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Long-term consequences of parental death in childhood: Psychological and physiological manifestations

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Abstract

• It has been widely theorized by researchers and clinicians that adverse childhood family experiences are linked to the development of some forms of psychopathology in adulthood. Types of adversity commonly thought to increase long-term vulnerability include abusive treatment; neglectful parenting; and family disruptions as a result of divorce, abandonment, or death of a parent. The focus of this chapter is on the long-term consequences of the early death of a parent. Although many years of research support links between childhood parental loss and the occurrence of certain forms of psychological disorder in adulthood, a number of studies have failed to find clear associations. The inconsistency in findings has led many theorists to disregard parental loss as a risk factor for later psychological disorder and others to suggest the need to go beyond main effects models to identify key pathways and moderators of outcomes (e.g., Sandler, 2001; see also chap. 25, this volume). Although less studied, recent evidence (Agid et al., 1999; Krause, 1998) also shows that early parental loss may influence physical health in later years, potentially through the development of neurobiological and physiological systems associated with stress-related illness. Like studies of psychological outcomes, some studies of stress-related illness have failed to find main effects of parental loss on physical health outcomes, further supporting the importance of moderating factors. (PsycINFO Database Record (c) 2015 APA, all rights reserved) • It has been widely theorized by researchers and clinicians that adverse childhood family experiences are linked to the development of some forms of psychopathology in adulthood. Types of adversity commonly thought to increase long-term vulnerability include abusive treatment; neglectful parenting; and family disruptions as a result of divorce, abandonment, or death of a parent. The focus of this chapter is on the long-term consequences of the early death of a parent. Although many years of research support links between childhood parental loss and the occurrence of certain forms of psychological disorder in adulthood, a number of studies have failed to find clear associations. The inconsistency in findings has led many theorists to disregard parental loss as a risk factor for later psychological disorder and others to suggest the need to go beyond main effects models to identify key pathways and moderators of outcomes (e.g., Sandler, 2001; see also chap. 25, this volume). Although less studied, recent evidence (Agid et al., 1999; Krause, 1998) also shows that early parental loss may influence physical health in later years, potentially through the development of neurobiological and physiological systems associated with stress-related illness. Like studies of psychological outcomes, some studies of stress-related illness have failed to find main effects of parental loss on physical health outcomes, further supporting the importance of moderating factors. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
... This is due to high caregiver-to-child ratio in the residential institutions which limits contact with an adult figure for redress opportunities (Government of Ghana, 2007;Merz & McCall, 2010). They also tend to have limited contact with their families (Luecken, 2008) and access to adults outside of the residential institution for external support due to stigma and restrictions of movement because of institutional regulations (UNICEF, 2017). Due to these limitations, peers become a very important source of contact and support to children in residential care (Salifu Yendork & Somhlaba, 2015a, 2015c, 2015d. ...
... These accounts show the significance of restoration of broken relationships to the participants. Peers are a major source of social network and interaction for children placed in residential care (Salifu Yendork & Somhlaba, 2015b, 2015c, 2015d due to the minimal contact they have with institutional caregivers as a result of high child-to-caregiver ratio (Merz & McCall, 2010) and limited or lack of contact with their families (Luecken, 2008). This perhaps explains why all attempts are made towards repair of broken relationships rather than holding a grudge and waiting for the person who caused harm to ask for forgiveness. ...
Article
Children placed in children’s homes encounter negative experiences in the form of abuse from caregivers, interpersonal conflicts with peers and victimizations from community members. How these children negotiate forgiveness of these negative experiences is unknown due to limited studies on the subject. The present study explored the nature of negative experiences reported by children in residential care, their understanding of forgiveness, as well as the process and motivations for extending forgiveness. Participants were 10 children in residential care, aged between 9 and 18 years, resident in two Children’s Homes in Accra. Results from these interviews show that while participants have cordial relationships with their peers and caregivers, they experience daily relational problems in the form of insults, bullying, being lied about, teasing and denial of gift items. Their knowledge of the meaning of forgiveness is largely different from all the three existing conceptualizations of the concept, and is influenced by religious, contextual factors in their relationships and the perceived benefits of forgiveness. Forgiveness process involved deferral to God, educating or confronting the offender on the impact of their behavior and reporting the offender to an authority. Implications of the findings are discussed.
