Risks and Interventions for the Parentally Bereaved Child

  • Janelle R. Lutzke
  • Tim S. Ayers
  • Irwin N. Sandler
  • Alicia Barr
Part of the Issues in Clinical Child Psychology book series (ICCP)


There are few other stressful events that occur in a child’s or adolescent’s life that have as potentially profound and lasting impact as the death of a parent. Yet, what evidence is there to support this statement? What, if any, kinds of mental health or adjustment problems might these children experience? And if the death of a parent does indeed put children or adolescents at risk, what are the important risk and protective factors that mediate or moderate the relationship between parental death and children’s adjustment? Finally, what kinds of preventive interventions have been or need to be developed for the parentally bereaved child? Some initial answers to these questions are provided in this chapter. We begin by discussing the epidemiology of parental death in children and adolescents. Next, we review the research literatures examining the risks of adjustment problems and other developmental outcomes in children and the mental health outcomes in adulthood. As part of these reviews, we use metaanalytic methods to begin to explore the strength of the findings across studies and at the same time offer critiques and point to some of the methodological limitations of these studies. We then turn to a review the literatures that have examined some of the factors associated with the effects of parental bereavement. We discuss the interventions that have been developed and experimentally evaluated for these children, and finally we conclude the chapter with some recommendations for further research in this area.


Mental Health Problem Panic Disorder Negative Life Event Conduct Disorder Control Belief 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Achenbach, T., McConaughy, S., & Howell, C. (1987). Child/adolescent behavioral and emotional problems: Implications of crossinformant correlations for situational specificity. Psychological Bulletin, 101, 213–232.PubMedCrossRefGoogle Scholar
  2. Adam, K., Bouckoms, A., & Streiner, D. (1982). Parental loss and family stability in attempted suicide. Archives of General Psychiatry, 39, 1081–1085.PubMedCrossRefGoogle Scholar
  3. Ambert, A., & Saucier, J. (1984). Adolescents’ academic success and aspirations by parental marital status. Canadian Review of Sociology and Anthropology, 21, 62–74.CrossRefGoogle Scholar
  4. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
  5. Barnes, G., & Prosen, H. (1985). Parental death and depression. Journal of Abnormal Psychology, 94, 64–69.PubMedCrossRefGoogle Scholar
  6. Bifulco, A., Brown, G., & Harris, T. (1987). Childhood loss of parent, lack of adequate parental care and adult depression: A replication. Journal of Affective Disorders, 12, 115–128.PubMedCrossRefGoogle Scholar
  7. Birtchnell, J. (1980). Women whose mothers died in childhood: An outcome study. Psychological Medicine, 10, 699–713.PubMedCrossRefGoogle Scholar
  8. Birtchnell, J., & Kennard, J. (1981). Early mother-bereaved women who have and have not been psychiatric patients. Social Psychology, 16, 187–197.Google Scholar
  9. Black, D., & Urbanowicz, M. A. (1985). Bereaved children family intervention. In J. E. Stevenson (Ed), Recent research in developmental psychopathology (pp. 179–187). Oxford, England: Pergamon.Google Scholar
  10. Breslau, N., Davis, G., & Prabucki, K. (1988). Depressed mothers as informants in family history research-Are they accurate? Psychiatry Research, 24, 345–359.PubMedCrossRefGoogle Scholar
  11. Brown, G. W., & Harris, T. (1978). Social origins of depression. New York: Free Press.Google Scholar
  12. Brown, G. W., Harris, T. O., & Bifulco, A. (1986). Long-term effects of early loss of parent. In M. Rutter, C. E. Izard, & P. B. Reid (Eds.), Depression in young people: Developmental and clinical perspectives (pp. 251–297). New York: Guilford Press.Google Scholar
