Traumatic grief among adolescents exposed to a peer's suicide.
OBJECTIVE
The phenomenology of grief among children and adolescents is not well studied. A syndrome of traumatic grief, distinct from depression and anxiety, has been described among bereaved adults. The purpose of this study was to describe the symptoms and course of traumatic grief among adolescents exposed to a peer's suicide and to examine the relationship between traumatic grief and depression and posttraumatic stress disorder (PTSD) in this population.


METHODS
A total of 146 friends and acquaintances of 26 suicide victims were included in this study. Subjects were interviewed at 6, 12-18, and 36 months after the peer's suicide. A subgroup was also interviewed 6 years afterward. The Texas Revised Inventory of Grief was administered at 6, 12-18, and 36 months; the Inventory of Complicated Grief was administered at the 6-year assessment.


RESULTS
Principal component analysis of the Texas Revised Inventory of Grief resulted in two factors: one assessing a traumatic grief reaction and another assessing a milder or even normal grief reaction. The occurrence of traumatic grief was found to be independent from that of depression and PTSD. Traumatic grief at 6 months predicted the onset or course of depression and PTSD at subsequent assessments.


CONCLUSIONS
Similar to adults, adolescents experience a traumatic grief reaction after exposure to a peer's suicide. Clinicians should be alerted to the occurrence of traumatic grief reactions among adolescents and the need to assess these reactions and address them in their treatment approaches.
Department of Child and Adolescent Psychiatry, Centers for Mid-Life and Late-Life Mood and Anxiety Disorders, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. melhemnm@msx.upmc.edu
Nadine M
NM
Melhem
Nancy
N
Day
M Katherine
MK
Shear
Richard
R
Day
Charles F
CF
Reynolds
David
D
Brent
D000223:Adaptation, Psychological; D000293:Adolescent; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005163:Factor Analysis, Statistical; D005500:Follow-Up Studies; D033062:Friends / Q000523:psychology; D006117:Grief; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D010379:Peer Group; D010555:Personality Inventory / Q000706:statistics & numerical data; D025341:Principal Component Analysis; D000297:Psychology, Adolescent; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D040921:Stress Disorders, Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data