Dyadic Relationships between a Surviving Parent and Children in Widowed Families: A Systematic Scoping Review

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.

Self-Compassion for Caregivers of Children in Parentally Bereaved Families: A Theoretical Model and Intervention Example

Family-based bereavement interventions have shown promises to prevent problem outcomes and promote resilience in parentally bereaved children. Evidence of the broad range of mental and physical health problems following the death of a parent supports the need for a transdiagnostic approach that promotes adaptation and reduces multiple problem outcomes for parentally bereaved families. We discuss self-compassion as a promising framework for a transdiagnostic approach. We argue that three elements of self-compassion-mindfulness (vs. over-identification), self-kindness (vs. self-judgment), and common humanity (vs. isolation)-can facilitate loss-oriented coping, restoration-oriented coping, and the oscillation process between the two. This sets the foundation for individual and family processes that support bereavement adjustment. To explain how self-compassion promotes adjustment outcomes in parentally bereaved families, we review the extant literature with a focus on parental emotion regulation and effective parenting and propose a conceptual model with testable hypotheses to guide more research in this area. The model suggests that caregivers' self-compassion is a resilience resource for multiple adaptive outcomes for themselves and for their child through its positive impacts on emotion regulation and effective parenting. We illustrate the utility of the framework with an example of a family-based bereavement prevention program that integrated self-compassion training. Future directions for research are discussed.

Cohort profile of FALCON: a prospective nationwide cohort of families with minor children who have lost a parent in Denmark in 2019-2021

Difficulties in recruiting newly bereaved families and following them over time present a major barrier in grief research following the death of a spouse/parent. We established FALCON-the first prospective nationwide cohort of families with children below age 18 years whose parent died in Denmark between April 2019 and July 2021. Data from parents and children were collected within 2 months of death with ongoing follow-up assessments up to 18 months post-death. A total of 992 families were invited. The final cohort consisted of 250 families (250 widowed parents, 134 adolescents, 120 children aged 6-12 years and 63 children aged 0-5 years). In this paper, we describe the rationale for the cohort's creation, the challenges of researching grief in families, the methods used and future plans to utilize this unique family-level dataset.

Feasibility, Acceptability, and Effectiveness of Adding an Evidence-Based Parent/Caregiver Program for Bereaved Families to Usual Community-Based Services

This paper briefly describes the development of the Resilient Parenting for Bereaved Families program (RPBF) and presents an evaluation of adding the RPBF to usual care (UC) provided by community agencies supporting families of bereaved children. The RPBF was adapted from the caregiver component of a family program that demonstrated significant benefits for parentally children and their parents in a randomized controlled trial. The current study found that the implementation of the RPBF program was feasible for implementation by community providers and was highly acceptable to caregivers. Subgroups of caregivers (n = 44) who received the RPBF in addition to UC (i.e., child groups and caregiver support groups) reported greater improvement in quality of parenting and complicated grief and reductions in children's behavior problems as compared with caregivers (n = 30) who received UC only. Improvement in parenting mediated the RPBF program's effect to reduce children's behavior problems.

Caregivers' Self-Compassion and Bereaved Children's Adjustment: Testing Caregivers' Mental Health and Parenting as Mediators

Objectives

Self-compassion, which involves mindfulness, self-kindness, and common humanity, has been found to be related to individuals’ mental health. Few studies have examined caregivers’ self-compassion in relation to parenting behaviors and child adjustment in addition to its relation to their own mental health. In the current study we examined caregivers’ self-compassion as a protective factor related to parentally bereaved children’s internalizing and externalizing problems and further tested whether these relations were mediated by caregivers’ mental health (complicated grief and psychological distress) and parenting.

Methods

The sample consisted of 74 caregivers (female = 78.4%) who participated in a larger study designed for bereaved families. At T1 (baseline) and T2 (20 weeks later), caregivers completed measures on demographic information, self-compassion, complicated grief, parental warmth, and consistent discipline, as well as child internalizing and externalizing problems.

Results

Findings supported that caregivers’ self-compassion was prospectively related to decreased internalizing and externalizing problems in bereaved children. Mediation analyses showed that the effect of self-compassion on externalizing problems was mediated by parental warmth and by consistent discipline. In addition, caregivers’ self-compassion was prospectively associated with decreased complicated grief and psychological distress of the caregiver.

Conclusions

These findings add to the knowledge on the benefits of self-compassion for bereaved families and suggest that caregivers’ self-compassion intervention may be a leveraging point to protect both bereaved caregivers from complicated grief and distress but also to strengthen parenting which leads to bereaved children’s adjustment.

Parenting through grief: A cross-sectional study of recently bereaved adults with minor children

BACKGROUND

Grieving adults raising parentally-bereaved minor children experience persistently elevated symptoms of depression and grief. However, the factors associated with their mental health outcomes are not well understood.

AIM

To investigate the psychosocial and demographic characteristics associated with grief distress and depressive symptom severity in bereaved adults with minor children.

DESIGN

Cross-sectional, web-based survey.

SETTING/PARTICIPANTS

Eight hundred forty-five bereaved adults raising minor (age <18 years) children who had experienced the death of a co-parent. Primary outcomes were grief distress (Prolonged Grief Disorder-13), depressive symptoms (Patient-Reported Outcomes Measurement Information System-Depression), and widowed parenting self-efficacy (WPSES).

RESULTS

Mean grief scores were 33.5; mean depression scores were 58.3. Among the 690 individuals more than 6 months bereaved, 132 (19.3%) met criteria for prolonged grief disorder. In adjusted models, participants reporting higher grief scores were more recently bereaved, identified as mothers, non-Caucasian, had lower education and income, and had not anticipated their co-parent's death. The statistical modeling results for depression scores were similar to grief scores except that depression was not associated with anticipation of co-parent death. Parents reporting lower WPSES scores had higher grief and depression scores. Retrospective assessments of more intense parenting worries at the time of co-parent death were also associated with higher grief and depression scores.

CONCLUSIONS

For bereaved adults with minor children, unanticipated co-parent death was linked with higher grief distress but not symptoms of depression. Addressing parenting concerns may represent a common pathway for improving the mental health of parentally-bereaved families.