Preliminary explorations of the effects of prior trauma and loss on risk for psychiatric disorders in recently widowed people.
BACKGROUND
This study compared the relative influence of childhood and adulthood adversities on current diagnoses of Major Depressive Episode (MDE), Post-Traumatic Stress Disorder (PTSD) and Traumatic Grief (TG) among recently widowed older adults.


METHODS
Eighty-five widowed persons were interviewed at a median of 4 months after their loss. The logistic regression procedure was used to estimate the effects of three childhood adversities (parental death, abuse, death of a sibling) and three prior adulthood adversities (death of a child, non-bereavement traumatic event, death of a sibling) on current diagnoses of MDE, PTSD and TG.


RESULTS
Adversities occurring in childhood (abuse and death of a parent) were significantly associated with TG and, secondarily, MDE, while adversities occurring in adulthood (non-bereavement traumatic event and death of a child) were only significantly associated with PTSD. The tendency of childhood adversities to predict TG and adult adversities to predict PTSD remained significant even after the clustering of adversities and comorbidity among psychiatric disorders were taken into account.


CONCLUSIONS
The results suggest that there is a vulnerability to TG rooted in childhood experiences explicitly, with more recent traumas having a stronger influence on PTSD secondary to widowhood. The distinctive etiological risks for bereavement-related PTSD, MDE, and TG suggest that therapeutic approaches should be tailored to the particular syndrome(s) present.
Silverman
G K
GK
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. gabriel.silverman@yale.edu
Johnson
J G
JG
Prigerson
H G
HG
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006117:Grief; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011599:Psychopathology; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology*; D017805:Widowhood / Q000523:psychology* / Q000706:statistics & numerical data