Psychological and environmental correlates of HPA axis functioning in parentally bereaved children: preliminary findings

Authors

Julie B Kaplow, Department of Psychiatry, University of Michigan Medical School, Ann Arbor
Danielle N Shapiro, Department of Psychology, University of Michigan, Ann Arbor
Britney M Wardecker, Department of Psychology, University of Michigan, Ann Arbor
Kathryn H Howell, Department of Psychiatry, University of Michigan Medical School, Ann Arbor
James L Abelson, Department of Psychiatry, University of Michigan Medical School, Ann Arbor
Carol M Worthman, Department of Anthropology, Emory University, Atlanta
Alan R Prossin, Department of Psychiatry, University of Michigan Medical School, Ann Arbor

Publication Date

4-8-2013

Journal

Journal of Traumatic Stress

DOI

10.1002/jts.21788

PMID

23526635

PMCID

5790317

PubMedCentral® Posted Date

1-30-2018

PubMedCentral® Full Text Version

accepted mss

Published Open-Access

no

Keywords

adaptation- psychological, adult, child, female, grief, humans, hydrocortisone, hypothalamo-hypophyseal system, parent-child relations, parental death, parents, pituitary-adrenal system, saliva, stress- psychological, surveys and questionnaires

Abstract

This study examined bereaved children's HPA-axis functioning (cortisol awakening response; CAR) in relation to psychological distress, coping, and surviving parents' grief reactions. Participants included 38 children (20 girls) with recent parental loss (previous 6 months) and 28 of their surviving caregivers (23 women) who were assessed using self-report instruments and in-person, semistructured interviews. Interviews involved discussions about the child's thoughts and feelings related to the loss. Participants provided 3 saliva samples at home (awakening, 30 minutes later, and evening) over 3 successive days, beginning on the day following the interview. Results show a significant relation between dampening of the child's Day 1 CAR and more symptoms of anxiety (r = -.45), depression (r = -.40), posttraumatic stress (r = -.45), and maladaptive grief (r = -.43), as well as higher levels of avoidant coping (r = -.53). Higher levels of parental maladaptive grief were also associated (r = -.47) with a dampening of the child's Day 1 CAR. Our results raise the possibility that blunted CAR may be a result of accumulating allostatic load and/or a result of emotionally challenging events (discussions regarding the deceased) and their subsequent processing (or lack thereof) within the family, which may be particularly stressful for those bereaved children experiencing high levels of psychological distress, avoidant coping, and parental maladaptive grief.

Comments

NIMH K08 MH76078