title: Parents bereaved by infant death: sex differences and moderation in PTSD, attachment, coping and social support.
abstract: OBJECTIVE
  Parents bereaved by infant death experience a wide range of symptomatology, including posttraumatic stress disorder (PTSD) that may persist for years after the loss. Little research has been conducted on PTSD in fathers who have lost an infant. Mothers report most symptoms to a greater extent than fathers, but not much is known about other sex differences following infant death.
  
  
  METHODS
  The present cross-sectional study examined sex differences in PTSD and sex differences in the relationship between PTSD severity and related variables. Subjects were 361 mothers and 273 fathers who had lost an infant either late in pregnancy, during birth or in the first year of life. Participants filled out questionnaires between 1.2 months and 18 years after the loss (M = 3.4 years).
  
  
  RESULTS
  Mothers reported significantly more PTSD symptoms, attachment anxiety, emotion-focused coping and feeling let down, but significantly lower levels of attachment avoidance than fathers. Attachment anxiety, attachment avoidance and emotion-focused coping were significantly more strongly associated with PTSD severity in mothers than fathers, but only when examined alone. When all variables and time since the loss were examined together, there were no longer any significant moderation effects of sex.
  
  
  CONCLUSIONS
  Persistent posttraumatic symptomatology exists in both mothers and fathers long after the loss. There are several sex differences in severity and correlates of PTSD, and a few moderation effects were identified for attachment and emotion-focused coping. Overall, more similarities than differences were found between mothers and fathers in the associations between PTSD and covariates.
authors.affiliation: Department of Psychology, University of Aarhus, Bartholins Allé 9, 8000 Aarhus C, Denmark; National Centre for Psychotraumatology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark. Electronic address: dochristiansen@health.sdu.dk.
authors.forename: Dorte M
authors.initials: DM
authors.lastname: Christiansen
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE Diemen, the Netherlands. Electronic address: m.olff@amc.nl.
authors.forename: Miranda
authors.initials: M
authors.lastname: Olff
authors.affiliation: National Centre for Psychotraumatology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Psychology Research Institute, School of Psychology, Faculty of Life and Health Sciences, University of Ulster, Londonderry, United Kingdom. Electronic address: aelklit@health.sdu.dk.
authors.forename: Ask
authors.initials: A
authors.lastname: Elklit
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001601:Bereavement; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D066088:Infant Death; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D010290:Parents / Q000523:psychology*; D066087:Perinatal Death; D012737:Sex Factors; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Bereavement; Infant death; Moderation; PTSD; Sex differences