Death of Parent Associated With Separation Anxiety, Conduct Disorder

HONOLULU – Children who experience bereavement, especially the loss of a parent, are significantly more likely to exhibit symptoms of separation anxiety and conduct disorder than those who have not experienced such a loss, a large longitudinal study shows.

In addition, bereavement is associated with a great risk of developing substance abuse problems, Julie B. Kaplow, Ph.D., and her colleagues wrote for a poster presentation at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

The data came from the Great Smoky Mountains Study of Youth, a longitudinal study of a representative sample of children from 11 counties in western North Carolina. Children were aged 9, 11, and 13 years at the time of enrollment, and investigators interviewed them annually for 14 years using the Life Events and Psychiatric Disorders sections of the Child and Adolescent Psychiatric Assessment.

For the purposes of the bereavement study, the investigators compared 172 children who had lost a parent (biological, foster/adoptive, or other parental figure), 815 who had lost a relative other than a parent (grandparent, aunt, or uncle), and 235 who had experienced no loss.

Investigators focused on the interview during which the loss was reported, as well as the interviews immediately before and after the index interview, wrote Dr. Kaplow, of the department of psychology at the University of Michigan, Ann Arbor.

There were some baseline differences among the groups. Children in the parent-bereaved group were significantly more likely to live in poverty (42% vs. 22% in the other-bereaved group and 23% in the nonbereaved group).

Before the loss, children in the parent-bereaved group also were significantly more likely to report substance abuse (14% vs. 4% in the other two groups). In addition, children in the parent-bereaved group had significantly lower global functioning scores.

After controlling for sex, age, race/ethnicity, poverty, and previous psychiatric symptoms, the investigators found that children in both of the bereaved groups were significantly more likely to report symptoms of separation anxiety than were children in the nonbereaved group. Children in the parent-bereaved group were twice as likely to show symptoms of conduct disorder than were those in the nonbereaved group, and children in the other-bereaved group were twice as likely to show symptoms of depression than either those in the parent-bereaved or nonbereaved groups.

Even after controlling for their higher rates of substance abuse at baseline, children in the parent-bereaved and other-bereaved groups showed a significantly higher risk of developing substance abuse after the loss than were nonbereaved children. The investigators speculated that this may be attributable to the bereaved individuals' poor coping skills and desire to self-medicate.

The investigators said the higher risk of conduct disorder symptoms after the loss could be tied to secondary stressors. “Parental discipline has been shown to suffer following the death of the other parent and is likely to be associated with new-onset behavioral problems in bereaved children,” they wrote.

The investigators stated that they had no conflicts of interest related to their presentation.

HONOLULU – Children who experience bereavement, especially the loss of a parent, are significantly more likely to exhibit symptoms of separation anxiety and conduct disorder than those who have not experienced such a loss, a large longitudinal study shows.

In addition, bereavement is associated with a great risk of developing substance abuse problems, Julie B. Kaplow, Ph.D., and her colleagues wrote for a poster presentation at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

The data came from the Great Smoky Mountains Study of Youth, a longitudinal study of a representative sample of children from 11 counties in western North Carolina. Children were aged 9, 11, and 13 years at the time of enrollment, and investigators interviewed them annually for 14 years using the Life Events and Psychiatric Disorders sections of the Child and Adolescent Psychiatric Assessment.

For the purposes of the bereavement study, the investigators compared 172 children who had lost a parent (biological, foster/adoptive, or other parental figure), 815 who had lost a relative other than a parent (grandparent, aunt, or uncle), and 235 who had experienced no loss.

Investigators focused on the interview during which the loss was reported, as well as the interviews immediately before and after the index interview, wrote Dr. Kaplow, of the department of psychology at the University of Michigan, Ann Arbor.

There were some baseline differences among the groups. Children in the parent-bereaved group were significantly more likely to live in poverty (42% vs. 22% in the other-bereaved group and 23% in the nonbereaved group).

Before the loss, children in the parent-bereaved group also were significantly more likely to report substance abuse (14% vs. 4% in the other two groups). In addition, children in the parent-bereaved group had significantly lower global functioning scores.

After controlling for sex, age, race/ethnicity, poverty, and previous psychiatric symptoms, the investigators found that children in both of the bereaved groups were significantly more likely to report symptoms of separation anxiety than were children in the nonbereaved group. Children in the parent-bereaved group were twice as likely to show symptoms of conduct disorder than were those in the nonbereaved group, and children in the other-bereaved group were twice as likely to show symptoms of depression than either those in the parent-bereaved or nonbereaved groups.

Even after controlling for their higher rates of substance abuse at baseline, children in the parent-bereaved and other-bereaved groups showed a significantly higher risk of developing substance abuse after the loss than were nonbereaved children. The investigators speculated that this may be attributable to the bereaved individuals' poor coping skills and desire to self-medicate.

The investigators said the higher risk of conduct disorder symptoms after the loss could be tied to secondary stressors. “Parental discipline has been shown to suffer following the death of the other parent and is likely to be associated with new-onset behavioral problems in bereaved children,” they wrote.

The investigators stated that they had no conflicts of interest related to their presentation.

HONOLULU – Children who experience bereavement, especially the loss of a parent, are significantly more likely to exhibit symptoms of separation anxiety and conduct disorder than those who have not experienced such a loss, a large longitudinal study shows.

In addition, bereavement is associated with a great risk of developing substance abuse problems, Julie B. Kaplow, Ph.D., and her colleagues wrote for a poster presentation at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

The data came from the Great Smoky Mountains Study of Youth, a longitudinal study of a representative sample of children from 11 counties in western North Carolina. Children were aged 9, 11, and 13 years at the time of enrollment, and investigators interviewed them annually for 14 years using the Life Events and Psychiatric Disorders sections of the Child and Adolescent Psychiatric Assessment.

For the purposes of the bereavement study, the investigators compared 172 children who had lost a parent (biological, foster/adoptive, or other parental figure), 815 who had lost a relative other than a parent (grandparent, aunt, or uncle), and 235 who had experienced no loss.

Investigators focused on the interview during which the loss was reported, as well as the interviews immediately before and after the index interview, wrote Dr. Kaplow, of the department of psychology at the University of Michigan, Ann Arbor.

There were some baseline differences among the groups. Children in the parent-bereaved group were significantly more likely to live in poverty (42% vs. 22% in the other-bereaved group and 23% in the nonbereaved group).

Before the loss, children in the parent-bereaved group also were significantly more likely to report substance abuse (14% vs. 4% in the other two groups). In addition, children in the parent-bereaved group had significantly lower global functioning scores.

After controlling for sex, age, race/ethnicity, poverty, and previous psychiatric symptoms, the investigators found that children in both of the bereaved groups were significantly more likely to report symptoms of separation anxiety than were children in the nonbereaved group. Children in the parent-bereaved group were twice as likely to show symptoms of conduct disorder than were those in the nonbereaved group, and children in the other-bereaved group were twice as likely to show symptoms of depression than either those in the parent-bereaved or nonbereaved groups.

Even after controlling for their higher rates of substance abuse at baseline, children in the parent-bereaved and other-bereaved groups showed a significantly higher risk of developing substance abuse after the loss than were nonbereaved children. The investigators speculated that this may be attributable to the bereaved individuals' poor coping skills and desire to self-medicate.

The investigators said the higher risk of conduct disorder symptoms after the loss could be tied to secondary stressors. “Parental discipline has been shown to suffer following the death of the other parent and is likely to be associated with new-onset behavioral problems in bereaved children,” they wrote.

The investigators stated that they had no conflicts of interest related to their presentation.