Parental Loss Research Articles

The Maternal Body, HIV and Race: Dual Raced and Ambivalent Maternal Experiences in a Vertically Infected HIV-Positive Adolescent

The HIV pandemic in South Africa has tragically left a wake of vertically infected children who have suffered parental loss and social marginalization. Vertically infected HIV-positive children are those who have acquired the virus from their mother during pregnancy, childbirth, or breastfeeding. In this paper, the development and alienation of the self is explored in a psychoanalytically informed research case study of a black adolescent girl who was vertically infected with HIV and later fostered by a white mother. This case study explores the sociogenic meanings of raced maternal experiences and disease identified in a series of psychoanalytic interviews, using interpretive phenomenological analysis. Drawing from Melanie Klein, Franz Fanon and other feminist and post-colonial psychoanalytic theorists, the early primal raced and diseased scene is considered through internalizations and fixation on the body. Nosipho is first introduced through a short vignette and a discussion of her early maternal relational experiences. The paper then explores the ambivalence experienced by the participant as part of her HIV and raced lived experiences. HIV and raced subjectivities are both powerful internalized conscious as well as unconscious embodied experiences. For Nosipho, it has been a complicated process found in the shared dual mothering experiences between a biological mother who is black and the subsequent white maternal experiences. The interrogation of this embodied dual experiences of having black mothers who are HIV-positive whilst simultaneously having white mothering roles in children who are vertically infected with HIV is a terrain that is infused by deep contradictory and conflicting emotional and affective states around love and hate, joy and despair, fear, and hope, all at once. Consequently, holding both the HIV and the raced subjectivities is deeply painful for black children who are vertically infected with HIV.

Loss of a Parent in Disney and Pixar Films: What We Can Learn?

Early parental loss is a tragic experience for children causing complex reactions to the loss. Providing a supportive environment where they can express their feelings is crucial to help them cope with this challenging experience. This study analyses the depiction of parental death in animated films by Disney and Pixar using a multimethod design and including the QUAGOL approach. We identified 13 films showing the death of one or both parents. The qualitative analysis of the films, published from 1937 until 2022, revealed seven concepts that potentially affect the way children see their grieving process reflected in the films: The representational techniques, finding protection and relationships, searching for identity, being different and having alternative skills, talking about death, dealing with emotions and coping with the loss. The identified films can be used to open a conversation with children who have lost one or both parents to discuss their situation.

Model of Coping Mechanism of Adolescents with Parental Loss due to COVID-19: A Study Using PLS-SEM Analysis

Model of Coping Mechanism of Adolescents with Parental Loss due to COVID-19: A Study Using PLS-SEM Analysis

Nicotine dependence and incident psychiatric disorders: prospective evidence from US national study.

We examined the prospective associations between nicotine dependence and the likelihood of psychiatric and substance use disorders in the general adult population. Participants came from a nationally representative sample of US adults aged 18 years or older, who were interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1, 2001-2002; Wave 2, 2004-2005). The primary analyses were limited to 32,671 respondents (13,751 male (47.9% weighted); mean age of 45 years (SD = 0.18)) who were interviewed in both waves. We used multiple regression and propensity score matching (PSM) to estimate the strength of independent associations between nicotine dependence related to the use of tobacco products at Wave 1 and incident psychiatric disorders at Wave 2. Psychiatric disorders were measured with a structured interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV). All analyses adjusted for multiple potential confounders, including childhood (family history of substance use disorders, parental loss, vulnerable family environment), early-adolescence (self-esteem, social deviance, conduct disorder), late-adolescence (education, personality and psychiatric disorders), adulthood (divorce, stressful life events, social deviance, quality of life, history of alcohol or other substance use disorder), and sociodemographic factors. Multiple regression analysis and PSM converged in indicating that nicotine dependence was associated with significantly increased incidence of any psychiatric disorder (OR = 1.39(95%CI:1.20;1.60)), including substance use disorders (OR = 1.91(95%CI:1.47;2.47)), and anxiety disorders (OR = 1.31(95%CI:1.06;1.62)). Population Attributable Risk Proportions were substantial, ranging from 12.5%(95%CI:8.10;17.0) for any psychiatric disorder to 33.3%(95%CI:18.7;48.0) for any other drug use disorder. Supplementary analyses also indicated significant associations between nicotine dependence and persistence of psychiatric and substance use disorders among patients having a disorder at Wave 1. In the general adult population, nicotine dependence is associated with an increased likelihood for several psychiatric and substance use disorders. Given its high prevalence, these findings have important public health implications.

