Parental death is always considered detrimental for children and adolescents. Critically evaluate presenting cross-cultural research findings and discussing risk factors
College for Humanistic Sciences – ICPS
University of Central Lancashire
M.Sc. in Psychology of Child Development
Child Behaviour and Impacts on Development
Parental death is always considered detrimental for children and adolescents. Critically evaluate presenting cross-cultural research findings and discussing risk factors
Losing a beloved person is one of the most distressful experiences in life, which has physical, emotional, cognitive and social consequences; the loss of a loved one signifies simultaneously a loss of a small or large part of one’s self, since every important relationship defines consciously or subconsciously one’s identity (Shear, 2015). One such traumatic experience is parental death during childhood (Berg et al., 2014). What actually makes a parental loss a traumatic experience is that the loss not only signals the death of a parent, but also the death of the relationship that the child developed with the parent; the death of the role of the parent for this child (Silverman, 2010). The child experiences an identity loss; the loss of the identity it held either through the mother (maternal loss) or the father (paternal loss). In this respect, the role that the deceased parent played in the child’s life in combination with the role that others play in this life are crucial and affect the child’s reaction and grief to the parental death (Silverman, 2010).
The potential effects that parental death imposes for a child depend on various factors (Berg et al., 2014), some of which will be scrutinized in this essay, such as: 1) the age of the child; the focus of this essay will be adolescence, and specifically early adolescence (12-15 years old)-, 2) the personality and the developmental stage the child holds, 3) the bond of the relationship between the deceased parent and the child, 4) the type of death of the parent (by natural or external factors), 5) the class and material circumstances, 6) the behaviour of the social and the wider family environment, 7) the reaction of the surviving parent, and whether and in which ways her/his presence facilitates the process of grief, 8) the quality of parenting the surviving parent provides, 9) the disruption or the continuity experienced after the death, 10) the degree that the socioeconomic level of the family was influenced by the death and whether the proportion of adolescents who lose their parents is higher in lower socioeconomic groups e.tc.
The possible effects of the parental death on the child, some of which will be analyzed in this essay are: health problems, health risk behaviours, and mortality, poor school performance (Fauth et al., 2009), alcohol and drug abuse and mental health problems, e.g. personality disorders and post-traumatic stress (Melhem et al., 2008) (Shear, 2009), increased suicide risk (Guldin et al., 2015), aggressive or depressive behaviour (Gray et al., 2011) and others.
From the outset, it should be stressed that is not an easy task to analyze and evaluate the effects of a parental death, since imponderable factors intervene and one can never be sure that a child would have a different process if the parent existed; it is possible that factors, such as the personality of the child or the influence of the social environment or unobserved factors would somehow or other have led the child to similar reactions. Based on the above-mentioned, the effects of parental death on children is scrutinized via the lens of both Western and non-Western countries.
Many studies have reported that parental death is usually followed by a decline in child’s well being (Amato and Anthony, 2014). A portion of authors distinguishes between the concepts of traumatic and complicated grief. A research study reported that children’s age, gender (females exhibited more traumatic grief), and ethnicity are factors predicting traumatic grief, whereas gender was a predictor of complicated grief, as well as the violent death of the parent (McClatchey et al., 2014).
The cognitive and emotional development possibly makes an adolescent to grieve in a different way in comparison to a child or to an adult. Even though adolescents are sufficiently old and mature to understand the death, they may not realize the lasting effects. Also, the unpredictable type of behaviour is a characteristic of adolescence and thus their reaction is not always the expected one. Because of the developmental stage they are into, it is possible that adolescents’ grief may last shorter than in adults, but it may appear again, later in years, as they grow up and develop emotionally (Robin and Omar, 2014). Adolescence (12-18 years) is the transitional period between childhood and adulthood, in which the children prepare for adult roles. At this age, there is physical, cognitive, behavioural, emotional, social and personality development, self-concept evolvement (D. R. Shaffer & Kipp, 2014). In many cases, adolescents feel empathy and are in conflict with parents (Van Lissa, Hawk, Branje, Koot, Meeus, 2015) and encounter an identity crisis (Gilmore, Meersand 2013). Adolescence is an age of self-discovery and some adolescents tend to consume alcohol and expose substance abuse in a desperate need to show that they are “cool”. But does parental death increase the risk for alcohol and substance abuse? A study revealed that bereaved adolescents face a larger risk to present abuse of alcohol and substance abuse or dependence (ASAD) as compared to nonbereaved adolescents and that adolescent boys with disruptive behaviour disorders face this risk in particular (Hamdan et al., 2013). This study refers to multiple possible reasons explaining this risk, such as: a) parents who die immaturely present high rates of ASAD themselves, so possibly genetic or environmental reasons could be involved, b) parental loss may cause depression, post traumatic stress disorder (PTSD), and financial problems to adolescents that all are correlated with ASAD, c) the surving parent may present depression, PTSD, and financial problems and thus adolescents could be less monitored and controled by this parent, resulting in a higher risk of ASAD.
