The role of peer relationships in parental bereavement during childhood and adolescence

When a parent dies: A scoping review of protective and risk processes for childhood bereavement

The death of a parent can have profound effects on child development. Yet, little is known about the individual and environmental processes that contribute to heterogeneity in child bereavement outcomes. A scoping review was conducted in samples of parentally bereaved children to identify key processes, synthesize results, and determine research gaps. This scoping review identified 23 studies (mainly from the United States), published between 1990 and 2023, that reported child (ages 3-22 years) individual and/or environmental protective and/or risk processes that contributed to bereavement outcomes. Individual processes (i.e., how children manage stressors and think about themselves/their environment) included child coping and perception of themselves and/or their environment. Environmental processes (i.e., contextual resources) included family, mentorship, and stress exposure. Findings can be used to apprise clinicians, families, and policymakers of the unique nature of childhood bereavement and to identify malleable processes to target in interventions designed to prevent problematic outcomes in bereaved children.

Enacted Stigma Influences Bereavement Coping Among Children Orphaned by Parental AIDS: A Longitudinal Study with Network Analysis

Purpose

The study aims to understand how enacted stigma influences bereavement coping at the style (scale) level and the specific pathways at the strategy (item) level.

Methods

The longitudinal data of 755 children orphaned by parental Acquired Immune Deficiency Syndrome (AIDS) in rural China were used. Grief processing and deliberate grief avoidance were measured at wave 1 (baseline) and wave 2 (one-year follow-up) to reflect bereavement coping in the contexts of being with family members, being with friends, being with community members, and being alone. Enacted stigma that measured at wave 1 was used to assess the experienced stigma of these AIDS-orphaned children. Network analyses were run following regressions.

Results

Controlling for demographics and baseline-level bereavement coping, multivariate regressions revealed that enacted stigma at wave 1 significantly predicted grief processing and deliberate grief avoidance at wave 2. Network analyses showed that, for grief processing, stigma increased searching for meaning alone and with friends and expressing feelings to community members, which then provoked the same strategy across contexts. Meanwhile, stigma triggered the deliberate grief avoidance network by initially suppressing the expression of feelings to community members.

Conclusion

Enacted stigma contributes to bereavement coping. Stigma stirs up complex feelings but forces AIDS-orphaned children to suppress expressions, and it increases needs to process grief through meaning making but cuts supporting forces by promoting avoidance. Interventions are imperative to reduce stigma, improve emotion regulation, and facilitate meaning making for people bereaved by stigmatized deaths.

'Nobody comes to help us': lived experiences and needs of older adults who lost their only child in China

PURPOSE

This qualitative study aimed to gather insights into the experiences of older adults after losing their only child and explore meaningful life needs as a basis for social interventions.

METHODS

We conducted individual face-to-face interviews with 29 participants from 10 communities in Changsha, Hunan Province, China. Interviews were transcribed verbatim and then analysed using the inductive category development of conventional content analysis.

RESULTS

The experience of losing an only child was devastating and linked with a helpless life in old age. The analysis generated the following three themes encompassing their lived experiences and needs: afraid of getting sick, lying on the edge of misery and surrounded by loneliness.

CONCLUSIONS

Losing an only child triggered older adults' feelings of being misunderstood, disconnected and hopeless. They had an increased likelihood of lacking more on love and belonging, esteem and self-actualization needs than their physiologic and safety needs. Findings from our study will raise awareness on this vulnerable group and help design intervention programmes targeting the specific needs of this neglected segment of the population.

The Impact of the COVID-19 Pandemic on Pediatric Dentistry: Insights from an Italian Cross-Sectional Survey

BACKGROUND

The COVID-19 pandemic has had a significant impact on pediatric dentistry and also dental education. This study aimed to assess the observed changes in children's oral health by pediatric dentists and also served as an educational tool for dentistry students during the pandemic.

METHODS

Postgraduate students in pediatric dentistry prepared a survey addressed to Italian pediatric dentists. Over 5476 dentists were invited to participate, and collaboration among the students took place through virtual meetings and electronic platforms. The online questionnaire was composed of 29 questions focusing on the management of pediatric patients during and after the lockdown period. A descriptive statistic was used for data analysis, and chi-square tests were performed (p < 0.05).

