The Distinctiveness of Grief, Depression, and Posttraumatic Stress: Lessons from Children After 9/11

Details

• Personal Author:
  Duarte CS ; Fan B ; Geronazzo-Alman L ; Guffanti G ; Hoven CW ; Layne CM ; Musa GJ ; Wicks J
• Description:
  Objective: The clinical and nosological significance of grief reactions in youth exposed to a shared trauma (9/11, the September 11, 2001 terrorist attacks on the United States) was tested by examining whether the predictors (ie, non-loss-related trauma versus traumatic bereavement), clinical correlates, factorial structure, and 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 6 months post-9/11, multivariate regressions examined predictors of grief, PTSD, and MDD, as well as the incremental validity of grief in predicting health problems and functional impairment. Factor analysis and latent class analysis determined, respectively, the factorial and the 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 multifaceted approach provided convergent evidence that grief reactions are independent of other common types of postdisaster 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. [Description provided by NIOSH]
• Subjects:
  Adolescent Behavior Mental Disorders Mental Health Nervous System Occupational Health Pathology Safety September 11 Terrorist Attacks Stress, Psychological
• Keywords:
  Adaptation Adolescents Author Keywords: Depression Behavior Patterns Children Emotional Stress Grief Humans Intervention Mental Disorders Mental Health Mental Processes Mental Stress Post-traumatic Stress Disorder Posttraumatic Stress Disorder Psychological Adaptation Psychological Effects Psychological Stress Psychosocial Factors PTSD Stress Terrorism World Trade Center WTC

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• ISSN:
  0890-8567
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  58
• Issue:
  10
• NIOSHTIC Number:
  nn:20060597
• Citation:
  J Am Acad Child Adolesc Psychiatry 2019 Oct; 58(10):971-982
• Contact Point Address:
  Lupo Geronazzo-Alman, PhD, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032
• Email:
  lupo.geronazzo@nyspi.columbia.edu
• Federal Fiscal Year:
  2020
• Performing Organization:
  New York State Psychiatric Institute, New York
• Peer Reviewed:
  True
• Start Date:
  20150701
• Source Full Name:
  Journal of the American Academy of Child and Adolescent Psychiatry
• End Date:
  20170630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:106684a8b4f9b4a25e313013838a40fa5830fdd00cd373c787a2fd2cc9c944353773aa638eff9c063a0861fd6ad07e9303deab17ad5cf2a0dc2a8c7f00bc5772
• Download URL:
  https://stacks.cdc.gov/view/cdc/224458/cdc_224458_DS1.pdf
• File Type:
  [PDF - 2.09 MB ]