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Schaadt AS, Bidstrup PE, Dall IC, Rosthøj S, Karlsen RV, Guldin MB, Søholm A, Karstoft KI, Dalton SO, Høeg BL. Coping and grief symptoms after parental loss in adolescence - a nationwide follow-up study. DEATH STUDIES 2024:1-10. [PMID: 38941174 DOI: 10.1080/07481187.2024.2370464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Knowledge about effective coping strategies is important to support bereaved adolescents who have lost a parent. We used data on 104 bereaved adolescents (13-17 years) from the FALCON nationwide questionnaire study of parentally bereaved families. We examined associations between adolescents' control-oriented and escape-oriented coping strategies (KidCOPE scale) approximately two months after loss and grief symptoms (PG-13 scale) at six months follow-up. We also examined associations between the perceived efficacy of each coping strategy at baseline and grief symptoms at six months. The use of escape-oriented coping (e.g., distraction, self-criticism and social withdrawal) was associated with higher grief symptoms at six months follow-up (β = 0.4, 95% CI 0.1-0.9, p = 0.02), but no associations were found for control-oriented coping or perceived coping efficacy. Finding alternatives to the use of escape-oriented coping strategies may be an important part of grief interventions for bereaved adolescents.
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Affiliation(s)
- Anne Sophie Schaadt
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ida Cathrine Dall
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
| | - Susanne Rosthøj
- Statistics and Data Analysis, Danish Cancer Institute, Copenhagen, Denmark
| | - Randi Valbjørn Karlsen
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Amalie Søholm
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
| | | | | | - Beverley Lim Høeg
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
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Redican E, Shevlin M, Hyland P, Karatzias T, Martsenkovskyi D, Ben-Ezra M. Development and validation of the caregiver-report version of the international grief questionnaire (IGQ-CG): Results from a Ukrainian sample of parents. Clin Child Psychol Psychiatry 2024:13591045241260897. [PMID: 38869939 DOI: 10.1177/13591045241260897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
The International Grief Questionnaire (IGQ) is a self-report measure of ICD-11 Prolonged Grief Disorder (PGD) in adults. This study sought to develop and validate a caregiver-report version of the IGQ for children and adolescents aged 7-17 years; the IGQ-Caregiver Version (IGQ-CG). 639 parents living in Ukraine provided data on themselves and one child in their household as part of the "The Mental Health of Parents and Children in Ukraine Study: 2023 Follow-up" study. The latent structure of the scale was tested using confirmatory factor analysis (CFA), while convergent validity was assessed through associations with other mental health correlates. Prevalence rates of probable ICD-11 PGD were estimated. CFA results supported a correlated two-factor model ('core' and 'associated' symptoms) and the internal reliability of the scale scores were acceptable. Convergent validity was supported through significant correlations with internalizing symptoms, while contact with the deceased, time since bereavement, and parental PGD were associated with higher scores on the IGQ-CG latent variables. The prevalence of probable ICD-11 PGD was 1.4%, and amongst those with a lifetime bereavement, the conditional rate was 3.2%. The IGQ-CG produces reliable and valid scores for ICD-11 PGD symptoms in children and adolescents as reported by their caregivers.
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Affiliation(s)
- Enya Redican
- School of Psychology, Ulster University, Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Ireland
| | | | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Ukraine
- Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Ukraine
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Qureshi SP, Judson E, Cummins C, Gadoud A, Sanders K, Doherty M. Resisting the (re-)medicalisation of dying and grief in the post-digital age: Natural language processing and qualitative analysis of data from internet support forums. Soc Sci Med 2024; 348:116517. [PMID: 38593612 DOI: 10.1016/j.socscimed.2023.116517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 04/11/2024]
Abstract
In the mid-twentieth century, the social movement of death revivalism sought to resist the medicalisation of dying and grief through promotion of the dying person retaining autonomy, and societal openness toward death and bereavement. Despite this advocacy, present-day dying in high income countries is largely institutionalised, with value placed on control over the body and emotions. These phenomena are at odds with the ambitions of death revivalism, and demonstrate the re-medicalisation of dying and grief. Furthermore, contemporary society is continually advancing into the post-digital age, reflected in digital technologies being a tacit part of human existence. Within this framework, this study aims to investigate how people living with life-limiting illness and their loved ones experience, negotiate, and resist medicalisation of dying and grief through online internet forums. We collected posts through web-scraping and utilised Natural Language Processing techniques to select 7048 forum posts from 2003 to 2020, and initially categorise data, before utilising Inductive Thematic Analysis, which generated two major themes. The theme of 'Comfort' describes online forums facilitating psychosocial support which was often used to compensate for systemic deficiencies, especially during the Covid-19 pandemic. Common sources of comfort included animal companions and spirituality, in stark contrast with the medicalised model. The theme of 'Capability' describes online forums acting as solutions for people facing disempowering care systems, including providing information on legal rights and benefits which may not be otherwise easily available, and facilitating collective advocacy. Our findings indicate that community-led online forums can play an effective and sustainable role in democratising care and retaining agency when facing life-limiting illness and grief. Future palliative and bereavement care research must focus on how online forums can be integrated into existing systems, made transparent and accessible, be adequately funded and structured, and be optimised, including compensating for service disruption encountered during future pandemics.