RESULTS

A total of 1752 pediatric dentists participated in the survey. During the lockdown, 68.3% of dentists exclusively handled dental emergencies. In the subsequent semester, a significant decrease in the number of pediatric treatments was reported. Pediatric dentists also noted a decline in children's oral hygiene practices, a deterioration in dietary habits, and an increase in anxiety during dental procedures.

CONCLUSIONS

This survey shed light on the diverse effects of the pandemic on children's oral health and also provided valuable educational insights.

Ready to Meet God? Faithfulness and the Death of a Loved One

Religiosity often predicts better adjustment after the death of a loved one, but findings vary. One source of variability could be the perceived faithfulness of the deceased. In study 1, more religious college students found the death of a hypothetical faithful person to be less sad than the death of a hypothetical unfaithful person, whereas less religious college students did not. In study 2, MTurk participants and highly religious Christians reported that the death of a faithful loved one was less difficult than the death of an unfaithful loved one, but the difference was greater for the highly religious Christians.

Parental Engagement in Grief Programming Is Related to Children's Outcomes

A multivariate model was used to study outcomes of childhood bereavement. The model included exogenous factors such as engagement and within-person resilience factors. Sixty-two parent-child dyads were recruited from a local children's grief center and completed measures of engagement in the programming, resilience and grief. A complex model was revealed in which parental engagement in the grief program was related to child engagement and the child's control beliefs which in turn were significantly related to the child's grief symptoms. These variables existed within a system, rather than within an individual.

"I Don't Know What to Say": Teachers' Perspectives on Supporting Bereaved Students After the Death of a Parent

This qualitative study examined teachers' experiences dealing with bereaved students following the death of a parent. The researchers conducted in-depth, semi-structured, face-to-face interviews with 25 teachers in Israeli schools who had counseled one of their students after the death of a parent. The interviews were recorded and transcribed and underwent content analysis. Analysis of the findings revealed that the teachers felt helpless, confused, overloaded emotionally and anxious when counseling students who had lost a parent. In addition, the teachers discussed the complex nature of their relationship with the remaining parent, ranging from a desire to support the family through avoidance for fear of hurting the parent to fears of being overwhelmed by the child's problems. Many teachers mentioned their need for support from school officials.

The Function of Connection: Examining Social Supports in the Lives of Parentally Bereaved Youth

Through reflexive thematic analysis, this study explored three forms of social support in the lives of parentally bereaved youth: support derived from one's spirituality, caregiver support via parent-child communication, and therapist support from grief counseling (N = 30 youth, Mage = 12.5 years, SD = 2.8 years). Results showed that these sources of support serve varied and vital functions in the lives of parentally bereaved youth. Namely, the benefits of grief counseling and spirituality were consistently identified by youth as critical in facilitating their coping with the loss of a parent; while parent-child communication regarding the deceased varied widely, highlighting the need for additional supports beyond their surviving caregiver. Findings also revealed differences among these supports across youth gender, race, ethnicity, and age. Adolescents were more likely to disengage from counseling services and reported less parental and spiritual support. Males and minoritized youth experienced more benefits from spiritual and therapist supports.

Children or adolescents who lost someone close during the Southeast Asia tsunami 2004 - The life as young

INTRODUCTION

To lose a person close suddenly, during childhood or adolescence, can be devastating. Many children or adolescents experienced the 2004 Indonesian tsunami when they were between 10- and 15-years-old. This study, from Stockholm, Sweden, describes the long-term effects of loss, eight- or nine-years post disaster, in young adulthood.

METHOD

A mixed-method approach was used including statistical analyses (n = 210) and interpretative phenomenological analysis (IPA).

RESULTS

It was shown that there was a significant difference between bereaved (n = 34) and nonbereaved (n = 176) respondents concerning, psychological distress, posttraumatic stress symptoms, and self-rated health. Three themes were found by using the IPA approach (n = 9): Living in traumas, carrying heavy baggage, and living with change.

CONCLUSION

The respondents described personal feelings of grief that are not expressed in their outward appearance or behavior in their daily living. When meeting young adults that have lost someone close in childhood or adolescence, this is important to have in mind.

