Long-term impact of sudden infant death: a 12- to 15-year follow-up

Remembered parenting style and psychological well-being in young adults whose parents had experienced early child loss

BACKGROUND

Pre-, peri-, or postnatal childloss can have devastating consequences for bereaved families. This study explored the long-term sequelae of these experiences for the young adult siblings' psychological well-being and the perceived quality of parenting received during participants' first 16 years of life.

METHODS

A bereaved group of young adult siblings was compared to a non-bereaved group on the Parent Bonding Instrument, the Rosenberg Self-esteem Scale and the Mental Health Index-5.

RESULTS

The loss group reported their mothers, but not their fathers, to have been more protective/controlling than non-bereaved participants. No differences between the loss group and the comparison group were found for parental care, their own mental health or self-esteem. Those participants whose siblings died during the peri/post-natal period perceived their parents as more controlling than the miscarriage group as well as the non-bereaved group. Higher protection scores were evident among those born subsequent to the loss than those who were born before. Lower levels of protection were associated with better mental health across all groups. In the non-bereaved group lower levels of protection were associated with better self-esteem, but in the bereaved group a different even opposite pattern was shown.

CONCLUSIONS

Young adults who lost a sibling when they themselves were under 5 recall their mothers as more protective/controlling than non-bereaved groups, although they do not report less care nor differ in mental health nor self-esteem. Higher levels of parental protection/control were found where the child was born subsequent to loss and for peri/post-natal loss rather than miscarriage. While high protection was associated with poorer mental health regardless of loss this may not be necessarily disadvantageous to the child's self-esteem. Differences with regard to parent gender were found.

Fathers’ Perspectives During Pregnancy, Postperinatal Loss

OBJECTIVE

To present information about the father's perspective during the experience of a pregnancy following perinatal loss.

DESIGN

Descriptive phenomenology.

SETTING

Interviews were done in a venue chosen by fathers (home, clinic).

PARTICIPANTS

Ten fathers who had experienced a loss within the prior year and were currently with that partner in a subsequent pregnancy. FOUR THEMES EMERGED: Recognition, preoccupation, stoicism, and support.

CONCLUSIONS

Participants describe the need to be recognized by others. The orderly conduct of their daily lives is disrupted by preoccupation with the pregnancy. They feel unable to share their own anxiety and fear because they want to protect the mothers. Societal pressure to "be strong" and the belief that "men don't share" appear to inhibit fathers from getting support. Strategies to assess and support fathers emotionally at the time of loss and in the subsequent pregnancy need to be explored.

Parental coping with sudden infant death after donor insemination: case report

We report the case of an artificial donor insemination couple experiencing sudden infant death of their 8-month-old child. Six months after the incident, the couple were investigated by means of an extensive interview, a repertory grid investigation and the Family Assessment Measure, as well as at 6 years after the incident by an extensive interview. The results show the importance of the diagnosis of male infertility and the preceding fertility treatment for coping with the death of their child. Six months after the incident, acute feelings associated with bereavement are mixed with feelings of anger and shame, apparently due to the experience of infertility. However, secrecy and shame associated with male infertility and donor insemination make it impossible for the couple to communicate their feelings to each other or to friends and relatives; furthermore, they decline psychological counselling. Repertory grid investigation and the Family Assessment Measure point to significant problems within the partnership. Six years after the incident, the couple's relationship is destabilized and both partners plan to divorce. We suggest a possible link between donor insemination secrecy and difficulties with coping. We discuss implications for couple counselling and emphasize the necessity for an improved legal framework for donor insemination in Germany.

Explanatory model of health in bereaved parents post-fetal/infant death

In order to identify which features contribute to attenuating or intensifying the deleterious consequences of a perinatal loss such that some family systems endure and sometimes even thrive when faced with such a situational stressor, while other family units seem to deteriorate and disintegrate under similar circumstances, an explanatory model of health was tested. The purpose of this longitudinal study was to examine how the relationships between the elements in the model namely: resources both internal (hardiness) and external (marital and social supports), as well as appraisal of the situation, predicted the health of 110 bereaved couples (husbands and wives).

Strategies of professional assistance after traumatic deaths: Empowerment or disempowerment?

