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RESEARCH ARTICLES
Published Online: 16 December 2020

Identifying Bereavement‐Related Markers of Mental and Behavioral Health Problems Among Clinic‐Referred Adolescents

Julie B. Kaplow, Rachel Wamser‐Nanney, Christopher M. Layne, Amanda Burnside, Cheryl King, Li‐Jung Liang, Alan Steinberg, Ernestine Briggs, Liza Suarez, and Robert PynoosAuthors Info & Affiliations
Publication: Psychiatric Research and Clinical Practice
Volume 3, Number 2
https://doi.org/10.1176/appi.prcp.20190021
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Abstract

Objective

This study examined bereavement‐related risk markers (number of deaths, cause of death, and relationship to deceased) of mental and behavioral health problems (suicidal thoughts or behaviors, self‐injury, depression, posttraumatic stress, and substance use) in a national sample of clinic‐referred bereaved adolescents.

Method

Participants included 1281 bereaved youth aged 12–21 years (M=15, SD=1.8; 62.1% female), from the National Child Traumatic Stress Network Core Data Set.

Results

Generalized linear mixed‐effects regression models controlling for demographics and other traumas revealed that youth bereaved by multiple deaths had higher posttraumatic stress scores than youth bereaved by a single death (Estimated difference ±SE=3.36 ± 1.11, p=0.003). Youth bereaved by suicide were more likely to report experiencing suicidal thoughts or behaviors (AOR=1.68, p=0.049) and alcohol use (AOR=2.33, p<0.001) than youth bereaved by natural causes. Youth bereaved by homicide were at greater risk for substance use than youth bereaved by natural death (AOR=1.76, p=0.02). Compared to parentally bereaved youth, youth who lost a peer were more likely to use alcohol (AOR=2.32, p=0.02) or other substances (AOR=2.41, p=0.01); in contrast, parentally bereaved youth were more likely to experience depression compared to those who experienced the death of an adult relative or unrelated adult (range of AOR: 0.40 to 0.64, p‐values<0.05).

Conclusion

These bereavement‐related contextual factors can serve as early markers of mental and behavioral health problems among bereaved youth.

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Information & Authors

Information

Published In

Go to Psychiatric Research and Clinical Practice
Psychiatric Research and Clinical Practice
Volume 3 • Number 2 • Summer 2021
Pages: 88 - 96

History

Received: 17 July 2019
Revision received: 13 September 2020
Accepted: 28 October 2020
Published online: 16 December 2020
Published in print: Summer 2021

Authors

Affiliations

Julie B. Kaplow
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Rachel Wamser‐Nanney
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Christopher M. Layne
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Amanda Burnside
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Cheryl King
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Li‐Jung Liang
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Alan Steinberg
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Ernestine Briggs
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Liza Suarez
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Robert Pynoos
The Trauma and Grief Center at the Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX (J. B. Kaplow); Department of Psychology, University of Missouri Saint Louis, Saint Louis, MO (R. Wamser‐Nanney); UCLA/Duke University National Center for Child Traumatic Stress, University of California, Los Angeles (C. M. Layne, A. Steinberg, R. Pynoos); Department of Psychology, Loyola University Chicago, Chicago, IL (A. Burnside); Department of Psychiatry, University of Michigan Medical School, Ann Arbor (C. King); David Geffen School of Medicine, University of California, Los Angeles (L. Liang); UCLA/Duke University National Center for Child Traumatic Stress, Duke University School of Medicine, Durham, NC (E. Briggs); Department of Psychiatry, Institute for Juvenile Research, University of Illinois at Chicago, Chicago (L. Suarez)
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Notes

Send correspondence to Dr. Kaplow ([email protected])

Funding Information

Substance Abuse and Mental Health Services Administration: 2U79SM054284‐12S, SM062111, SM16008

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