Bereavement and educational outcomes in children and young people: A systematic review

Experiencing bereavement due to the death of a close person is rife in the lives of young people. This review aimed to investigate how bereavement affects educational outcomes of students at various educational levels and what factors may be involved in moderating these outcomes. The systemic review was conducted according to the PRISMA guidelines with searches of peer-reviewed literature in Embase, Emcare, Medline, PsycINFO and Scopus. Twenty-two studies (17 quantitative and 5 qualitative) were included. In general, bereavement can constitute a barrier to educational achievement in young people compromising academic performance, and educational engagement and attainment. Several factors can place young people at greater risk of experiencing this disadvantage and further research into these mechanisms and interventions to mitigate short- and long-term consequences, especially among high-risk groups, is warranted.

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

OBJECTIVES

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.

METHOD

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.

RESULTS

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.

DISCUSSION

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.

The experience of children with a parent suffering from Amyotrophic Lateral Sclerosis during the COVID-19 pandemic

Children that have a parent with Amyotrophic Lateral Sclerosis (ALS) suffer from the progressive loss of their beloved ones. During the COVID-19 pandemic, the difficulties faced by these children have increased. The study aimed to detect whether there were differences between the minors experiencing a relative's ALS and the minors with no experience of ALS and it aimed also to detect the impact of COVID-19 pandemic on these minors. The study involved Italian participants, in particular: the target group consisted of 38 children (7-18 years) (T0/T1); the control group consisted of 38 children (9-14 years) (T0 only). The following variables were measured: attachment with the Security Scale (SS), affects with the Positive and Negative Affect Schedule for Children (PANAS-C), behavioural problems with Strengths and Difficulties Questionnaire (SDQ), death representation with Testoni Death Representation Scale for Children (TDRS-C), self-concept with the Multidimensional Self Concept Scale (MSCS), resilience and socio-emotional skills with the Devereux Student Strengths Assessment (DESSA). The results showed higher negative affectivity (p < .001), externalising behaviours (p < .05), uncertainty in reflective function (p < .05) in the target group compared to the control one; after the COVID-19 pandemic minors in the target group showed reduced certainty of mental states (p < .05) and interpersonal and scholastic self-esteem (p < .05). The impact of ALS on these minors is significant and produces negative affect, externalizing behaviours and uncertainty of mental states. The lockdown situation due to the COVID-19 pandemic has further aggravated minors in their school and interpersonal self-esteem.

Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study

Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child’s age at death with psychosis, both overall and by ethnic group. In fully adjusted multivariable mixed-effects logistic regression models, experiencing early parental death was associated with 1.54-fold greater odds of psychosis (95% confidence interval (CI): 1.23, 1.92). Experiencing maternal death had 2.27-fold greater odds (95% CI: 1.18, 4.37), paternal death had 1.14-fold greater odds (95% CI: 0.79, 1.64), and both deaths had 4.42-fold greater odds (95% CI: 2.57, 7.60) of psychosis compared with no early parental death. Experiencing parental death between 11 and 16 years of age had 2.03-fold greater odds of psychosis than experiencing it before five years of age (95% CI: 1.02, 4.04). In stratified analyses, experiencing the death of both parents had 9.22-fold greater odds of psychosis among minority ethnic groups (95% CI: 2.02–28.02) and no elevated odds among the ethnic majority (odds ratio (OR): 0.96; 95% CI: 0.10–8.97), which could be due in part to the higher prevalence of early parental death among minority ethnic groups but should be interpreted cautiously given the wide confidence intervals.

Grief and Best Friendship Among Adolescent Girls

This article explores the relationship between grief and best friendship (BF) dynamics among adolescent girls. Based on a qualitative interview study with 10 Danish girls, findings suggest that bereavement affects friendship dynamics in ways that challenge the by-standing friend in succeeding with being and staying supportive. Through a thematic analysis, we identify 12 themes that cut across the case stories, all of which testify to the difficulties bereavement represent to friendship quality and maintenance. Among other issues, it seems like grief is contagious and the bereaved friend changes her way of responding to the by-standing friend in ways that disturb expectations, values, and virtues of BF among girls in adolescence. The general categories found to be characteristic for long-term BFs, that is, positivity, supportiveness, openness, and interaction are all affected by bereavement in adolescent BFs among girls.