Referring to research and theory in the field, this discussion paper addresses the more overarching question of current strategies for professional assistance to populations bereaved by traumatic death. The issues and controversies that have long surrounded the "medicalization" of mental health arise anew with respect to the medicalization and professionalization of psychosocial help for people who have been traumatically bereaved. Who should provide what help and how? To what extent should the bereaved be expected to help themselves, receive help and support from friends and family, or even the wider community; and to what extent should the bereaved be able to access appropriate professional help when they are in crisis? Recent studies have indicated that bereaved parents want to receive help from mainstream crisis psychology, and this is not always available. Families experiencing traumatic bereavement are not able to access appropriate services along the same lines as those suffering similar levels of somatic complaints. It is argued that the main factors contributing to this situation are the lack of knowledge and inadequate organization of services; the fact that somatic issues take priority over psychosocial difficulties and dysfunction, and curative services over prophylactic intervention; and particularly the de-medicalization ideology. By not listening to the needs of user groups, the de-medicalization movement disempowers rather than empowers users - the very opposite of the desired effect.

Bereaved parents’ experience of research participation

Despite the ethical codes guiding bereavement research, few studies have been conducted to evaluate the perceived stress experienced by the bereaved, and to explore which methodologies cause least distress. This article investigates how bereaved and traumatised populations experience research participation, and they voice their recommendations for future research. The data are from a nationwide three-phase study in Norway among parents who had lost their child by suicide, SIDS, and accidents between July 1, 1997 and December 31, 1998. Whereas the first phase reported quantitative results of perceived psychosocial health and focused on offered and ideal support (N=262), the second phase investigated the same issues through in-depth interviews of a sub sample (N=69). Phase three, reported here, included the responses of 64 parents to a short questionnaire evaluating research participation in the two previous phases. The results show that 100% of the parents experienced participation as "positive"/"very positive", and none regretted participating. They linked the positive experiences to being allowed to tell their complete story, the format of the interview, and a hope that they might help others. Apparently, processes of meaning reconstruction and increased awareness of the bereavement process were facilitated by the interviews. However, three-quarters of the interviewees reported that it was to a greater or lesser degree painful to talk about the traumatic loss. Regression analysis showed that being a woman and high levels of psychic distress were the most important predictors of a painful interview experience. In order to protect bereaved and vulnerable populations from harm, already existing ethical codes must be strictly applied, and the researchers must listen respectfully to recommendations from bereaved parents.

Old losses: a retrospective study of miscarriage and infant death 1926-1955

Childbearing-related losses of 16 elderly Caucasians (13 women and 3 men, aged 69-90) were examined retrospectively in this qualitative study. Recollections of social support, grief at the time of loss, and current meaning attributed to the loss were the foci of the study. Most respondents recalled having felt grief at the time of miscarriage, fetal death, or infant death, and most did not have lingering feelings of grief. Women who did not have grandchildren and who recalled insufficient social support appeared to be more vulnerable to feelings of lasting grief. A life course approach, which examines personal narrative in relation to ontological, generational, and historical time, fits with the interpretation given by elderly respondents to their childbearing losses.

Assistance from local authorities versus survivors' needs for support after suicide

As part of a larger study, this article describes the local authorities in Norway as providers of help and survivors as recipients of help after the suicide of a young person (<30 years) in 83 families. A questionnaire developed for this study maps the extent of professional community support as reported by parent survivors (N = 128). Additionally, 41 survivors described the quality of the assistance through in-depth interviews. Another questionnaire assesses the provisions and the organization of intervention strategies in local communities. Personnel in 321 of Norway's 481 municipalities responded. Although survivors' wishes for ideal support coincide with recommendations by experts in the field, local authorities lack the organization to fulfill such expectations. The discussion highlights issues relating to content, organization, and ideology of the assistance.

Refugee families' experience of research participation

Because refugees can experience crisis, bereavement, and traumatization, there has been a rapid increase of research carried out with refugees. This study investigated how refugee families respond to participation in research. A previous study explored how adults and children had communicated about the difficult question of repatriation after arriving in a new country. Did the in-depth interviews harm or benefit them? Are there any ethical risks in research on traumatized refugees? From an original sample of 74 Bosnian refugees (5-73 years), 30 family members from 9 families including 14 children aged 6 to 19, were re-interviewed. The refugees rated participation as positive. A few parents lacked information that could have enabled them to inform the children better before the interviews. The study shows that studies on traumatized/bereaved populations can have beneficial effects.