Latent Profile Analysis in Child Bereavement

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PROJECT SUMMARY Parental death is the most profound childhood experience, with long-term and negative mental health consequences, including elevated risk for depression and suicide, compared to the general population. Early adolescents are particularly vulnerable to the resultant consequences of a parental death. This age group is developing and adjusting to shifts in their cognition, motivation, social behaviors, and environments, each of which shapes their interactions and relationships. Early stress experiences, such as a parental death, influence the child’s development by provoking emotional crises. These crises may contribute to the development of mental health disorders and persist into young adulthood, the peak age for mental illness onset. To mitigate these effects, bereavement interventions have targeted this population to enhance adaptive coping and emotional expression. However, empirical studies evaluating the effectiveness of these interventions are limited in number and methodological rigor, and there is little data regarding their long-term effectiveness. Moreover, these studies use variable-centered approaches, which assume all grief responses are the same, rather than person-centered approaches to account for variation in experience and individual characteristics. This application will address these limitations by leveraging a person-centered analysis (i.e., Latent Profile Analysis) to examine: individual support-seeking coping and emotional expression characteristics at baseline (i.e., near time of loss), mental health outcomes across child- and young adulthood based on those individual characteristics, and if individual differences at baseline predict intervention response. This application aligns with NICHD and NIMH priorities of enhancing understanding of longitudinal developmental and mental health outcomes of bereaved children by identifying risk factors, behavioral indicators, and intervention responses. These aims will be addressed through person-centered analyses that leverage a rich and unique dataset with five waves of data spanning child- to young adulthood in a sample of 244 parentally-bereaved children. The specific aims are: (1) to identify subgroups of bereaved children based on patterns of coping and emotional expression, (2) identify heterogeneity in longitudinal depression and suicide outcomes as a function of child coping and emotional expression patterns, and (3) examine ways in which intervention effects differ based on profile membership. Person-centered analyses are necessary for understanding the individual differences that contribute to heterogeneity in mental health outcomes and intervention response, and considers the dynamic nature of grief. This research is a timely public health priority, given the stark increase of parental loss due to COVID-19. The research and training outlined in this NRSA F31 predoctoral fellowship application will equip me with the skills and support needed to pursue a successful career as an independent research scientist, and will increase my knowledge of relevant theoretical models and their application to prevention, competencies in advanced statistical methods for longitudinal research, and scientific writing, and dissemination.