Mental Health Diagnoses in Bereaved Children Following Loss of Active-Duty Service Member Fathers in 2001-2006: A Case-Control Study

Objective: In a retrospective case-controlled study of children of deceased male active duty service members, we examined the prevalence of mental health diagnoses in paternally bereaved children before loss and 1 and 2 years after loss compared to non-bereaved children. Method: Prevalence rates of mental health diagnoses in 1,212 bereaved and 1,212 non-bereaved children (matched on child age, child sex, pre-loss military health care use, parental military rank and deployment history) were calculated based on electronic medical record data in the military health care system. Logistic regressions compared prevalence rates between bereaved and non-bereaved children 1 and 2 years following paternal loss. Results: Prevalence rates of depressive and adjustment disorders were 2 to 4 times higher in bereaved compared to non-bereaved youth 1 and 2 years after loss. Rates of acute stress disorder/post-traumatic stress disorder (PTSD) were 9.5 times higher in the first year after loss in bereaved vs non-bereaved youth. Models stratified by sex indicated that rates of depressive disorders, adjustment disorders, and acute stress disorder/PTSD were higher in both bereaved male and female youth compared to their non-bereaved counterparts. However, few sex differences were found. An examination of developmental differences indicated that bereaved school-aged children had higher rates of acute stress disorder/PTSD compared to adolescents in the first year after paternal death. Conclusion: Paternal bereavement is associated with increased prevalence of depressive disorders, adjustment disorder, and acute stress disorder/PTSD 1 and 2 years following loss among children in active military duty families. Paternally bereaved school-aged children may be at heightened risk for trauma-related diagnoses.