This study reports on the incidence of post-traumatic stress disorder (PTSD) symptoms among a sample (n = 46) of bereaved children. PTSD symptoms in children who have experienced loss due to an expected death through illness have not been previously studied.
Method:
An exploratory cross-sectional design was used to compare Impact of Event Scale (IES) scores between two groups of bereaved children. One group experienced the sudden, unexpected death of a family member; the second group experienced the expected death of a family member following protracted illness.
Findings:
Overall, almost two-thirds of the children were found to be experiencing moderate to severe levels of PTSD related symptoms of intrusion and avoidance as measured by the IES. Additionally, there was no significant difference in the IES scores of the two groups of children.
Implications:
Findings are discussed in relation to current practice with and research on bereaved children.
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References
1.
AdamsK. N. (1996). Bereavement counseling groups with elementary school students. Dissertation Abstracts International Section A: Humanities & Social Sciences, 56(11A), 4277.
2.
Amick-McMullanA.KilpatrickD. G., & ResnickH. S. (1991). Homicide as a risk factor for PTSD among surviving family members. Behavior Modification, 15, 545–559.
3.
American Psychiatric Association (APA). (1980). Diagnostic and Statistical Manual for Mental Disorders (3rd ed.) (DSM-III). Washington, DC: Author.
4.
American Psychiatric Association (APA). (1994). Diagnostic and Statistical Manual for Mental Disorders (4th ed.) (DSM-IV). Washington, DC: Author.
5.
American Psychiatric Association (APA). (2000). Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR). Washington, DC: Author.
6.
BlackD. (1978). The bereaved child. Child Psychology, 19, 287–292.
7.
BlackD. (1998). Working with the effects of traumatic bereavement by uxoricide (spouse killing) on young children's attachment behaviour. International Journal of Psychiatry in Clinical Practice, 2(4), 245–249.
8.
BriereJ., & ElliottD. M. (1998). Clinical utility of the impact of event scale: Psychometrics in the general population. Assessment, 5(2), 171–180.
9.
BrosiusK. K. (2004). Children who have lost their siblings due to homicide: A phenomenological study. Dissertation Abstracts International: Section B; The Sciences & Engineering, 64(8-B), 4025.
10.
BryantR. A., & HarveyA. G. (1995). Avoidant coping style and post-traumatic stress following motor vehicle accidents. Behavior Research Therapy, 33, 631–635.
11.
ChristG. H. (2000). Impact of development on children's mourning. Cancer Practice, 8(2), 72–81.
12.
ClementsP. T., & BurgessA. W. (2002). Children's responses to family member homicide. Family & Community Health, 25(1), 32–42.
13.
CorneilW.BeatonR.MurphyS.JohnsonC., & PikeK. (1999). Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. Journal of Occupational Health Psychology, 4(2), 131–141.
14.
DyregrovA.KuterovacG., & BarathA. (1996). Factor analysis of the impact of event scale with children in war. Scandinavian Journal of Psychology, 37, 339–350.
15.
DyregrovA.GjestadR., & RaundalenM. (2002). Children exposed to warfare: A longitudinal study. Journal of Traumatic Stress, 15(1), 59–68.
16.
DyregrovA., & YuleW. (1995). Screening measures: The development of the UNICEF Screening Battery. Fourth European Conference on Traumatic Stress: Paris.
17.
EthS., & PynoosR. S. (1994). Children who witness the homicide of a parent. Psychiatry, 57, 287–306.
18.
FelnerR. D.GinterM. A.BoikeM. F., & CowenE. L. (1981). Parental death or divorce and the school adjustment of young children. American Journal of Community Psychology, 181–191.
19.
FlorianV., & MikulincerM. (1997). Fear of personal death in adulthood: The impact of early and recent losses. Death Studies, 21, 1–24. Munice, IN: Accelerated Development, Inc.
20.
GibbonsM. B. (1992). A child dies, a child survives: The impact of sibling loss. Journal of Pediatric Health Care, 6(2), 65–72.
21.
