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. 2021 Jun 28;12(1):1936916.
doi: 10.1080/20008198.2021.1936916. eCollection 2021.

Peritraumatic distress predicts prolonged grief disorder symptom severity after the death of a parent in children and adolescents

Alexis Revet  1   2   3 , Agnès Suc  4 , Françoise Auriol  5 , A A A Manik J Djelantik  6   7 , Jean-Philippe Raynaud  1   2 , Eric Bui  8   9
Affiliations

Peritraumatic distress predicts prolonged grief disorder symptom severity after the death of a parent in children and adolescents

Alexis Revet et al. Eur J Psychotraumatol. .

Abstract
in English, Spanish, Chinese

Background: In 2015 nearly 140 million children and adolescents under 18 had experienced the death of one or both parents. Parental death is often considered the most traumatic event that a child can experience in their lifetime. While parental loss may lead to the development of prolonged grief disorder (PGD), little is known about risk factors for such negative mental health outcome in children. Objective: The present study aims to examine peritraumatic reactions as predictors of PGD in children who lost a parent. Method: Thirty-four children (M age = 10.9, SD = 3.2, 67.6% females) who lost a parent (time since death = 4.6 months, SD = 2.3) were assessed for peritraumatic distress and peritraumatic dissociation experienced at the time of the loss, and for PGD symptom severity at three timepoints post-loss (<6 months; 6-12 months; >12 months). Results: PGD score was correlated with peritraumatic distress (.61; p < .01) but not with peritraumatic dissociation (.24; p = .3). Results from the mixed-model regression analysis identified peritraumatic distress as the only significant predictor of PGD symptom severity (B = 1.58, SE = .31; p < .0001), with no statistically significant effect of peritraumatic dissociation (B = - .43, SE = .36; p = .2), or time (B = - 3.84, SE = 2.99; p = .2). Conclusion: Our results suggest that peritraumatic distress might be useful to identify children at risk for developing PGD, and in need of further support. The development of early preventive strategies to prevent PGD in parentally bereaved children who experienced high peritraumatic distress is warranted.

Antecedentes: En el 2015 cerca de 140 millones de niños y adolescentes menores a 18 años experimentaron la muerte de uno o ambos padres. La muerte parental es considerada a menudo como el evento más traumático que un niño puede experimentar en su vida. Mientras que la pérdida parental puede conducir al desarrollo de Duelo Prolongado (PGD), poco se sabe respecto a los factores de riesgo para dicha consecuencia negativa en la salud mental de los niños.Objetivo: El presente estudio apunta a examinar reacciones peritraumáticas como predictores de PGD en niños que han perdido un padre o madre.Método: Treinta y cuatro niños (Edad promedio = 10.9, DE = 3.2, 67,6% mujeres) quienes perdieron su padre o madre (tiempo desde la muerte = 4.6 meses, DE=2.3) fueron evaluados en relación a angustia peritraumática y disociación peritraumática experimentados al momento de la pérdida, y en relación a severidad sintomática de PGD en tres momentos diferentes tras la pérdida (< 6 meses; 6-12 meses; > 12 meses).Resultados: El puntaje de PGD se correlacionó con angustia peritraumática (0.61; p < .01) pero no con disociación peritraumática (0.24; p = .3). Resultados del análisis de regresión de modelo mixto identificaron a la angustia peritraumática como el único predictor significativo para severidad sintomática de PGD (B = 1.58; p < .0001), sin efecto estadísticamente significativo de disociación peritraumática (B = – 0.43; p = .2) o según el tiempo (B = – 3.84; p = .2).Conclusión: Nuestros resultados sugieren que la angustia peritraumática puede ser útil para identificar niños en riesgo de desarrollar PGD, y en necesidad de mayor apoyo. Está justificado el desarrollo de estrategias preventivas tempranas para prevenir PGD en niños en duelo por pérdida parental que experimentan angustia peritraumática severa.

背景: 2015年, 将近1.4亿未满18岁的儿童和青少年经历过单亲或双亲的死亡。父母死亡通常被认为是一个孩子一生中经历最大的创伤性事件。虽然父母丧失可能导致发展出延长哀伤障碍 (PGD), 但对儿童不良心理健康结果的风险因素知之甚少。目的: 本研究旨在考查失去父母的儿童的创伤反应作为PGD的预测指标。方法: 评估了34名丧失父母 (自死亡起时间= 4.6个月, SD = 2.3) 的儿童 (平均年龄= 10.9, SD = 3.2, 女性占67.6％) 丧失时的创伤性精神痛苦和创伤性解离, 丧失以及丧失后三个时间点 (<6个月; 6-12个月;> 12个月) 的PGD症状严重程度。结果: PGD评分与创伤性精神痛苦相关 (.61; p<.01), 但与创伤性解离无关 (.24; p= .3) 。混合模型回归分析的结果表明, 创伤性精神痛苦是PGD症状严重程度的唯一显著预测因子 (B= 1.58; p<.0001), 而创伤前分离 (B=−.43; p= .2) 或时间 (B=−3.84; p= .2) 统计上不显著。结论: 我们的结果表明, 创伤性精神痛苦可能有助于确定有发生PGD风险的儿童, 需要进一步的支持。有必要开发出早期预防策略来预防经历高创伤性精神痛苦的丧失父母的儿童的PGD.

Keywords: Peritraumatic distress; children and adolescents; complicated grief; peritraumatic dissociation.

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Conflict of interest statement

Dr. Bui receives honorarium or royalties from Springer Nature, from Wolters Kluwer, and Taylor & Francis, as well as research funding from the National Institute of Health, the Department of Defense and the Patient-Centered Outcome Research Institute. The other authors have no conflict of interest to report in relation to the present article.

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