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Parental death in childhood and self-inflicted injuries in young adults-a national cohort study from Sweden

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Abstract

Previous studies have shown that parental death influences health and mortality in bereaved offspring. To date, few studies have examined whether exposure to parental bereavement in childhood is associated with suicidality later in life. The aim of the present research was to investigate whether parental death during childhood influences self-inflicted injuries/poisoning in young adulthood. A national cohort born during 1973–1982 (N = 871,402) was followed prospectively in the National Patient Discharge Register from age 18 to 31–40 years. Cox regression analyses of proportional hazards, with adjustment for socio-demographic confounders and parental psychosocial covariates, were used to test hypotheses regarding parental loss and hospital admission due to self-inflicted injuries/poisoning. Parental deaths were divided into deaths caused by (1) external causes/substance abuse and (2) natural causes. Persons who had lost a parent to an external cause/substance abuse-related death had the highest risk of being admitted to a hospital for a self-inflicted injury/poisoning; HRs 2.03 (1.67–2.46) for maternal death and 2.03 (1.84–2.25) for paternal death, after adjustment for socio-demographic confounders and risk factors among surviving parents. Risks were also increased for parental death due to natural causes, but at a lower level: 1.19 (1.01–1.39) and 1.28 (1.15–1.43), respectively. Losing a father before school age was associated with a higher risk of hospital admission for a self-inflicted injury/poisoning than was loss at an older age for both genders. Maternal loss before school age was associated with a higher risk only for men, particularly maternal death by natural causes (p < 0.01).

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References

  1. Hjern A, Manhica H (2013) Barn som anhöriga i vården—hur många är de? NKA Barn som anhöriga 2013:1

    Google Scholar 

  2. Rostila M, Saarela J (2011) Time does not heal all wounds. Mortality following the death of a parent. J Marriage Fam 73:236–249

    Article  Google Scholar 

  3. Geulayov G, Gunnell D, Holmen TL, Metcalfe C (2012) The association of parental fatal and non-fatal suicidal behavior and depression: a systematic review and meta-analysis. Psych Med 42:1567–1580

    Article  CAS  Google Scholar 

  4. Parkes CM (1998) Bereavement in adult life. BMJ 316:856–859

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Merlevede E, Spooren D, Henderick H et al (2004) Perceptions, needs and mourning reactions of bereaved relatives confronted with a sudden unexpected death. Resuscitation. 61:341–348

    Article  PubMed  Google Scholar 

  6. Serafini G, Muzio C, Piccinini G, Flouri E, Ferrigno G, Pompili M, Girardi P, Amore M (In press) Life adversities and suicidal behaviour in young individuals: a systematic review. Eur Child Adolesc Psychiatry

  7. Kuramoto JS, Stuart EA, Runeson B, Lichtenstein P, Långström N, Wilcox H (2010) Maternal or paternal suicide and offspring’s psychiatric and suicide-attempt hospitalization risk. Pediatrics 126:e1026–e1032

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wilcox HC, Kuramoto SJ, Lichtenstein P, Långström N, Brent DA, Runeson B (2010) Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death. J Am Acad Child Adolesc Psychiatry 49:514–523

    PubMed  Google Scholar 

  9. Skytte Jakobsen I, Christiansen E (2011) Young people’s risk of suicide attempts in relation to parental death: a population-based register study. J Child Psychol Psychiatry 52:176–183

    Article  Google Scholar 

  10. Kuramoto JS, Runeson B, Stuart E, Lichtenstein P, Wilcox HC (2013) Time to hospitalization for suicide attempt by the timing of parental suicide during offspring early development. JAMA Psychiatry 70:149–157

    Article  PubMed  PubMed Central  Google Scholar 

  11. von Borczyskowski A, Lindblad F, Vinnerljung B, Reintjes R, Hjern A (2011) Familial factors and suicide: an adoption study in a Swedish National Coohort. Psych Med 41:749–758

    Article  Google Scholar 

  12. Niederkrotenthaler T, Floderus B, Alexanderson K, Rasmussen F, Mittendorfer-Rutz E (2012) Exposure to parental mortality and markers of morbidity, and the risks of attempted and completed suicide in offspring: an analysis of sensitive life periods. J Epidemiol Community Health 66:233–239

    Article  PubMed  Google Scholar 

  13. Bylund Grenklo T, Kreicbergs U, Hauksdottir A, Valdimarsdottir UA, Nyberg T, Steinbeck G, Furst CJ (2013) Self-injury in teenagers who lost a parent to cancer. JAMA Pediatrics 167:133–140

    Article  PubMed  Google Scholar 

  14. Bylund Grenklo T, Krecbergs U, Hauksdottir A, Valdimarsdottir UA, Nyberg T, Steinbeck G, Furst CJ (2014) Self-injury in youths who lost a parent to cancer: nationwide study of the impact of family-related and health-care-related factors. Psycho-Oncology 23:989–997

    Article  PubMed  Google Scholar 

  15. Dube SR, Anda RF, Felitti VJ, Croft JB, Edwards VJ, Giles WH (2001) Growing up with parental alcohol abuse: exposure to childhood abuse, neglect, and household dysfunction. Child Abuse Negl 25:1627–1640

    Article  CAS  PubMed  Google Scholar 

  16. Vinnerljung B, Hjern A, Lindblad F (2006) Suicide attempts and severe psychiatric morbidity among former child welfare clients—a national cohort study. J Child Psychol Psychiatry 47:723–733

