INNOVATOR: PSYCHIATRY
Grieving hits children especially hard. Kids who lose a parent are at greater risk than their peers for depression, anxiety, and other chronic mental-health problems. By working with children who had a parent die on September 11, Cynthia Pfeffer hopes to ease grieving kids’ anguish.
A number of studies are under way to monitor the emotional health of children who lost parents in the terror attacks, but Pfeffer, director of the Childhood Bereavement Program at Weill Medical College of Cornell University, takes the matter a step further: In addition to studying children’s emotional responses, she’s monitoring their height, weight, and, most important, their levels of a hormone called cortisol. “These are areas of physiological response that haven’t been studied in kids,” Pfeffer says.
Cortisol levels tend to rise when people are under stress, and that increase can have significant physical effects (the hormone’s normal role is to regulate everything from blood pressure to cardiovascular function).
Over time, high levels of cortisol may affect how a child’s brain functions, Pfeffer says. “Among children suffering from major depressive disorder, a high percentage have high cortisol levels,” she says. And because children are still developing, doctors think that stress can have more significant effects than it does on adults. “When there is a significant stress like losing a loved one, it may sensitize the child to other future types of stress,” Pfeffer says. “In animal studies, you don’t need a very extensive stress to get a significant reaction in terms of memory or learning capabilities.”
By monitoring children’s cortisol levels over a period of years, Pfeffer hopes to isolate a physiological component to the effects of loss on children. Having followed about 60 kids since the spring of 2002, Pfeffer is just beginning to assess the data. It’s too early to talk about results, she says, “but my guess is that we’ll find that this has been a very protracted type of bereavement for these kids. It seems that this is an especially intense form of stress, more so than from other causes, because families are ovewhelmed with other external issues—the publicity, the identification of the bodies, the financial and legal problems.”
Perhaps, Pfeffer says, she’ll identify a physical correlation between high cortisol levels and children with serious mental-health problems. “Then we can begin to think about how to intervene before kids are at risk.”