Bereaved Children Research Articles

Neurocognition and academic achievement among bereaved children in the Generation R Cohort

Childhood bereavement is an adverse event, yet children demonstrate considerable variability in health outcomes. Bereaved children are at risk of lower lifelong educational attainment, though the contribution of neurocognitive performance is yet to be investigated. Using data from the population-based Generation R Study wherein nearly 10,000 pregnant mothers were recruited between 2002 and 2006, we estimated the association of bereavement by age 10 years with four subtests of cognitive function and academic achievement at 13 years. Bereavement by 10 years of age was experienced by n = 796 (37.3%) of youth and was associated with a 1.12-point (SD = 0.55; p-value = 0.04) lower full-scale IQ at 13 years, which was mainly driven by lower matrix reasoning scores (βadjusted = −0.27, SE = 0.11, p < 0.02). There were no differences in academic achievement or other subtests of neurocognitive function between bereaved and non-bereaved children. Secondary analyses adjusting for pre-bereavement nonverbal cognitive ability and mental health problems revealed an overall association between bereavement and subsequent full-scale IQ and matrix reasoning, but only among those youth whose caregivers reported that the loss had an emotional influence on the child. These novel findings leveraging prospective assessments in a population-based birth cohort highlight risk and resilience mechanisms warranting further research.

Evaluating Bereavement Response Plans in Daycare: A Comparative Analysis of Support Systems in Denmark and Norway

This study examines the implementation and use of bereavement response plans (bereavement plans) in Danish and Norwegian daycare institutions. Two large-scale surveys were conducted to explore the implementation rates, satisfaction levels, and source of the plans. The data collected was analyzed using frequency analyses and Chi-square tests of independence. The findings suggest that 87% of Danish institutions have bereavement plans compared to 98% in Norway. Furthermore, the study highlights the differences in the development of bereavement plans between the two countries, as Danish institutions trust their individually tailored plans more than their Norwegian counterparts, while the Norwegian plans seem to be of higher quality. Despite these differences, bereavement plans provide a sense of safety for staff when supporting bereaved children in both countries. This study contributes to the ongoing efforts to improve bereavement support in daycare institutions and emphasizes the importance of continued research and development in this area.

Intergenerational coping: Examining how caregiver and child coping relate to resilience in bereaved children

The death of a loved one can have harmful effects on children’s mental health, yet some bereaved children exhibit resilience. Various caregiver and child coping strategies, including active and avoidant coping, may affect the psychosocial functioning of bereaved children. The current study recruited 78 bereaved children aged 8–17 and one of their caregivers to explore: 1) how caregivers’ coping strategies affect their child’s coping strategies and resilience, and 2) associations between children’s coping and their resilience. Results from the active coping mediation model revealed that children’s active coping was significantly associated with their resilience, and caregivers’ active coping was indirectly associated with children’s resilience through children’s active coping. The avoidant coping model was not significant. These preliminary findings highlight the importance of promoting active coping strategies among bereaved children and caregivers.

Bereaved pupil support in schools: teacher training

ObjectivesApproximately, 1600 pupils are bereaved by a parent or sibling each year in Northern Ireland, equating to at least one child in every school class. Despite this, many children who...

Caregiver behaviors associated with positive youth development among bereaved children

Grounded in Multidimensional Grief Theory, this study examined the cross-sectional associations between child-reported caregiver grief facilitation behaviors (ongoing connection, grief expression, existential continuity and support, grief inhibition/avoidance) and positive youth development outcomes (future orientation, gratitude, social responsibility) in treatment-seeking bereaved children ages 7 to 18 (N = 170; 54.1% girls; 35.9% Hispanic/Latinx, 24.9% White, 17.8% Black) from the United States. Results indicate that higher levels of perceived caregiver existential continuity and support (behaviors theorized to promote the continuity of child routines and reassurance of a positive future after experiencing a death) were associated with greater future orientation and social responsibility values among participants. Findings suggest that in the wake of a death, structured and supportive caregiver responses may be related to children’s positive outlook on their future and commitment to others.

Teachers as caregivers of grieving children in school in the post-COVID-19 era: using the self-determination theory to conceptualize teachers' needs when supporting grieving children's mental health.