GreenB. L.KorolM. G.GraceM. C.VaryN. G.LeonardA. C.GleserG. C., & Smitson-CohenS. (1991). Children and disaster. Age, gender, and parental effects of PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 30(6), 945–951.
22.
GreenB. L.LindyJ. D.GraceM. C., & LeonardA. C. (1992). Chronic posttraumatic stress disorder and diagnostic comorbidity in a disaster sample. Journal of Nervous and Mental Disorders, 180, 760–766.
23.
HorowitzM.WilnerN., & AlvarezW. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 42(3), 209–218.
24.
HoyertD.KungH-C., & SmithB. L. (2005). Deaths, preliminary data for 2003. National Vital Statistics Reports, 53(15), Hyattsville, MD: National Center for Health Statistics.
25.
HussS. N., & RitchieM. (1999). Effectiveness of a group for parentally bereaved children. The Journal for Specialists in Group Work, 24, 186–196.
26.
JonesR. T.RibbeD. P.CunninghamP. B.WeddleJ. D., & LangleyA. K. (2002). Psychological impact of fire disaster on children and their parents. Behavior Modification, 26(2), 163–186.
27.
KnieperA. J. (1999). The suicide survivor's grief and recovery. Suicide & Life-Threatening Behavior, 29(4), 353–364.
28.
KranzlerE. M.ShafferD.WassermanG., & DaviesM. (1990). Early childhood bereavement. Journal of the American Academy of Child & Adolescent Psychiatry, 29, 513–520.
29.
LeonI. G. (1986). The invisible loss: The impact of perinatal death on siblings. Journal of Psychosomatic Obstetrics and Gynecology, 5, 1–14.
30.
LindyJ. D.GreenB. L.GraceM., & TitchenerJ. (1983). Psychotherapy with survivors of the Beverly Hills Supper Club fire. American Journal of Psychotherapy, 37, 593–610.
31.
LundinT. (1984). Morbidity following sudden and unexpected bereavement. British Journal of Psychiatry, 144, 84–88.
32.
MalmquistC. P. (1986). Children who witness parental murder: Posttraumatic aspects. Journal of the American Academy of Child Psychiatry, 25, 320–325.
33.
MarceyM. M. (1996). A comparison of the long-term effects of bereavement after four types of death: Anticipated death, sudden death, drunk driver crash, and homicide. Dissertation Abstracts International: Section B: The Sciences & Engineering, 56(11-B), 6399.
34.
NaderK. O.PynoosR. S.FairbanksL. A.al-AjeelM., & al-AsfourA. (1993). A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis. British Journal of Clinical Psychology, 32, 407–416.
35.
NaiermanN. (1997). Reaching out to grieving students. Educational Leadership, 55, 62–65.
36.
NealL. A.BusuttilW.RollinsJ.HerepathR.StrikeP., & TurnbullG. (1994). Convergent validity of measures of post-traumatic stress disorder in a mixed military and civilian population. Journal of Traumatic Stress, 7, 447–455.
37.
PrigersonH. O., & JacobsS. C. (2001). Traumatic grief as a distinct disorder: A rationale, consensus criteria, and a preliminary empirical test. In StroebeM. S. & HanssonR. O. (Eds.), Handbook of bereavement research: Consequences, coping, and care. Washington, DC: American Psychological Association.
38.
PynoosR. S.NaderK.FredrickC.GondaL., & StuberM. (1987). Grief reactions in school age children following a sniper attack at school. Israel Journal of Psychiatry and Related Sciences, 24, 53–63.
39.
RandoT. A. (1984). Grief, dying and death: Clinical interventions for caregivers. Champaign, IL: Research Press Company.
40.
RaphaelB. (1997). The interaction of trauma and grief. In BlackD.NewmanM.Harris-HendriksJ., & MezeyG. (Eds.), Psychological trauma: A developmental approach (pp. 31–43). London: Gaskell.
41.
RothS.DyeE., & LebowitzL. (1988). Group therapy for sexual assault victims. Psychotherapy, 25, 82–93.
42.
SandlerI. N.WestS.BacaL.PillowD.GerstenJ. C.RogoschF.VirdinL.BealsJ.ReynoldsK. D., & KallgrenC. (1992). Linking empirically based theory and evaluation: The Family Bereavement Program. American Journal of Community Psychology, 20(4), 491–521.