... Thus, results from such behavioral assessments (e.g., Behavior Assessment System for Children, Third Edition) may need to be considered more critically given the social-emotional context in which the administration is occurring. However, research on the impact of death and grief on child development and learning over the life span has shown that the negative effects can be both immediate and long-term (Brent et al., 2012;Cohen & Mannarino, 2011;Luecken, 2008). Similarly, trauma research has illustrated repeatedly the deleterious effects of trauma on all facets of a child's well-being, including learning (e.g., Horsman, 2004;Sitler, 2009). ...
Article
The COVID-19 crisis and the subsequent social distancing measures have imposed numerous challenges on school psychologists balancing public health and students’ right to a free and appropriate education. This article addresses one of the most contentious issues for school psychologists during the pandemic: how to ethically conduct valid psychoeducational assessments without placing anyone’s health at risk. Legal guidance and regulations pertaining to special education evaluations during the pandemic are first delineated, followed by a discussion of the feasibility of tele-assessment from ethical, legal, and implementational perspectives. Lastly, based on the epidemiological knowledge of COVID-19 transmission and practices implemented in other countries, a protocol for special education assessment is introduced that aims at assisting school psychologists to conduct necessary assessments in face of the ongoing pandemic.
... Indicators of emotional arousal, such as activity of the autonomic nervous system (ANS; Kreibig, 2010), may provide insight into the regulatory mechanisms involved in unresolved states of mind. Previous studies suggest that adults' recall of childhood loss or trauma is associated with dysregulated ANS reactivity (Bernstein, Measelle, Laurent, Musser, & Ablow, 2013;Dale et al., 2018;Koopman et al., 2004;Luecken, 2008). Thus far, only one study investigated the relation between unresolved states of mind and ANS reactivity during the AAI, using a sample of adolescents (Beijersbergen, Bakermans-Kranenburg, Van IJzendoorn, & Juffer, 2008). ...
Article
Unresolved loss/trauma in the context of the Adult Attachment Interview (AAI) has been theorised to result from dissociative processing of fear-related memories and ideas. To examine the plausibility of this model, this study tested hypothesised associations between unresolved loss/trauma and indicators of autonomic nervous system (ANS) reactivity. First-time pregnant women (N = 235) participated in the AAI while heart rate (interbeat interval; IBI) and indicators of parasympathetic reactivity (respiratory sinus arrhythmia; RSA) and sympathetic reactivity (pre-ejection period; PEP, skin conductance level; SCL) were recorded. Using multilevel modelling, ANS reactivity was examined in relation to topic (loss/trauma versus other questions); discussion of actual loss/trauma; classification of unresolved/disorganised; and unresolved responses during the interview. Responses to loss/trauma questions and discussion of loss were associated with respectively larger and smaller IBIs. There was no moderation by unresolved/disorganised status. Unresolved responses about loss were associated with smaller IBIs. Participants classified as unresolved/disorganised showed decreasing PEP and blunted SCL throughout the whole inter- view. The findings suggest that unresolved speech about loss co-occurs with physiological arousal, although the inconclusive findings regarding parasympathetic and sympathetic nervous system responses fail to clearly support the role of fear.
... Losing a parent to death or to divorce as a child was also associated with experiencing IPV (Alzahrani et al., 2016). From a psychological perspective, all these factors could be interpreted as early traumatization that led to either experiencing or perpetrating violence later in life (Høeg et al., 2016(Høeg et al., , 2018Luecken, 2008). ...
Article
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Intimate partner violence (IPV) profoundly damages physical, sexual, reproductive, and psychological health, as well as social well-being of individuals and families. We sought in this systematic review to examine the risk factors according to the integrative ecological theoretical framework for IPV for women living in the Arab countries. We searched Embase, PubMed, PsycINFO, and SCOPUS, supplemented by hand searching of reference lists. A research strategy was developed and observational studies were included if they considered female participants (age ≥13) in heterosexual relationships, estimates of potential risk factors of IPV, and IPV as a primary outcome. We conducted a narrative synthesis of the risk factors data from 30 cross-sectional studies. Factors associated with increased IPV against women were extracted and categorized into four levels according to the updated integrative ecological model. At the individual level, risk factors were either related to victims or perpetrators of IPV. Factors relating to marriage, conflict within the family, etc., were explored and included within the family level, whereas factors relating to the extended family and the nature of marriage were included in the community level. Finally, risk factors relating to the cultural context that are influenced by the political and religious backgrounds were included in the societal level. The complex structure of violence against women in the Arab world calls for socioculturally sensitive interventions, which should be accompanied by systematic and structured work aimed at improving Arab women’s status at all levels.
