Citation

Geronazzo-Alman L, Fan B, Duarte CS, Layne CM, Wicks J, Guffanti G, Musa GJ, Hoven CW. J. Am. Acad. Child Adolesc. Psychiatry 2019; ePub(ePub): ePub.

Copyright

(Copyright © 2019, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2018.12.012

PMID

30877043

Abstract

OBJECTIVE: The clinical and nosological significance of grief reactions in youth exposed to a shared trauma (9/11) was tested by examining whether the (1) predictors (i.e., non-loss related trauma vs. traumatic bereavement), (2) clinical correlates, (3) factorial structure, and (4) phenomenology of grief reactions are distinct from those of major depressive disorder (MDD) and 9/11-related posttraumatic stress disorder (PTSD).

METHOD: In a representative sample of New York City schoolchildren (N=8,236; grades 4-12; n=1,696 bereaved), assessed six months post-9/11, multivariate regressions examined (1) predictors of grief, PTSD, and MDD, and (2) the incremental validity of grief in predicting health problems and functional impairment; factor analysis and latent class analysis determined, respectively, (3) the factorial and (4) syndromic distinctiveness of grief, PTSD, and MDD.

RESULTS: Four types of evidence supporting the distinctiveness of grief emerged. (1) Bereavement was associated with grief independently of PTSD and MDD, but not with PTSD and MDD after adjusting for grief; conversely, non-loss related trauma was associated primarily with PTSD. (2) Grief contributed uniquely to functional impairment. (3) Grief reactions loaded on a separate factor. (4) Youth with elevated grief reactions fell into two classes characterized by only moderate and negligible probability of co-occurring PTSD and MDD symptoms, respectively.

CONCLUSION: A multi-faceted approach provided convergent evidence that grief reactions are independent of other common types of post-disaster child and adolescent psychopathology, and capture a unique aspect of bereavement-related distress. These findings suggest that grief reactions in traumatically bereaved youth merit separate clinical attention, informing tailored interventions.

Copyright © 2019. Published by Elsevier Inc.

Language: en