We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Substance Abuse and Other Adverse Outcomes for Military-Connected Youth in California Results From a Large-Scale Normative Population Survey

Kathrine Sullivan, MSW1; Gordon Capp, MSW, LCSW1; Tamika D. Gilreath, PhD1; Rami Benbenishty, PhD2; Ilan Roziner, PhD2; Ron Avi Astor, PhD1
[+] Author Affiliations
1University of Southern California School of Social Work, Los Angeles
2Bar Ilan University School of Social Work, Ramat Gan, Israel
JAMA Pediatr. 2015;169(10):922-928. doi:10.1001/jamapediatrics.2015.1413.
Text Size: A A A
Published online

Importance  Military families and military-connected youth exhibit significant strengths; however, a sizeable proportion of these families appear to be struggling in the face of war-related stressors. Understanding the consequences of war is critical as a public health concern and because additional resources may be needed to support military families.

Objective  To determine whether rates of adverse outcomes are higher for military-connected adolescents during war compared with nonmilitary peers.

Design, Setting, and Participants  This study is a secondary data analysis of a large, normative, and geographically comprehensive administrative data set (2013 California Healthy Kids Survey) to determine whether military-connected youth are at risk for adverse outcomes, including substance use, experiencing violence and harassment, and weapon carrying, during wartime. These outcomes are of particular concern because they affect socioemotional adjustment and academic success. Data were collected in March and April 2013 and participants included 54 679 military-connected and 634 034 nonmilitary-connected secondary school students from public civilian schools in every county and almost all school districts in California.

Main Outcomes and Measures  Outcomes included lifetime and recent use of alcohol, tobacco, marijuana, prescription medications, and other drugs, as well as experiences of physical and nonphysical violence and harassment and weapon carrying during the last year.

Results  Multivariable logistic regression models indicated that military-connected youth had greater odds of substance use, experience of physical violence and nonphysical harassment, and weapon carrying. For example, military-connected youth had 73% greater odds of recent other drug use (eg, cocaine and lysergic acid diethylamide; odds ratio [OR], 1.73; 95% CI, 1.66-1.80) and twice the odds of bringing a gun to school (OR, 2.20; 95% CI, 2.10-2.30) compared with nonmilitary-connected peers. Their odds of being threatened with a weapon or being in a fight were also significantly higher than their civilian counterparts (OR, 1.87; 95% CI, 1.80-1.95 and OR, 1.67; 95% CI, 1.62-1.71, respectively).

Conclusions and Relevance  Most military-connected youth demonstrate resilience. However, results suggest that during wartime, military-connected youth are at increased risk for adverse outcomes. Further, when compared with data from 2011, the rates of these negative outcomes appear to be increasing. These findings suggest a need to identify and intervene with military-connected adolescents and reflect a larger concern regarding the well-being of military families during wartime.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles