Caregivers' positive emotional expression and children's psychological functioning after parental loss

Investigation of Childhood Traumas of Individuals Who Experienced Parental Death in Childhood or Adolescence in Turkey

This study investigates the childhood traumas of individuals who experienced parental death in childhood or adolescence in Turkey. Participants (n = 382; 63.1% female and 36.9% male; MAGE=29.41, SD = 9.6) are composed of individuals who lost either or both of their parents before the age of 18. The findings indicated that there is a significant difference between the subdimensions of Childhood Trauma Questionaire and the study variables including gender, marital status, educational status, number of siblings, gender of the deceased parent, the caregiver after the parental death, relationship with the surviving parent and the age at the time of parental death (p < .05). The results further show that individuals who lost their parents before the age of 10, who lost their mothers, and who received care from other relatives instead of parents are exposed to more neglect and abuse. By identifying childhood traumas in individuals and examining related variables, the findings contribute trauma-informed social work practices. Based on the results, it is recommended that school social work programs focus on monitoring the relationship between caregivers and children, as well as enhancing the psychosocial well-being of students. These programs can also serve as a means to raise awareness among professionals and students.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-024-00629-2.

Measurement invariance of the Grief Facilitation Inventory with respect to youth gender, race, ethnicity, and age

The Grief Facilitation Inventory (GFI) assesses caregiver grief facilitation behaviors among bereaved youth. Initial analyses supported the GFI's reliability and validity. The purpose of this study was to evaluate measurement invariance of the GFI across gender, race/ethnicity, and age. Participants were 558 clinic-referred youth aged 7-18 (58.8% female; 43.6% Latino(a), 24.9% White, 14.9% Black, 16.6% Multiracial). Multigroup confirmatory factor analyses provided evidence of measurement invariance for ongoing connection, caregiver grief expression, and existential continuity and support-but not grief inhibition/avoidance-across subgroups. Results suggest that ongoing connection, caregiver grief expression, and existential continuity and support are measuring similar constructs, to a similar degree, across demographics, thereby supporting generalizability and clinical utility of these subscales. The grief inhibition/avoidance subscale should be used with caution and interpreted in the context of low reliability for Black, Latino(a), and younger youth, with further research needed to improve conceptualization and measurement of this subscale.

Individual and systemic variables associated with prolonged grief and other emotional distress in bereaved children

Most children confronted with the death of a loved one do not experience persisting psychological problems. However, for some, acute grief reactions develop into prolonged grief disorder (PGD) and other mental health problems. Research findings suggest that bereavement outcomes in children are associated with negative cognitions and avoidant coping and with different parenting behaviours. However, knowledge about factors influencing grief in children is still limited and few studies have examined the relative impact of psychological (individual-level) variables and systemic (family-level) variables in affecting their responses to loss. The aim of the current study was to examine the association of different bereavement outcomes in 8-18 year old children (including levels of self-rated PGD, depression, and posttraumatic stress (PTS)) with sociodemographic variables, individual-level variables (including negative cognitions and anxious and depressive avoidance), and family-level variables (including the severity of caregiver's PGD, depression, and anxiety, and indices of parenting behaviours, rated both by children and by their caregivers). Questionnaire data were used from 159 children plus one of their caregivers, gathered as part of the pre-treatment assessment in a randomized controlled trial. Results showed that most of the children's bereavement outcomes, including PGD severity and PTS severity, were associated with indices of negative cognitions and avoidance behaviours. Caregiver's depression and anxiety showed a very small, yet significant, association with two children's outcomes. Caregiver-rated reasoning/induction (one index of parenting behaviours) showed a small association with children's PTS-related functional impairment. Exploratory analyses indicated that the linkage between parenting behaviour and children's outcomes may be moderated by whether the behaviour comes from father or mother. This is one of the first studies examining how individual cognitive behavioural variables plus the mental health of caregivers and indices of parenting may affect PGD and other outcomes in bereaved children. The findings provide tentative indications that individual and family-level variables influence these outcomes, albeit that more research is urgently needed.

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.

Caregiver behaviors associated with positive youth development among bereaved children

Grounded in Multidimensional Grief Theory, this study examined the cross-sectional associations between child-reported caregiver grief facilitation behaviors (ongoing connection, grief expression, existential continuity and support, grief inhibition/avoidance) and positive youth development outcomes (future orientation, gratitude, social responsibility) in treatment-seeking bereaved children ages 7 to 18 (N = 170; 54.1% girls; 35.9% Hispanic/Latinx, 24.9% White, 17.8% Black) from the United States. Results indicate that higher levels of perceived caregiver existential continuity and support (behaviors theorized to promote the continuity of child routines and reassurance of a positive future after experiencing a death) were associated with greater future orientation and social responsibility values among participants. Findings suggest that in the wake of a death, structured and supportive caregiver responses may be related to children's positive outlook on their future and commitment to others.

The relationship between social acknowledgment and prolonged grief symptoms: a multiple mediation effect of beliefs about the goodness and controllability of grief-related emotions

Background: Social acknowledgment is a protective factor for survivors of trauma. However, the role of social acknowledgment in association with prolonged grief symptoms has not yet been established.Objectives: The current study aims to explore the relationship between social acknowledgment and prolonged grief via two beliefs foundational to how people think about grief-related emotions (1) goodness (i.e. whether emotions are desirable, useful, or unwanted and harmful), and (2) controllability (i.e. whether emotions are regulated according to our will or involuntary, arising of their own accord). These effects were explored in two different cultural samples of bereaved people.Methods: One hundred and fifty-four German-speaking and two hundred and sixty-two Chinese bereaved people who lost their loved ones completed questionnaires assessing social acknowledgment, beliefs about the goodness and controllability of grief-related emotions, and prolonged grief symptoms.Results: Correlation analyses showed that social acknowledgment was positively linked with stronger beliefs about the goodness and controllability of grief-related emotions and negatively related to prolonged grief symptoms. Beliefs about the goodness and controllability of grief-related emotions correlated negatively with prolonged grief symptoms. Multiple mediation analyses suggested that beliefs about the controllability and goodness of grief-related emotions mediated the link between social acknowledgment and prolonged grief symptoms. Cultural groups did not moderate the above model.Conclusion: Social acknowledgment may be related to bereavement adjustment consequences via the roles of beliefs about the goodness and controllability of grief-related emotions. These effects seem to be consistent cross-culturally.