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Affiliation(s)
- Shaun Peter Qureshi
- Centre for the Art of Dying Well, Faculty of Business and Law, St Mary's University Twickenham, London, TW1 4SX, United Kingdom.
| | - Ellen Judson
- Centre for the Analysis of Social Media, Demos, 15 Whitehall, London, SW1A 2DD, United Kingdom.
| | - Ciaran Cummins
- Centre for the Analysis of Social Media, Demos, 15 Whitehall, London, SW1A 2DD, United Kingdom.
| | - Amy Gadoud
- Lancaster Medical School, Lancaster University, Sir John Fisher Drive, LA1 4AT, United Kingdom; Trinity Hospice, Low Moor Road, Blackpool, FY2 OGB, United Kingdom.
| | - Karen Sanders
- Centre for the Art of Dying Well, Faculty of Business and Law, St Mary's University Twickenham, London, TW1 4SX, United Kingdom.
| | - Margaret Doherty
- Centre for the Art of Dying Well, Faculty of Business and Law, St Mary's University Twickenham, London, TW1 4SX, United Kingdom.
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Asgari Z, Naghavi A. Moving Forward: A Close Look at Healing Process After Traumatic Parental Death. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241250242. [PMID: 38687250 DOI: 10.1177/00302228241250242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Recovery from traumatic grief after parental loss is a challenging and gradual process. The current study aimed to capture the rich and nuanced experiences of adolescents' healing process after traumatically losing their parent(s). A phenomenological approach was utilized for data collection and analysis. To reach the research aim, interviews with 15 Iranian adolescents who had lost their parent(s) at least three-year ago were conducted. Two main themes from Colaizzi's analysis including Grief work and Rebuilding new life were extracted from data. Findings highlight an understanding of how adolescents with an experience of traumatic parental death would heal and could provide valuable insights into creating successful interventions and support systems tailored to help them cope with the devastating effects of traumatic loss and grief.
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Affiliation(s)
- Zahra Asgari
- Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Azam Naghavi
- Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
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Hanauer C, Telaar B, Rosner R, Doering BK. The efficacy of psychosocial interventions for grief symptoms in bereaved children and adolescents: A systematic review and meta-analysis. J Affect Disord 2024; 350:164-173. [PMID: 38218256 DOI: 10.1016/j.jad.2024.01.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The present meta-analysis investigates the efficacy of psychosocial interventions in bereaved children and adolescents. METHOD We conducted a systematic review searching PsycINFO, PsycARTICLES, PubMed, MEDLINE, PSYNDEX, Web of Science, CINAHL and ERIC. Random-effects meta-analyses examined the effect of interventions on symptoms of grief, posttraumatic stress disorder (PTSD) and depression in controlled and uncontrolled studies. RESULTS We included 39 studies (n = 5.578). Post-treatment, preventive interventions demonstrated a significant effect on grief (uncontrolled studies: g = 0.29, 95%CI [0.09;0.48]; controlled studies: g = 0.18, 95%CI [0.03;0.32]). For symptoms of PTSD and depression, only uncontrolled preventive studies yielded significant effects (PTSD: g = 0.24, 95%CI [0.11;0.36]; depression: g = 0.28, 95%CI [0.10;0.45]). Interventions targeting youth with increased grief-related distress demonstrated a significant effect in uncontrolled studies on grief (g = 1.25, 95%CI [0.94;1.57]), PTSD (g = 1.33, 95%CI [0.85;1.82]) and depression (g = 0.61, 95%CI [0.45;0.77]). A controlled effect size could only be calculated for PTSD symptoms (g = 0.71, 95%CI [0.15;1.27]). LIMITATIONS Interventions varied widely, contributing to high heterogeneity. Only a small number of studies with mostly limited quality could be analysed. CONCLUSIONS Psychosocial interventions may ameliorate grief symptoms in bereaved youth, especially when targeting youth with elevated grief distress. However, the effects observed in uncontrolled studies are substantially reduced when controlling for the natural course of bereavement. Given the increasing number of children worldwide bereaved through ongoing crises, research on interventions is surprisingly sparse.