Moreover, the type of the parental death may affect differently an adolescent; for example, it is characteristic that, as reported by a Swedish research, the suicide of a parent was a factor of an increased risk for suicidal thoughts and hospitalization for suicide attempt, depressive, psychotic, and personality disorders, while in the case of accidental death or other types of parental death such a risk was not detected (Wilcox, 2010). However, another study, which compared mental health features among adolescents bereaved by parental suicide, other types of parental death, and adolescents who did not experience parental death, indicated that the type of death made no difference. As explained in the study, the impact of the parental death by suicide is affected by pre-loss attributes in relation to personal/family history of mental health, family life, suicidal behaviour, and the emotional closeness of relationship and by post-loss adjustment, depending mainly on the quality of remaining relationships (Andriessen et al., 2016).
When the parental death is unexpected and sudden, it seems that there is a significant impact on subsequent developmental competencies. Based on these findings, it seems that the sudden death is a synonym of a sudden end of childhood; Adolescents may feel that their solid and stable conditions fall apart in a moment. A study reported that sudden parental bereavement had effects on adolescent developmental competence: children exposed lower capability in their peer relations, in their career planning, their educational ambitions, and in their work. These effects were mediated by factors, such as the wider family environment and the quality of parenting by the surviving parent.
Another interesting aspect is the impact of parental death as compared to the impact of parental illness, since in Western countries, 4 to 12% of adolescents live with a parent with a chronic illness (Razaz et al., 2014). Research reveals that parental cancer has been correlated with high degree of distress and stress response symptoms (SRS) in adolescents. The studies indicate that adolescents facing parental cancer feel more distressed during the terminal phase of the illness than after the actual loss. The impact on adolescents may vary depending on factors such as: poor parenting, open communication style, age, and the parent–child relationship (Phillips, 2014). Regarding another chronic disease, Multiple Sclerosis (MS), Razaz et al. (2014) concluded on mixed results: despite the negative psychosocial effects, some positive aspects were also found.
Educational attainment and school performance are an aspect of adolescent’s life, which may be affected by the parental loss. For example, a British study revealed that parental absence in general when a child is at the age of 11-15 is correlated to low educational attainment for both genders, and when the absence is caused by parental death then the effects are more significant for boys than for girls (Fronstin et al., 2001). Very interestingly a study conducted in Norway -a country with high divorce rates- indicates that a) parental divorce is related to a reduction in a child’s likehood to attend college, b) the effect of a father’s death is not significantly related to progression beyond the higher secondary level and c) children who experience a parental divorce at younger ages are somewhat less likely to continue their education after lower secondary school (Steele et al., 2009). The reasons that children present lower educational attainment derive either from the absence of the one parent or from the changes the family disruption causes, since their role in the family could change. However, the above-mentioned refer to the differences that a parental loss makes if it is caused by a parental divorce or a parental death. A research study examining the results of parental death on school performance concluded that both maternal and paternal loss is associated with lower school performance. Lower school performance is in many cases associated with the socioeconomic disadvantage (parental death may also lead to placement to foster care, which may have negative effects on school performance) that the death causes and the psychosocial problems the family faces after the death (Berg et al., 2014). Specifically, Berg et al. (2014) focus on adolescents 15-16 years old, for whom parental death was related to psychosocial problems that the family experienced and financial disadvantage, both factors that seemed to explain the negative consequences of the parental death on school performance.
