ADULT PSYCHIATRIC ILLNESS ASSESSED FOR CHILDHOOD PARENTAL LOSS, AND PSYCHIATRIC ILLNESS IN FAMILY MEMBERS--A STUDY OF 748 PATIENTS AND 250 CONTROLS

Death and the Child: An Anterospective Test of the Childhood Bereavement and Later Behavior Disorder Hypothesis

Does parental loss through death in childhood have a long-term effect on a person, or is the experience generally normalized in a relatively short period of time? Our anterospective identification of a thirty-three year old cohort and the comparative analysis of behavioral and attitudinal data indicates that there are differential consequences in early middle age, but that differences are not as great nor in the direction suggested by previous studies. In particular, the interaction of childhood divorce experience and bereavement emerged as an important sociological pattern.

Adult Child Loss and the Two-Track Model of Bereavement

The Two-track Model of Bereavement suggests that response to loss can be more effectively assessed when both the behavioral-psychological functioning and the internalized relationship to the deceased are considered [1–4]. Research based on this paradigm examined the experiences of 102 Israeli parents bereaved of sons four and thirteen earlier and a comparison group of seventy-three non-bereaved parents. All parents completed measures of functioning, anxiety, evaluation of self and son, written description of the son, and measures of the current life situation. Results indicated that the bereaved parents manifested difficulties in functioning and in their covert relationship to the deceased son. Differences between and within the bereaved groups by time and sex are considered. Regression documented an association between functioning and relationship to the deceased, and lent support to the assumptions underlying the Two-track Model of Bereavement. This discussion addresses the course of bereavement for adult sons with some implications for bereavement research and intervention.

Parental deprivation due to death in male soldiers with psychiatric disorders

BACKGROUND

The importance of early relationship with parents has been stressed by most personality theorists. Deprivation of the nurturing influence can lead to an adverse impact.

AIM

To study the effect of early parental loss in the development of adult psychiatric disorder.

METHODS

A total of 289 soldiers suffering from assorted ICD-10 identified psychiatric disorders were studied to ascertain parental losses during their developmental period. The findings were compared with those of 127 patients drawn from general medical wards.

RESULTS

A higher percentage of psychiatric patients had lost their parents before the age of 18 years compared with medical patients (21.5% vs. 8.7%). The difference, which was highly significant, was due to bipolar disorder to some extent and alcohol dependence syndrome to a larger extent. Loss of the father appears to be more significant than loss of the mother. Parental loss is found to be not a significant factor in depression and neurotic disorders. There is no excess of maternal loss in cases of depression.

CONCLUSION

This study indicates that parental loss is a significant factor in the future development of psychiatric disorders. It does not appear to be an important factor in the development of neurotic disorders. The aspect requires comprehensive evaluation.

Childhood parental loss and alcohol dependence among Japanese men: a case-control study. Group for Longitudinal Affective Disorders Study (GLADS)

There have been many studies in the literature examining childhood parental loss as a risk factor for adult psychiatric disorders such as depression, schizophrenia or anxiety disorders. However, with regard to alcohol dependence, only a limited number of such studies exists, and these have reported inconsistent findings. The present paper aims to examine the relationship between early parental loss and subsequent development of alcohol dependence among Japanese men. We directly interviewed 75 men with alcohol dependence (according to DSM-III-R), who were visiting 23 psychiatric hospitals and clinics all over Japan, and 52 healthy controls without any lifetime psychiatric diagnosis, drawn from a general population. When stratified for sex and age, there was no statistically significant difference between the patients and the controls in the rates of maternal or paternal death or separation before the age of 16 years. These findings and the review of the literature suggest that the relationship between childhood parental loss and alcohol dependence is not a straightforward one.

The role of loss in treatment outcomes of persistent somatization

The present study examines the effect of loss on treatment outcome in 92 persistently somatizing patients treated in an inpatient program. Patients were divided into one of three groups depending on the form of loss they experienced: early loss (loss of a parent before the age of 17, N = 25); recent loss (bereavement within the last 2 years, N = 21); or no loss (N = 46). The results indicate that patients experiencing an early loss had the poorest treatment outcome. The early loss group was characterized by poorer social adjustment prior to entry into the program compared with the recent loss group and a greater incidence of dependent personality disorder. The recent loss group showed the best outcome following treatment. The results support the concept that persistent somatization may arise from many precipitating factors. Assessing loss experiences in the patient may be an important factor in developing appropriate treatment strategies.

Early life events and affective disorder revisited

The incidence of traumatic events during the first ten years of life was investigated in two groups of patients suffering from major affective disorder, as well as in mixed psychiatric patients and in healthy subjects. While there were no significant differences between the two groups of affective patients or between the two control groups, the incidence of subjects who underwent such trauma was significantly higher in depressives, compared with controls. These differences are small and are further reduced if events secondary to psychiatric disturbances of family members are excluded.

