Patterns of mental distress following the violent death of a child and predictors of change over time.

We observed 173 parents bereaved by the violent death of an adolescent or young adult child. Data were collected 4, 12, 24, and 60 months postdeath. Using latent growth modeling, we examined how initial levels of mental distress and the rate of change over time are influenced by nine predictors: parents' gender, self-esteem, three coping strategies, perceived social support, negative life stressors, posttraumatic stress disorder (PTSD) symptoms, and an intervention offered in the early bereavement period. The results support a multiple-risk and -protective factor model of loss accommodation. Parents' gender, self-esteem, and affective and repressive coping were predictive of changes in mental distress over time. Although parents' initial levels of PTSD were the best predictor of baseline mental distress, they did not predict reductions in distress 5 years later. Theoretical, empirical, and clinical implications are discussed. Copyright 2002 Wiley Periodicals, Inc. Res Nurs Health 25:425-437, 2002.