Grief Instruments in Children and Adolescents: A Systematic Review

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.

Exploring Factors That Helped Adolescents Adjust and Continue With Life After the Death of a Parent

The aim of this study was to explore factors that helped adolescents to adjust and continue with life after the death of a parent. A qualitative research design was utilized, in which 12 participants participated in semistructured interviews. Data were analyzed according to thematic analysis. The following categories and themes emerged from the data: family support-supportive remaining parent, parent has a supportive partner and supportive extended family; social support-child has supportive friends and supportive community; religion--religion as a coping mechanism and religion as means of communicating with the deceased parent; and a strong personal sense of coherence (the ability to relate to and make sense of the world) as an intrapersonal coping mechanism. In addition, the following themes also emerged: exercising, allowing time to prepare for the death of a terminally ill parent, tangible reminders of the deceased, and journal writing. The findings can be used to design interventions for adolescents whose parent has passed away.

Cremation and Grief: Are Ways of Commemorating the Dead Related to Adjustment Over Time?

Funeral services are known to serve multiple functions for bereaved persons. There is also a common, intuitively reasonable assumption of positive associations between engaging in funeral activities and adjustment to bereavement. We examined whether restricting ceremonial cremation arrangements to a minimum has a negative association with grief over time. Bereaved persons in the United Kingdom completed questionnaires 2 to 5 months postloss and again a year later (N = 233 with complete data; dropout = 11.4%). Neither type nor elaborateness of the cremation service, nor satisfaction with arrangements (typically high), emerged as significantly related to grief; no major subgroup differences (e.g., according to income level) were found. Results suggested that it does not matter to grief whether a more minimalistic or elaborate funeral ceremony was observed. We concluded that the funeral industry represented in this investigation is offering bereaved people the range of choices regarding cremation arrangements to meet their needs. Limits to generalizability are discussed.

Peer support for bereaved children: Setting eyes on children's views through an educational action research project

This article investigates children's views on providing peer support to bereaved children. The data (pre- and postinterviews and written documents) come from an action research study of a teacher-researcher and her 16 children aged 10-11 years old. Analysis of the data shows children's ideas on supporting a bereaved child and how this support should be provided, taking into consideration various factors such as the relationship with the bereaved and the role of memories. The paper emphasizes that children should have structured opportunities across the whole-school curriculum to learn how loss affects people's lives to support themselves and others.

Testing for Plausibly Causal Links Between Parental Bereavement and Child Socio-Emotional and Academic Outcomes: A Propensity-Score Matching Model

The extant literature on parentally bereaved children has focused almost exclusively on the presence of negative mental health and socio-emotional outcomes among these children. However, findings from this literature have been equivocal. While some authors have found support for the presence of higher levels of internalizing and externalizing problems or mental health problems among this population, others have not found such a relationship. Additionally, study designs in this body of literature have limited both the internal and external validity of the research on parentally bereaved children. The present study seeks to address these issues of internal and external validity by utilizing propensity-score matching analyses to make plausibly causal inferences about the relationship between bereavement and internalizing and externalizing problems among children from a nearly nationally representative sample. This study also extends examination of the influence of parental bereavement to other domains of child development: namely, to academic outcomes. Findings suggest a lack of support for causal relationships between parental bereavement and either socio-emotional or academic outcomes among U.S. children. The plausibility of assumptions necessary to draw causal inferences is discussed.

Personal Transformation in Midlife Orphanhood: An Empirical Phenomenological Study

The present study explores the ways in which being orphaned at midlife leads to personal transformation. Empirical phenomenological methods were applied to in-depth interviews with four participants. Analysis of the explicit and implicit lived meanings of this experience yielded 74 themes organized into a general structural narrative. This narrative ranged from early experiences of providing care to the dying parent to an eventual reorganization of self. In crossing the generational line and assuming the role of elder, study participants developed an increased sense of purpose and meaning, transcendence of egoistic concern, a greater sense of interconnectedness to others, and deeper sensitivity and compassion. Further, the results provide evidence that an ongoing relationship to the deceased parent serves several vital psychological and developmental functions, and that actively “holding on” to the deceased parent drives many of the dynamics through which personal transformation is effected.

Reliability generalization of the Texas Revised Inventory of Grief (TRIG)

While grief is a universal experience, this phenomenon is experienced in a variety of ways largely dependent upon one's cultural schema. To consider the potential problems inherent in generalizing the results of an assessment tool across cultures, this study explores the notion of generalizability in assessment by evaluating the reliability of the Texas Revised Inventory of Grief (TRIG) using a meta-analytic technique called reliability generalization. The TRIG demonstrated strong reliability with mean Cronbach's alphas of .90 and .82 for the present and past subscales, respectively. Overall, the TRIG, especially the present subscale, appears to produce reliable scores even across cultures.

The good funeral: toward an understanding of funeral participation and satisfaction

This study posits a model of funeral satisfaction in which religiosity predicts general funeral attitudes, which predict levels and types of funeral participation, mediating the relationship between attitudes and satisfaction in a particular bereavement context. Over a thousand respondents rated their attitudes toward funerals in general and evaluated the most recent funeral they had actually attended. The resulting model indicated that religiosity and favorable attitudes, when enacted through participation and involvement, tend to predict funeral satisfaction, in combination with favorable comparisons, and when the deceased was close and the death unexpected or tragic. Evaluations of the funeral, in turn, independently influence a person's general attitudes about funerals. Theoretical and practical implications for understanding funerals and bereavement are explored.