  13. Christ, G., Siegel, K., Mesagno, F., & Langosch, D. (1991). A preventive intervention program for bereaved children. American Journal of Orthopsychiatry, 61, 168–178.PubMedCrossRefGoogle Scholar
  14. Clark, D. C., Pynoos, R. S., & Goebel, A. E. (1994). Mechanisms and processes of adolescent bereavement. In R. J. Haggerty, L. R. Sherrod, N. Garmezy, & M. Rutter (Eds.), Stress, risk, and resilience in children and adolescents: Processes, mechanisms, and interventions (pp. 100–146). New York: Cambridge University Press.Google Scholar
  15. Coie, J. D., Watt, N. F., West, S. G., Hawkins, J. D., Asarnow, J. R., Markman, H. J., Ramey, S. L., Shure, M. B., & Long, B. (1993). The science of prevention: A conceptual framework and some directions for a national research program. American Psychologist, 48, 1013–1022.PubMedCrossRefGoogle Scholar
  16. Cook, T. D. (1990). The generalization of causal connections: Multiple theories in search of clear practice. In L. Sechrest, E. Perrin, & J. Bunker (Eds.), Research methodology: Strengthening causal interpretations of non-experimental data, AHCPR Conference Proceedings (pp. 9–31). US Department of Health and Human Services, Agency for Health Care Policy and Research.Google Scholar
  17. Coopersmith, S. (1967). The antecedents of self-esteem. San Francisco: W. H. Freeman.Google Scholar
  18. Elizur, E., & Kaffman, M. (1983). Factors influencing the severity of childhood bereavement reactions. American Journal of Orthopsychiatry, 53, 668–676.PubMedCrossRefGoogle Scholar
  19. Felner, R., Ginter, M., Boike, M., & Cowen, E. (1981). Parental death or divorce and the school adjustment of young children. American Journal of Community Psychology, 9, 181–191.PubMedCrossRefGoogle Scholar
  20. Felner, R., Stolberg, A., & Cowen, E. (1975). Crisis events and school mental health referral patterns of young children. Journal of Consulting and Clinical Psychology, 43, 305–310.PubMedCrossRefGoogle Scholar
  21. Feiner, R., Terre, L., & Rowlinson, R. (1988). A life transition framework for understanding marital dissolution and family reorganization. In S. A. Wolchik & P. Karoly (Eds.), Children of divorce: Empirical perspectives on adjustment (pp. 35–65). New York: Gardner Press.Google Scholar
  22. Gardner, F. (1989). Inconsistent parenting: Is there evidence for a link with children’s conduct problems? Journal of Abnormal Child Psychology, 17, 223–233.PubMedCrossRefGoogle Scholar
  23. Gersten, J., Beals, J., & Kallgren, C. (1991). Epidemiology and preventive interventions: Parental death in childhood as a case example. American Journal of Community Psychology, 19, 481–499.PubMedCrossRefGoogle Scholar
  24. Gray, R. (1987). Adolescent response to the death of a parent. Journal of Youth and Adolescence, 16, 511–525.CrossRefGoogle Scholar
  25. Gregory, I. (1965). Anterospective data following childhood loss of a parent. Archives of General Psychiatry, 13, 99–109.PubMedCrossRefGoogle Scholar
  26. Grych, J., & Fincham, F. (1990). Marital conflict and children’s adjustment: A cognitive contextual framework. Psychological Bulletin, 108, 267–290.PubMedCrossRefGoogle Scholar
  27. Hainline, L., & Feig, E. (1978). The correlates of childhood father absence in college-aged women. Child Development, 49, 37–42.CrossRefGoogle Scholar
  28. Hallstrom, T. (1987). The relationships of childhood socio-demographic factors and early parental loss to major depression in adult life. Acta Psychiatrica Scandinavica 75, 212–216.PubMedCrossRefGoogle Scholar
  29. Harris, E. (1991). Adolescent bereavement following the death of a parent: An exploratory study. Child Psychiatry and Human Development, 21, 267–281.PubMedCrossRefGoogle Scholar
