ARTICLES
Phenomenology and Correlates of Complicated Grief in Children and Adolescents

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ABSTRACT

Objective:

To describe the phenomenology of complicated grief (CG) in parentally bereaved children and adolescents and to examine its correlates.

Method:

This is a preliminary report from an ongoing 5-year, population-based, longitudinal study of the impact of parental loss on family members. Analyses of cross-sectional data at intake are presented. The sample consists of 129 children and adolescents of parents who died by suicide, accident, or sudden natural death. Their average age is 13.3 ± 3.1 years (range 7-18 years). A modified version of the Inventory of Complicated Grief-Revised (ICG-R) was administered and its factor structure, internal consistency, and convergent and discriminant validity were examined.

Results:

CG was significantly related to functional impairment even after controlling for current depression, anxiety, and posttraumatic stress disorder. CG was also associated with other measures of psychopathology, including suicidal ideation.

Conclusions:

In this preliminary analysis, CG appears to be a clinically significant syndrome in children and adolescents. Longitudinal data will help to clarify the prognostic significance of CG as well as to examine the interrelationship of CG and other psychopathology over time.

Section snippets

Sample

This is a preliminary report from an ongoing 5-year, population-based, longitudinal study of the impact of parental loss on family members. Analyses of cross-sectional data at intake are presented here. A sample of 129 children, 7 to 18 years old, was recruited from 89 families in which a parent died by suicide (n = 33, 25.6%), accident (n = 31, 24%), or sudden natural death (n = 65, 50.4%). Biological children and nonbiological children living with the deceased at the time of death were

Characteristics of Study Sample

This article is based on baseline data for 129 offspring from 89 families recruited. The sample is almost equally distributed by sex (52.7% males), and the mean age is 13.3 ± 3.1 years (range 7-18 years). The proportion of subjects who have always lived with their deceased parent was 60.5%, 37.2% lived with their parent part of the time, and only 2.3% never lived with the deceased but had visiting arrangements. Most of the probands were male (75.3%) and white (86.5%). Their mean age at death

DISCUSSION

In this study, we present initial evidence of a psychometrically sound measure of CG in children and adolescents. The ICG-R shows high internal consistency. Higher scores on the ICG-R were correlated with clinically rated and self-rated functional impairment. When controlling for depression, anxiety, and PTSD, CG scores remained significantly correlated with clinically rated functional impairment, suggesting that it is tapping a clinical dimension, CG, that is unique from these disorders.

REFERENCES (40)

  • AT Beck et al.

    An inventory for measuring clinical anxiety: psychometric properties

    J Consult Clin Psychol

    (1988)
  • AT Beck et al.

    Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation

    Am J Psychiatry

    (1985)
  • AT Beck et al.

    An inventory for measuring depression

    Arch Gen Psychiatry

    (1961)
  • PA Boelen et al.

    Complicated grief, depression, and anxiety as distinct postloss syndromes: a confirmatory factor analysis study

    Am J Psychiatry

    (2005)
  • GA Bonanno

    Is complicated grief a valid construct?

    Clin Psychol Sci Pract

    (2006)
  • N Breslau et al.

    Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma

    Arch Gen Psychiatry

    (1998)
  • N Breslau et al.

    Trauma exposure and posttraumatic stress disorder: a study of youths in urban America

    J Urban Health

    (2004)
  • E Brown et al.

    Childhood traumatic grief following September 11, 2001: construct development and validation

    J Clin Child Adolesc Psychol

    (2005)
  • JA Cohen et al.

    Treatment of childhood traumatic grief

    J Clin Child Adolesc Psychol

    (2004)
  • JA Cohen et al.

    Childhood traumatic grief: concepts and controversies

    Trauma Violence Abuse

    (2002)

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    This study was supported by an R01 grant (MH65368) from the National Institute of Mental Health (Dr. Brent) and a young investigator award from the American Foundation for Suicide Prevention (Dr. Melhem).

    Article Plus (online only) materials for this article appear on the Journal's Web site: www.jaacap.com.

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    Copyright © 2007 The American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.