#3115 Systematic review into the effects of sleep disorders on the development of PTSD

ObjectivesTo examine if sleep problems act as a risk factor for future PTSD development in military, child, and general adult demographics. We will also be examining specific sleep disorders, such as nightmares and insomnia, as well as examining general sleep complaints in a series of sub-sections (REM sleep, Sleep duration, quality, latency, and maintenance) to see if it is possible with the current literature to discover potential hints into the development of PTSD.MethodsSix databases (Medline, Embase, Web of Science, Psych info, AMED, and OpenGray) were searched with a standardised search strategy. The papers were then screened for relevance and quality controlled using the Ottowa-Newcastle Scale and the CASP cohort checklist by two reviewers until only relevant and high quality cohort studies remained. Relevant information and data was extracted from published sources and information on insomnia, nightmares, REM sleep, and 4 specific sleep subcategories (sleep duration, quality, latency, and maintenance) were gathered and examined. Nometa-analysis was planned.ResultsOut of the 1813 documents gathered from the various databases, 25 papers were deemed fit for narrative synthesis. 19 discussed insomnia or general sleep complaints, and found that those tended to correlate with development of future PTSD, with little distinction between if the insomnia appeared pre or post-trauma. 6 discussed nightmares and found that those too were predictive, and 2 discussed REM sleep and found that REM theta waves were potentially predictive.ConclusionIt is almost certain that complaints of poor sleep predict future PTSD development, with insomnia being predictive of many psychiatric conditions not just PTSD, and nightmares being more specific to the development of just PTSD. It has also been suggested that only subjectively (not objectively) poor sleep predicts PTSD. This would explain why specific sleep categories all have mostly mixed results, but the idea is not backed completely in the literature.

The Military Child Care Act of 1989

The Department of Defense (DoD) operates the largest employer-sponsored child care in the nation. For Soldiers, Sailors, Airmen, Marines and more, the Military Child Care Act (MCCA) of 1989 was enacted to establish law-mandated standards for all branches. Providing high-quality, available child care to service members helps maintain a mission ready force. Before the passing of the MCCA, the services’ child care programs were tainted with poor oversight, deplorable conditions and child abuse scandals detailed in GAO reports and congressional hearings. Investigations and legislative activity leading up to the passing of the MCCA, which became law under the National Defense Authorization Act of 1990 and 1991, forced the DoD to take responsibility for a new breed of service members—the military family.As a military spouse with children and employee of the DoD who co-supervises a child development center (CDC), I understand the importance of the MCCA and am able to witness DoD’s investment in their military families. The history of abhorrent conditions has all but vanished, due in part to public access of government publications. The timeline of this legislation in combination with nongovernment publications helps tell the story of the how the military model of child care became one in which the civilian sector strives to accomplish. My decade long career of federal service, my desire to be more knowledgeable of the original MCCA and my interest in military history inspired my research. My intended audience are those unfamiliar to military child care and those who may not understand the needs and sacrifices of our nation’s military families.

Affective Pedagogies for Military Children

This chapter explores how a range of institutions, both state and non-state, negotiate the instability latent in the term ‘military child.’ Focusing on internet resources for military children, the chapter analyzes how the websites represent the emotional experiences of military childhood back to that very audience. The chapter begins with the story of Omar Khadr, illustrating the politics of recognizing the militarized political subjectivities of young people. It then turns to a genealogy of the so-called military brat and an overview of the various ways that the U.S. military has interfaced with children, and how these histories inform the investments of affection, admiration, gratitude, pity, and anger circulating around military children today. The core of the analysis is a comparison of two websites, Sesame Street for Military Families (SSMF) and Military Kids Connect (MKC). Military homes on Sesame Street are characterized by warmth, intimacy, and intense focus on children’s needs. By contrast, Military Kids Connect presumes a military household marked by varying degrees of stress, constraint, and dysfunction. In disparate ways, both of these websites acknowledge and deny the impact of militarization on children, while also instrumentalizing their emotional well-being and transform coping into a child’s patriotic obligation.

Preparing for the Next Move

School transitions sometimes happen with little time for the family or the teachers to prepare. A teacher might walk into the classroom one morning to find that a student withdrew the previous afternoon and there was no opportunity to say goodbye or tell the child that he or she will be missed. These situations should not keep teachers or counselors from contacting the family and offering support through the process of transferring to a new school. If the child is relocating to another school in the district, a process can be created for teachers from the sending and receiving schools to communicate about the student if any questions arise—perhaps informally through an email or more formally by filling out a form. If the district has a transition team, as described in Chapter 9, these individuals can make suggestions and create procedures to follow when a student transfers within a district. For example, a teacher or counselor at the sending school might fill out a form that accompanies the student’s academic records and gives more descriptive informa­tion about the child’s strengths, needs, and interests. Or a checklist could be created for families to remind them what documents and other information they should gather if their child is changing schools. The Military Child Education Coalition created such a checklist for military families, which could be used as a guide. If a teacher or other school staff member is aware in advance that a child is transferring—whether it’s within the district or across the country—a variety of strategies are available for helping the family prepare for the change. A discussion with the child and family before a move is a chance for everyone involved to review the student’s academic progress and address any important issues that might need attention when the child moves into a new school. Similar to a parent–teacher conference, these meetings can help answer “what next” questions for both the parents and the child.

Kinship Caregivers: Communicating with Children about a Parent’s Deployment

The deployment of a military parent is undoubtedly a difficult time for children. This is especially true if the military child is being cared for by a relative, or kinship parent such as a grandparent, aunt, uncle, or older sibling. The child may have to experience a kind of personal deployment from their own home. To help children cope with these changes, it is important for the kinship parent to effectively communicate with the child about the deployment and the deployed parent. This will safeguard against emotional and behavioral problems and can lead to improvements in the child’s overall sense of well-being. This 3-page fact sheet was written by Elizabeth Thomas and Larry F. Forthun and published by the UF Department of Family Youth and Community Sciences, March 2013. http://edis.ifas.ufl.edu/fy1367