It has been estimated in recent studies that more than 1.5 million children worldwide lost a caregiver due to the COVID-19 pandemic. Childhood bereavement is associated with heightened risks of impaired academic and social performance, mental health issues, substance use disorders, and higher mortality rates. Yet children may receive insufficient support post-loss. Although the role of school psychologists in supporting grieving students has been examined, little is known about the role of teachers in this context. Specifically, knowledge about teachers' needs when supporting bereaved children is lacking. The study's aim was to explore teachers' needs, drawing upon a well-established framework-self-determination theory (SDT)-which focuses on three human needs considered essential for optimal functioning: autonomy, competence, and relatedness. Employing a qualitative approach, 36 teachers were interviewed about their needs when supporting grieving students. Interviews were transcribed and then analyzed using thematic content analysis. Analysis revealed three SDT-related needs: knowledge (theory- and practice-related), acknowledgment, and support (emotional and practical). The findings enhance our theoretical understanding of childhood bereavement and may promote policy changes that ensure teachers' needs satisfaction. Its significance lies in the basic premise that supporting teachers' needs in the context of pediatric grief may eventually lead to their optimal ability to enact best practices for supporting grieving students' well-being.

How Gender Shapes Sibling Tension in Adulthood Following Parental Death.

This study investigates gender differences in the effect of parents' deaths on sibling tension among bereaved adult children. Previous scholarship on adult sibling relations following the deaths of parents presents inconsistent results. These disparate findings may stem from past studies not taking into consideration the gender of both the deceased parent and the bereaved child. Analyses are based on three harmonized waves of quantitative and qualitative data collected from 654 adult children nested within 303 families as part of the Within-Family Differences Study. Multilevel models revealed that for daughters, but not sons, mothers' deaths in the past five years were associated with increases in sibling tension, whereas fathers' deaths did not predict changes in either sons' or daughters' sibling tension, regardless of timing. Qualitative analyses showed marked differences by child's gender in perceptions of patterns of shared work and support surrounding parents' deaths. Typically, sons expressed solidarity with siblings when mothers died and felt that the division of caregiving prior to mothers' deaths and arrangements following their deaths were fair. In contrast, daughters expressed increased solidarity with sisters surrounding mothers' deaths and disdain toward brothers who failed to contribute caregiving, support, or instrumental tasks. These findings underscore how gender of both parents and adult children differentially shape changes in adult children's relationships with their siblings in the face parental deaths, much as they do in other contexts across the life course.

What we learnt from parents' death experience: A cross-sectional study of death literacy and parent's death quality among adult children in China.

This study aims at investigating the current status of death literacy and parent's death quality among adult children in China. A cross-sectional survey was conducted to explore the associations between death literacy and parent's death quality and to provide evidence for developing public policies for improving the quality of death and end-of-life care for the population in the Greater Bay Area (GBA) of China. A cross-sectional design was adopted. Participants who experienced their father's and/or mother's death were recruited from 5 cities in the GBA of China in 2022. The Good Death Inventory (GDI) and the Death Literacy Index (DLI) were used to investigate the perceived quality of death of the parents of the participants and the death literacy of the participants. A total of 511 participants were recruited. Participants with higher GDI scores were positively associated with DLI scores (p<0.001). Adult children who had close relationships before their parents' death also had higher levels of DLI. This study investigated death literacy among bereaved adult children in China, filling a gap in the investigation of death literacy among Chinese residents. It found that parents' death experience can have a significant impact on the death literacy of adult children, which may affect their understanding and preparation for their own eventual death. Promotion of family discussion on death, development of community palliative care, and improving public death literacy are urgently needed in China.

What Bereaved Children Want to Know About Death and Grief

While childhood bereavement is common, children’s bereavement needs are not well understood. It is recognized that children’s understandings of death fundamentally differ from those of adults, however, limited research has explored this from a child’s perspective. Insight about children’s understandings and needs can be drawn from the questions they ask about it. Bereaved children aged 5–12 years were invited to submit questions about death and grief during a camp for grieving children. Children’s questions (N = 213) from 10 camps were analyzed using conventional content analysis. Five themes were identified: Causes and Processes of Death; Human Intervention; Managing Grief; The Meaning of Life and Death; and After Death. Children’s questions revealed that they are curious about various biological, emotional, and existential experiences and concepts, demonstrating complex and multi-faceted considerations of death and its subsequent impact on their lives. Findings suggest that bereaved children may benefit from opportunities to freely discuss their thoughts about death, which may facilitate appropriate education and emotional support.