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Affiliation(s)
- Christina Hanauer
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Germany
| | - Berit Telaar
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Germany
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Chipalo E. Adverse Childhood Experiences and Mental Distress Among Adolescents and Youth in Zimbabwe. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241234660. [PMID: 38444122 DOI: 10.1177/08862605241234660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Adverse childhood experiences (ACEs) are a global public health crisis associated with physical and poor mental health outcomes. The current study examined the prevalence and association between individual and cumulative ACEs with mental distress among adolescents and youth in Zimbabwe. Data from the 2017 Violence Against Children and Youth Survey were utilized (13-25 years old, n = 8,715). Bivariate analysis was conducted using chi-square tests to obtain the prevalence estimates. Two sets of logistic regression models were conducted to determine significant associations between independent variables (i.e., experiencing childhood physical, emotional, and sexual violence; witnessing intimate partner violence (IPV) and community violence; orphan status; and cumulative ACE exposure) and the dependent variable (i.e., mental distress in the past 30 days as measured by Kelser 6). 28.4% of the adolescents and youth reported experiencing mental distress in the past 30 days. Regarding ACEs, cumulative ACE exposure (34.7%; adjusted odds ratio [AOR] = 2.13) and individual ACEs (i.e., experiencing childhood physical violence [39.3%; AOR = 1.41], emotional violence [55.8%; AOR = 2.67], sexual violence [50.8%; AOR = 2.00], witnessing community violence [47.3%; AOR = 1.52], witnessing IPV [43.1%; AOR = 1.47], and being orphaned during childhood [33.6%; AOR = 1.24]) were significantly associated with higher prevalence rates and odds of experiencing mental distress in the past 30 days among adolescents and youth in Zimbabwe. These findings show that ACEs are highly prevalent and increases the risk of mental distress for vulnerable adolescents and youth in Zimbabwe. Effective interventions to reduce violence exposure in families, schools, and communities are essential to mitigate the negative consequences of ACEs and mental distress of adolescents and youth in Zimbabwe. Strengthening child protection policies and involving social workers, psychologists, and mental health workers are also crucial for safeguarding vulnerable children who might be impacted by ACEs in Zimbabwe. Implications for future research are further discussed.
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Willi N, Pancoast A, Drikaki I, Gu X, Gillanders D, Finucane A. Practitioner perspectives on the use of acceptance and commitment therapy for bereavement support: a qualitative study. BMC Palliat Care 2024; 23:59. [PMID: 38418964 PMCID: PMC10900636 DOI: 10.1186/s12904-024-01390-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND There is currently a high demand for bereavement support coupled with inconclusive findings as to the efficacy of existing approaches. Acceptance and Commitment Therapy (ACT) aims to improve human functioning and has shown efficacy across a wide range of conditions. ACT may be a promising means of supporting bereaved people, yet evidence on the use of ACT for bereavement support is lacking. The aim of this study is to explore how ACT is currently used for bereavement support and practitioner perspectives of how it helps following bereavement. METHODS Semi-structured interviews were conducted online via MS Teams with practitioners experienced in using ACT for bereavement support. Data were analysed thematically guided by a framework approach. RESULTS Nine participants were recruited. Three themes were identified: (i) creating psychological space around grief; (ii) using psychological space for value-directed action in the midst of grieving, and (iii) adapting ACT for bereavement support. Practitioners indicated that ACT improves clients' relationship with distressing internal experiences. Metaphors and mindfulness techniques were used to encourage acceptance of grief responses, taking perspective on distressing thoughts and images, and contact with the present moment. Better relationships with distressing experiences were regarded as less psychologically taxing, improving coping and well-being, while providing the psychological space to engage in value-directed action. Values exploration, sometimes using metaphors and exercises, was seen as supporting the bereaved person to rediscover a sense of purpose and engage in meaningful activities alongside their grief. Practitioners used ACT flexibly, integrating other interventions, and adapted ACT to the perceived sensitivities of bereaved people, and age-related and developmental factors. CONCLUSION ACT is used to support people who have been bereaved to live effectively with the difficult thoughts and feelings associated with grieving and to enable them to gradually identify, reconnect with, and act in line with their values after loss.