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.

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

The death of a family member affects not only individual family members but also their relationships and interactions. Grief has been studied mostly as an intrapersonal experience. Adopting the family perspective, this systematic scoping review focused on parent-child relationships in widowed families so as to identify what is already known on this topic and the research gaps for future study. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Four databases (Web of Science, Psycinfo, PubMed, and CINAHL Plus) were searched. Search terms were combinations of two concepts: (1) loss of a parent (20 terms) and (2) parent-child (eight terms). 5,419 studies were identified during the search, of which 36 studies were included in the review following two rounds of screening. Four research themes emerged, and the aggregated findings were identified: (a) The surviving parent and children are likely to become closer following the loss of a parent, while other relevant factors need to be taken into account; (b) Better parent-child relationships play a protective role in children's adjustment to loss; (c) The surviving parent and children's adjustment to loss are interdependent; (d) Through parenting, communication style, coping strategy, and other attributes, the surviving parent can influence their children's adjustment. Gender and age differences were identified in parent-child relationships. The findings further justify the importance of a family perspective when conducting research and practice on bereavement. Several research gaps were identified. Existing studies paid insufficient attention to children's agency and bidirectional relationships, and the interaction process and its role underlying parent-child bidirectional causality. A conceptual framework of parent-child relationships in widowed families is proposed based on these findings.

Caregiver behaviors and childhood maladaptive grief: Initial validation of the Grief Facilitation Inventory

The Grief Facilitation Inventory (GFI) is a newly-developed measure of caregiver behaviors theorized to facilitate or hinder children's adaptive grief reactions. We examine its factor structure, reliability, and validity. An exploratory factor analysis identified four factors: Ongoing Connection, Existential Continuity/Support, Caregiver Grief Expression, and Grief Inhibition/Avoidance. Both child- and caregiver-report versions had adequate-to-good internal consistency. The child-report GFI showed evidence of criterion-referenced validity via significant correlations with measures of child maladaptive grief and other psychological symptoms. Results provide preliminary evidence of the reliability, validity, and clinical utility of the GFI as a measure of caregiver grief-facilitation behaviors.

Initial Validation and Measurement Invariance of the Active Inhibition Scale Among Traumatized and Grieving Youth

The Active Inhibition Scale (AIS; Ayers, Sandler, & Twohey, 1998) is an 11-item, self-report measure of emotional suppression among children and adolescents. Previous research with the AIS has linked emotional suppression to several clinically significant outcomes, such as posttraumatic stress symptoms (PTSS) and suicide, among trauma-exposed and bereaved youth; however, there are no published evaluations of its psychometric properties. We examined the factor structure and criterion validity of the AIS in two samples. Sample 1 included youth (M = 12.22 years, SD = 2.96, range: 6-18 years; 55.4% female) referred to an outpatient psychology clinic specializing in childhood trauma and grief. Sample 2 included youth (M = 13.18 years, SD = 2.58, range: 8-18 years; 61.8% female) referred to a community grief counseling center. Confirmatory factor analytic results supported a one-factor solution, Cronbach's α = .94. Additionally, AIS scores correlated positively with PTSS, depression, and maladaptive grief, rs = .43-.64. Evidence of factorial invariance was found across gender, race/ethnicity, and age group. Emotional suppression scores were higher among girls compared to boys, Black and Hispanic youth compared to White youth, and older compared to younger age groups. The magnitude of correlations between AIS and symptom measure scores was comparable across groups. These results support the reliability and criterion validity of the AIS with diverse youth populations and underscore the role that emotional suppression may play in explaining group differences in mental health symptoms.

Expressions of Grief in Online Discussion Forums-Linguistic Similarities and Differences in Pet and Human Bereavement

We compared online discussion forum posts related to pet loss to those related to human bereavement. Posts (N = 401) were analyzed using the Linguistic Inquiry and Word Count software for frequencies of word use relevant to bereavement. Words related to anger, sadness, and negative emotions were used at similar frequencies for all grief. Sibling loss was associated with using first person pronouns at higher frequencies, and positive emotion words at lower frequencies than other categories of loss. There were some similarities in partners and pets in the word use related to friends and social connectedness. Words related to religion were highest when writing about losing a child and lowest when losing a pet. Our results highlight the similarities in the vocabulary in pet and human bereavement. Findings demonstrate the importance of online discussion forums for understanding the process of grief and specific relationship types.

Associations between dimensions of religiousness and psychosocial functioning among bereaved youth

Using a sample of recently bereaved youth (N = 2,425; M_age = 15.31, SD = 1.50), this study examined associations between dimensions of religiousness and current functioning. Youth reported on their religious service attendance, religious coping, and the importance of religious beliefs and substance use, academic achievement, depressive symptoms, and self-esteem. Greater religious service attendance was associated with lower substance use and the greater importance of religious beliefs was associated with lower substance use and greater self-esteem. Greater religious coping was associated with greater academic achievement. Findings suggest distinct dimensions of religiousness may have differential implications for adolescent functioning after experiencing loss.