L’engagement des adultes proches d’un enfant endeuillé par la perte d’un membre de sa fratrie : une recherche qualitative exploratoire

ObjectiveThe purpose of this research was to establish an overview of the social support provided by the adults to a bereaved child. The death of a sibling is a terrible experience for a child. Social support is an effective protective factor against the high risk of psychological distress. However, adults are reluctant to get involved because many do not know how to support a bereaved child. To date, few studies have looked at how to empower relatives to engage with the child. MethodologyWe conducted an exploratory inductive qualitative study. Seven adults who had been involved with a child experiencing the loss of a sibling participated in a cycle of three group workshops. An analysis by coding, categorizing, and relating the data set was conducted. ResultsThe results identified four phenomena that lead adults to avoid dealing with the child's grief. These are grief anxiety, grief cognitions, feeling of legitimacy, and tendency to avoid. The way parents and child function also contributes to the barriers participants identified to engaging with the bereaved child. ConclusionsCategorizing and relating the phenomena led to a better understanding and a new knowledge of the difficulties encountered by the adults around a bereaved child. Clinical and research perspectives emerged from our results, notably the identification of a reference person, the design of an inventory of the bereaved child's needs, and collaborative work between parents, child, and their relatives, in order to promote adult involvement and prevent psychosocial risks for the bereaved child.

SERIOUS MENTAL ILLNESS EXACERBATION POST-BEREAVEMENT: A POPULATION-BASED STUDY OF PARTNERS AND ADULT CHILDREN

Abstract The death of a family member may trigger exacerbations among individuals with serious mental illness (SMI). We hypothesized that bereavement would be associated with SMI exacerbations among bereaved partners and adult children diagnosed with SMI. Using linked population-based registries in Denmark, we identified partners and adult children diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, and major depression in the five years preceding the family member’s death. Generalized estimating equations were used to estimate the odds of SMI exacerbation two years after decedent death. Partners had increased odds of SMI exacerbation at 3 months into bereavement compared to 9-12 months prior to partners’ death (AOR=1.43, [1.13-1.81]). Children with a history of SMI had lower odds of SMI exacerbation in the second year of bereavement. Sociodemographic characteristics and co-occurring alcohol and substance abuse disorders were associated with higher odds of SMI exacerbations. These findings have implications for targeted bereavement support.

Do we all grieve the same? A multigroup test of the dimensional structure of prolonged grief disorder among Danish bereaved partners and children

Prolonged Grief Disorder (PGD) is a newly recognized mental disorder in ICD-11 and DSM-5-TR. Several studies using exploratory factor analysis have found a unidimensional structure of the Prolonged Grief-13 (PG-13) measure of PGD. The recently published ICD-11 proposal proposes a distinction between two clusters of symptoms: Separation distress symptoms and associated cognitive, emotional and behavioral symptoms. The aim of the current study is to test competing factor structures of PGD in Danish samples of bereaved. Confirmatory factor analysis was used to test competing models of PGD among two samples of in total 1093 adults that completed the questionnaires 6 months post loss of either a parent or a partner. Convergent and divergent validity was tested via the relationship to depression, anxiety, post-traumatic stress disorder (PTSD) and general wellbeing using regression analysis. The Danish version of the PG 13 appeared to be both valid and reliable. A two-factor model reflecting the division of core- and associated symptoms of prolonged grief disorder provided the best description of the PG-13 among Danish bereaved adults and there was evidence of partial structural invariance of the latent structure of PGD across bereavement types. Convergent and divergent validity analysis supported the validity of the two-factor model of PGD. Significant outcomes: A latent variable model differing between core- and associated symptomatology of grief is supported. The Danish translation of PG-13 is a valid measure of prolonged grief symptomatology.

