Symptom structure of posttraumatic stress disorder after parental bereavement - a network analysis of Chinese parents who have lost their only child

Hurricane-Force Grief: A Mirror of Fathers' Love

A child's death is a traumatic experience that profoundly impacts parents' psychological, physical, and social wellbeing. The literature describes gender differences in grief response associated with child loss, yet less is known about fathers' grief in comparison that of mothers due to fathers' underrepresentation in bereavement research. There is a need for scholarly exploration to advance understanding of fathers' grief. This article presents selected findings on fathers' grief responses that emerged from a larger qualitative study, which aimed to describe fathers' lived experience of bereavement after a child's death. Profound grief emerged as one essential theme of fathers' bereavement experience. Participants described the meaning of their grief, their multidimensional grief responses, their grief triggers, and their grief intensity. Findings deepen understanding of fathers' grief associated with child loss and advance the body of parental bereavement literature.

Symptom structure of posttraumatic stress disorder in workplace trauma: A "distraction-avoidance" pattern

BACKGROUND

Individuals who experience a workplace trauma are at a high risk of developing posttraumatic stress disorder (PTSD). Most of these people return to work soon after the trauma (i.e., experience early-stage natural exposure). This study aims to explore the response pattern of workers who have experienced a workplace trauma and early-stage natural exposure through network analysis and provide insights into the potential impact of early-stage natural exposure.

METHODS

Our study included 278 workers directly experiencing the workplace explosion in the Tianjin Economic and Technological Development Zone. A partial correlation network analysis was used to explore the PTSD symptoms relationship and identify central symptoms.

RESULTS

The results suggest that emotional numbness, difficulty in concentration, re-experiencing symptoms, and avoidance of thoughts are the most central symptoms, reflecting a "distraction-avoidance" pattern.

CONCLUSIONS

The current study found that workers who experienced workplace trauma exhibited a "distraction-avoidance" pattern, which helps deepen our understanding of the PTSD network and leads to some suggestions on intervention measures.

Time course of attentional bias and its relationship with PTSD symptoms in bereaved Chinese parents who have lost their only child

Background: The death of a child is a highly traumatic event for parents and often leads to posttraumatic stress disorder (PTSD). Attentional bias has been demonstrated in the onset and maintenance of PTSD symptoms.Objective: This study aimed to investigate the time course of attentional bias among bereaved Chinese parents who have lost their only child (Shidu parents), and to examine its relationship with PTSD symptoms and symptom clusters.Methods: Shidu parents (n = 38; 50-72 years of age) completed a dot-probe task with negative (trauma-related), positive, and neutral images at four stimulus presentation times (250, 500, 750, and 1250 ms). PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5).Results: We observed difficulty in disengaging from both negative and positive stimuli at 750 ms and attentional bias away from negative stimuli at 1250 ms. At 1250 ms, attentional avoidance of trauma-related stimuli was positively correlated with PCL-5 total and intrusion scores. Difficulty in disengaging from positive stimuli was negatively correlated with PCL-5 total and intrusion scores as well as negative alterations in cogniti and mood scores.Conclusions: These findings enhance our understanding of attentional bias and cognitive-affective processing in PTSD. This study provides evidence that attentional bias (difficulty in disengaging from positive stimuli and bias away from negative stimuli) are correlated with PTSD symptoms and certain symptom clusters.

Longitudinal changes in brain structure and their relationship with subclinical psychiatric symptoms in parents who lost their only child in China

BACKGROUND

Losing an only child (Shidu) is a grievous traumatic event that may affect brain structure, even if it does not lead to psychiatric disorders. However, longitudinal changes in brain structure and their relationship to subclinical psychiatric symptoms (SPS) have not been well investigated in Shidu parents without any psychiatric disorders (SDNP).

OBJECTIVES

This study aimed to investigate cross-sectional and longitudinal changes in cortical thickness and surface area in SDNP, and to explore their relationship with SPS.

METHODS

A total of 50 SDNP and 40 matched healthy controls (HC) were enrolled. All participants underwent structural MRI scans and clinical assessment at baseline and at the 5-year follow-up. Differences in brain structural phenotypes (cortical thickness, surface area, and their annual rate of change) between the SDNP and HC groups were compared using FreeSurfer. Correlations between significant brain structural phenotypes and SPS in the SDNP group were evaluated using multiple linear regressions.

RESULTS

The SDNP group showed a smaller surface area in the left inferior parietal cortex than the HC group at baseline and follow-up. The SDNP group showed slower rates of cortical thinning and surface area loss in several brain regions than the HC group from baseline to follow-up. Moreover, slower rates of cortical thinning in the left insula, superior frontal cortex, and superior temporal cortex were associated with greater reductions in avoidance, depression, and trauma re-experiencing symptoms scores over time in the SDNP group, respectively.

CONCLUSIONS

Shidu trauma-induced structural abnormalities in the inferior parietal cortex may persist over time and be independent of the severity of psychiatric symptoms. The expansion of prefrontal, temporal, and insular cortex implicated in emotional regulation may contribute to improvements in psychiatric symptoms in Shidu parents.

Parental stress and child mental health: a network analysis of Romanian parents

Parental stress is related to child mental health problems, with numerous evidence indicating that it is an important predictor of parenting and parent-child relationship. New approaches to psychopathology could be particularly informative for clinical research, however, there is limited research that employs network analysis with parents. Network analysis could contribute to a better understanding of the relationship between child mental health problems and parental stress by highlighting the most central nodes and how the two constructs influence each other. The scope of the study was to identify potential new intervention targets to reduce the mental health problems of children and prevent contagion between parent stress and child psychopathology. Furthermore, we also sought to test whether the dynamic between parental stress and child psychopathology differs across the level of parent stress and child total difficulties. In this endeavor, we had three main directions. First, we estimated a network at the level of child mental health problems and identified the most central nodes. Second, we mapped the main paths through which parent stress and child mental health problems communicate with each other. Third, we investigated the network invariance across the level of parent stress (high vs moderate) and child mental health problems (low vs. high total difficulties). Participants (N = 1014) were parents of children with ages between four and 17 years old. The analyses were conducted in RStudio. Results indicated that perceived coping was a central node, bridging the two constructs. The global strength of the network was higher for parents who reported high levels of stress compared to those who reported only moderate levels of stress. In contrast, we found that the global strength of the network was lower for children with high levels of total difficulties compared to those with low levels of total difficulties. In conclusion, we argue the importance of focusing on the targeting nodes with high bridge centrality, such as perceived coping, for designing prevention and intervention programs. Future research should use temporal dynamics between parental stress and child mental health problems and explore mechanisms between the two constructs.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03520-1.