  30. Harris, T., Brown, G., & Bifulco, A. (1987). Loss of parent in childhood and adult psychiatric disorder: The role of social class position and premarital pregnancy. Psychological Medicine, 17, 163–183.PubMedCrossRefGoogle Scholar
  31. Harter, S. (1979). Manual: Perceived Competence Scale for Children. Denver, CO: University of Denver.Google Scholar
  32. Hetherington, E. (1972). Effects of father absence on personality development in adolescent daughters. Developmental Psychology, 7, 313–326.CrossRefGoogle Scholar
  33. Hetherington, E., Cox, M., & Cox, R. (1982). Effects of divorce on parents and children. In M. Lamb (Ed.), Nontraditional families: Parenting and child development. Hillsdale, NJ: Erlbaum.Google Scholar
  34. James, L. R., & Brett, J. M. (1984). Mediators, moderators and tests for mediation. Journal of Applied Psychology, 69, 307–321.CrossRefGoogle Scholar
  35. Janoff-Bulman, R. (1985). The aftermath of victimization: Rebuilding shattered assumptions. In C. Figley (Ed.), Trauma and it’s wake: The study and treatment of posttraumatic stress disorder (pp. 15–35). New York: Brunner/Mazel.Google Scholar
  36. Johnson, B. T. (1993). DSTAT software for the meta-analytical review of research literatures (version 1.11) [Computer software]. Hillsdale, NJ: Erlbaum.Google Scholar
  37. Kendler, K., Neale, M., Kessler, R., Heath, A., & Eaves, L. (1992). Childhood parental loss and adult psychopathology in women. Archives of General Psychiatry, 49, 109–116.PubMedCrossRefGoogle Scholar
  38. Kranzler, E., Shaffer, D., Wasserman, G., & Davies, M. (1990). Early childhood bereavement. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 513–520.PubMedCrossRefGoogle Scholar
  39. Kurdek, L. A. (1988). Cognitive mediators of children’s adjustment to divorce. In S. A. Wolchik & P. Karoly (Eds.), Children of divorce: Empirical perspectives on adjustment (pp. 233–267). New York: Gardner.Google Scholar
  40. Lawerence, G. B. (1995). The impact of coping and perceived control on adjustment in children who have lost a parent. Unpublished doctoral dissertation, Columbia University, New York.Google Scholar
  41. Lempers, J., Clark-Lempers, D., & Simons, R. (1989). Economic hardship, parenting, and distress in adolescence. Child Development, 60, 25–39.PubMedCrossRefGoogle Scholar
  42. Li, S., Lutzke, J., Sandler, I., & Ayers, T. S. (1995, June). Structure and specificity of negative life event categories for bereaved children. Poster presented at the Biennial Conference of the Society for Community Research and Action, Chicago, IL.Google Scholar
  43. Lipsey, M. W. (1992). Theory as method: Small theories of treatments. In L. B. Sechrest & A. G. Scott (Eds.), New directions for program evaluation (No. 57, pp. 5–38). San Francisco: Jossey-Bass.Google Scholar
  44. Lohnes, K., & Kalter, N. (1994). Preventive intervention groups for parentally bereaved children. American Journal of Orthopsychiatry, 64, 594–603.PubMedCrossRefGoogle Scholar
  45. Lutzke, J., Li, S., Ayers, T., & Sandler, I. (1995, June). Self-esteem and locus of control as mediators of the effects of bereavement stress on children’s adjustment. Poster presented at the Biennial Conference of the Society for Community Research and Action, Chicago, IL.Google Scholar
  46. Mash, E., & Johnson, C. (1983). Parental perceptions of child behavior problems, parenting selfesteem, and mother’s reported stress in younger and older hyperactive and normal children. Journal of Consulting and Clinical Psychology, 51, 86–99.PubMedCrossRefGoogle Scholar
  47. McIntosh, D., Cohen Silver, R., & Wortman, C. (1993). Religion’s role in adjustment to a negative life event: Coping with the loss of a child. Journal of Personality and Social Psychology, 65, 812–821.PubMedCrossRefGoogle Scholar
  48. McLeod, J. (1991). Childhood parental loss and adult depression. Journal of Health and Social Behavior, 32, 205–220.PubMedCrossRefGoogle Scholar
