A multidimensional approach to assessing six-year trajectories of outcomes of bereaved children, the effects of the FBP to modify trajectories and mediation of effects 15 years later

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Principal Investigator: Irwin N. Sandler
Organization: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
Fiscal Year: 2024
Award: $196,250
Funding agency: National Institute of Mental Health

Abstract
Parental death is one of the most stressful events of childhood and is associated with increased risk for
multiple mental health problems as well as impairments in developmental competencies in childhood and
adulthood. This study uses a secondary data analysis of a 15-year longitudinal study of a randomized trial of
the Family Bereavement Program (FBP) to characterize the developmental trajectories of problems and
competencies of bereaved children over six years; to study the effects of the FBP to reduce problem
trajectories; and to study how changing these trajectories account for FBP effects on mental disorder in young
adulthood 15 years later. The study builds on a major advance in research to assess individual differences in
trajectories of outcomes over time following potentially traumatic events such as bereavement. Multiple studies
using this method have concluded that the great majority of children and adults have low levels of problems
over time and can be considered to be resilient. The current study questions this conclusion which is based on
the assessment of trajectories of single outcomes (a unidimensional approach) and does not consider that
different people may experience problems in different ways following adversity. Recent research with bereaved
adults adapted a multidimensional approach to assess trajectories across five outcomes and found that few
adults (only 8%) had low levels of problems across outcomes. The current study adapt this multidimensional
approach to assess trajectories of grief, mental health problems, competencies and risk and protective factors
over a six year period for bereaved children in a secondary analysis of data from the longitudinal study of the
FBP. This is the first study to apply a multidimensional approach to assess individual trajectories of four
domains of outcomes (grief, mental health problems, developmental competencies and risk and protective
factors) of children following any major adversity. The findings have significant implications for understanding
which bereaved children who could benefit from evidence-based services. The study will apply the
multidimensional approach to assess the effects of the FBP on trajectories of problem and competence
outcomes as well as targeted risk and protective factors over six years. It will also assess the effects of the
FBP to improve the aggregate number of problem trajectories across outcomes. Individuals for whom the FBP
reduces one or more problem trajectories can be considered responders to the program. The study will also
assess how changing trajectories in problems, competencies or risk and protective factors across six years in
childhood and adolescence mediate FBP effects to reduce mental disorder, suicidal ideation/behavior or
mental health service use nine years later when participants are young adults. Findings from these analyses
have action implications to optimize effective dissemination of components of the FBP that target mediators
that are successfully changed by the program and that mediate FBP effects on adult mental health problems.

Terms: <0-11 years old><12-20 years old><21+ years old><Adolescence><Adult><Adult Human><Age><Behavior><Bereavement><COVID-19><CV-19><Cessation of life><Child><Child Mental Health><Child Youth><Childhood><Children (0-21)><Chronic><Competence><Coronavirus Infectious Disease 2019><Data Analyses><Data Analysis><Death><Development><Dimensions><Disease><Disorder><Evaluation><Family><Family Study><Feeling suicidal><Generalized Anxiety Disorder><Goals><Grief><Grief reaction><Impairment><Individual><Individual Differences><Intervention><Intervention Strategies><Longitudinal Studies><Major Depressive Disorder><Mediating><Mediation><Mediator><Mental Depression><Mental Health><Mental Health Services><Mental Hygiene><Mental Hygiene Services><Mental disorders><Mental health disorders><Methods><NIMH><National Institute of Mental Health><Negotiating><Negotiation><Outcome><Paper><Participant><Persons><Population><Prevalence><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Publishing><Randomization trial><Reporting><Research><Risk><Risk Factors><Risk Reduction><Sampling><Services><Strategic Planning><Stressful Event><Suicidal thoughts><Testing><Time><adolescence (12-20)><adult youth><adulthood><ages><clinical depression><competence factor><coronavirus disease 2019><coronavirus disease-19><coronavirus infectious disease-19><data interpretation><depression><developmental><dimensional analysis><effective intervention><evidence base><experience><health service use><health service utilization><improved><interventional strategy><kids><long-term study><longitudinal outcome studies><longterm study><major depression><major depression disorder><mental development><mental health care><mental healthcare><mental illness><pandemic><pandemic disease><pediatric><peer><person centered><program dissemination><programs><project dissemination><protective factors><psychiatric illness><psychological disorder><randomized trial><reduce risk><reduce risks><reduce that risk><reduce the risk><reduce these risks><reduces risk><reduces the risk><reducing risk><reducing the risk><resilience><resilient><responders and non-responders><responders from non-responders><responders or non-responders><responders versus non-responders><responders vs non-responders><responders/nonresponders><risk-reducing><secondary analysis><stressful experience><stressful life event><stressful life experience><suicidal><suicidal behavior><suicidal ideation><suicidal thinking><suicidality><suicide behavior><suicide ideation><thoughts about suicide><traumatic event><young adult><young adulthood><youngster>