Couples at Risk Following the Death of Their Child: Predictors of Grief Versus Depression.

This longitudinal study examined the relative impact of major variables for predicting adjustment (in terms of both grief and depression) among bereaved parents following the death of their child. Couples (N = 219) participated 6, 13, and 20 months postloss. Use of multilevel regression analyses enabled assessment of the impact of several predictors and facilitated analysis of factors that were either shared by parents or individual. Grief was predicted mainly by shared parent factors: child's age, cause and unexpectedness of death, and number of remaining children. By contrast, depression was predicted by individual parent factors: gender, religious affiliation, and professional help seeking. Theoretical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When a child dies: The sociobiology of bereavement.

Investigated the grief intensity of bereaved parents and their immediate families using ratings made by 263 bereaved parents. Predictions were derived from sociobiological tenets relating to (a) parental investment, (b) paternal uncertainty, and (c) the propagation potential of both parents and children. It was found that (1) mothers grieved more than fathers; (2) healthy children were grieved for more than unhealthy children; (3) male children were grieved for more than female children; (4) health of child and sex of child interacted such that the pattern of grief intensity obtained was healthy male?>?healthy female?=?unhealthy female?=?unhealthy male; (5) similar children were grieved for more than dissimilar children; (6) maternal grandmothers grieved more than either maternal grandfathers or paternal grandmothers, who in turn grieved more than paternal grandfathers; and (7) mothers' siblings grieved more than fathers' siblings. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of the family bereavement program on multiple indicators of grief in parentally bereaved children and adolescents.

Objectives: This article reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentally bereaved children and adolescents over a 6-year period. Method: Participants were 244 youths (ages 8–16, mean age = 11.4 years) from 156 families that had experienced the death of a parent. The sample consisted of 53% boys and 47% girls; ethnicity was 67% non-Hispanic White and 33% ethnic minority. Families were randomly assigned to the FBP (N = 135) or a literature control condition (N = 109). Two grief measures, the Texas Revised Inventory of Grief and the Intrusive Grief Thoughts Scale (IGTS) were administered at 4 times over 6 years: pretest, posttest, and 11-month and 6-year follow-ups. A 3rd measure, an adaptation of the Inventory of Traumatic Grief (ITG) was administered only at the 6-year follow-up. Results: Compared with the control group, the FBP group showed a greater reduction in their level of problematic grief (IGTS) at posttest and 6-year follow-up and in the percentage at clinical levels of problematic grief at the posttest. The FBP also reduced scores on a dimension of the ITG, Social Detachment/Insecurity, at 6-year follow-up for 3 subgroups: those who experienced lower levels of grief at program entry, older youths, and boys. Conclusion: These are the first findings from a randomized trial with long-term follow-up of the effects of a program to reduce problematic levels of grief of parentally bereaved youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding gender differences in bereavement following the death of an infant: Implications of or treatment.

The death of an infant confronts parents with a multitude of difficult challenges. Bereaved parents often experience a grief that is unexpectedly pervasive, intense and enduring. Support from family, friends, and medical professionals is often limited, and most parents rely predominantly on their partner or spouse for sustained support and understanding over time, partners often experience increased difficulties in supporting each other due to gender differences in grief and coping, strained communication, and characteristic patterns of misunderstandings. This article discusses research findings regarding gender similarities and differences in grief and coping following perinatal loss or loss from sudden infant death syndrome (SIDS), and regarding marital difficulties associated with incongruent grieving. Also discussed are the impact of social support on the experience of bereavement, typical patterns of misunderstandings underlying many grief-related marital difficulties, and treatment recommendations for psychotherapists working with individual clients or bereaved couples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Impact of an Older Adult's Death on the Family.

The death of an older adult member in a family can have a significant impact on family functioning, and clinicians often find themselves in unfamiliar territory when treating bereaved family members. Psychologists' conception of the grief process has changed a great deal over recent years in combination with a new emphasis on the context in which an individual's grief is taking place. This article focuses on the impact of an older adult family member's death on members of the surviving family, particularly the impact of a parent's death on surviving adult children. The impact of a grandparent's death on surviving children and on the family as a whole is also considered. Implications for treatment are provided based on a review of the theoretical and empirical literatures pertaining to this topic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Jungian family sandplay with bereaved children: Implications for play therapists.

