Traumatic Grief and Mental Health Outcomes in Parentally Bereaved Children

描述(申请人提供)：在美国和世界各地，由于战争、艾滋病、自然灾害或暴力，大量儿童在创伤环境中失去了父母(S)。因此，儿童创伤性悲痛(悲痛和创伤后应激的组合)是一个严重的问题，具有潜在的重大心理健康后果。然而，几乎没有实证研究来阐明童年创伤性悲伤、正常(不复杂的)丧亲和创伤后应激障碍(PTSD)在丧亲背景下的区别。此外，缺乏关于儿童创伤性悲伤及其相关功能障碍发展的心理社会、背景和生理风险和保护因素的理论指导的研究。虽然已经努力为受创伤损失影响的儿童提供心理社会援助，但这些方案正在进行中，没有一个经过经验验证的儿童创伤悲痛模型。这个有指导的临床科学家发展奖(K08)的目的是使候选人，一位最近在儿童创伤方面接受博士后培训的临床心理学家，成为一名独立的调查者，对儿童创伤后悲伤的病因和后果进行综合研究，包括创伤后应激障碍、焦虑、抑郁和免疫功能。这项拟议的研究侧重于开发和测试儿童创伤性悲痛的病因、综合模型的主要组成部分。为了测试这个模型，候选人将接受发展流行病学、童年丧亲、压力心理生理学和纵向研究方法论方面的培训。研究项目包括：(1)对两项大规模纵向研究进行的二级数据分析，这些研究涉及儿童创伤性悲伤的症状和长期后果的检查；(2)一项初步研究，探讨父母失去亲人的儿童创伤性悲伤的急性风险和保护因素。在这个K奖的背景下获得的培训将为候选人提交R01申请做好准备，该申请旨在测试父母失去亲人的儿童创伤性悲伤的病因和后果的改进的、纵向的模型。这项工作将有助于我们理解儿童创伤性悲痛的病因、病程和长期后果，并最终有助于其评估、预防和治疗。

DESCRIPTION (provided by applicant): In the United States and world-wide, a large number of children have lost a parent(s) under traumatic circumstances as a result of war, AIDS, natural disasters, or violence. Thus, childhood traumatic grief (the combination of grief and posttraumatic stress) is a serious problem with potentially significant mental health consequences. However, almost no empirical research has been conducted to elucidate the differences between childhood traumatic grief, normal (uncomplicated) bereavement, and posttraumatic stress disorder (PTSD) in the context of bereavement. Furthermore, theory-guided research on psychosocial, contextual, and physiological risk and protective factors for the development of childhood traumatic grief and associated functional impairment is lacking. While efforts have been made to provide psychosocial aid to children affected by traumatic loss, these programs are proceeding without an empirically-validated model of childhood traumatic grief. The purpose of this Mentored Clinical Scientist Development Award (K08) is to enable the candidate, a clinical psychologist with recent postdoctoral training in childhood trauma, to become an independent investigator conducting integrative research on the etiology and consequences of childhood traumatic grief, including PTSD, anxiety, depression, and immune functioning. The proposed research focuses on developing and testing main components of an etiological, integrative model of childhood traumatic grief. To test this model, the candidate will obtain training in developmental epidemiology, childhood bereavement, psychophysiology of stress, and longitudinal study methodology. Research projects include: (1) secondary data analysis of two large-scale, longitudinal studies involving the examination of symptoms and long-term consequences of childhood traumatic grief and (2) a pilot study examining acute risk and protective factors for traumatic grief in parentally bereaved children. The training obtained in the context of this K award will prepare the candidate to submit an R01 application designed to test a refined, longitudinal model of the etiology and consequences of traumatic grief in parentally bereaved children. This work will contribute to our understanding of the etiology, course, and long-term consequences of childhood traumatic grief and, ultimately, assist in its assessment, prevention, and treatment.