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Affiliation(s)
- Nikolaus Willi
- Clinical Psychology, University of Edinburgh, Edinburgh, UK.
| | - Anna Pancoast
- Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Ioanna Drikaki
- Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Xueying Gu
- Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | | | - Anne Finucane
- Clinical Psychology, University of Edinburgh, Edinburgh, UK
- Marie Curie Hospice Edinburgh, Edinburgh, UK
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Hoppe R, Alvis L, Oosterhoff B, Kaplow J. Caregiver behaviors associated with positive youth development among bereaved children. DEATH STUDIES 2024:1-11. [PMID: 38288688 DOI: 10.1080/07481187.2024.2309475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
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.
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Affiliation(s)
- Rebecca Hoppe
- Trauma and Grief (TAG) Center at the Meadows Mental Health Policy Institute (MMHPI), Dallas, Texas, USA
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - Lauren Alvis
- Trauma and Grief (TAG) Center at the Meadows Mental Health Policy Institute (MMHPI), Dallas, Texas, USA
| | - Benjamin Oosterhoff
- Trauma and Grief (TAG) Center at the Meadows Mental Health Policy Institute (MMHPI), Dallas, Texas, USA
| | - Julie Kaplow
- Trauma and Grief (TAG) Center at the Meadows Mental Health Policy Institute (MMHPI), Dallas, Texas, USA
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Aguirre LC, Jaramillo A, Saucedo Victoria T, Botero Carvajal A. Mental health consequences of parental death and its prevalence in children: A systematic literature review. Heliyon 2024; 10:e24999. [PMID: 38304821 PMCID: PMC10830864 DOI: 10.1016/j.heliyon.2024.e24999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 02/03/2024] Open
Abstract
The death of a loved one can occur at any stage of life and can have a profound clinical impact on the patient. During childhood and adolescence, smoking has a functional impact on key aspects of family, school, and social life. The negative effects of parental death on children's mental health and its prevalence are unknown. Therefore, this systematic literature review aimed to describe the effects of parental death on children's mental health and its prevalence. The PubMed/Medline, WoS, and Cochrane Trials databases were searched for articles on patients aged 4-18 years. This review examines three articles. Anxiety and depression were identified as the predominant mental health outcomes, with a prevalence ranging from 7.5 % to 44.67 % of the mental health consequences associated with parental death.
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Affiliation(s)
| | - A.K. Jaramillo
- School of Health, Universidad Santiago de Cali, Cali, Colombia
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Weaver MS, Nasir A, Lord BT, Starin A, Linebarger JS. Supporting the Family After the Death of a Child or Adolescent. Pediatrics 2023; 152:e2023064426. [PMID: 38009001 DOI: 10.1542/peds.2023-064426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 11/28/2023] Open
Abstract
Whether death occurs in the context of a chronic illness or as the sudden loss of a previously healthy infant, child, or adolescent, the death of a child is a highly stressful and traumatic event. Psychosocial support for families after the death of a child embodies core medical values of professional fidelity, compassion, respect for human dignity, and promotion of the best interests of a grieving family. The pediatrician has an important role in supporting the family unit after the death of a child through a family-centered, culturally humble, trauma-informed approach. This clinical report aims to provide the pediatrician with a review of the current evidence on grief, bereavement, and mourning after the loss of a child and with practical guidance to support family caregivers, siblings, and the child's community. Pediatricians have an important role in helping siblings and helping families understand sibling needs during grief. Ways for pediatricians to support family members with cultural sensitivity are suggested and other helpful resources in the community are described.