    Article  PubMed  Google Scholar 

  17. Dube SR, Anda RF, Whitfield CL, Brown DW, Felitti VJ, Dong M, Giles WH (2005) Long-term consequences of childhood sexual abuse by gender of victim. Am J Prev Med 28:430–438

    Article  PubMed  Google Scholar 

  18. Ringbäck Weitoft G, Hjern A, Haglund B, Rosén M (2003) Mortality, severe morbidity, and injury in children living with single parents in Sweden: a population-based study. Lancet 361:289–295

    Article  Google Scholar 

  19. Fergusson DM, Boden JM, Horwood LJ (2008) Exposure to childhood sexual and physical abuse and adjustment in early adulthood. Child Abuse Negl 32:607–619

    Article  PubMed  Google Scholar 

  20. Appel CW, Johansen C, Deltour I, Fredriksen K, Hjalgrim H, Dalton SO, Dencker A, Dige J, Boge P, Rix BA, Dyregov A, Engelbrekt P, Helweg E, Mikkelsen OA, Hoybye MT, Bidstrup PE (2013) Early parental death and risk of hospitalization for affective disorder in adulthood. Epidemiology 24:608–615

    Article  PubMed  Google Scholar 

  21. FHI (2013) Folkhälsorapport 2013. Folkhälsoinstitutet, Östersund

    Google Scholar 

  22. Fritzell S, Burström B (2006) Economic strain and self-rated health among lone and couple mothers in Sweden during the 1990s compared to the 1980s. Health Policy 79:253–264

    Article  PubMed  Google Scholar 

  23. Maier EH, Lachman ME (2000) Consequences of early parental loss and separation for health and well-being in midlife. Int J Behav Dev 24:183–189

    Article  Google Scholar 

  24. Caughy MO, Huang K, Lima J (2009) Patterns of conflict interaction in mother-toddler dyads: differences between depressed and non-depressed mothers. J Child Fam Stud 18:10–20

    Article  Google Scholar 

  25. Luecken L, Roubinov DS (2012) Pathways to lifespan health following childhood parental death. Soc Pers Psychol Compass 6:243–257

    Article  Google Scholar 

  26. Elder GH Jr (1994) Time, human agency, and social change: perspectives on the life course. Social Psychol Quart 57:4–15

    Article  Google Scholar 

  27. Kuh D, Ben-Shlomo Y (2002) A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol 31:285–293

    Article  PubMed  Google Scholar 

  28. Bowlby J (1970) Attachment and loss, vol 1. Hogarth, London

    Google Scholar 

  29. Brown GW, Harris T, Copeland JR (1971) Depression and loss. Br J Psychiatry 130:1–18

    Article  Google Scholar 

  30. Kaufman J, Charney D (2001) Effects of early stress on brain structure and function: implications for understanding the relationship between child maltreatment and depression. Dev Psychopathol 13:451–471

    Article  CAS  PubMed  Google Scholar 

  31. Hawton K, Comabella CC, Haw C, Saunders K (2013) Risk factors for suicide in individuals with depression; systematic review. J Affect Disord 147:17–28

    Article  PubMed  Google Scholar 

  32. Billings A, Moos RH (1981) The role of coping responses and social resources in attenuating the stress of life events. J Behav Med 4:139–157

  33. Umberson D, Meichu C, House J, Hopkins K, Slaten E (1996) The effect of social relationships on psychological well-being: are men and women really so different? Am Sociol Rev 61:837–857

    Article  Google Scholar 

  34. Meert K, Thurston C, Celia S et al (2001) Parental coping and bereavement outcome after the death of a child in the pediatric intensive care unit. Pediatr Crit Care Med 2:324–328

    Article  CAS  PubMed  Google Scholar 

  35. Lobb EA, Kristjanson LJ, Aoun SM et al (2010) Predictors of complicated grief: a systematic review of empirical studies. Death Stud 34:673–698

    Article  PubMed  Google Scholar 

  36. Berg L, Rostila M, Saarela J, Hjern A (2014) Parental death during childhood and school performance—a national cohort study. Pediatrics 133:682–689

    Article  PubMed  Google Scholar 

  37. Currier J, Holland JM, Neimeyer RA (2007) The effectiveness of bereavement interventions with children: a meta-analytic review of controlled outcome research. J Clin Child Adolesc Psychol. 36:253–259

    Article  PubMed  Google Scholar 

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Acknowledgments

Mikael Rostila was funded by the Swedish Research Council (Grant No. 2011-1649).

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Authors and Affiliations

  1. Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, 10691, Stockholm, Sweden

    Mikael Rostila, Lisa Berg, Arzu Arat & Anders Hjern

  2. Department of Social Work, Stockholm University, Stockholm, Sweden

    Bo Vinnerljung

  3. Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

    Anders Hjern

Authors
  1. Mikael Rostila
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  2. Lisa Berg
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  3. Arzu Arat
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  4. Bo Vinnerljung
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  5. Anders Hjern
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Correspondence to Mikael Rostila.

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Rostila, M., Berg, L., Arat, A. et al. Parental death in childhood and self-inflicted injuries in young adults-a national cohort study from Sweden. Eur Child Adolesc Psychiatry 25, 1103–1111 (2016). https://doi.org/10.1007/s00787-016-0833-6

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  • DOI: https://doi.org/10.1007/s00787-016-0833-6

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