Monday, March 13, 2023

Family Bereavement Program Offers Long-Term Protection Against Depression

Children who experience the death of a parent are known to be at an increased risk of depression and other internalizing problems later in life. A study in the Journal of the American Academy of Child & Adolescent Psychiatry has found that children who together with their families participated in a bereavement program within 2.5 years of the death were less likely to experience depression up to 15 years later.

“The findings from this study have implications for future research on the prevention of depression,” wrote Irwin Sandler, Ph.D., of Arizona State University and colleagues.

Sandler and colleagues enrolled 244 youth aged 8 to 16 who had experienced the death of a parent 3 to 30 months prior to the study and their caregivers for a randomized, controlled trial. A total of 156 families participated in 12 sessions of a family bereavement program or were mailed three age-appropriate books about dealing with grief (literature control).

The family bereavement program included separate group sessions for the children and their caregivers. The caregiver sessions focused on supporting grieving caregivers, strengthening positive parenting techniques such as active listening, and reducing children’s exposure to stressful life events. The youth sessions focused on strengthening positive coping and emotion regulation skills. The children and their caregivers then came together for two joint sessions, where they could together practice their learned skills.

Sandler and colleagues conducted follow-up interviews with the youth to assess grief, intrusive thoughts, internalizing symptoms, depression, and anxiety; these interviews were conducted immediately after the family bereavement or control program, 11 months later, 6 years later, and 15 years later. A total of 186 children (now adults) were still in the trial at the 15-year follow-up.

Between the 6- and 15-year follow-up, 13.46% of the adults who had participated in the family bereavement program as children met the criteria for depression (assessed with the World Health Organization’s World Mental Health Composite International Diagnostic Interview) compared with 28.05% of those in the literature group; 4.81% of the adults who participated in the family bereavement program as children had generalized anxiety disorder as adults compared with 12.20% in the literature group.

After adjusting for multiple variables, Sandler and colleagues calculated that youth who participated in the family bereavement program were 67% less likely to have depression 15 years later compared with youth who had not participated in the program. Youth who participated in the family bereavement program were also less likely to develop anxiety disorders as adults.

“It may [be] that the FBP [family bereavement program] reduces MDD [major depressive disorder] in part through its reduction of negative self-referential processing of the stressors involved in grappling with academic, career, and romantic developmental tasks of early adulthood,” Sandler and colleagues wrote. “Future research is needed to study how preventive interventions such as the FBP may reduce negative self-referential processing as a pathway to the prevention of MDD.”

To read more on this topic, see the American Journal of Psychiatry study “CBT for Prolonged Grief in Children and Adolescents: A Randomized Clinical Trial.”

(Image: iStock/PeopleImages)

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