6/6. Thanks to a great team :) @espenr.bsky.social @ragnhildbangnes.bsky.social Tilmann von Soest and @omidvebrahimi.bsky.social

5/6. This paper follows several articles in which we show how risk factors exhibit granular associations with mental disorder symptoms. Such relationships can be overlooked when global measures, such as (symptom) sum scores, are used.

See also:
doi.org/10.1016/j.ja...
doi.org/10.1037/amp0...

4/6. We describe three key findings:

1️⃣ Several symptom-specific associations were discernible.
2️⃣ Depressive symptoms were more strongly tied to financial adversity compared with anxiety.
3️⃣ Hopelessness about the future was most strongly connected to financial adversity.

3/6. We incorporate multiple subjectively assessed financial factors (e.g., ability to cope with unforeseen expenses) and register-based financial data (e.g., income, assets).

2/6. We apply a systems-based approach to identify symptom-specific relationships. Why? Financial adversity is complex and multidimensional and may exhibit granular associations with specific mental disorder symptoms (i.e., different mental health experiences).

(9/9) This work was conducted as part of my research visit at Karolinska Institutet last year. Many thanks to all of the fantastic collaborators on this paper!

(8/9) Still, our findings suggest that altered stress resilience is one mechanism linking childhood loss of a parent or sibling to psychiatric disorder risk in adulthood.

This is among the most comprehensive longitudinal studies on childhood bereavement and mental health across decades of life.

(7/9) There are some important limitations: We lack information about the resilience measure and only one measurement was available. Generalisability is also uncertain, with strong assumptions underlying causal mediation analysis, pointing to the need for triangulation across methods.

(6/9) Using causal mediation analysis (see vanderWeele 2014), we identified a mediating effect of stress resilience on the associations between childhood bereavement and psychiatric disorder risk.


The proportion mediated ranged from 6–22%, depending on the model and outcome.

(5/9) We found that loss of a parent/sibling, in particular parental loss, is associated with increased risk of psychiatric disorders in adulthood. The strongest associations were with depression.

Bereavement was also linked to a higher probability of lower stress resilience in late adolescence.

(4/9) We used Swedish registry data from more than 1.7 million individuals, with a follow-up of up to 34 years. Resilience was measured around age 18.

This unique dataset allowed for conducting comprehensive longitudinal and mediation analyses, with strong multivariable adjustment.

(3/9) And few studies have examined the potential mechanistic role of resilience in associations between childhood bereavement and psychiatric disorder risk.

We ask: Does altered stress resilience mediate associations between bereavement experiences in childhood and psychiatric disorder risk?

(2/9) Associations between childhood bereavement and increased risk of depression have been documented for > 60 years.

However, most studies have short follow-up durations (e.g., first two years after bereavement) and not comprehensively examined associations with different psychiatric outcomes.