Impact of Sudden Parental Death on Children and Families

Summary

Principal Investigator: D Brent
Affiliation: University of Pittsburgh
Country: USA
Abstract: This is a 5-year A1 competitive renewal to study the impact of sudden parental death on children. During the initial project period, we recruited a cohort of 245 children who have lost a parent to suicide, accident, or sudden natural death, and a demographically similar, non-bereaved control group of 185 children and assessed them at 1 and 2 years after parental death. We find evidence of a persistent impact two years after the death: parental bereavement quadruples the risk for child depression, even adjusting for pre-death risk factors. We propose to reassess this cohort at 3 and 6 years after the parental death for a total of 4 follow-up assessment points in order to examine the relationship between parental loss and child outcomes in the domains of psychopathology (e.g., incident disorder, symptom trajectory), attainment of developmental competence (educational, vocational, relational), and health-related outcomes (e.g., BMI, impact on the hypothalamic pituitary adrenal [HPA] axis). We evaluate the construct and discriminant validity of complicated grief to determine if it has a stable factor structure and explains a unique proportion of the variance in outcome. We test an explanatory model by examining specific pathways that may mediate (e.g., child coping, family cohesion) or moderate (e.g., pre-death psychopathology, gender) the relationship between parental death and child mental health, developmental, and physical health outcomes. As an exploratory aim, we examine if polymorphisms in genes may moderate the relationship between parent death and cortisol response to a social stressor (e.g., glucocorticoid receptor) or depression (e.g., serotonin transporter promoter). This project will lead to new knowledge, because it: (1) is the only controlled, prospective study of parentally bereaved children with a follow-up period of longer than 2 years; (2) assesses outcomes complementary to psychiatric outcome, namely developmental competency, health, and the HPA axis; (3) tests models of mediation and moderation; (4) is large enough to assess if parental bereavement by suicide is uniquely deleterious; and (5) will address whether complicated grief in youth has construct and discriminant validity and has a direct impact on functional outcome. These results will help to identify bereaved youth and families at risk for sub-optimal mental and physical health and developmental outcomes, thus framing targets for future prevention and intervention studies.Project Narrative: The loss of a parent is widely recognized to be among the most stressful events that a child can experience, and numerous retrospective studies indicate that parent loss has serious and enduring mental health effects. However, there have been no long-term, controlled, prospective studies of the effects of parental bereavement on children.
Funding Period: 2002-08-09 - 2012-12-31
more information: NIH RePORT

Top Publications

  1. ncbi Phenomenology and correlates of complicated grief in children and adolescents
    Nadine M Melhem
    Department of Child and Adolescent Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA
    J Am Acad Child Adolesc Psychiatry 46:493-9. 2007
  2. ncbi Antecedents and sequelae of sudden parental death in offspring and surviving caregivers
    Nadine M Melhem
    Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
    Arch Pediatr Adolesc Med 162:403-10. 2008
  3. ncbi The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death
    David Brent
    Western Psychiatric Institute and Clinic, Rm 315, Bellefield Towers, 3811 O Hara St, Pittsburgh, PA 15213, USA
    Am J Psychiatry 166:786-94. 2009

Scientific Experts

  • D Brent
  • Nadine M Melhem
  • Grace Moritz
  • Monica Walker
  • M Katherine Shear

Detail Information

Publications3

  1. ncbi Phenomenology and correlates of complicated grief in children and adolescents
    Nadine M Melhem
    Department of Child and Adolescent Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA
    J Am Acad Child Adolesc Psychiatry 46:493-9. 2007
    ..To describe the phenomenology of complicated grief (CG) in parentally bereaved children and adolescents and to examine its correlates...
  2. ncbi Antecedents and sequelae of sudden parental death in offspring and surviving caregivers
    Nadine M Melhem
    Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
    Arch Pediatr Adolesc Med 162:403-10. 2008
    ..To examine the psychiatric antecedents that put parents at risk for early death, and the psychological sequelae of bereavement in offspring and caregivers...
  3. ncbi The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death
    David Brent
    Western Psychiatric Institute and Clinic, Rm 315, Bellefield Towers, 3811 O Hara St, Pittsburgh, PA 15213, USA
    Am J Psychiatry 166:786-94. 2009
    ..This study examined effects of bereavement 21 months after a parent's death, particularly death by suicide...