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Affiliation(s)
- Meaghann S Weaver
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska
- National Center for Ethics in Health Care, Veterans Health Affairs, Washington, District of Columbia
| | - Arwa Nasir
- Department of Pediatrics, University of Nebraska, Omaha, Nebraska
| | - Blyth T Lord
- Courageous Parents Network, Newton, Massachusetts
| | - Amy Starin
- National Association of Social Workers, Washington, District of Columbia
| | - Jennifer S Linebarger
- Department of Pediatrics, Children's Mercy Kansas City, University of Missouri, Kansas City, School of Medicine, Kansas City, Missouri
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Alvis L, Zhang N, Sandler IN, Kaplow JB. Developmental Manifestations of Grief in Children and Adolescents: Caregivers as Key Grief Facilitators. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:447-457. [PMID: 35106114 PMCID: PMC8794619 DOI: 10.1007/s40653-021-00435-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 05/26/2023]
Abstract
The death of a loved one represents one of the most distressing and potentially traumatic life events in childhood and adolescence. Grief reactions in youth are influenced by ongoing developmental processes and manifest differently depending on the child's age and developmental stage. These grief-related processes unfold within youths' caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. Despite the field's increasing recognition of the potential for maladaptive grief reactions to impede functioning over time, few longitudinal research studies on childhood grief currently exist. In this article, we will (a) provide a brief overview of the childhood bereavement literature; (b) review the new DSM-5 and ICD-11 Prolonged Grief Disorder diagnostic criteria through a developmentally-informed lens; (c) describe how grief reactions manifest in children and adolescents of different ages through the lenses of multidimensional grief theory and relational developmental systems theory; (d) highlight key moderating factors that may influence grief in youth, and (e) discuss a primary moderating factor, the caregiving environment, and the potential mechanisms through which caregivers influence children's grief.
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Affiliation(s)
- Lauren Alvis
- The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX USA
| | - Na Zhang
- Human Development and Family Sciences, University of Connecticut, Storrs, CT 06269 USA
| | - Irwin N. Sandler
- Department of Psychology, Arizona State University, Tempe, AZ 85281 USA
| | - Julie B. Kaplow
- The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX USA
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Høeg BL, Guldin MB, Karlsen RV, Løppenthin KB, Kissane D, Dalton SO, Bidstrup PE. Cohort profile of FALCON: a prospective nationwide cohort of families with minor children who have lost a parent in Denmark in 2019-2021. DEATH STUDIES 2023; 48:228-237. [PMID: 37249101 DOI: 10.1080/07481187.2023.2214899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
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.
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Affiliation(s)
- Beverley Lim Høeg
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Randi Valbjørn Karlsen
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Breen LJ, Greene D, Rees CS, Black A, Cawthorne M, Egan SJ. A co-designed systematic review and meta-analysis of the efficacy of grief interventions for anxiety and depression in young people. J Affect Disord 2023; 335:289-297. [PMID: 37196936 DOI: 10.1016/j.jad.2023.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Grief in young people is common and associated with symptoms of anxiety and depression, yet grief interventions for this age group are under-researched. METHOD We conducted a systematic review and meta-analysis to examine the efficacy of grief interventions in young people. The process was co-designed with young people and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PsycINFO, Medline, and Web of Science databases were searched in July 2021 (updated December 2022). RESULTS We extracted results from 28 studies of grief interventions with young people (14-24 years) that measured anxiety and/or depression (N = 2803 participants, 60 % girls/women). Cognitive behavior therapy (CBT) for grief demonstrated a large effect for anxiety and medium effect for depression. Meta-regression indicated that CBT for grief that included a higher degree of CBT strategies, was not trauma focused, had >10 sessions, offered on an individual basis, and did not involve parents, was associated with larger effect sizes for anxiety. Supportive therapy had a moderate effect for anxiety and a small-moderate effect for depression. Writing interventions were not effective for anxiety or depression. LIMITATIONS Studies are limited in number and there were few randomized controlled studies. CONCLUSIONS Findings indicate that CBT for grief is an effective intervention for reducing symptoms of anxiety and depression in young people experiencing grief. CBT for grief should be offered as the first line treatment for grieving young people experiencing anxiety and depression. PROTOCOL REGISTRATION PROSPERO (registration number CRD42021264856).
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Affiliation(s)
- Lauren J Breen
- enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth 6845, Australia; Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia.
| | - Danyelle Greene
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | - Clare S Rees
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | - Amy Black
- Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
| | | | - Sarah J Egan
- enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth 6845, Australia; Discipline of Psychology, Curtin School of Population Health, Curtin University, Australia
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14
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Zhang T, Krysinska K, Alisic E, Andriessen K. Grief Instruments in Children and Adolescents: A Systematic Review. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231171188. [PMID: 37078181 DOI: 10.1177/00302228231171188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Many children and adolescents experience the death of a close person, such as a family member or a friend. However, there is a scarcity of literature on the assessment of grief in bereaved youth. The use of validated instruments is essential to advance our knowledge of grief in children and adolescents. We conducted a systematic review, adhering to PRISMA guidelines, to identify instruments that measure grief in this population and explore their characteristics. Searches in six databases (Medline, PsycINFO, Embase, Emcare, Scopus, and Web of Science) identified 24 instruments, encompassing three categories: general-purpose grief scales, maladaptive grief scales, and specialized grief scales. We extracted data using a predetermined list of descriptive and psychometric properties. Findings indicate a need to direct research towards more stringent validation of existing instruments and the design of new instruments in line with developments in the understanding of grief in this population.
