Studies of Parental Deprivation in Psychiatric Patients

Gregory, Ian

doi:10.1176/ajp.115.5.432

Cited by 104 publications

(23 citation statements)

References 17 publications

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“…[10][11][12] The patient groups for our study were consecutively recruited at a number of large medical centers and may be considered representative of the populations under treatment at these centers. They were carefully matched to control subjects from the same population in terms of age, gender, ethnic origin and immigration status and possible effects of exposure to the Nazi Holocaust were excluded.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] (i) A primary difficulty has been the definition of EPL. Although most earlier studies focused on parental death, others included separation and many did not clearly distinguish the type of loss.…”

Section: Introductionmentioning

confidence: 99%

“…(iii) A third difficulty relates to the control groups to which rates of EPL in psychiatric patients have been compared. As noted by a number of authors, [10][11][12] controls should ideally be matched to the patient group for age, gender, socio-economic status of the family of origin and age of the parents at the birth of the subject (although some of these matching criteria are very difficult to implement in practice). Many other factors could influence the likelihood of parental death or separation.…”

Section: Introductionmentioning

confidence: 99%

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Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

Agid¹,

et al. 1999

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The current focus on identifying genes which predispose to psychiatric illness sharpens the need to identify environmental factors which interact with genetic predisposition and thus contribute to the multifactorial causation of these disorders. One such factor may be early parental loss (EPL). The putative relationship between early environmental stressors such as parental loss and psychopathology in adult life has intrigued psychiatrists for most of this century. We report a case control study in which rates of EPL, due to parental death or permanent separation before the age of 17 years were evaluated in patients with major depression (MD), bipolar disorder (BPD) and schizophrenia (SCZ), compared to individually matched, healthy control subjects (MD-Control, 79 pairs; BPD-Control, 79 pairs; SCZ-Control, 76 pairs). Loss of parent during childhood significantly increased the likelihood of developing MD during adult life (OR = 3.8, P = 0.001). The effect of loss due to permanent separation (P = 0.008) was more striking than loss due to death, as was loss before the age of 9 years (OR = 11.0, P = 0.003) compared to later childhood and adolescence. The overall rate of EPL was also increased in BPD (OR = 2.6, P = 0.048) but there were no significant findings in any of the subcategories of loss. A significantly increased rate of EPL was observed in schizophrenia patients (OR = 3.8, P = 0.01), particularly before the age of 9 years (OR = 4.3, P = 0.01). Comparison of psychosocial, medical and clinical characteristics of subjects with and without a history of EPL, within the larger patient groups from which the matched samples were drawn (MD, n = 136; BPD, n = 107; SCZ, n = 160), yielded few significant findings. Among the controls (n = 170), however, subjects who had experienced EPL, reported lower incomes, had been divorced more frequently, were more likely to be living alone, were more likely to smoke or have smoked cigarettes and reported more physical illness (P = 0.03-0.001). Long term neurobiological consequences of early environmental stressors such as maternal deprivation have been extensively studied in many animal species. Recently, enduring changes in hypothalamic-pituitary-adrenal axis function, including corticotrophin releasing factor gene expression, have received particular attention. Analogous processes may be implicated in the effect of EPL on human vulnerability to psychopathology, via alterations in responsiveness to stress. Genetic predisposition may influence the degree of susceptibility of the individual to the effects of early environmental stress and may also determine the psychopathological entity to which the individual is rendered vulnerable as a consequence of the stress.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

Agid¹,

et al. 1999

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“…Oltman et al (1952) and Gregory (1958) maintain in their comprehensive reviews that considerable evidence was accumulated to indicate a high frequency of parental loss and separation among individuals who subsequently manifest antisocial or psychopathic behaviour, and that the incidence of parental deprivation and broken homes was very similar among individuals who later become manic-depressive and in normal control subjects. Stenstedt (1 952) reported the existence of unfavourable home conditions during childhood, defined according to Amark's (1951) criteria (sce below) in about 25 per cent of his psychotic depressives.…”

Section: A) Childhood Environmentmentioning

confidence: 99%

II. Childhood environment and precipitating factors

Perris

1966

Acta Psychiatr Scand

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“…Reviewers of the literature from the 1920s through the 1970s ( Berlinsky & Biller, 1982 ;Crook & Eliot, 1980 ;Gregory, 1958 ;Lloyd, 1980 ;Markusen & Fulton, 1971) , criticized research design and methods for noncomparable samples, nonrepresentative samples, inappropriate applications of statistical signi® cance, unjusti® ed generalizations, and inappropriate inferences of causality from correlation studies. Theoretical assumptions about the inevitability of depression were questioned by researchers who cited examples of parentally bereaved children who had suc-C hildhood B ereavement E xperience s 19 cessfully resolved their grief because of strongly supportive family environments ( Birtchnell, 1969 ;Elizur & Ka man, 1983 ;E.…”

mentioning

confidence: 99%

Adults View Their Childhood Bereavement Experiences

Hurd¹

1999

Death Studies

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This study sought to determine if depression is an inevitable outcome of childhood bereavement experiences, as the Freudians believed, or if children can experience healthy mourning, as Bowlby predicted. In an application of Q methodology, 43 adults parentally bereaved as children sorted statements about childhood bereavement experiences and outcomes in adulthood. Debriefing interviews followed. Four distinct types of experience emerged through factor analysis: appreciation, frustration, enmeshment, and ambivalence. Depression was not found to be an inevitable outcome, and Bowlby's prediction that certain positive family factors can influence a child toward healthy mourning during childhood were corroborated. Salient factors contributing to healthy childhood mourning included positive relationships between the child and both parents, ample emotional and psychological support from the surviving parent, and open and honest communication with the child about the death and its impact on the family.

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Studies of Parental Deprivation in Psychiatric Patients

Cited by 104 publications

References 17 publications

Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

Environment and vulnerability to major psychiatric illness: a case control study of early parental loss in major depression, bipolar disorder and schizophrenia

II. Childhood environment and precipitating factors

Adults View Their Childhood Bereavement Experiences

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