Facing the loss of siblings in childhood: Interactions and dynamics between bereaved siblings and their parents

IntroductionThe loss of a child in a family is a painful experience. Despite this, most studies focus on the grieving experience of parents. Our understanding of sibling bereavement therefore remains underexplored. This study aims to address this gap by exploring the bereavement experience of younger bereaved siblings from the perspective of the bereaved child and the parents. MethodThis study is a qualitative study conducted in Hong Kong. We recruited eleven bereaved families from 2019 to 2020. Semi-structured interviews were conducted separately with bereaved children and parents. Thematic analyses were performed. FindingsEleven bereaved siblings, aged 5 to 11, and their parents were interviewed. Four themes were generated: Parents' unawareness of bereaved siblings' grief, protecting parents from grief, comparison with the deceased siblings, and learning how to grieve. ConclusionOur findings suggest that the family dynamics and interactions in the grieving experience are complex. The impact of grief on the bereaved child could emanate from the loss of the sibling or from the grief of the parents or from family interactions. Practice implicationsThis study highlights the importance of viewing the sibling bereavement experience in a family context and of enhancing sibling bereavement services. Helping professionals should not only provide more bereavement support to the bereaved siblings individually, but they should also enhance parents' capacity to support their bereaved children.

Sibling Grief over Perinatal Loss—A Retrospective Qualitative Study

Grief over perinatal loss is a personal experience that has a lasting impact on the life of the surviving siblings. This retrospective study is an in-depth exploration of the symbolic construction of the bond with the lost sibling employing Interpretative Phenomenological Analysis, a method to study sensitive themes. Our results have confirmed the strong social and cultural embeddedness of the grief experience. Participants of the study related perinatal loss to other major crises, conflicts, and overwhelming secrets in the lives of their families. Communication outside the family was often insensitive and stigmatizing, transforming bereaved children’s stories into silenced stories.

Reconciling the Uniquely Embodied Grief of Perinatal Death: A Narrative Approach

The death of a baby, stillborn or living only briefly after birth, is a moral affront to the cycle of life, leaving parents without the life stories and material objects that traditionally offer comfort to the bereaved, nor—in an increasingly secularized society—a religious framework for making sense of their loss. For the grieving mother, it is also a physical affront, as her body continues to rehearse its part in its symbiotic relationship with a baby whose own body is disintegrating. Attempting to forge continuing bonds with her child after death makes special demands upon the notion of embodied spirituality, as she attempts to make sense of this tragedy in an embodied way. This paper, which reconciles the distinct perspectives of bereaved mothers and children’s doctors, proposes that the thoughtful re-presentation of medical insight into pregnancy and fetal development may assuage parents’ grief by adding precious detail to their baby’s life course, and by offering the mother a material basis to conceptualize her own body as part of the distributed personhood of her baby.

A thematic analysis of teachers' perspectives on supporting victims of childhood bereavement in British primary schools

AbstractThere is a distinct lack of literature considering childhood bereavement within the United Kingdom. There is particularly a lack of age‐specific research into childhood bereavement and the types of support schools are providing for this group of children. In light of this lack of research, the aim of this study was to explore the experiences, perspectives and views of teachers on supporting children in British primary schools. Interviews were analysed using thematic analysis (TA). Analysis revealed four major themes relating to bereavement support: ‘support available is inconsistent’, ‘systemic limitations’, ‘lack of policy and guidance’ and ‘speaking to children about death’. The research showed that bereavement support in British primary schools is varied and inconsistent, with examples of good practice and areas for improvement. At the same time, both childhood bereavement and the support available to bereaved children are socially biased, with those in socioeconomically deprived areas more likely to experience a bereavement and receive lower quality support. This study indicates that government policy or guidance with regards to childhood bereavement would be advantageous, for staff and children alike. Context and implicationsRationale for this studyThis study was undertaken due to the distinct lack of research into childhood bereavement in the UK. One in 29 children in the UK will be bereaved of a parent or sibling before their 16th birthday (McLaughlin et al., 2019) and evidence suggests schools are well placed to support bereaved children in the aftermath of loss.Why the new findings matterThe research investigates the perspectives and experiences of teachers supporting bereaved children in British primary schools, highlighting what support currently exists, that teachers do not feel confident supporting bereaved children, and the systemic limitations which hinder the support they can provide.Implications for policymakers and education professionalsThe study has implications for policy makers, particularly the Department for Education (DfE), who may consider devising a national bereavement policy akin to those available abroad. Education professionals, including teachers and educational psychologists, might consider the findings in light of their own practice and develop local authority level bereavement protocols to support children. There are implications for teacher training providers who might consider the lack of bereavement training available at present (both in initial teacher training and continued professional development) and address this. Other researchers may consider the gaps in research found in our study and conduct further research to deepen the knowledge base.

