disorder or major depression (Iverson et al. 2011). Likewise, a study of 2,677 U.S. National Guard soldiers returning from a 16-month deployment to Iraq (OIF) found higher rates of depression in female military personnel than in males (Ferrier-Auerbach et al. 2010). Of the few studies which have considered the specific impact of deployment on service mothers, most were conducted in the U.S. These studies have
Downloaded by [University of Otago] at 18:52 03 October 2015
The Well-Being of Australian Service Mothers
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suggested that service mothers may be at particular risk of adverse psychological and/or social health outcomes. Likewise, a study of U.S. Air Force women found that being deployed and being a parent was significantly associated with reports that physical symptoms interfered with their social life after deployment (Pierce, Lewandowski-Romps, and Silverschanz 2011). However, a paper published by the Millennium Cohort Study (Nguyen et al. 2012) suggested that only U.S. women who experienced combat-like exposure after childbirth were significantly more likely to screen positive for depression. Given the recent changes to the role of women in conflict zones (Australian Humans Rights Commission 2012), we aimed to investigate the psychological and physical symptoms reported by Australian service women in general and service mothers in particular, who deployed to Afghanistan and/or Iraq in support of Australian Defence Force (ADF) operations. This study was the first of which we were aware to investigate any differences in physical or psychological health outcomes of service women who had dependent children at the time of deployment to the Middle East Area of Operations (MEAO) compared to deployed service women who did not have children and to consider inter-service, inter-rank differences and age.
METHODS Data for this article were drawn from the MEAO Census Study (Dobson et al. 2012). The MEAO Census Study was funded by the Australian Department of Defence with the aim of investigating the health of ADF members who deployed to the MEAO prior to January 2010. This cross-sectional study was undertaken by the Centre for Military and Veterans’ Health between 2010 and 2011. Ethics approval for the study protocol was provided by the Australian Defence Human Research Ethics Committee, the University of Queensland Human Research Ethics Committee, and Department of Veterans’ Affairs Human Research Committee. Participation was voluntary, and written and signed informed consent was obtained prior to administering either an online or hardcopy survey.
Participants All current and ex-serving ADF members who had deployed to the MEAO between October 1, 2001 and December 31, 2009 (n = 26,915) were eligible for the MEAO Census Study. From April 2010, warm-up letters were sent to eligible participants by email and when not available, by mail. This warm-up letter advised that the study was commencing and that an invitation to participate would be sent out shortly. Invitations including an information brochure highlighting the voluntary nature of the study were sent out approximately 1 week later, advising invitees that they could access the online
Downloaded by [University of Otago] at 18:52 03 October 2015
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C. P. Davy et al.
consent form and survey through a hyperlink, or if they preferred, they could request a hard copy. Approximately 3 weeks after the invitations, reminders were sent to non-responders. Reminders were also issued when persons had commenced, but not completed, the online questionnaire, or had requested, but not returned, hard copy questionnaires. Telephone follow up was attempted for all individuals for whom a response was not received within 3 weeks of the reminder. Up to ten telephone calls were made at a variety of times during different days. Survey data were obtained from 58.7 percent of all eligible members. This response rate compares favorably with other similar studies, including the consolidated Centre for Military and Veterans’ Health Near North Area of Influence studies (Centre for Military and Veterans’ Health 2008, 2009a, 2009b), the 2010 ADF Mental Health Prevalence and Wellbeing Study (McFarlane et al. 2011), and the first waves of data collection for the King’s Cohort in the UK and the United States Millennium Cohort (Pinder et al. 2012). Findings presented in this article were obtained from data collected from women who completed either the online or hardcopy MEAO Census Study survey. Of the total number of women eligible to participate in the MEAO Census Study (n = 2,947), 1,730 women (58.7 percent) completed the survey. Of these participants, 921 provided sufficient information to ascertain whether they had dependent children at the time of their last deployment and therefore were considered to be ‘responders’ for the purposes of the analyses presented in this article. Responses from participating women were divided into two groups: ●
Group One: Service women who had dependent children (
ISSN: 0363-0242 (Print) 1541-0331 (Online) Journal homepage: http://www.tandfonline.com/loi/wwah20
The Well-Being of Australian Service Mothers Carol P. Davy PhD, Michelle Lorimer BS, Alexander McFarlane MBBS, MD, FRANZCP, Stephanie Hodson PhD, Samantha Crompvoets PhD, Ellie Lawrence-Wood PhD & Susan J. Neuhaus MBBS, PhD, FRACS, GAICD To cite this article: Carol P. Davy PhD, Michelle Lorimer BS, Alexander McFarlane MBBS, MD, FRANZCP, Stephanie Hodson PhD, Samantha Crompvoets PhD, Ellie Lawrence-Wood PhD & Susan J. Neuhaus MBBS, PhD, FRACS, GAICD (2015) The Well-Being of Australian Service Mothers, Women & Health, 55:7, 737-753, DOI: 10.1080/03630242.2015.1050541 To link to this article: http://dx.doi.org/10.1080/03630242.2015.1050541
Accepted online: 21 May 2015.Published online: 21 May 2015.
