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Psychological and Environmental Correlates of HPA Axis Functioning in Parentally Bereaved Children: Preliminary Findings


  • This research was supported in part by grants NIMH K08 MH76078, the Todd Ouida Clinical Scholars Award, and the Laurence Polatsch Memorial Fund given to the first author. The authors wish to thank Michelle Belke, Alena Grieser, Heather Hammerstrom, Harriett Jones, Georgia Stamatopoulos, and Amanda Tarantowski for their assistance with conducting interviews. We also thank Emilie Lerner for her assistance with project coordination and Valerie Elsesser, Kara Koppinger, Mirele Mann, Meredith Merlanti, and Teera Parr for their assistance with data management, data entry, and cortisol assays. Finally, we wish to acknowledge the Gilda's Club of Grand Rapids staff for their administrative support, and all participating children, parents, and guardians.

Correspondence concerning this article should be addressed to Julie B. Kaplow, Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI 48109–5765. E-mail:


This study examined bereaved children's HPA-axis functioning (cortisol awakening response; CAR) in relation to psychological distress, coping, and surviving parents' grief reactions. Participants included 38 children (20 girls) with recent parental loss (previous 6 months) and 28 of their surviving caregivers (23 women) who were assessed using self-report instruments and in-person, semistructured interviews. Interviews involved discussions about the child's thoughts and feelings related to the loss. Participants provided 3 saliva samples at home (awakening, 30 minutes later, and evening) over 3 successive days, beginning on the day following the interview. Results show a significant relation between dampening of the child's Day 1 CAR and more symptoms of anxiety (r = −.45), depression (r = −.40), posttraumatic stress (r = −.45), and maladaptive grief (r = −.43), as well as higher levels of avoidant coping (r = −.53). Higher levels of parental maladaptive grief were also associated (r = −.47) with a dampening of the child's Day 1 CAR. Our results raise the possibility that blunted CAR may be a result of accumulating allostatic load and/or a result of emotionally challenging events (discussions regarding the deceased) and their subsequent processing (or lack thereof) within the family, which may be particularly stressful for those bereaved children experiencing high levels of psychological distress, avoidant coping, and parental maladaptive grief.

Traditional and Simplified Chinese Abstracts by AsianSTSS


撮要:本文檢視孩童喪親後HPA軸功能(包括皮質醇睡醒反應;CAR) 與心理困擾、應對、和另一尚存家長的悲傷反應之間的關係。樣本包括38名孩童(20名女童曾在過去6個月有家長離世)和28名尚存的孩童家長(23名女性),他們會接受自我答問工具和半結構面談,而面談包括討論孩童對喪親的想法及感受,面談後連續三日,受訪者會提供3個在家唾液樣本(睡醒時,30分鐘後和黃昏時)。結果顯示孩童第1天CAR減退與更多焦慮症狀(r= -.45) 、 抑鬱症狀(r= -.40) 、 創傷後壓力症狀(r= -.45) 、不適應哀悼症狀(r= -.43) 和迴避性應對水平(r= -.53)有顯著關連。家長的更高不適應哀悼水平(r= -.47) 亦與孩童第1天CAR減退有關連。這些數據突出了減弱的CAR可能是累積穩態負荷和(又或)情緒上刺激的事件(與死者相關的討論),及在家庭中相關的後續處理(或缺少處理)而導致的。這些可能對喪親兒童(已經歷高度心理困擾、迴避應對和家長的不適應哀悼)來說已是特別壓力。


撮要:本文检视孩童丧亲后HPA轴功能(包括皮质醇睡醒反应;CAR) 与心理困扰、应对、和另一尚存家长的悲伤反应之间的关系。样本包括38名孩童(20名女童曾在过去6个月有家长离世)和28名尚存的孩童家长(23名女性),他们会接受自我答问工具和半结构面谈,而面谈包括讨论孩童对丧亲的想法及感受,面谈后连续三日,受访者会提供3个在家唾液样本(睡醒时,30分钟后和黄昏时)。结果显示孩童第1天CAR减退与更多焦虑症状(r= -.45) 、 抑郁症状(r= -.40) 、 创伤后压力症状(r= -.45) 、不适应哀悼症状(r= -.43) 和回避性应对水平(r= -.53)有显著关连。家长的更高不适应哀悼水平(r= -.47) 亦与孩童第1天CAR减退有关连。这些数据突出了减弱的CAR可能是累积稳态负荷和(又或)情绪上刺激的事件(与死者相关的讨论),及在家庭中相关的后续处理(或缺少处理)而导致的。这些可能对丧亲儿童(已经历高度心理困扰、回避应对和家长的不适应哀悼)来说已是特别压力。