Grief in Children and Adolescents Bereaved by Sudden Parental Death

Abstract

Context There have been major advances in our understanding of the phenomenology and course of grief in adults. However, little is known about the course of grief in children. Objective We report on course and impact of children’s grief reactions following parental sudden death on subsequent psychiatric and functional status. Design Longitudinal study of bereaved children and families with yearly comprehensive assessments up to three years after parental death. Setting Bereaved children and their surviving parents recruited through the coroners’ records and advertisement. Participants 182 parentally bereaved children between 7 and 18 years of age whose parent died from suicide, accident, or sudden natural deaths. Main Exposure Sudden parental death. Main Outcome Measures Grief, functional impairment, incident depression. Results There were 3 distinct trajectories of grief reactions with a group, consisting of 10.4% of the sample, with increased grief reactions that showed no change 33 months post-death. Youths with prolonged grief reactions had higher rates of previous personal history of depression. Prolonged grief made unique contribution to increased levels of functional impairment even after controlling for clinical characteristics antecedent and following the death. Conversely, prolonged grief, both in youths and the surviving caregiver, predisposed to an increased hazard of incident depression. Another group (30%) showed increased grief reactions 9 months following the death, which gradually decreased over time. Despite this, grief reactions in this group were also associated with functional impairment and increased risk of incident depression. Conclusions Grief reactions abate over time for most children bereaved by sudden parental death; however, a subset show increased or prolonged grief reactions, which in turn increases the risk for functional impairment and depression. Research on interventions designed to relieve the burden of grief in bereaved children are needed. Such efforts should also assess and address grief reactions in the surviving parent.

Early indicators of problematic grief trajectories following bereavement

“…In the previous study of Melhem et al (2011) in a sample of children, three classes were found. A possible explanation could be that the nature of the sample and losses differed between both studies.…”

“…In two subsequent studies (Melhem, Porta, Shamseddeen, Walker Payne, & Brent, 2011; Melhem, Porta, Walker Payne, & Brent, 2013), children who had lost a parent due to suicide, accident or sudden natural death were followed up to 33 months after bereavement. Latent Class Growth Analysis (LCGA) was conducted to identify classes of children with similar grief trajectories.…”

Los niños ante la pérdida de uno de los progenitores: revisión de pautas de comunicación eficaces.

“…Los principales factores de riesgo que se han asociado con el desarrollo de duelo patológico a corto o largo plazo son (19,17,24,(25)(26)(27)(28) : a. la presencia de antecedentes psicopatológicos en el menor o en el cuidador principal. b. la simultaneidad de acontecimientos vitales estresantes.…”

“…La investigación apunta a que la intervención dirigida al progenitor superviviente o a los familiares encargados del cuidado de los niños es clave para favorecer el proceso de duelo en los menores (12,28,36) . Esta intervención tiene un doble objetivo: promover la adaptación de los adultos y prevenir al mismo tiempo la complicación del duelo en los niños.…”

Factors Affecting Depression among Married Women Living in Urban Squatter Settlements of Karachi, Pakistan

“…According to Mirza, 2004, relationship and adjustment difficulties with husband and in-laws, number of children and financial difficulties were found to be associated with depression [15]. Moreover, death of a loved one [16] and increasing age of married women are also associated with depression [17] whereas, social, and family support are "considered as buffering agents or protective factors against depression" [18] [19].…”