... It is also a preventive intervention and aims to build resilience in the participating children. FTI might be needed in families where a parent has a life-threatening illness, to reduce the psychological problems that may arise for children, both in bereavement and many years after the loss of a parent (Bylund Grenklo, et al., 2014;Luecken, 2008). As a part of the FTI method, the interventionists always ask each child whether they have permission to share his/her story (derived from Meeting 3) with the parents. ...
Article
Having a parent with a life-threatening illness is challenging throughout the illness trajectory, and for some also in bereavement. Article 12 of the United Nations Convention on the Rights of the Child states a child’s right to express their opinion and have it respected in processes that affect them. The aims of this paper were to explore the child’s active participation in a family support programme, the Family Talk Intervention, in accordance with Article 12, when having a parent cared for in palliative care. Twenty families with 50 children participated. Fieldnotes were taken during the programme and later analysed with interpretive descriptions. The study shows that all children were listened to, but only a quarter reached the minimum point required in Article 12, where their views were taken into account. The Family Talk Intervention in palliative care would benefit from implementing a child-centred approach in order for all children to be active participants.
... In a previous study of the CES, parent/sibling death was omitted due to a lack of convergence with other ACEs and mental health outcomes (Author, 2017), but it was included in this study due to its modest correlation with other ACEs in the combined sample. Although the death of a parent or sibling is often a profound experience, neither parent nor sibling death has been consistently linked to longterm consequences (Fletcher, Mailick, Song, & Wolfe, 2013;Luecken, 2008), and it remains an open question if this form of loss should be defined as an ACE. These exceptions notwithstanding, evidence of model invariance across three distinct samples increases confidence in the results. ...
... Although the literature on the long-term effects of childhood parental death is limited, the literature on the short-term effects of childhood parental death is fairly substantial (Davies & Limbo, 2010). For instance, parentally bereaved children are at increased risk of psychological effects such as depression (Mack, 2001) and other affective disorders (Luecken, 2008), as well as physiological effects such as metabolic syndrome (Alciati et al., 2013) and poor health behaviors (Repetti et al., 2002). These children are also more likely to experience difficulty after parental death if family and peer relationships are strained prior to parental death (Ribbens McCarthy & Jessop, 2005) or if additional changes and losses occur after parental death (Christ et al., 2005). ...
Article
This qualitative study examined the long-term experience of childhood parental death by exploring how adults (a) retrospectively conceptualize their experiences of childhood parental death and (b) currently experience their parent’s death. Analysis of interviews with 12 adults who experienced parental death as children identified six themes centered on the impact of parental death circumstances, their initial reactions, other losses, long-term grief triggers, and relationships with the deceased parent, surviving parent, and other family members on their grieving process. Themes indicated the grief experience was ongoing and connected to attachment needs.
... Consequently, the circumstances of the loss and the child's perception of the death as well as the impact on the child's life need to be taken into account when classifying a loss as traumatic (Kaplow, Layne, Pynoos, Cohen, & Lieberman, 2012). The experience of interpersonal loss in childhood has been described as a significant adverse life event (Kaplow, Saunders, Angold, & Costello, 2010) and a risk factor for mental health and social problems (Luecken, 2008). ...
