Peritraumatic distress predicts prolonged grief disorder symptom severity after the death of a parent in children and adolescents.

: In 2015 nearly 140 million children and adolescents under 18 had experienced the death of one or both parents. Parental death is often considered the most traumatic event that a child can experience in their lifetime. While parental loss may lead to the development of prolonged grief disorder (PGD), little is known about risk factors for such negative mental health outcome in children. : The present study aims to examine peritraumatic reactions as predictors of PGD in children who lost a parent. : Thirty-four children (M age = 10.9, SD = 3.2, 67.6% females) who lost a parent (time since death = 4.6 months, SD = 2.3) were assessed for peritraumatic distress and peritraumatic dissociation experienced at the time of the loss, and for PGD symptom severity at three timepoints post-loss (<6 months; 6-12 months; >12 months). : PGD score was correlated with peritraumatic distress (.61; < .01) but not with peritraumatic dissociation (.24; = .3). Results from the mixed-model regression analysis identified peritraumatic distress as the only significant predictor of PGD symptom severity (B = 1.58, SE = .31; < .0001), with no statistically significant effect of peritraumatic dissociation (B = - .43, SE = .36; = .2), or time (B = - 3.84, SE = 2.99; = .2). : Our results suggest that peritraumatic distress might be useful to identify children at risk for developing PGD, and in need of further support. The development of early preventive strategies to prevent PGD in parentally bereaved children who experienced high peritraumatic distress is warranted.