43.
SandlerI. N.AyersT. S.WolchikS. A.TeinJ. Y.KwokO. M.HaineR. A.Twohey-JacobsJ.SuterJ.LinK.Padgett-JonesS.WeyerJ. L.ColeE.KriegerG., & GriffinW. A. (2003). The family bereavement program: Efficacy evaluation of a theory-based prevention program for parentally bereaved children and adolescents. Journal of Consulting and Clinical Psychology, 71(3), 587–600.
44.
SchillingR. F.KohN.AbramovitzR., & GilbertL. (1992). Bereavement groups for inner-city children. Research on Social Work Practice, 2(3), 405–419.
45.
SchoenA. A.BurgoyneH., & SchoenS. F. (2004). Are the developmental needs of children in America adequately addressed during the grief process?Journal of Instructional Psychology, 31(2), 143–148.
46.
SchutH. A. W.de KeijserJ. D.Van Den BoutJ., & DijkhuisJ. H. (1991). Post-traumatic stress symptoms in the first years of conjugal bereavement. Anxiety Research, 4, 225–234.
47.
SelekmanJ.BuschT., & KimbleC. S. (2001). Grieving children: Are we meeting the challenge?Pediatric Nursing, 27(4), 414–419.
48.
ShahN., & MudholkarS. (2000). Clinical aspects of post-traumatic stress disorder in children and adolescents. In DwivediK. N. (Ed.), Post-traumatic stress disorder in children and adolescents. London, England: Whurr Publishers, Ltd.
49.
SmallA. M., & SmallA. D. (1984). Children's reactions to suicide in the family and the implications for treatment. In LinzerN. (Ed.), Suicide: The will to live vs the will to die. New York: Human Sciences Press.
50.
SmithC. (1993). Post traumatic stress disorder in South Africa's children and adolescents. Southern African Journal of Child & Adolescent Psychiatry, 5(2), 57–69.
51.
SmithM. Y.ReddW. H.PeyserC., & VoglD. (1999). Post-traumatic stress disorder in cancer: A review. Psycho-Oncology, 8, 521–537.
52.
SprangG., & McNeilJ. (1998). Post-homicide reactions: Grief, mourning and post-traumatic stress disorder following a drunk driving fatality. Omega: Journal of Death & Dying, 37(1), 41–58.
TerrL. C. (1991). Childhood traumas: An outline and overview. American Journal of Psychiatry, 148(1), 10–20.
55.
TonkinsS. A. M., & LambertM. J. (1996). A treatment outcome study of bereavement groups for children. Child & Adolescent Social Work Journal, 13(1), 3–21.
56.
WilkenC. S., & PowellJ. (1991). Learning to live through loss: Helping children understand death. National Center for Childcare. Manhattan, KS: Kansas State University Cooperative Extension Service.
57.
WilsonD. L. (1995). An outcome study of a time-limited group intervention program for bereaved children. Dissertation Abstracts International Section A: Humanities & Social Sciences, 55(12-A), 3793.
58.
WinjeD., & UlvikA. (1998). Long-term outcome of trauma in children: The psychological consequences of a bus accident. Journal of Child Psychology and Psychiatry, 39(5), 635–642.
59.
WolfeltA. D. (1991). A child's view of grief. Fort Collins, CO: Companion Press.
60.
WordenJ. W. (1991). Grief counseling & grief therapy: A handbook for the mental health professional. New York: Springer Publishing Company.
61.
WordenJ. W.DaviesB., & McCownD. (1999). Comparing parent loss with sibling loss. Death Studies, 23, 1–15.
62.
WordenJ. W., & SilvermanP. R. (1996). Parental death and the adjustment of school age children. Omega, 33, 91–102.
63.
YuleW., & WilliamsR. M. (1990). Post-traumatic stress reactions in children. Journal of Traumatic Stress, 3, 279–295.
64.
YuleW. (2001). Post-traumatic stress disorder in children and adolescents. International Review of Psychiatry, 13, 194–200.
