Psychological and environmental correlates of HPA axis functioning in parentally bereaved children: preliminary findings
Open accessAbstract
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.
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Expressive suppression was concurrently positively associated with complicated grief symptoms in a small cross-sectional survey.
“Moreover, expressive suppression (inhibiting the outward expression of an emotion) was concurrently positively associated with CG symptoms in a small cross-sectional survey (Kaplow et al., 2013).”
From Emotion Regulatory Strategies in Complicated Grief: A Systematic Review (2021) · cites this paper as Kaplow et al., 2013
The Methods (Measures; page unavailable) show that this small study measured both children’s maladaptive grief and avoidant coping, including efforts not to show sadness. The Results (page unavailable) associate each measure separately with a dampened cortisol awakening response, but do not report a positive association between suppression and complicated-grief symptoms themselves. (LLM, conf=0.81)
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- Authors
- Kaplow, J. B., Shapiro, D. N., Wardecker, B. M., Howell, K. H., Abelson, J. L., Worthman, C. M., & Prossin, A. R.
- Affiliations
- University of Michigan (US)
- Emory University (US)
- Corresponding author
- Kaplow, Julie B.
- ORCID
- Venue
- Journal of Traumatic Stress
- Publisher
- Wiley
- Published
- 2013-03-22
- Volume
- 26
- Issue
- 2
- Pages
- 233-240
- ISSN
- 0894-9867 (ISSN-L)
- 1573-6598
- PMC
- PMC5790317
- OpenAlex
- W1945091363
- Cited by
- 29
- References
- 53
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 3 · 2020: 2 · 2018: 2 · 2017: 3 · 2016: 2 · 2015: 3 · 2014: 4 · 2012: 1
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Traumatic Stress (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Digital Commons-TMC (Texas Medical Center) (submittedVersion)
- Funders
- NIMH (K08 MH76078)
- Todd Ouida Clinical Scholars Award
- Laurence Polatsch Memorial Fund
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- parental bereavement, children of bereaved parents, hypothalamic-pituitary-adrenal axis, cortisol awakening response, blunted cortisol response, psychological distress, anxiety, depression, post-traumatic stress, avoidance coping, parental grief, allostatic load
- MeSH terms
- Adaptation, Psychological, Adult, Child, Female, Grief, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Parent-Child Relations, Parents, Pituitary-Adrenal System, Surveys and Questionnaires, Saliva, Stress, Psychological, Parental Death
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