Parental loss by death in the early childhood of depressed patients and of their healthy siblings

The incidence of parental loss by death before the age of 15 was investigated in a series of 200 depressed patients, sub-divided into unipolars, bipolars and neurotic-reactive depressives, and in their healthy siblings at risk. The age of onset of illness of patients who had lost a parent before 15 was compared with that of depressed controls. No excess of parental loss at any age was found in any of the patient sub-groups, as compared with their healthy siblings, nor did parental loss affect the age of onset of later depression. The results do not support the assumption that the loss of either parent by death in early childhood is significantly associated with depression in adult life, though parental death may be an important variable for individual patients.

Genetic and environmental factors in major depression

A study of 48 individuals with major depression in a sample of 443 adoptees has shown that depression is positively but not significantly correlated with a biologic background of affective disorder. Both primary and secondary depression was positively and significantly correlated with several environmental factors. In males, an adoptive home where another individual had an alcohol problem increased depression; in females, death of an adoptive parent prior to adoptee age 19 and an adoptive family where another individual had a behavior disturbance increased depression. Results suggest that the environmental factors occurring prior to adoptees age 18 predisposed to depression.

A two-track model of bereavement: theory and application in research

Much remains to be learned about the long-term effects of adult bereavement. A two-track model, considering both affective attachment to the deceased and extent of personality change, is used in the present study to examine aspects of the maternal reaction to sudden infant death. It is suggested that this two-track perspective offers greater specificity in studying the nature and duration of the effects of loss.

Parental death in childhood and risk of adult depressive disorders: a review

The authors review the evidence that parental death in childhood predisposes to depressive disorders in later life. The findings in general are quite inconsistent; this is due in part to the methodological limitations of most studies, principally that of inadequate control of potentially confounding variables. Where experimental and control samples were most rigorously matched, no association was found between childhood parental bereavement and depression in later life. Parental death in childhood appears to have little effect on adult depressive morbidity.

The interrelationship between social class, early parent death, and mental illness

The study aims to determine (1) the extent to which parental social class influences the incidence of early parent death; (2) the effect of parental social class on the outcome of early parent death, in terms of vulnerability to adult mental illness; (3) whether early parent death affects the age of terminating full-time education; and (4) whether early bereaved subjects lag behind their non-bereaved contemporaries in social class status. The study shows that parental social class does influence the outcome of early parent death and that early bereaved subjects do lag behind in social class status.

Effects of parental deprivation: an overview of literature and report on some current research

The present paper reviews some pertinent literature on the effects of parental deprivation during early childhood. Several studies of parental separation during early childhood are presented. These studies tend to show that separation of child from parents, either for a short or a long period, will result in significant behavioral change.

Childhood experience and depression

The possibility of a relationship between early parental loss and mental illness, suicide, or delinquency in later life is a well-known, although by no means universally accepted, theory. In this investigation, we have attempted to compare patients with carefully matched controls and to investigate, when possible, the various categories of depression separately. Also, as we felt that a study concerned with childhood deprivation based solely on the physical absence of parents would tell us little of the daily emotional experiences of the child, we have attempted to take into account the quality of the family relationships present in childhood.

Life events and psychiatric illness. A study of 100 patients and 100 controls

Many investigators have studied the relationship between life events and psychiatric illness to discover whether certain events predispose to some disorders or precipitate them, and to discover the effect of illnesses already in progress on subsequent life events and the effect of events on established illnesses. The validity of such studies depends, among other things, on the selection of suitable controls. For example, if adult patients with depression differ from a group of controls in that they had a higher incidence of parental death, it might indicate that bereavement had made them more susceptible to the development of the illness. But if the depressed patients were from a lower social class than their controls, the greater incidence of bereavement might be explained by the fact that there is a higher death rate in that stratum of society. This would then cast doubt on a conclusion about a causal relationship in that group between childhood bereavement and depression in adult life.

Childhood bereavement and adult depression

The effect that childhood experience may have upon the individual's adult life has always been a subject of great interest.

Since the publication of Freud's essay on “Mourning and Melancholia” (1917), much thought has been devoted to the influence of bereavement in childhood, more especially as an antecedent to depressive illness in the adult. Bereavement is peculiarsluyitable for such an investigation since the death of a parent is one of the few reasonably frequent events which are largely independent of the behavioural pattern of the family.

Intactness of the home and behavioural problems in children

Referral problems for children in out-patient psychiatric clinics were compared for intact homes and for broken homes in which parents were widowed, divorced, separated, unmarried or "other". All varieties of broken homes were over-represented in the clinic population compared to the general population; intact homes were under-represented. Type of home was significantly differentiated by four referral problems: anxiety and neurotic symptoms, aggression, anti-social behaviour, and problems of habit formation. The evidence suggests that the broken home should not be treated as a unitary concept.

Childhood bereavement and subsequent psychiatric disorder

Introductory View

Bereavement is only the most measurable of many possible traumata in childhood; it is fortunately not the commonest and its frequency is still diminishing.

Childhood bereavement and psychiatric illness

The accidental event of childhood bereavement by death of a parent, and its possible importance in the later development of psychiatric illness, has been under study in recent years. It is a truism to state that, in the present organization of European society, such an event is a catastrophe, but whether bereavement is an event of aetiological importance in mental illness has not yet been decided.