Family Death During Upbringing and Maladaptive Personality Traits

Major depression and other serious mental health concerns appear to follow parental or sibling death for many child and adolescent survivors. While grief and depression remain a central focus in bereavement research, the impact of sibling and parental death on personality development remains incompletely understood. This study focused on coarser personality adaptations that may occur in response to childhood or adolescent grief. Analysis was conducted on a crowdsourced survey sample (N = 2,398) which included respondents with parent (n = 143) or sibling (n = 102) death prior to age of 17. Parental death was associated with Callousness and Hostility as personality dimensions. Sibling death was linked to higher Callousness, Hostility, Physical Aggression, Depressivity, and Hypomanic trait scores. Callousness elevations (>1 SD) were more common among respondents classified in the sibling and parental bereavement groups (ORs of 3.02 & 2.17, respectively). Significant differences were found after control of variance associated with respondent age and childhood adversity exposure count. Parent and sibling suicide exclusions reduced trait differences between the bereaved and nonbereaved respondents. Sibling death was associated with more trait differences and larger effect sizes than parental loss. Questions remain regarding the nature of the psychological conditions that differentiate normative, resilient, and callous personality adaptations in the aftermath of early family tragedy. The prognostic value of the DSM-5-TR traumatic bereavement specifier was discussed.

Self-Compassion and Friendship Quality Toward Resilience Of Adolescents Who Experienced Parental Loss

Self-Compassion and Friendship Quality Toward Resilience Of Adolescents Who Experienced Parental Loss

Family Communication With Children and Adolescents Post Parental Loss in Road Traffic Accidents: A Qualitative Study

Background: Traumatic parental loss during childhood and adolescence can have long-lasting effects on the developmental trajectory of youngsters. While there is some literature on the advantages of positive family communication fostering better adjustment in bereaved children and adolescents, patterns of family communication post parental loss have not received much attention. An understanding of these patterns can pave the way for more holistic interventions in this vulnerable group. Aim: The aim of the study was to explore parental loss-related communication in families of children and adolescents who have lost a parent to a road traffic accident. Method: The study was carried out in a tertiary hospital setting in Bengaluru. The sample comprised of 24 children and 17 surviving parents. The study employed a qualitative research design. Semi-structured in-depth interviews were conducted with surviving parents/caregivers and the children/adolescents. The interviews were analysed by using inductive thematic analysis. Results: The themes generated from the semi-structured interviews highlighted patterns of communication in parentally bereaved families. Four major themes emerged from the semi-structured interviews – mode of getting to know about the death, disclosure regarding the death, discussion regarding the death and individual needs related to communication. Conclusions: Communication regarding parental loss as a result of road traffic accidents in the family context seems to be desirable and may enable healthy grieving in youngsters. Short-term interventions aimed at enhancing family communication patterns following traumatic parental loss need to be developed in the Indian context.

Intergenerational Chain of Violence, Adverse Childhood Experiences, and Elder Abuse Perpetration

It is widely known that individuals with adverse childhood experiences (ACEs) have an increased risk of abusing their own children, thereby perpetuating the cycle of violence. However, the association between ACEs and elder abuse perpetration has not been fully examined. To examine the association between ACEs and elder abuse and the mediating factors. This cross-sectional study used data collected via the self-administered Japan COVID-19 and Society Internet Survey from September 12 to October 19, 2022. Men and women aged 20 to 64 years who responded to related questions were included. Data were analyzed from July 2023 to April 2024. ACEs, defined as the experience of any of 7 items-interpersonal loss (parental loss and parental divorce), family psychopathology (parental mental disease and violence in family), abuse (physical and psychological abuse), and neglect-before the age of 18 years. The primary outcome was the perpetration of physical and/or psychological abuse against an older person (aged ≥65 years) self-reported via questionnaire. The direct and indirect effect estimates were determined using logistic regression analyses. Of a total of 13 318 participants (mean [SD] age, 41.1 [12.1] years; 6634 female [49.8%]), 1133 (8.5%) reported perpetrating violence against older adults. Compared with individuals without ACEs, the odds ratios (ORs) for perpetrating violence were 3.22 (95% CI, 2.74-3.79) for those with 1 ACE and 7.65 (95% CI, 6.41-9.13) for those with 2 or more ACEs. In the mediation analysis, factors with large indirect effect estimates included depression (OR, 1.13; 95% CI, 1.11-1.14; proportion mediated [PM], 18.6%), mental illness other than depression (OR, 1.12; 95% CI, 1.10-1.14; PM, 17.3%), and self-rated health (OR, 1.04; 95% CI, 1.03-1.05; PM, 6.0%). These findings suggest that intergenerational cycles of violence may extend to any vulnerable group, not only children but also older adults. Further research into the prevention of ACEs and breaking these cycles of violence is warranted.

