Differential Vulnerability to Early-Life Parental Death: The Moderating Effects of Family Suicide History on Risks for Major Depression and Substance Abuse in Later Life

Abstract

Only a portion of those exposed to parental death in early life (PDE) develop behavioral health disorders. We utilized demographic pedigree data from the Utah Population Database to test for differential vulnerability to PDE by creating a risk score of familial susceptibility to suicide (FS) at the population level. Using logistic panel regression models, we tested for multiplicative interactions between PDE and FS on the risks of major depressive disorder (MDD) and substance abuse (SA), measured with Medicare claims, after age 65. The final sample included 155,983 individuals (born 1886 through 1944), yielding 1,431,060 person-years at risk (1992 through 2009). Net of several potential confounders, including probability of survival to age 65, for females we found an FS × PDE interaction, where PDE and FS as main effects had no impact but jointly they increased MDD risk. No statistically significant main or interactive effects were found for SA among females, or for either phenotype among males. Our findings are consistent with a differential vulnerability model for MDD in females, where early-life stress increases the risk for poor behavioral health only among the vulnerable. Furthermore we demonstrate how demographic and pedigree data might serve as tools for investigating differential vulnerability hypotheses.

Childhood family risks and mental health of older adults in China: The moderating effect of age

“…There are often two forms of the broken family structure presented in the literature, namely parental divorce and parental death. The death of parents breaks the family structure and seriously affects children's psychological development (Hollingshaus et al, 2016 ; Appel et al, 2019 ).…”

“…Behaviorally, childhood stress leads to excessive threat vigilance, poor social relationships, mistrust of others, impaired self-regulation, and unhealthy lifestyle choices (Miller et al, 2011 ). Cognitively and psychologically, exposure to CFRs, especially over a long period of time, may harm cognitive ability (Blair and Raver, 2016 ; McCoy et al, 2016 ), lead to suicidal ideation and major depressive disorders in later life (Hollingshaus et al, 2016 ), and cause many other psychotic symptoms (Trotta et al, 2015 ).…”

Family Member Deaths in Childhood Predict Systemic Inflammation in Late Life

“…In addition, it has been theorized that childhood adversity may program one to greater stress reactivity throughout life (Marsland 2013), particularly among children with diminished coping resources. Consistent with this theory, early-life adversity has been linked with greater CRP levels and depression in adulthood (Caspi et al 2010; Hollingshaus et al 2016; Karg et al 2011; Schrepf, Markon, and Lutgendorf 2014), with excess adult mortality (Smith et al 2014), and with AD in later life (Moceri et al 2000). Early parental death (EPD) has received particular attention as an early-life stressor.…”

“…Deaths of first-degree relatives (i.e., children, parents, siblings) represent substantial objective stressors, including significant and lasting social disruption resulting from changes in financial security, living arrangements, and social status, as well as subjective stressors, such as increased fear and guilt. Indeed, familial death has been linked to markers of chronic stress, including increased cortisol levels and sympathetic nervous system activity; with increased psychological morbidity, included including greater anxiety and depression (Hollingshaus et al 2016); with cardiovascular problems, including increased heart rate, hypertension, coronary heart disease (CHD), and disruption of arterial plaques among persons with CHD (Buckley et al 2010); and with late-life cognitive health, including risk of AD (Hatch, Schwartz, and Norton 2015), with evidence suggesting these bereavement-related changes to be mediated by systemic inflammation (Schultze-Florey et al 2012).…”

Theoretical Insights into Preconception Social Conditions and Perinatal Health: The Role of Place and Social Relationships

“…However, considerable evidence supporting this type of moderating effect has emerged in studies examining early life adversity and pro-inflammatory responses (Miller and Chen 2010, Saxton, John-Henderson et al 2011, McDade 2012), childhood poverty and social subordination in classrooms (Boyce, Obradović et al 2012), low maternal education and maternal negativity (Browne and Jenkins 2012), and parental death and familial susceptibility to suicide (Hollingshaus, Coon et al 2016). …”