  49. Osterweis, M., Solomon, F., & Green, M. (1984). Bereavement reactions, consequences and care. New York: Raven Press.Google Scholar
  50. Parker, G., & Manicavasagar, V. (1986). Childhood bereavement circumstances associated with adult depression. British Journal of Medical Psychology, 59, 387–391.PubMedCrossRefGoogle Scholar
  51. Partridge, S., & Kotler, T. (1987). Self-esteem and adjustment in adolescents from bereaved, di- vorced, and intact families: Family type versus family environment. Australian Journal of Psychology, 39, 223–234.CrossRefGoogle Scholar
  52. Patterson, G. (1982). Coercive family process. Eugene, OR: Castalia.Google Scholar
  53. Program for Prevention Research. (1987). Documentation of scales: PIRC community survey. Tempe: Arizona State University.Google Scholar
  54. Saler, L., & Skolnick, N. (1992). Childhood parental death and depression in adulthood: Roles of surviving parent and family environment. American Journal of Orthopsychiatry, 62, 504–516.PubMedCrossRefGoogle Scholar
  55. Sandler, I. N., Barr, A., Ayers, T. S., & Lutzke, J. R. (1996). Unpublished data analysis. Program for Prevention Research, Arizona State University, Tempe, AZ.Google Scholar
  56. Sandler, I., Gersten, J., Reynolds, K., Kallgren, C., & Ramirez, R. (1988). Using theory and data to plan support interventions: Design of a program for bereaved children. In B. H. Gottlieb (Ed.), Marshaling social support: Formats, processes, and effects (pp. 53–83). Newbury Park, CA: Sage.Google Scholar
  57. Sandler, I. N., Rameriz, R., & Reynolds, K. D. (1986, August). Life stress for children of divorce, bereaved and asthmatic children. Poster presented at the American Psychological Association Convention, Washington, DC.Google Scholar
  58. Sandler, I., West, S., Baca, L., Pillow, D., Gersten, J., Rogosch, F., Virdin, L., Beals, J., Reynolds, K., Kallgren, C., Tien, J., Kriege, G., Cole, E., & Ramirez, R. (1992). Linking empirically based theory and evaluation: The Family Bereavement Program. American Journal of Community Psychology, 20, 491–521.PubMedCrossRefGoogle Scholar
  59. Sandler, I., Wolchik, S., & Braver, S. (1988). The stressors of children’s postdivorce environments. In S. A. Wolchik & P. Karoly (Eds.), Children of divorce: Empirical perspectives on adjustment (pp. 111–144). New York: Gardner Press.Google Scholar
  60. Saucier, J., & Ambert, A. (1982). Parental marital status and adolescents’ optimism about their future. Journal of Youth and Adolescence, 11, 345–354.CrossRefGoogle Scholar
  61. Saucier, J., & Ambert, A. (1986). Adolescents’ perception of self and of immediate environment by parental marital status: A controlled study. Canadian Journal of Psychiatry, 31, 505–512.Google Scholar
  62. Schneiderman, G., Winders, P., Tallett, S., & Feldman, W. (1994). Do child and/or parent bereavement programs work? Canadian Journal of Psychiatry, 39, 215–218.Google Scholar
  63. Shaw, D., & Emery, R. (1988). Chronic family adversity and school-aged children’s adjustment. Journal of American Academy of Child and Adolescent Psychiatry, 27, 200–206.CrossRefGoogle Scholar
  64. Silverman, P., & Worden, W. (1992). Children’s reactions in the early months after the death of a parent. American Journal of Orthopsychiatry, 62, 93–104.PubMedCrossRefGoogle Scholar
  65. Silverman, P., & Worden, W. (1993). Children’s reactions to the death of a parent. In M. Stroebe, W. Stroebe, & R. Hansson (Eds.), Handbook of bereavement: Theory, research and intervention (pp. 300–316). New York: Cambridge University Press.CrossRefGoogle Scholar
  66. Sood, B., Weller, E., Weller, R., Fristad, M., & Bowes, J. (1992). Somatic complaints in grieving children. Comprehensive Mental Health Care, 2, 17–25.Google Scholar
  67. Strength, J. M. (1991). Factors influencing the mother-child relationship following the death of the father and how that relationship affects the child’s functioning. Unpublished doctoral dissertation, Rosemead School of Psychology, La Mirada, CA.Google Scholar