Submit your article to this journal
Article views: 36
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=wwah20 Download by: [University of Otago]
Date: 03 October 2015, At: 18:52
Women & Health, 55:737–753, 2015 Copyright © Taylor & Francis Group, LLC ISSN: 0363-0242 print/1541-0331 online DOI: 10.1080/03630242.2015.1050541
The Well-Being of Australian Service Mothers CAROL P. DAVY, PhD South Australian Health and Medical Research Institute; and Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, South Australia, Australia
Downloaded by [University of Otago] at 18:52 03 October 2015
MICHELLE LORIMER, BS Data Management and Analysis Centre, University of Adelaide, Adelaide, South Australia, Australia
ALEXANDER McFARLANE, MBBS, MD, FRANZCP Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, South Australia, Australia
STEPHANIE HODSON, PhD Department of Veterans’ Affairs, Canberra, Australian Capital Territory, Australia
SAMANTHA CROMPVOETS, PhD College of Medicine, Biology and Environment, Australian National University, Canberra, Australia Capital Territory, Australia
ELLIE LAWRENCE-WOOD, PhD and SUSAN J. NEUHAUS, MBBS, PhD, FRACS, GAICD Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, South Australia, Australia
In recent years servicewomen with dependent children have for the first time in history been deployed into conflict zones in support of Australian Defence Force operations. This represents a significant social change, and the implications of deployment on the health of these service mothers are not fully understood. Data from women who participated in the Middle East Area of Operations Census study were analyzed to compare the psychological and physical symptoms reported by service mothers with service women who had no dependent children at the time of deploying to Afghanistan
Received January 18, 2014; revised August 31, 2014; accepted September 17, 2014. Address correspondence to Carol P. Davy, PhD, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, South Australia 5001, Australia. E-mail: carol. [email protected] 737
738
C. P. Davy et al.
Downloaded by [University of Otago] at 18:52 03 October 2015
and/or Iraq. Of the 921 women who were included in this analysis, 235 had dependent children and 686 had no dependent children (comparison group). Service mothers were significantly older and were more likely to have served in the Air Force than women in the comparison group. Findings demonstrate that serving mothers were not at any significantly higher risk of psychological distress, posttraumatic stress symptoms, alcohol misuse, or reporting of somatic symptoms, than women who had no dependent children. A number of possible explanations for these findings are discussed, including the healthy soldier/mother effect, support from partners and extended family members, and collegial networks. KEYWORDS military health, mothers, psychological well-being, somatic symptoms
INTRODUCTION Recently, Australian service women, including those with dependent children, have been permitted to take on direct combat roles in support of Australian military operations (Australian Humans Rights Commission 2012). In addition to the normal challenges such changes pose, these service mothers must also cope with being separated from, and at the same time support, their children who may be experiencing a range of emotions (McFarlane 2009). While a number of studies have already investigated the impact of deployment on children of service personnel (De Pedro et al. 2011; DeVoe and Ross 2012; Galinsky 2005; Johnson and Ling 2012), and even deployed fathers (Willerton et al. 2011), very few have addressed the emerging issues that may be faced by service mothers who deploy. A number of studies have, however, suggested that, in general, women who deploy may be at greater risk of psychological symptoms compared to men. In a sample of United States (U.S.) National Guard personnel, females (27 percent) were twice as likely to meet clinician-administered diagnostic criteria for depression compared to males (13 percent) (Kehle et al. 2011). A study of 12,605 American/U.S. veterans of the Afghanistan and Iraq conflicts with deployment-related traumatic brain injury also found that women were twice as likely as men to be diagnosed by a clinician with depression and 1.3 times as likely to have a diagnosis of co-morbid post-traumatic stress disorder or major depression (Iverson et al. 2011). Likewise, a study of 2,677 U.S. National Guard soldiers returning from a 16-month deployment to Iraq (OIF) found higher rates of depression in female military personnel than in males (Ferrier-Auerbach et al. 2010). Of the few studies which have considered the specific impact of deployment on service mothers, most were conducted in the U.S. These studies have