Article
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Loss is a commonly experienced traumatic event among children. Although the experience of loss can potentially lead to posttraumatic stress symptoms (PTSS), little is known about PTSS levels after traumatic loss versus other traumatic events. We investigated data from a randomized controlled trial (RCT) on trauma‐focused cognitive behavioral therapy (TF–CBT) versus a waitlist condition for children with PTSS. In a secondary analysis, we compared participants who reported traumatic loss as their index event (n = 23) to those who reported the two most frequently reported index events in the RCT: sexual abuse (SA; n = 59) and physical violence (PV; n = 55). The index event was rated according to the participants’ most distressing traumatic event reported on the Clinician‐Administered PTSD Scale for Children and Adolescents. Participants who experienced traumatic loss reported fewer PTSS and better general functioning than those who reported SA. A subgroup RCT (n = 19) revealed TF–CBT to be highly effective in reducing PTSS in cases of traumatic loss, d = 1.69. The effect sizes for PTSS indicated that all three trauma groups benefited from TF–CBT. In the waitlist group, PTSS symptoms improved for SA and PV, ds = 0.76 and 0.98, respectively, but not for traumatic loss, d = 0.23. These findings suggest that TF–CBT is a feasible and promising treatment for children who experience PTSS after traumatic loss. The results are limited by the post hoc quality of the analyses and lack of a measure of grief in the RCT.
... Conversely, several studies have suggested that parental loss in childhood is not negatively associated with earnings and occupational status attainment in adulthood (Biblarz and Gottainer 2000;Corak 2001;Lang and Zagorsky 2001). These considerable inconsistencies in studies on long-term effects of early parental death on health and labor market outcomes have led researchers to suggest that moderating factors, such as the child's age at bereavement and the sex of the deceased parent, play an important role in explaining this relationship (Luecken 2008). ...
Thesis
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Parental death in childhood, which is often referred to as demographic stress, is a traumatic event that may influence an individual’s life course in many different ways. This doctoral thesis therefore aims to investigate how individuals responded to parental death in the family and how this potential threat to their well-being affected children’s transition to adulthood, thereby focusing on the Netherlands in the period 1850-1952. Studying the consequences of parental death is relevant because a large share of the population was confronted with the death of a parent in the past. For instance, nearly one out of four children born in the study area between 1850 and 1880 lost a parent by the age of 16. In this doctoral thesis, three outcomes related to the transition to adulthood are researched in detail: age at first leaving home, entry into first marriage, and occupational position in young adulthood. Moreover, systematic changes in family dynamics such as parental remarriage, family dissolution, and outmigration following the death of a parent are examined. The Historical Sample of the Netherlands (HSN) is exploited which contains rich information about the life courses of 37,000 male and female individuals born in the Netherlands between 1850 and 1922. Quantitative methods such as event-history analysis are applied to compare the adulthood transitions of parentally bereaved individuals with those of their nonbereaved counterparts. The results show that parental death strongly accelerates non-marital home leaving, whereas the transition to marriage is hardly affected by the loss of a parent. The most consistent finding of this interdisciplinary thesis reveals that a mother’s death is generally more disruptive than a father’s death. Given the structural differences in the allocation of tasks between husband and wife in the study period, this indicates that from a life course perspective the loss of parental care in childhood is more harmful than a decline in economic resources and living standards.
Article
Background International interest in adverse childhood experiences (ACE) is on the rise. In China, recent research has explored the effects of ACEs on health-related outcomes, but little is known about how ACEs impact the psychological functioning of rural Chinese youth as they make transition to adulthood. Objective This study is aimed to assess the prevalence and psychological consequences of ACEs among a group of rural Chinese young adults. Participants and settings 1019 rural high school graduates from three different provinces of China participated in this study. Methods A web-based survey was used to assess ten conventional ACEs and seven other novel ACEs using the Childhood Experiences Survey. Using validated brief measures, six indicators of psychological functioning were assessed: anxiety, depression, perceived stress, posttraumatic stress, loneliness, and suicidality. Descriptive and correlational analyses of all ACEs were performed, and multivariate regressions were conducted to test associations between ACEs and study outcomes. Results Three-fourths of Chinese youth endorsed at least one of ten conventional ACEs. The most prevalent ACEs were physical abuse (52.3 %) and domestic violence (43.2 %). Among seven new adversities, prolonged parental absence (37.4 %) and parental gambling problems (19.7 %) were most prevalent. Higher conventional ACEs scores were significantly associated with poorer psychological functioning, and each type of new adversity was associated with one or more psychological problems. Conclusion ACEs were prevalent among rural Chinese young adults and had deleterious effects on their psychological well-being. Further work is needed to address ACEs by developing culturally appropriate assessment practices, interventions, and policy responses.
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