Adolescents' Adverse Childhood Experiences, Poor Mental Health, and Substance Use During the COVID-19 Pandemic

PurposeAdverse childhood experiences (ACEs) increase the risk for poor mental health (MH) and substance use. We describe relationships between adolescents' ACEs, substance use, and poor MH occurring during the COVID-19 pandemic. MethodsWe conducted a secondary analysis of data among U.S. high school students aged <18 years, who participated in the nationally representative Adolescent Behaviors and Experiences Survey. Data were collected from January to June 2021. Bivariate and multivariable analyses assessed associations between individual ACEs (physical, emotional abuse by parent or caregiver, parent or caregiver job loss, food insecurity, sexual violence, physical dating violence, or cyber bullying) and cumulative ACEs (0, 1–2, 3, 4+) experienced during the pandemic and substance use; stratified analyses assessed effects of poor MH on associations between ACEs and substance use. ResultsUse of all substances was higher among adolescents with ACEs, particularly those who experienced both ACEs and poor MH during the COVID-19 pandemic. Prevalence of substance use was especially high among adolescents exposed to any sexual violence or physical dating violence. Compared to adolescents without ACEs, a higher percentage of adolescents with 4+ ACEs reported current use of alcohol (adjusted prevalence ratio [aPR], 5.32) or marijuana (aPR, 5.86), misuse of prescription pain medications (aPR, 8.82), binge drinking (aPR, 7.70), and increased alcohol (aPR, 6.54) or drug (aPR, 7.09) use during the pandemic. DiscussionThe individual and combined impact of ACEs and MH on adolescent substance use reinforce the need for trauma-informed care and primary prevention of ACEs to prevent and mitigate poor MH and substance use among adolescents.

Evaluation of Anxiety and Depression Among Orphan and Non-Orphan Adolescents in a Rural Residential School of Maharashtra

Abstract Background: Adolescence marks a critical stage of development characterized by profound physical, emotional, and social changes. This study explores the prevalence of anxiety and depression among orphan and non-orphan adolescents in a rural residential school setting, aiming to identify associated factors. Method: A community-based cross-sectional descriptive study was conducted among 100 adolescents (50 orphans and 50 non-orphans) aged 10-19 years in Warudi, Jalna from August 10 to October 10, 2022. Institutional ethical approval and written informed consent were obtained. Data collection included DSM-5 criteria for anxiety and depression assessment, using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HDRS). Additional parameters assessed were sleep disturbances, academic performance, social interactions, duration of stay in the residential school, and type of orphanhood. Statistical analysis was performed using SPSS version 21, with qualitative parameters presented as percentages and the chi-square test used for comparisons (p&lt;0.05 considered significant). Result: The study revealed notable disparities in mental health outcomes between orphan and non-orphan adolescents. Orphans, predominantly categorized as double orphans (54%), exhibited higher prevalence rates of anxiety (46%) and depression (30%) compared to non-orphans (anxiety 14%, depression 12%). Factors such as prolonged stays in residential schools and the duration of orphanhood were significantly associated with heightened levels of anxiety and depression among orphans. Conclusion: Orphan adolescents residing in rural residential school face significantly elevated risks of anxiety and depression compared to their non-orphan peers. The findings highlight the urgent need for targeted psychological support and interventions tailored to the unique challenges of orphanhood, including the prolonged institutional care and the emotional impact of parental loss. Future research should focus on longitudinal studies to assess the effectiveness of interventions and track mental health trajectories over time.

One-year predictors of PTSD symptoms, anxiety, and depression in SARS-CoV-2 survivors: psychological flexibility and major life events as main predictive factors.