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Affiliation(s)
- Toni Zhang
- Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Karolina Krysinska
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Eva Alisic
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Karl Andriessen
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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15
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Woodward KP, Yu Z, Chen W, Chen T, Jackson DB, Powell TW, Wang L. Childhood Bereavement, Adverse and Positive Childhood Experiences, and Flourishing among Chinese Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4631. [PMID: 36901641 PMCID: PMC10001697 DOI: 10.3390/ijerph20054631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/06/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Childhood bereavement (CB) resulting from a parent or primary caregiver death is associated with a range of adverse outcomes. Little is known about the association between CB and adult flourishing in the context of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs). In a cross-sectional observational study, we examined how ACEs, PCEs, and adult flourishing differs by self-reported CB history among 9468 Chinese young adults (18-35 years), of which 4.3% experienced CB (n = 409). Data collection included convenience sampling among university students in Mainland China. Respondents voluntarily completed an online survey between August and November 2020. Descriptive statistics, chi-square tests, and logistic regressions examined frequencies and differences in ACEs, PCEs, and flourishing by the history of CB controlling for a few demographic covariates. Bereaved individuals reported significantly higher ACEs and lower PCEs. The odds of experiencing emotional, physical, and sexual abuse as well as household substance abuse, parental mental illness, and parental incarceration ranged from 2.0-5.2 times higher for bereaved individuals. Bereaved participants also reported significant negative relationships with Flourishing Index (β = -0.35, t = -4.19, p < 0.001) and Secure Flourishing Index (β = -0.40, t = -4.96, p < 0.001). Consistent with previous research, our findings demonstrate the lasting effects of CB on well-being. We discuss study implications for ACEs and PCEs screening and surveillance as well as grief counseling to promote flourishing among bereaved youth in China and beyond.
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Affiliation(s)
- Krista P. Woodward
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Zhiyuan Yu
- Johns Hopkins School of Nursing, 525N Wolfe Street, Baltimore, MD 21205, USA
| | - Wenyi Chen
- Johns Hopkins School of Nursing, 525N Wolfe Street, Baltimore, MD 21205, USA
| | - Tingting Chen
- Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Dylan B. Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Terrinieka W. Powell
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Lin Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200240, China
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16
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Muacevic A, Adler JR, Snider J. Vision Loss in a Healthy Child: A Case of Vitamin A Deficiency. Cureus 2022; 14:e31683. [PMID: 36561592 PMCID: PMC9767668 DOI: 10.7759/cureus.31683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 11/21/2022] Open
Abstract
Vitamin A deficiency (VAD) is common in developing countries but rare in resource-rich countries. In developed countries, malabsorption and behavioral issues are more common reasons for VAD. The current case is an example of a healthy child who developed ocular symptoms due to vitamin A deficiency in the setting of cultural influences and emotional stressors.
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Impediments to child education, health and development during the COVID-19 pandemic in India. THE LANCET REGIONAL HEALTH - SOUTHEAST ASIA 2022; 1:100005. [PMID: 35769107 PMCID: PMC9073404 DOI: 10.1016/j.lansea.2022.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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18
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Trauma-Directed Interaction (TDI): An Adaptation to Parent-Child Interaction Therapy for Families with a History of Trauma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106089. [PMID: 35627624 PMCID: PMC9140737 DOI: 10.3390/ijerph19106089] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/29/2022]
Abstract
Parent-Child Interaction Therapy (PCIT) is one of the strongest evidence-based treatments available for young children and their families. Research has supported the use of PCIT for children with a history of trauma; however, the treatment does not directly address trauma in the child. PCIT is a dyadic treatment; yet, the impact of the carer’s trauma on the carer-child relationship is not assessed or incorporated into treatment. For these reasons, therapists, families, agencies, and funders tend to view PCIT as a trauma treatment with skepticism. PCIT therapists who currently address trauma within the intervention do so without a standardized approach. Trauma-Directed Interaction (TDI) is an adaptation developed to directly address these concerns. TDI maintains the key elements and theoretical underpinnings of PCIT while adding sessions to cover psychoeducation about trauma, carer response to a child’s trauma reactions (SAFE skills), and coping skills to aid both the child and the carer to manage trauma activators (COPE skills). The TDI module creates a consistent strategy for PCIT therapists to address trauma, thus allowing research and replication which will advance the dual fields of PCIT and family trauma. The theoretical conceptualization of TDI is presented along with next steps in its evaluation.