Social relationships and caregiving behavior between recently orphaned chimpanzee siblings

When their mothers die, chimpanzees often adopt younger vulnerable siblings who survive with their care. This phenomenon has been widely reported, but few studies provide details regarding how sibling relationships change immediately following the deaths of their mothers. A disease outbreak that killed several females at Ngogo in Kibale National Park, Uganda, furnished an opportunity to document how maternal death influenced the social relationships of siblings. We describe social interactions between four adolescent and young adult males and their younger immature maternal siblings 9 months before and 8 months after their mothers died. We also show how the behavior of individuals in the four recently orphaned sibling pairs contrasts to the behavior displayed by chimpanzees in 30 sibling pairs whose mothers were alive. Following the death of their mothers, siblings increased the amount of time they associated, maintained spatial proximity, groomed, reassured, and consoled each other. During travel, younger orphans followed their older siblings, who frequently looked back and waited for them. Both siblings showed distress when separated, and older siblings demonstrated heightened vigilance in dangerous situations. Chimpanzees who were recently orphaned interacted in the preceding ways considerably more than did siblings whose mothers were alive. These findings suggest that siblings provide each other support after maternal loss. Further research is needed to determine whether this support buffers grief and trauma in the immediate aftermath of maternal loss and whether sibling support decreases the probability that orphans will suffer long-term consequences of losing a mother if they survive.

Development and piloting of a novel, peer-led bereavement intervention for young people living with HIV in Zimbabwe

Background: Research emphasizes lasting psychological implications when young people are not adequately supported following close family deaths. In sub-Saharan Africa, adolescents living with HIV (ALHIV) experience multiple personal deaths along with other serious losses. ALHIV highlight that not processing their grief negatively impacts their daily lives including their ART adherence. This article describes the development and piloting of a bereavement intervention for ALHIV in Zimbabwe. Methods: Formative research with 10 ALHIV peer counsellors (18-21 years) supported intervention development. After training, these peer counsellors facilitated a six-session bereavement intervention in 10 existing community-based ALHIV support groups. Qualitative data was collected from facilitators, ALHIV intervention participants, and their caregivers. Results: Key themes: i) limited experience recognizing their losses; ii) lacking control over poorly understood feelings; iii) recurrent feelings of isolation, hopelessness, depression, fear, and guilt; iv) reticence to share, believing their feelings were unusual; v) shame surrounding connections felt towards their deceased. Following intervention implementation, members reported relief in learning of shared experiences, the ability to link their feelings with specific experiences and employ constructive coping strategies to address them, leading to greater emotional control. Conclusion: Implementing high-quality grief interventions is critical when responding to the complex realities of ALHIV in sub-Saharan Africa.

Understanding grief in children who have lost a parent with cancer: How do they give meaning to this experience? Results of an interpretative phenomenological analysis

Though the adjustment of bereaved children is increasingly investigated through quantitative studies, their intimate representations regarding the loss of their parent remain unknown. This qualitative study aims at exploring how they give meaning to this experience. Nondirective interviews with bereaved children were conducted and submitted to an interpretative phenomenological analysis. Fourteen children (8 boys, 6 girls, mean age = 8.5 years) were recruited. Seven major themes depicting their grief experience were identified. The importance of the surviving parent is critically highlighted. Findings suggest that the remaining parent could become a fundamental actor in providing grief support for the bereaved children.

Peer support for bereaved children: Setting eyes on children's views through an educational action research project

This article investigates children's views on providing peer support to bereaved children. The data (pre- and postinterviews and written documents) come from an action research study of a teacher-researcher and her 16 children aged 10-11 years old. Analysis of the data shows children's ideas on supporting a bereaved child and how this support should be provided, taking into consideration various factors such as the relationship with the bereaved and the role of memories. The paper emphasizes that children should have structured opportunities across the whole-school curriculum to learn how loss affects people's lives to support themselves and others.

Latent Profiles of Posttraumatic Growth and Their Relation to Differences in Resilience among Only-Child-Lost People in China

AIMS

Since the early 1980s, the one-child policy has been implemented nationwide in China. A special group called the "only-child-lost family" (OCL family) has emerged and has become a social phenomenon that cannot be ignored. We report latent profiles of posttraumatic growth and their relation to differences in resilience among OCL people in China.

METHODS

A total of 222 OCL people were investigated using the Posttraumatic Growth Inventory and the Connor-Davidson Resilience Scale. Latent profile analysis was applied to explore PTG latent profiles. Multinomial logistic regression was used to analyze the socio-demographic variables in each latent profile and the association between profile membership and resilience.