Parental Attachment Style and Young Persons\u2019 Adjustment to Bereavement

BackgroundPrevious clinical and theoretical work supports the idea that parental attachment style and complicated grief affect young persons’ mental health, but empirical research investigating their impact on young person’s adjustment to bereavement is lacking.ObjectiveThis study investigated the impact of parental attachment style and complicated grief on young person’s adjustment to bereavement. It was hypothesised that a) parental attachment anxiety, avoidance, and complicated grief would moderate the link between bereavement experience and psychological distress in young persons and b) parental attachment style would moderate the link between parental complicated grief and psychological distress experienced by bereaved young persons.MethodThis was a questionnaire-based case control study, involving two participant groups: 133 parents of young persons who had experienced the loss of the loved one and 101 parents of young persons with no bereavement experience.ResultsBereaved young persons experienced greater externalising and internalising problems than the non-bereaved only when they were raised by an anxiously attached parent, but when parental attachment anxiety was low, bereaved children had fewer problems than the non-bereaved. When parental attachment avoidance was low, bereaved children also had fewer externalising problems than the non-bereaved. Among the bereaved, high levels of parental attachment anxiety and attachment avoidance amplified the link between parental complicated grief and child post-traumatic stress, while in the presence of low parental anxiety, complicated grief was negatively associated with an immediate distressing response and numbing-dissociative symptomatology.ConclusionsPsychological vulnerability in bereaved young persons was associated with an insecure parental attachment style.

Dealing with bereaved children: a case study.

Introduction:A personal reflection on managing bereaved children (BC) following unexpected death of a parent.Questions:What evidence is available to assist ambulance clinicians when supporting BC?Methods:A literature search on BC in pre-hospital environments was undertaken.Results:Paucity of literature necessitated search expansion beyond pre-hospital/ambulance focus, and use of supplementary sources of credible information from registered bereavement charities and help groups.Conclusion:More research is needed to better support this vulnerable, unique demographic. It is hoped that this article will encourage further discussion and research into this topic.

Death, bereavement and grief: the role of the teacher in supporting a child experiencing the death of a parent

ABSTRACT Experiencing the death of a parent as a child can have substantial implications on their present and future life. The nature of grief is complex, with many contextual factors influencing the child’s management. This study explores the teacher’s role in supporting a child bereaved of a parent through the use of interviews with three teachers who have supported a bereaved child. Using the themes that emerged from the literature and interviews, a questionnaire was disseminated, with 16 individuals reflecting on their experience of a parental death whilst in school. The results reveal informed views from teachers in relation to the vital role that they can play in supporting a bereaved child. Responses from bereaved individuals offer guidance on how school staff might offer support and understanding in these circumstances. Overall, the study suggests that teachers have a significant role in the child’s management of their grief. Despite a lack of initial teacher training in the area of loss, often their small, dynamic forms of support, such as listening and taking a genuine interest in the child, along with supportive proactive school approaches, are what makes a difference to the child effectively managing their grief.

Racial Differences in Early Parental Death, Midlife Life Problems, and Relationship Strain With Adult Children.

Black Americans typically experience the death of a parent earlier in the life course than do non-Hispanic Whites, and early parental death is known to hinder subsequent relationship outcomes. Whether early parental death may contribute to racial differences in midlife family relationships and the role midlife adults' current life problems play remain unexplored. Using multilevel modeling, we examined how timing of parental death is associated with relationship strain with adult children and whether the association differs by midlife adults' life problems in Black (n = 166) and non-Hispanic White (n = 467) families from the Family Exchanges Study. Losing a parent in childhood was associated with more relationship strain with adult children for Black midlife adults, but not for their non-Hispanic White counterparts. Among the bereaved, earlier timing of parental death was associated with more relationship strain with adult children only for Black midlife adults. In both bereaved and nonbereaved sample, participants' recent physical-emotional problems exacerbated the link between timing of parental death and relationship strain with adult children for Black midlife adults. Experiencing the death of a parent in the early life course can be an added structural disadvantage that imposes unique challenges for Black Americans in midlife. Policies and programs aimed at supporting bereaved children may benefit relationships with their own children later in life, and addressing physical-emotional problems in midlife may be a viable intervention point for those midlife adults who experienced the death of a parent in the early life course.