Effect of parental bereavement on health risk behaviors in youth: A 3-year follow-up

Objective: To examine the course of health risk behaviors (HRBs) during a 3-year period after a parent's death in bereaved youth compared with nonbereaved youth (control subjects). Design: A longitudinal population-based study. Setting: Bereaved families were recruited through coroner records and by advertisement. Control families were recruited using random-digit dialing and by advertisement. Participants: Two hundred forty parentally bereaved offspring were compared with 183 nonbereaved control offspring. Main Exposure: Sudden parental death due to accident, suicide, or sudden disease-related (natural) death. Main Outcome Measures: The sum of the total number of HRBs at a clinically significant frequency threshold assessed 9, 21, and 33 months after the parent's death. Results: The bereaved group showed a higher number of HRBs over time compared with the nonbereaved group (univariate effect sizes, 0.22-0.52; P<.04), even after taking into account correlates of bereavement and of HRBs, such as youth aggression, as well as antisocial and anxiety disorders of the deceased parent. Conclusions: Parental bereavement is associated with higher HRBs in youth over time, even after controlling for other covariates associated with bereavement and HRBs. Clinicians should be aware that bereaved youth may be vulnerable to HRBs. Further work is warranted on interventions to attenuate the negative effect of bereavement on HRBs.