Abstract | BACKGROUND: Studies suggest that stressful events increase risk for childhood anxiety and depression and hypothalamic-pituitary-adrenal (HPA) axis dysregulation. This prospective longitudinal study evaluated relationships among severe psychosocial stress, psychiatric morbidity, and HPA axis function in children. METHODS: Forty-five children (mean age: 8.9 +/- 2.9 years) suffering parent death from September 11, 2001 terror attacks and 34 nonbereaved children (mean age: 9.3 +/- 2.5 years) were evaluated prospectively at 6-month intervals in this 2-year study. Assessments involved diagnostic interviews (Child Schedule for Affective Disorders and Schizophrenia [K-SADS]) for psychopathology and 3 days of baseline salivary cortisol and a salivary dexamethasone suppression test for HPA axis function. RESULTS: Bereaved children, but not nonbereaved children, had significantly increased rates of psychiatric disorders involving anxiety disorders, especially posttraumatic stress disorder ( PTSD), after September 11, 2001 compared with retrospective assessments before September 11, 2001. Morning (AM) and 4:00 pm baseline cortisol were significantly and persistently higher for bereaved than nonbereaved children. Compared with bereaved children without psychopathology, bereaved children with PTSD had significantly lower 4:00 pm baseline cortisol and significantly greater 4:00 pm cortisol suppression. Children with generalized anxiety disorder had significantly less AM cortisol suppression than children without psychopathology. CONCLUSIONS: Children bereaved by sudden, unexpected parent death had persistent psychological dysfunction and HPA axis dysregulation in this study.
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Authors | Cynthia R Pfeffer, Margaret Altemus, Moonseong Heo, Hong Jiang |
Journal | Biological psychiatry
(Biol Psychiatry)
Vol. 61
Issue 8
Pg. 957-65
(Apr 15 2007)
ISSN: 0006-3223 [Print] United States |
PMID | 17137565
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
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Topics |
- Adolescent
- Anxiety
(etiology)
- Bereavement
- Child
- Child, Preschool
- Female
- Humans
- Hydrocortisone
(metabolism)
- Life Change Events
- Longitudinal Studies
- Male
- Probability
- Psychopathology
- Retrospective Studies
- Saliva
(metabolism)
- Stress Disorders, Post-Traumatic
(metabolism, physiopathology, psychology)
- Time Factors
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