  68. Thyer, B., Himle, J., & Miller-Gogoleski, M. A. (1989). The relationship of parental death to panic disorder: A community-based replication. Phobia Practice and Research Journal, 2, 29–36.Google Scholar
  69. Toedter, L. J., Lasker, J. N., & Campbell, D. T. (1990). The comparison group problem in bereavement studies and the retrospective pretest. Evaluation Review, 14, 75–90.CrossRefGoogle Scholar
  70. US Bureau of the Census. (1990). Statistical abstracts of the US, 1990 (110th ed.). Washington, DC: US Government Printing Office.Google Scholar
  71. US Bureau of the Census, Current Population Reports. (1994). Marital status and living arrangements: March, 1994 Washington, DC: US Government Printing Office.Google Scholar
  72. Van Eerdewegh, M., Bieri, M., Parrilla, R., & Clayton, P. (1982). The bereaved child. British Journal of Psychiatry, 140, 23–29.PubMedCrossRefGoogle Scholar
  73. Van Eerdewegh, M., Clayton, P., & Van Eerdewegh, P. (1985). The bereaved child: Variables influencing early psychopathology. British Journal of Psychiatry, 147, 188–194.PubMedCrossRefGoogle Scholar
  74. Vicary, J., & Lerner, J. (1986). Parental attributes and adolescent drug use. Journal of Adolescence, 9, 115–122.PubMedCrossRefGoogle Scholar
  75. Vuchinich, S., Bank, L., & Patterson, G. (1992). Parenting, peers, and the stability of antisocial behavior in preadolescent boys. Developmental Psychology, 28, 510–521.CrossRefGoogle Scholar
  76. Weissman, M., Leckman, J., Merikangas, K., Gammon, G., & Prusoff, B. (1984). Depression and anxiety disorders in parents and children. Archives of General Psychiatry, 41, 845–852.PubMedCrossRefGoogle Scholar
  77. Weller, E., Weller, R., Fristad, M., & Bowes, J. (1990). Dexamethasone suppression test and depressive symptoms in bereaved children: A preliminary report. The Journal of Neuropsychiatry and Clinical Neurosciences, 2, 418–421.PubMedGoogle Scholar
  78. Wentzel, K., Feldman, S., & Weinberger, D. (1991). Parental child rearing and academic achievement in boys: The mediational role of social—emotional adjustment. Journal of Early Adolescence, 11, 321–339.CrossRefGoogle Scholar
  79. West, S., Sandler, I., Pillow, D., Baca, L., & Gersten, J. (1991). The use of structural equation modeling in generative research: Toward the design of a preventive intervention for bereaved children. American Journal of Community Psychology, 19, 459–489.PubMedCrossRefGoogle Scholar
  80. Wheaton, B. (1985). Models for the stress-buffering functions of coping resources. Journal of Health and Social Behavior, 26, 352–354.PubMedCrossRefGoogle Scholar
  81. Worden, J. W. (1994, November). What really helps in the long run? New findings of a longitudinal study of school-aged children who lose a parent to death. Paper presented at the National Conference on Loss and Transition/West, Scottsdale, AZ.Google Scholar
  82. Worden, J. W., & Silverman, P. R. (1996). Parental death and the adjustment of school-age children. Omega Journal of Death and Dying, 33, 91–102.CrossRefGoogle Scholar
  83. Zall, D. (1994). The long-term effects of childhood bereavement: Impact on roles as mothers. Omega Journal of Death and Dying, 29, 219–230.CrossRefGoogle Scholar
  84. Zambelli, G., & DeRosa, A. (1992). Bereavement support groups for school-age children: Theory, intervention, and case example. American Journal of Orthopsychiatry, 62, 484–493.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Janelle R. Lutzke
    • 1
  • Tim S. Ayers
    • 2
  • Irwin N. Sandler
    • 2
  • Alicia Barr
    • 1
  1. 1.Department of PsychologyArizona State UniversityTempeUSA
  2. 2.Department of Psychology and Program for Prevention ResearchArizona State UniversityTempeUSA

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