Jungian family sandplay (JFS) with bereaved clients, especially young children, may assist family members in communicating their intrapersonal world of grief through symbolic methods. Specifically, play therapists using JFS provide the opportunity for children to share feelings with caretakers that may be developmentally difficult to verbalize. With JFS, children use nonthreatening images to portray feelings and struggles associated with the death of a loved one. The focus of this article is the importance of including caretakers and family members in bereaved children’s sandplay. In addition, we include a clinical vignette to illuminate the potential benefits of incorporating JFS with bereaved children. We conclude with implications for play therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comprehensive approach to bereavement

Bereavement is associated with significant mental and physical health consequences, and risk factors for illness associated with bereavement have been demonstrated. Although bereavement cannot be eliminated as a health risk, primary care providers can screen for it, facilitate the normal grief process, and mitigate risks for bereavement complications and health deterioration. Considering the time constraints in today's fast-paced health care environment, this article offers a clear and comprehensive framework for primary care of grieving people. The framework presented here includes (1) empirically shown risk factors for health deterioration in bereavement; (2) an assessment and screening patient history format suitable for primary bereavement care; (3) primary care guidelines for differential diagnosis of bereavement; and (4) principles of primary care for the bereaved. This article also addresses primary care for bereaved children, parents, and other specific bereaved populations, and discusses pharmacotherapy and multicultural considerations in bereavement.     

The relative risk and timing of divorce in families of children with an autism spectrum disorder.

We compared the occurrence and timing of divorce in 391 parents of children with an autism spectrum disorder (ASD) and a matched representative sample of parents of children without disabilities using a survival analysis. Parents of children with an ASD had a higher rate of divorce than the comparison group (23.5% vs. 13.8%). The rate of divorce remained high throughout the son's or daughter's childhood, adolescence, and early adulthood for parents of children with an ASD, whereas it decreased following the son's or daughter's childhood (after about age 8 years) in the comparison group. Younger maternal age when the child with ASD was born and having the child born later in the birth order were positively predictive of divorce for parents of children with an ASD. Findings have implications for interventions focused on ameliorating ongoing and long-term marital strains for parents of children with an ASD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of psychological counseling that facilitate the grieving process of bereaved parents.

42 bereaved parents (aged 28–66 yrs) were requested to (a) listen to an audiotaped testimony of a bereaved parent's experience in coping with the death of a child during the phases of numbing, yearning and searching for the lost figure, disorganization and despair, and reorganization; (b) discuss how their experience in coping with their child's death compared to what they listened to on tape; and (c) for each phase, complete the Scale of Counseling Dimension Preferences, which depicts preferences for action orientation or insight orientation, cognition or conation, and structure or ambiguity. Results suggest that bereaved parents have generalized preferences for counseling dimensions during different phases of grieving. Findings are discussed in terms of influences that facilitate the grieving process of bereaved parents during individual psychological counseling. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional and cardiovascular sensitization to daily stress following childhood parental loss.

Adverse childhood events can influence the development of emotional and physiological self-regulatory abilities, with significant consequences for vulnerability to psychological and physical illness. This study evaluated stress sensitization and inoculation models of the impact of early parental death on stress exposure and reactivity in late adolescence/young adulthood. Ambulatory blood pressure (BP) and diary reports of minor stress were collected every 30 min during waking hours over a 24-hr period from 91 late adolescents/young adults (43 early bereaved, 48 nonbereaved). Across the sample, minor stressors were associated with elevated BP and negative affect. The bereaved group had lower BP than did the nonbereaved group. Within the bereaved group, higher perceived caring from the surviving parent was associated with fewer reports of minor stress and lower stress-related negative affect. Higher perceived parental caring during childhood was associated with lower BP across the sample and more frequent hassles in the nonbereaved group. Findings support both the stress inoculation and sensitization models, suggesting that childhood parental loss and parental caring exert important influences on children's development of stress sensitivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conflicting preferences of parents and offspring over criteria for a mate: A study in Argentina.