Downloaded by [University of Otago] at 18:52 03 October 2015
The Well-Being of Australian Service Mothers
739
suggested that service mothers may be at particular risk of adverse psychological and/or social health outcomes. Likewise, a study of U.S. Air Force women found that being deployed and being a parent was significantly associated with reports that physical symptoms interfered with their social life after deployment (Pierce, Lewandowski-Romps, and Silverschanz 2011). However, a paper published by the Millennium Cohort Study (Nguyen et al. 2012) suggested that only U.S. women who experienced combat-like exposure after childbirth were significantly more likely to screen positive for depression. Given the recent changes to the role of women in conflict zones (Australian Humans Rights Commission 2012), we aimed to investigate the psychological and physical symptoms reported by Australian service women in general and service mothers in particular, who deployed to Afghanistan and/or Iraq in support of Australian Defence Force (ADF) operations. This study was the first of which we were aware to investigate any differences in physical or psychological health outcomes of service women who had dependent children at the time of deployment to the Middle East Area of Operations (MEAO) compared to deployed service women who did not have children and to consider inter-service, inter-rank differences and age.
METHODS Data for this article were drawn from the MEAO Census Study (Dobson et al. 2012). The MEAO Census Study was funded by the Australian Department of Defence with the aim of investigating the health of ADF members who deployed to the MEAO prior to January 2010. This cross-sectional study was undertaken by the Centre for Military and Veterans’ Health between 2010 and 2011. Ethics approval for the study protocol was provided by the Australian Defence Human Research Ethics Committee, the University of Queensland Human Research Ethics Committee, and Department of Veterans’ Affairs Human Research Committee. Participation was voluntary, and written and signed informed consent was obtained prior to administering either an online or hardcopy survey.
Participants All current and ex-serving ADF members who had deployed to the MEAO between October 1, 2001 and December 31, 2009 (n = 26,915) were eligible for the MEAO Census Study. From April 2010, warm-up letters were sent to eligible participants by email and when not available, by mail. This warm-up letter advised that the study was commencing and that an invitation to participate would be sent out shortly. Invitations including an information brochure highlighting the voluntary nature of the study were sent out approximately 1 week later, advising invitees that they could access the online
Downloaded by [University of Otago] at 18:52 03 October 2015
740
C. P. Davy et al.
consent form and survey through a hyperlink, or if they preferred, they could request a hard copy. Approximately 3 weeks after the invitations, reminders were sent to non-responders. Reminders were also issued when persons had commenced, but not completed, the online questionnaire, or had requested, but not returned, hard copy questionnaires. Telephone follow up was attempted for all individuals for whom a response was not received within 3 weeks of the reminder. Up to ten telephone calls were made at a variety of times during different days. Survey data were obtained from 58.7 percent of all eligible members. This response rate compares favorably with other similar studies, including the consolidated Centre for Military and Veterans’ Health Near North Area of Influence studies (Centre for Military and Veterans’ Health 2008, 2009a, 2009b), the 2010 ADF Mental Health Prevalence and Wellbeing Study (McFarlane et al. 2011), and the first waves of data collection for the King’s Cohort in the UK and the United States Millennium Cohort (Pinder et al. 2012). Findings presented in this article were obtained from data collected from women who completed either the online or hardcopy MEAO Census Study survey. Of the total number of women eligible to participate in the MEAO Census Study (n = 2,947), 1,730 women (58.7 percent) completed the survey. Of these participants, 921 provided sufficient information to ascertain whether they had dependent children at the time of their last deployment and therefore were considered to be ‘responders’ for the purposes of the analyses presented in this article. Responses from participating women were divided into two groups: ●
Group One: Service women who had dependent children (