RESULTS

Three latent profiles were identified and labeled the "high appreciation-power group" (30.6%), the "general moderate growth group" (47.7%) and the "low growth and extreme possibility group" (21.7%). Compared to those in the high appreciation-power group, individuals with monthly income >2000 ($312) were less likely to be in the general moderate growth group (OR = 0.13, P<0.01), whereas individuals with a spouse were less likely to be in the low growth and extreme possibility group (OR = 0.43, P<0.01). Individuals in the "general moderate growth group"(OR = 0.92, P<0.01, 95%CI:0.89-0.94) and the "low growth and extreme possibility" groups (OR = 0.83, P<0.01, 95%CI:0.79-0.87) demonstrated significantly lower levels of resilience compared to the high appreciation-power group.

CONCLUSION

The PTG patterns in only-child-lost parents were varied. Promoting resilience may be a way to foster these parents' PTG. Targeted intervention should be developed based on the characteristics of each latent class, and timely attention must be paid to the mental health of OCL parents who are without a spouse and have low income.

Peer Interactions of Parentally Bereaved Children and Adolescents: A Qualitative Study

This study investigates peer interaction and peer support for parentally bereaved children and adolescents. Using data from an extensive study of bereaved families in southeastern Michigan, previously transcribed semistructured interviews on peer relationships from a sample of 35 parentally bereaved children aged 6 to 15 were qualitatively analyzed using the constant comparative method. This analysis explores peer interaction in the context of parental loss, revealing the nearly ubiquitous desire of bereaved children to be perceived as "normal" and maintain their social life as it was before the death, the avoidance of bereavement-related peer interaction, the nature of and possible reasons for the relative lack of peer support, deliberately hurtful peer behavior, the multiple functions of peer support, and the value of close friends in bereavement.

Dealing With the Concepts of “Grief” and “Grieving” in the Classroom: Children’s Perceptions, Emotions, and Behavior

This article presents an action research study that explores how a fifth-grade classroom of 10- to 11-year-old children in Cyprus perceive the concepts of grief and grieving, after an educational intervention provided space for discussing such issues. It also explores the impact that the intervention program had on children’s emotions while exploring these concepts and illustrates how it affected their behavior. The findings suggest that the intervention had a constructive impact on children’s understandings of grief and grieving along two important dimensions. First, the intervention helped children better define emotional responses to loss (grief). Second, children seemed to overcome their anxiety while talking about grief and grieving and were able to share relevant personal experiences. The study has important implications for curriculum development, pedagogical practice, and teacher training on death education.

Parentally Bereaved Children and Adolescents

This study investigates peer interaction and peer support for parentally bereaved children and adolescents. Using data from an extensive bereavement study, transcribed semistructured interviews on peer relationships from a sample of 35 parentally bereaved children aged 6 to 15 were systematically coded. Exploratory dimensions of inquiry included incidence counts of teasing, peer interaction regarding bereavement, and preference for interaction, among 12 other dimensions. Hypotheses related to age, gender, and parental death type (anticipated vs. sudden) differences on peer support reception were also tested. Major findings included the following: 71.4% of the sample received support from peers, although 71.4% preferred not to have bereavement-related peer interaction. A significantly greater percentage of females versus males experienced peer support and a positive emotional response, and a significantly greater percentage of children bereaved by anticipated deaths versus sudden deaths had received bereavement-related peer interaction and support. No significant differences were found between younger and older children.

[Parental death in childhood: the state of theoretical knowledge and clinical challenges in the future]

Although children's psychological adaptation to parental cancer is a wide field for psycho-oncological research, few empirical studies target children bereavement specifically following parental cancer. In this paper, our purpose is to make a state of art about literature concerning parental death. Literature dealing with grief concerns psychopathological consequences of parental loss and most recently post-traumatic growth. Although references about support programs have emerged, few of these programs have been scientifically evaluated. This review underlines that more studies are needed with prospective quantitative and qualitative studies, in order to describe more precisely children bereavement process and long term effects of bereavement. Psychological support for other family members and evaluation of support programs seem to be critical to improve children adaptation to parental death.

The taunting of parentally bereaved children: an exploratory study

This exploratory study addresses the rarely mentioned, minimally investigated topic of peer taunting of parentally bereaved children. It suggests that social support cannot be adequately conceptualized or measured on an essentially one-dimensional scale from high to low support. The data are derived from lengthy semistructured transcribed research interviews of bereaved children. Using conservative criteria, 7 of the 35 children were found to have experienced direct, raw taunting about their loss. The varied forms of taunting experienced are described, as well as a range of victim reactions. Suggestions of foci for future research are presented.