The COVID-19 pandemic held considerable health-related outcomes worldwide, including mental health challenges, with elevated risk of psychiatric sequelae. This study aimed to test the longitudinal (1 year) predictive role of psychosocial factors on post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms in SARS-CoV-2 survivors (N = 209 at T1; N = 61; attrition rate 70.83%), through Pearson's correlation analyses and longitudinal multiple regression analyses. Participants (age M = 35.4, SD = 10.1) completed online self-report questionnaires of psychosocial variables, PTSD, anxiety, and depression. Depression and anxiety symptoms were increased, and 42% of survivors presented clinically meaningful PTSD symptoms. PTSD symptoms were longitudinally predicted by having children (β = 0.32, p < 0.01), number of recent major life events (β = 0.34, p < 0.01), and psychological flexibility (β = -0.36, p < 0.01). Number of major life events (β = 0.29, p < 0.05) and psychological flexibility (β = -0.29, p < 0.05) predicted anxiety. Number of recent major life events (β = 0.32, p < 0.01) was the sole predictor of depressive symptoms. Psychosocial variables contribute to the long-term harmful effects of the COVID-19 pandemic on psychopathological symptoms. These results suggest that, during the pandemic, mental health was impacted by both socio-contextual factors and individual self-regulatory skills, namely the ability to respond flexibily to contextual cues and guide behavior according to the direct experience. Specifically, results point out the importance of societal incentives to reduce parental burden and socioeconomic losses, as well as to promote adaptive psychological skills such as psychological flexibility.

Family Coping With COVID-19: Unexpected Parental Loss and Surviving Parent Coping, Grief and Posttraumatic Growth Outcomes Based on Child Age.

Guided by the conceptual framework of widowed parenting, the current study takes a relational approach to understand more about how the characteristics of parents of young and adult children relate to coping following the unexpected death of a partner due to COVID-19, and how these variables predict complicated grief and posttraumatic growth. A sample of 81 widowed parents completed self-report measures examining parenting self-efficacy, relationship uncertainty, coping, complicated grief, and posttraumatic growth. Results of hierarchical regression analyses suggest that, when controlling for time since death (1) relationship uncertainty and avoidant coping significantly predict complicated grief for parents in the sample with adult children, and (2) widowed parenting self-efficacy and both problem-focused and emotion-focused coping significantly predict posttraumatic growth for parents in the sample with young children. Results of the current study may inform future practices (e.g., use of Emotionally Focused Family Therapy) to aid families grieving an unexpected loss.

Unmasking Orphan Students' Deep Psychological Defeat

General Background: Psychological defeat significantly impacts individuals' emotional well-being, particularly in vulnerable populations such as orphan students. Existing research often overlooks the nuanced experiences of orphans in secondary education. Specific Background: Orphanhood, encompassing the loss of one or both parents, creates unique psychological challenges that can affect students' emotional and academic performance. This study addresses the gap in understanding how these challenges manifest among orphan students in secondary schools. Knowledge Gap: Despite acknowledging the emotional difficulties faced by orphans, limited research has specifically explored psychological defeat among this group, particularly concerning the impact of parental loss and gender differences. Aims: This research aims to identify and measure the degree of psychological defeat among orphan students in secondary schools in Basra Governorate. The study also seeks to determine if psychological defeat varies by the type of parental loss and gender. Results: The study found that orphan students experience a high level of psychological defeat, with no significant gender differences observed. However, significant variations in psychological defeat were identified based on the type of parental loss (father, mother, or both). Novelty: This research introduces a newly developed scale for measuring psychological defeat tailored to the context of orphan students, filling a critical gap in existing literature. Implications: The findings underscore the need for targeted psychological support and interventions for orphan students, considering the type of parental loss. Recommendations include developing tailored counseling programs and support mechanisms to address the specific needs of these students and mitigate their psychological defeat. Highlights: High psychological defeat in orphan students, regardless of gender. Variations by parental loss type, significant differences found. New scale developed for measuring psychological defeat in orphans. Keywords: Psychological defeat, orphan students, secondary education, parental loss, emotional well-being

Grief Accompanied by Suicidal Thoughts After Traumatic Loss in Adolescent: A Case Report

Grief is a normal process that occurs following the irreversible loss of a loved one. This process, characterized by painful experiences, varies widely and is influenced by numerous factors, including the identity of the deceased, the circumstances of their death, the individual characteristics of the bereaved, and the availability of support systems. The suddenness and violence of a loss can disrupt the normal grieving process, leading to the manifestation of traumatic symptoms. This phenomenon, referred to as “traumatic grief” in the literature, is associated with an increased risk of various psychiatric disorders, including major depression, anxiety disorders, and post-traumatic stress disorder. The death of a parent represents a profound loss for an adolescent, complicating their coping mechanisms and significantly impacting their psychological well-being. Parental loss alone is a significant risk factor for suicidal behavior in adolescents. When a parent’s death is traumatic, it can further exacerbate this risk, leading to suicidal thoughts and behaviors by disrupting the normal grief process, even in adolescents who were previously mentally healthy. This article presents the diagnosis and treatment of a 17-year-old girl who exhibited active suicidal thoughts and behaviors after her father was killed with a firearm. The objective of this case report is to explore the atypical grief symptoms that can follow traumatic losses during adolescence and to assess the effectiveness of holistic approaches that combine supportive psychotherapy with pharmacotherapy in treating such cases.