Current evolutionary research on human mating has largely ignored the fact that mating decisions may be heavily influenced by parents. Recent research, however, shows that parents and children may have conflicting mate preferences. Specifically, parents tend to have a relatively stronger preference for children to pair with mates with characteristics signaling high parental investment and cooperation with the in-group, whereas children tend to have a relatively stronger preference to pair with mates with characteristics signaling genetic quality. The present research among 242 young adults from Argentina showed that in this country the same parent–offspring conflict was observed as had been found previously in North America, the Netherlands, Uruguay, and Kurdistan. This result provides additional support for the universal character of this type of conflict. In addition, the present research expanded previous work by showing that the two conflict dimensions were indeed psychometrically independent, and that more conflict was reported by older and married participants. In addition, more conflict was reported among women who were more in favor of parental control over mate choice and among men who were higher in social comparison orientation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enigma in swaddling clothes: sudden infant death syndrome

SIDS strikes suddenly, and its cause is unknown. It elicits trauma such as profound guilt and calls into question a lost parental role and status, the ability of parents to fulfill the societal expectation of child rearing, and the legitimacy of the grief process for which the parents are unprepared. Grief includes reactions to loss and separation anxiety and results from lost attachments experienced by parents. Counselors can help rebuild the emotional constellations of bereaved parents, ease the communication between the parents, and interpret the needs of one parent to the other. When counseling bereaved parents they should enlist the help of resilient and emotionally mature family members. Because many bereaved parents abruptly leave their homes to forget and recover, helping professionals should move swiftly yet cautiously to aid immediate and extended families. Their efforts may be the first and last change to intervene.     

Adolescent Adjustment Before and After HIV-Related Parental Death.

The impact of HIV-related parental death on 414 adolescents was examined over a period of 6 years. The adjustment of bereaved adolescents was compared over 4 time periods relative to parental death and was also compared with the adjustment of nonbereaved adolescents. Bereaved adolescents had significantly more emotional distress, negative life events, and contact with the criminal justice system than nonbereaved youths; these behaviors did not remain significantly higher after parental death. Depressive symptoms and passive problem solving increased soon after parental death, as compared with nonbereaved adolescents. One year subsequent to parental death, depression and passive problem solving were similar to the levels of nonbereaved peers. Only sexual risk behaviors increased following parental death. These results suggest the importance of early family intervention soon after parental HIV diagnosis, prior to parental death, and sustained over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intellectual stability in children with unilateral brain lesions

Developmental differences in behavior and self-perception were examined in a group of 44 preschool and school-age children referred for evaluation of sexual abuse and 41 comparison children with no history of sexual abuse, matched on age and gender, and from a similar socioeconomic background. Children suspected of having been sexually abused were rated by their parents as having more internalizing and externalizing problems than comparison children. When children rated their self-competence and social acceptance, there were no group differences between children based on their abuse status; however, there was significant within-group variation among the children suspected of having been sexually abused. Preschool children had elevated scores of perceived competence and social acceptance, and school-age children had depressed scores. There were no age differences among the children in the comparison group. The results suggest that among children suspected of abuse, not only does their self-perception vary by their developmental level, but preschool children may respond with elevated perceptions of themselves. Focusing on individual differences in children's response to suspicions of sexual abuse enables us to identify risk and protective factors that contribute to the psychological outcomes of child sexual abuse.     

Do parents reinforce somatic complaints in their children?

Objective: To examine the influence of parental solicitousness on self-reported somatic complaints in school-age children. Design and Main Outcome Measures: Participants were 564 children (mean age 10 years) and their parents. Children completed self-report measures of somatic complaints, parental solicitousness, depressiveness, fear, and sense of coherence. Somatic complaints were assessed again 6 months later. Parents also completed a questionnaire about solicitousness. Results: Parental solicitousness as reported by children or parents was unrelated to the frequency of self-reported somatic complaints. Symptoms of depression, fear, and lower sense of coherence were associated with more somatic complaints, but did not interact with parental solicitousness. Conclusion: Parental solicitousness seems unrelated to more frequent somatic complaints in schoolchildren. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and parental adjustment to pediatric cancer.