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de Matos Brasil AAG, Correia da Silva KVC, Júnior JG, Alves RNP, Lima NNR, Sampaio ML, de Matos Cassiano CJ, Neto MLR. SOCIAL INEQUALITIES AND EXTREME VULNERABILITY OF CHILDREN AND ADOLESCENTS IMPACTED BY THE COVID-19 PANDEMIC. LANCET REGIONAL HEALTH. AMERICAS 2022; 5:100103. [PMID: 34816145 PMCID: PMC8601865 DOI: 10.1016/j.lana.2021.100103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Affiliation(s)
| | | | - Jucier Gonçalves Júnior
- Department of Internal Medicine, Division of Rheumatology, Universidade de São Paulo (USP), Brazil
| | | | - Nádia Nara Rolim Lima
- Graduate Program in Neuropsychiatry, Universidade Federal de Pernambuco – UFPE, Recife, Pernambuco, Brazil
| | - Monique Leite Sampaio
- Obstetrician and Gynaecologist, Preceptor of the Federal University of Campina Grande - UFCA, Campus Cajazeiras-PB / HUJB
| | | | - Modesto Leite Rolim Neto
- Productivity Scholarship of the Juazeiro do Norte School of Medicine from Juazeiro do Norte – FMJ/Estacio, Juazeiro do Norte, Ceará, Brazil
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de Matos AAG, Cruz Correia da Silva KV, Júnior JG, Alves RNP, Lima NNR, Sampaio ML, de Matos Cassiano CJ, Neto MLR. Social inequalities and extreme vulnerability of children and adolescents affected by the COVID-19 pandemic. J R Soc Med 2021; 115:36-37. [PMID: 34844462 DOI: 10.1177/01410768211061357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
| | | | - Jucier Gonçalves Júnior
- School of Medicine, Universidade Federal do Cariri - UFCA, Barbalha, Ceará, Brazil.,Department of Internal Medicine, Division of Rheumatology, Universidade de São Paulo (USP), São Paulo, Brazil
| | | | - Nádia Nara Rolim Lima
- Graduate Program in Neuropsychiatry, Universidade Federal de Pernambuco - UFPE Recife, Pernambuco, Brazil
| | - Monique Leite Sampaio
- School of Medicine, 154624Universidade Federal de Campina Grande - UFCG, Cajazeiras, Paraíba, Brazil
| | | | - Modesto Leite Rolim Neto
- School of Medicine, Universidade Federal do Cariri - UFCA, Barbalha, Ceará, Brazil.,School of Medicine from Juazeiro do Norte FMJ/Estacio, Juazeiro do Norte, Ceará, Brazil
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21
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Affiliation(s)
- Rachel A Kentor
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030-2399, USA.
