Co-occurrence of psychosocial sequelae in bereaved offspring

Latent profiles of coping and subjective views in parentally bereaved children: Predicting depression symptoms, intrusive grief, and suicidality over time

Childhood bereavement is a public health issue with significant mental health implications, including depression, intrusive grief, and suicidality. Theories suggest that children's malleable processes, like coping and subjective views of themselves and their environment, influence adaptation to bereavement. Protective processes may mitigate mental health risks, while risk processes may exacerbate them. Using a sample of support-seeking, parentally-bereaved children (8-16 years; M = 11.39, SD = 2.43; 53% male; 67% White), this study employs latent profile analysis to identify baseline patterns of coping and subjective views; and examines how profile membership predicts depression symptoms, intrusive grief, and suicidality at 14-month and six-year assessments. Three profiles were identified: Low Protective-High Risk (34%), High Protective-Low Risk (23%), and High Protective-High Risk (43%). Profile membership predicted depression symptoms. Children in the Low Protective-High Risk profile showed higher depression symptoms than those in the other profiles 14-months later, while children in the High Protective-Low Risk profile unexpectedly showed higher depression symptoms six-years later compared to those in the Low Protective-High Risk profile. Profile membership did not predict intrusive grief or suicidality. Findings underscore the importance of person-centered approaches in understanding adaptation following parental death and raise questions about the association between baseline childhood protective processes and long-term depression symptoms.

Effectiveness and Acceptability of Interventions Offered for Those Bereaved by Parental Loss to Suicide in Childhood: A Mixed Methods Systematic Review

OBJECTIVES

Identify interventions offered for children bereaved by parental suicide, investigate reported effectiveness and explore the acceptability of identified interventions.

METHOD

Six electronic databases were systematically searched for primary studies investigating intervention effectiveness and acceptability, (August 2011 to June 2023). Eligibility required inclusion of participants bereaved by parental suicide during childhood among sample populations. Methodological quality was evaluated applying JBI critical appraisal tools. Narrative synthesis was conducted using parallel-results convergent design.

RESULTS

Of the 22 eligible reports, 19 articles reported on 12 manual-based supports provided during childhood; three papers described users' experiences of various specified intervention types offered following childhood loss. Twenty-one studies reported on interventions offered for heterogeneous participant groups that included children bereaved by parental suicide. Time from loss to intervention generally included both recent (1 < 30mths) and more distant loss, with just one intervention described as solely for recently bereaved children. Eight interventions (n = 12 studies) demonstrated significant positive effects (p < 0.05), for maladaptive grief, mental health, quality of life. Only one study investigated suicide-related outcomes. Qualitative findings (n = 8 studies) facilitated development of four acceptability themes: Perceived utility, Relationships, Components and Delivery.

CONCLUSIONS

Heterogeneity in causes of loss/trauma and relationships with the deceased limit specific conclusions regarding effectiveness/acceptability of reviewed interventions for children bereaved by parental suicide. Few sub-group analyses of effects were reported, and qualitative evidence specifically from children bereaved by parental suicide was limited. Further research is recommended regarding mixed-user interventions, specifically for children bereaved by parental suicide.

Description and evaluation of a French grief workshop for children and adolescents bereaved of a sibling or parent

Background

Childhood bereavement is common, and is associated with elevated symptoms of grief with distress and impairment. However, few developmentally appropriate interventions to support grieving children are available to date. In Toulouse, France we developed an innovative four-session group intervention to support grieving families and evaluated its feasibility and acceptability.

Methods

The workshop consists of four sessions over 4 months, open to children bereaved of a sibling or parent, and co-facilitated by two mental health professionals. After an intake assessment, children were placed into closed groups according to age and relation to the deceased. The session content was balanced between creative activities and grief-related discussions. Overall satisfaction was evaluated in March-April of 2020 by an 8-question online survey of children and parents having participated between 2011 and 2019. Freeform commentaries were analysed using the thematic synthesis process.

Results

Of the 230 emails sent in March 2020, 46 children and 81 parents agreed to participate (55% response rate). The families reported an overall high level of satisfaction regarding the intervention that was rated as good to excellent. A majority of respondents considered their participation in the workshop helpful and in accordance with their expectations. Most would recommend the workshop to a friend, and would participate again in the group if needed. The group intervention helped reduce social isolation, facilitated grief expression, and supported the creation of a sense of community among bereaved families.

Conclusions

Encouraging community and mutual support among grieving families is fundamental in bereavement care. Our four-session workshop held over 4 months and led by mental health professionals aimed to help reduce social isolation and foster coping skills through artistic creation and group discussion. Our results highlight the potential need for family bereavement support over a longer period and a provision of a variety of services. Our intervention model is feasible for families, and further studies examining its efficacy are warranted.