Assessed the psychosocial adjustment of 107 23–58 yr old parents whose children had cancer using the Psychosocial Adjustment to Illness Scale. Ss whose child had died showed poorer adjustment than Ss whose child was in treatment or had completed treatment. Ss over 30 yrs of age showed better adjustment than younger Ss. Different patterns of association between 11 sources of social support and adjustment were found. Psychosocial adjustment of Ss with a child in treatment was correlated more frequently with perceived social support than for other Ss. Results suggest that particular attention should be paid to the psychosocial adjustment of young bereaved parents. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal resolution of child diagnosis: Stability and relations with child attachment across the toddler to preschooler transition.

In this longitudinal study, the authors investigated individual differences in how families adapt to a child's congenital disorder. Family impact, maternal grief resolution, and child attachment were assessed among 74 mothers and their toddlers with a neurological disorder or disfigurement. Fifty dyads were reevaluated 16 months later. For children with neurological compared with disfigurement diagnoses, there was a greater likelihood of negative impact on family, unresolved maternal grief, and insecure attachment at Time 1. Children classified as secure were significantly more likely to have mothers classified as resolved regarding their reactions to their children's diagnosis. Maternal grief resolution was significantly stable (77%) over time and mediated the relation between type of diagnosis and child security. With time, negative impact of child condition on the family decreased and percentage of children classified as secure increased, suggesting that on average families improved. Results suggest that helping parents come to terms emotionally and cognitively with their child's condition may be a useful focus for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcomes from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) program for bereaved caregivers.

Although preventive efforts for bereaved individuals have not been shown to be particularly effective in past studies, it has been suggested that intervention effects might be underestimated due to methodological issues such as short follow-up assessments. Thus, the present study aimed to assess the efficacy (as whole intervention packages and as component parts) of the Resources for Enhancing Alzheimer's Caregiver Health (REACH) interventions in preventing complicated grief, normal grief, and depressive symptoms at a longer term follow-up assessment among bereaved caregivers (N = 224). On average, active interventions showed a statistically significant effect on normal grief symptoms (d = 0.28), exhibited a trend toward improvement on complicated grief symptoms (d = 0.25), and demonstrated little impact on depressive symptoms (d = 0.09). Interestingly, the examination of intervention components revealed differential effects, whereby cognitive and behavioral strategies were most effective at reducing levels of complicated grief, information and emotional support were most effective for addressing normal grief, and environmental modifications were most effective for ameliorating depressive symptoms. These findings suggest that different preloss interventions might be warranted depending on a caregiver's unique clinical presentation and combination of risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The accuracy of parental recall of aspects of child development and of child rearing practices.

Retrospective accounts of child rearing obtained from parents of 3-year-olds were compared with reports they previously gave in the course of a longitudinal study begun with the birth of the child. The parents were quite inaccurate in their memory of details about child rearing practices and early development progress, in spite of the frequent rehearsal of these data due to their participation in the longitudinal study, and in spite of the relatively young age of the children. In-accuracies were greatest for items dealing with the age of weaning and toilet training, the occurrence of thumbsucking, and demand feeding. Inaccuracies tended to be in the direction of the recommendations of experts in child rearing, especially on the part of the mothers. In general, mothers recalled more correctly than fathers. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of sudden bereavement: Marital and parent-child relationships and children's reactions.

Explored long-term family adjustment to sudden, unexpected bereavement by conducting interviews with 40 Ss whose spouse died in a motor vehicle crash 4–7 yrs earlier and with 39 matched controls. Interviews were also conducted with 54 parents whose 1–28 yr old child died in a motor vehicle crash 4–7 yrs earlier and with 61 matched controls. Findings indicate that marital relationships generally strengthened or dissolved after a child's death. Most bereaved adults reported feeling closer to their children after the loss of a family member. Parental reports suggest that the death of a parent or sibling is overwhelmingly negative for children, and extremely so for a significant percentage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)