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22
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Hillis SD, Unwin HJT, Chen Y, Cluver L, Sherr L, Goldman PS, Ratmann O, Donnelly CA, Bhatt S, Villaveces A, Butchart A, Bachman G, Rawlings L, Green P, Nelson CA, Flaxman S. Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: a modelling study. Lancet 2021; 398:391-402. [PMID: 34298000 PMCID: PMC8293949 DOI: 10.1016/s0140-6736(21)01253-8] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic priorities have focused on prevention, detection, and response. Beyond morbidity and mortality, pandemics carry secondary impacts, such as children orphaned or bereft of their caregivers. Such children often face adverse consequences, including poverty, abuse, and institutionalisation. We provide estimates for the magnitude of this problem resulting from COVID-19 and describe the need for resource allocation. METHODS We used mortality and fertility data to model minimum estimates and rates of COVID-19-associated deaths of primary or secondary caregivers for children younger than 18 years in 21 countries. We considered parents and custodial grandparents as primary caregivers, and co-residing grandparents or older kin (aged 60-84 years) as secondary caregivers. To avoid overcounting, we adjusted for possible clustering of deaths using an estimated secondary attack rate and age-specific infection-fatality ratios for SARS-CoV-2. We used these estimates to model global extrapolations for the number of children who have experienced COVID-19-associated deaths of primary and secondary caregivers. FINDINGS Globally, from March 1, 2020, to April 30, 2021, we estimate 1 134 000 children (95% credible interval 884 000-1 185 000) experienced the death of primary caregivers, including at least one parent or custodial grandparent. 1 562 000 children (1 299 000-1 683 000) experienced the death of at least one primary or secondary caregiver. Countries in our study set with primary caregiver death rates of at least one per 1000 children included Peru (10·2 per 1000 children), South Africa (5·1), Mexico (3·5), Brazil (2·4), Colombia (2·3), Iran (1·7), the USA (1·5), Argentina (1·1), and Russia (1·0). Numbers of children orphaned exceeded numbers of deaths among those aged 15-50 years. Between two and five times more children had deceased fathers than deceased mothers. INTERPRETATION Orphanhood and caregiver deaths are a hidden pandemic resulting from COVID-19-associated deaths. Accelerating equitable vaccine delivery is key to prevention. Psychosocial and economic support can help families to nurture children bereft of caregivers and help to ensure that institutionalisation is avoided. These data show the need for an additional pillar of our response: prevent, detect, respond, and care for children. FUNDING UK Research and Innovation (Global Challenges Research Fund, Engineering and Physical Sciences Research Council, Medical Research Council), UK National Institute for Health Research, US National Institutes of Health, and Imperial College London.
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Affiliation(s)
- Susan D Hillis
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - H Juliette T Unwin
- MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, UK
| | - Yu Chen
- Department of Mathematics, Imperial College, London, UK
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Lorraine Sherr
- Institute of Global Health, University College London, London, UK
| | | | | | - Christl A Donnelly
- MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, UK; Department of Statistics, University of Oxford, Oxford, UK
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, UK; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andrés Villaveces
- CDC COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Gretchen Bachman
- Office of Global HIV/AIDS, US Agency for International Development, Washington, DC, USA
| | | | | | - Charles A Nelson
- Department of Pediatrics, Harvard Medical School and Boston Children's Hospital, Boston, MA, USA
| | - Seth Flaxman
- Department of Mathematics, Imperial College, London, UK; Department of Computer Science, University of Oxford, Oxford, UK
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23
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Schuelke T, Crawford C, Kentor R, Eppelheimer H, Chipriano C, Springmeyer K, Shukraft A, Hill M. Current Grief Support in Pediatric Palliative Care. CHILDREN (BASEL, SWITZERLAND) 2021; 8:278. [PMID: 33916583 PMCID: PMC8066285 DOI: 10.3390/children8040278] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/27/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
Grief support changes as more is learned from current grief theory and research. The authors provide a comprehensive overview of current grief support as it relates to Pediatric Palliative Care (PPC). The following aspects of grief are addressed: (1) anticipatory grief: the nondeath losses that occur with a complex and chronic illness, as well as the time leading up to death; (2) grief around the time of death: the intense and sacred experience of companioning with a dying child; (3) grief after death: supporting bereavement and mourning through programing and other methods; (4) innovative approaches: the future of grief support. The contents of this article are meant to support and educate programs currently providing grief services and those aiming to begin the meaningful work of grief support.
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Affiliation(s)
- Taryn Schuelke
- Department of Pediatric Palliative Care, Texas Children’s Hospital, 6621 Fannin St., Houston, TX 77030, USA; (C.C.); (K.S.)
| | - Claire Crawford
- Department of Pediatric Palliative Care, Texas Children’s Hospital, 6621 Fannin St., Houston, TX 77030, USA; (C.C.); (K.S.)
| | - Rachel Kentor
- Department of Pediatrics, Baylor College of Medicine, Psychology Service, Texas Children’s Hospital, 6701 Fannin St., Houston, TX 77030, USA;
| | - Heather Eppelheimer
- Memorial Hermann Pediatric Hospice, 902 Frostwood Suite 288, Houston, TX 77024, USA;
| | | | - Kirstin Springmeyer
- Department of Pediatric Palliative Care, Texas Children’s Hospital, 6621 Fannin St., Houston, TX 77030, USA; (C.C.); (K.S.)
| | - Allison Shukraft
- Department of Pediatrics, Pediatric Advanced Care Team, Atrium Health’s Levine Children’s Hospital, MEB 415-F, 1000 Blythe Blvd, Charlotte, NC 28203, USA;
| | - Malinda Hill
- Justin Michael Ingerman Center for Palliative Care, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA;
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