The long-lasting effect of armed conflicts deaths on the living: Quantifying family bereavement.

Armed conflicts escalate combatant and civilian mortality and produce considerable levels of family bereavement. Yet, we know little about the prevalence of bereavement in conflict-affected populations. The violent loss of kin affects individuals across several dimensions, including trauma, mental health, socioeconomic status, and caregiving, especially during childhood and old age. Here, we propose a method to quantify population-level loss of parents and offspring in conflict-affected populations. Our analyses demonstrate that bereavement levels consistently surpass fatality rates in 16 conflict-affected settings. Using demographic projections, we show that these populations will continue to experience considerable levels of bereavement in the coming decades, independent of the future development of the respective conflicts. This quantification underscores bereavement as a profound yet understudied consequence of conflict with potentially far-reaching implications lingering long after the conflict's end.

Psychosocial and mental health challenges facing perinatally HIV-infected adolescents along the Kenyan coast: a qualitative inquiry using the socioecological model.

The advent of antiretroviral therapy has led perinatally HIV-infected (PHI) adolescents to live long, fulfilling lives through lifelong treatment. However, there is limited knowledge about the lived experiences and psychosocial and mental health challenges faced by PHI adolescents in sub-Saharan Africa, where 80% of PHI adolescents reside. To address this gap, we adapted the socioecological model to investigate the challenges and lived experiences of PHI adolescents in rural coastal Kenya. Between October and November 2018, a sample of 40 participants (20 PHI adolescents and their 20 primary caregivers) participated in a qualitative study using an H-assessment data collection approach for adolescents and focus group discussions with caregivers. Data analysis was conducted using a framework approach on NVIVO 11 software. PHI adolescents from this setting experience many challenges across various levels of the ecosystem. At the individual level, challenges include living in denial, HIV status disclosure, antiretroviral adherence, internalized stigma, and mental health issues. Within the family, challenges such as parental loss, insufficient care from parents, and unacceptance lead to threats of harm. In the broader community, key challenges such as gossip, unsupportive community members, long waiting times at the health facility, isolation, rejection, and an unresponsive school system fail to address the needs of PHI adolescents. Finally, HIV-related stigma and discrimination manifested across different levels of the socioecological framework. To cope with these challenges, PHI adolescents often rely on privacy and social support from their families. The findings underscore the need to develop and implement multi-level adolescent-friendly interventions to address PHI adolescent challenges and guide future investment in adolescent's health. Furthermore, there is a need to address internalized and interpersonal stigmas through individual-level interventions that promote resilience and the active involvement of adolescents, their caregivers, peers, and teachers who are their social support system.

Familial Loss of a Loved One and Biological Aging

The link between familial loss of a loved one and long-term health decline is complex and not fully understood. To test associations of losing a parent, sibling, child, or partner or spouse with accelerated biological aging. Data from the National Longitudinal Study of Adolescent to Adult Health, a US population-based longitudinal cohort study, were analyzed. Participants were enrolled from 1994 to 1995 for wave 1, while in grades 7 to 12, and followed up through wave 5 in 2018. The study analyzed participant reports of loss collected at each wave from 1 to 5 over 24 years and used a banked wave 5 blood sample for subsequent DNA methylation testing and epigenetic clock calculation from 2018 to 2024. Data were analyzed from January 2022 to July 2024. Loss of biological parents or parental figures, partners or spouses, siblings, or children at waves 1 to 3 or during childhood, adolescence (aged <18 years), or adulthood at wave 4 to wave 5 (aged 18-43 years). Biological aging assessed from blood DNA methylation using the Horvath, PhenoAge, GrimAge, and DunedinPACE epigenetic clocks at wave 5. Data from 3963 participants were analyzed, with a weighted mean (range) age of 38.36 (36.78-39.78) years at wave 5; 2370 (50.3%) were male, 720 (15.97%) were Black, 400 (8.18%) were Hispanic, and 2642 (72.53%) were White. Nearly 40% of participants experienced loss by wave 5 when they were aged 33 to 43 years, and participants who were Black (379 participants [56.67%]), Hispanic (152 participants [41.38%]), and American Indian (18 participants [56.08%]) experienced a greater proportion of losses compared with White participants (884 participants [34.09%]). Those who experienced 2 or more losses tended to have older biological ages for several of the clocks (PhenoAge β = 0.15; 95% CI, 0.02 to 0.28; GrimAge β = 0.27; 95% CI, 0.09 to 0.45; DunedinPACE β = 0.22; 95% CI, 0.10 to 0.34) compared with those with no losses. In contrast, there were no associations with 2 or more losses for the Horvath clock (β = -0.08; 95% CI, -0.23 to 0.06). This study reveals associations between various measures of loss experienced from childhood to adulthood and biological aging in a diverse sample of the US population. These findings underscore the potentially enduring impact of loss on biological aging even before middle age and may contribute to understanding racial and ethnic disparities in health and mortality.

