Impact of Sudden Parental Death on Children and Families

Summary

Principal Investigator: D Brent
Affiliation: University of Pittsburgh
Country: USA
Abstract: DESCRIPTION (provided by applicant): 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. pmc Protecting adolescents from self-harm: a critical review of intervention studies
    David A Brent
    University of Pittsburgh and Western Psychiatric Institute and Clinic Electronic address
    J Am Acad Child Adolesc Psychiatry 52:1260-71. 2013
  2. pmc Alcohol and substance abuse in parentally bereaved youth
    Sami Hamdan
    School of Behavioral Science, the Academic College of Tel Aviv Jaffa MTA, Tel Aviv, Israel
    J Clin Psychiatry 74:828-33. 2013
  3. pmc Identifying prolonged grief reactions in children: dimensional and diagnostic approaches
    Nadine M Melhem
    University of Pittsburgh School of Medicine, PA, USA
    J Am Acad Child Adolesc Psychiatry 52:599-607.e7. 2013
  4. pmc Preserved hippocampal function during learning in the context of risk in adolescent suicide attempt
    Lisa Pan
    Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Psychiatry Res 211:112-8. 2013
  5. pmc Cortisol response to social stress in parentally bereaved youth
    Laura J Dietz
    Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Biol Psychiatry 73:379-87. 2013
  6. pmc The phenomenology and course of depression in parentally bereaved and non-bereaved youth
    Sami Hamdan
    University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    J Am Acad Child Adolesc Psychiatry 51:528-36. 2012
  7. pmc Effect of parental bereavement on health risk behaviors in youth: a 3-year follow-up
    Sami Hamdan
    Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Arch Pediatr Adolesc Med 166:216-23. 2012
  8. pmc Grief in children and adolescents bereaved by sudden parental death
    Nadine M Melhem
    Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA
    Arch Gen Psychiatry 68:911-9. 2011
  9. pmc Dissociable patterns of neural activity during response inhibition in depressed adolescents with and without suicidal behavior
    Lisa A Pan
    University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    J Am Acad Child Adolesc Psychiatry 50:602-611.e3. 2011
  10. pmc Health risk behaviors in parentally bereaved youth
    Melissa Muñiz-Cohen
    Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O Hara St, Pittsburgh, PA 15213, USA
    Arch Pediatr Adolesc Med 164:621-4. 2010

Scientific Experts

  • Nadine M Melhem
  • D Brent
  • Sami Hamdan
  • Giovanna Porta
  • Monica Walker Payne
  • Laura J Dietz
  • Lisa Pan
  • Annamaria Segreti
  • Lisa A Pan
  • Melissa Muñiz-Cohen
  • Myung Soon Song
  • Fabrice Jollant
  • Samuel Stoyak
  • Jorge Almeida
  • Karen A Matthews
  • Natalia Lawrence
  • Mary Phillips
  • David Mazariegos
  • Dalila Akkal
  • Silvia C Batezati-Alves
  • Jorge R C Almeida
  • Sara Lakdawala
  • Mary L Phillips
  • Stefanie Hassel

Detail Information

Publications14

  1. pmc Protecting adolescents from self-harm: a critical review of intervention studies
    David A Brent
    University of Pittsburgh and Western Psychiatric Institute and Clinic Electronic address
    J Am Acad Child Adolesc Psychiatry 52:1260-71. 2013
    ..To review the studies that test treatments targeting adolescent suicidal ideation, suicide attempts, or self-harm, and to make recommendations for future intervention development...
  2. pmc Alcohol and substance abuse in parentally bereaved youth
    Sami Hamdan
    School of Behavioral Science, the Academic College of Tel Aviv Jaffa MTA, Tel Aviv, Israel
    J Clin Psychiatry 74:828-33. 2013
    ..Our aim was to examine whether the incidence of alcohol and substance abuse is higher in parentally bereaved youth and, if so, what might explain this increased incidence...
  3. pmc Identifying prolonged grief reactions in children: dimensional and diagnostic approaches
    Nadine M Melhem
    University of Pittsburgh School of Medicine, PA, USA
    J Am Acad Child Adolesc Psychiatry 52:599-607.e7. 2013
    ..We also identify a screening tool for PGR...
  4. pmc Preserved hippocampal function during learning in the context of risk in adolescent suicide attempt
    Lisa Pan
    Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Psychiatry Res 211:112-8. 2013
    ..Functional abnormalities in neural circuitry implicated in learning in the context of risk may underlie risk for MDD, but not risk for suicide attempt, in adolescence...
  5. pmc Cortisol response to social stress in parentally bereaved youth
    Laura J Dietz
    Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Biol Psychiatry 73:379-87. 2013
    ..However, few studies have prospectively examined the association between parental bereavement and cortisol response while accounting for psychiatric disorders in both youth and their caregivers...
  6. pmc The phenomenology and course of depression in parentally bereaved and non-bereaved youth
    Sami Hamdan
    University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    J Am Acad Child Adolesc Psychiatry 51:528-36. 2012
    ..To compare the phenomenology and course of bereavement-related depression to depression that occurred later in the course of bereavement and to depression in non-bereaved youth...
  7. pmc Effect of parental bereavement on health risk behaviors in youth: a 3-year follow-up
    Sami Hamdan
    Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Arch Pediatr Adolesc Med 166:216-23. 2012
    ..To examine the course of health risk behaviors (HRBs) during a 3-year period after a parent's death in bereaved youth compared with nonbereaved youth (control subjects)...
  8. pmc Grief in children and adolescents bereaved by sudden parental death
    Nadine M Melhem
    Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA
    Arch Gen Psychiatry 68:911-9. 2011
    ..Major advances have been made in our understanding of the phenomenology and course of grief in adults. However, little is known about the course of grief in children and adolescents...
  9. pmc Dissociable patterns of neural activity during response inhibition in depressed adolescents with and without suicidal behavior
    Lisa A Pan
    University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    J Am Acad Child Adolesc Psychiatry 50:602-611.e3. 2011
    ..Impaired attentional control and behavioral control are implicated in adult suicidal behavior. Little is known about the functional integrity of neural circuitry supporting these processes in suicidal behavior in adolescence...
  10. pmc Health risk behaviors in parentally bereaved youth
    Melissa Muñiz-Cohen
    Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O Hara St, Pittsburgh, PA 15213, USA
    Arch Pediatr Adolesc Med 164:621-4. 2010
    ..To investigate whether parentally bereaved offspring are more likely to engage in health risk behaviors than nonbereaved control offspring...
  11. pmc 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...
  12. pmc 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...
  13. 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...