Exploring Factors Limiting Girls’ Participation in Primary School Education: A Case of Sumbawanga District, Tanzania

The study employed a mixed-methods research approach and specifically a cross-sectional survey design. Purposive and simple random sampling techniques were used in selecting 114 respondents and 10 public primary schools. The sample comprised head teachers, other teachers, school management committee (SMC) chairpersons, ward education co-ordinators (WEC), district education officer (DEO), faith-based organizations(FBOs) and non-governmental organizations(NGOs), parents, and pupils in school. Data were collected through questionnaires, interview schedules, documentary review and focus group discussions (FGDs). Qualitative data was subjected to thematic analysis to develop common themes, while quantitative data was analysed descriptively by using the Statistical Package for the Social Sciences (SPSS) version20. The study established that the main factors that limited girls’ full participation in schools were orphan hood due to loss of parents, poverty, school factors, domestic activities and parental preferences given to male children in education. Based on the results, the study suggests that the government should promptly remove these barriers by implementing comprehensive educational initiatives to address prejudices and promote girls' education.

Coping and grief symptoms after parental loss in adolescence - a nationwide follow-up study

Knowledge about effective coping strategies is important to support bereaved adolescents who have lost a parent. We used data on 104 bereaved adolescents (13–17 years) from the FALCON nationwide questionnaire study of parentally bereaved families. We examined associations between adolescents’ control-oriented and escape-oriented coping strategies (KidCOPE scale) approximately two months after loss and grief symptoms (PG-13 scale) at six months follow-up. We also examined associations between the perceived efficacy of each coping strategy at baseline and grief symptoms at six months. The use of escape-oriented coping (e.g., distraction, self-criticism and social withdrawal) was associated with higher grief symptoms at six months follow-up (β = 0.4, 95% CI 0.1–0.9, p = 0.02), but no associations were found for control-oriented coping or perceived coping efficacy. Finding alternatives to the use of escape-oriented coping strategies may be an important part of grief interventions for bereaved adolescents.

Parental Loss and Mental Health in Post-Khmer-Rouge Cambodia

Adverse childhood events (ACE) may have lasting consequences throughout the life course. We focus on one particular type of ACE, parental loss in Cambodia—a country that lost nearly 25% of its population during the 1975-79 Khmer-Rouge regime—and on mental health disorders, one of the potential mechanisms through which ACE may have long-term consequences. Self-reports of symptoms that map on to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) criteria for anxiety, depression, and post-traumatic stress disorder (PTSD) were collected from 4,405 adults aged 20 and over. We first assess exposure to traumatic events and the prevalence of anxiety, depression, and PTSD using the DSM and alternative criteria. Based on the DSM criteria and previously validated Likert-scale thresholds, we find a high prevalence of anxiety (56.0%), depression (42.8%), and PTSD (2.3%), and even higher levels even among KRR survivors. We then use logit models to analyze the effect of parental loss before age 20 on the likelihood of having experienced traumatic events and experiencing mental health disorders. We find the loss of one parent increases the likelihood of full-PTSD symptoms, but the loss of both parents does not. These findings may result from positive selection into better-off households for orphans whose parents have both died but may also reflect the grief-related difficulties faced by the surviving parent of paternal or maternal orphans. While alternative thresholds for PTSD produced higher prevalence estimates, these measures did not perform better for assessing the effect of parental loss on mental health.