HIV virus (Human Immunodeficiency Virus) is a lentivirus, which progressively leads to the Acquired Immunodefiency Syndrome (Douek et al., 2009). In the developing countries, HIV continues being a major wound, especially for children who lose their parents due to HIV-AIDS. According to a study (Sharp et al., 2015), the immediate as well as the long-term effects of AIDS orphanhood are abated, since there exists a number of risk and protective factors (risk factors, e.g. gender of the child, poverty, gender of deceased parent, quality of caregiver support, social network factors and protective factors, e.g. HIV/AIDS knowledge, better mental health, healthy surviving parent, trusting caregiver, more social support e.tc.). Specifically, this study indicates that the mental health effects of AIDS orphanhood are moderated, as children live in a high-risk area, experiencing poverty and extreme low amenities. Based on the study, when it comes to internalizing and behavioural problems and school functioning, AIDS orphans do experience more psychosocial distress than non-orphans. But when the comparison is made between AIDS orphans and orphans by other reasons, AIDS orphans do not present great differences regarding externalizing or school functioning complications. The only difference is that AIDS orphans present more internalizing and social problems, especially during adolescence, which are correlated with the different types of stigma (perceived stigma, personalized stigma, enacted stigma) adolescents go through.
Another study (Chi and Li, 2013) concludes on mixed results, indicating, however, that AIDS orphans exposed poorer psychological wellbeing as compared with children orphaned by other causes. The difference in effects regarding maternal and paternal loss related to HIV/AIDS causes is not so clear. Still, it is very interesting that Nyirenda et al. (2010) reported that maternal loss for adolescent girls was associated with increased earlier sexual activity and HIV infection. It seems that there exists a strong correlation between the death of a parent of the same sex and the careless sexual behaviour and an increased HIV risk for adolescents, which is possibly explained by the loss of the role model; losing a parent of the same sex, could mean for an adolescent losing the exemplar. Last but not least, research literature on HIV/AIDS reports that a mother’s death has typically great negative effects for the education of children; on the contrary, the paternal loss has insignificant effects. This denotes the significance of the mother’s role in educational attainment. Nyirenda et al. (2010) provide one possible explanation: the father who lives and works in other areas and as such the mother’s role is much more meaningful.
In 2004, one of the most catastrophic natural disasters took place in the Indian Ocean at the island of Sumatra: the tsunami, which caused the death of more than 160,000 people. As a result of this deadly event, many children lost one or both parents; it is estimated that about 10,000 lost one parent and about 4,400 both of them. A thought-provoking research study by Cas et al. (2014) utilizes longitudinal data on children whose homes were along the coast that the tsunami hit and the unexpected nature of the tsunami that allows us to understand how parental death affects children. The research deals with both short-term and long-term impact of parental death, since it provides interviews approximately one year and interviews about five years after the event.
This study concludes that 1) the major factors, which define the impact of parental death, are the child’s age and gender, 2) the short-term effects do not necessarily predict the long-term effects and 3) the loss of both parents largely leads to the human capital accumulation of 15-17 years old, both girls and boys, and possibly of 9-14 years old girls. The paternal loss has a greater impact on older males and specifically on their education after the loss, in comparison with other males who did not experience a paternal loss in the tsunami. On the other hand, the maternal loss does not have a great impact on school attendance and education, but has an impact on time allocation of children. The roles of mother and father comes in contrast with the findings presented above for Africa and AIDS-HIV orphans; different countries, different parental roles.
In particular, one year after the catastrophic tsunami and the parental death children were less likely to attend school. It is sad that although there existed scholarship programmes, the least likely to receive such a scholarship were older males, who lost both parents in the tsunami. It is characteristic that five years after the tsunami, older males who have lost a father or both parents were forced to leave school and work; it seems that these males replaced the father and took the responsibility to look after other siblings or their mother or these adolescents were likely living in areas in which the tsunami reduced the access to schools. On the other hand, there is no evidence that older females, who lost one or both parents, presented less school attainment than females whose parents survived.
The maternal loss or the loss of both parents did have an impact on lower school attainment, but the greatest effect was that these orphans took over the housework, and thus experienced changes in social relationships, early maturity and sudden loss of childhood. Five years after the tsunami, the older females in a percentage of 62% were more likely to be married, due to the decline of psychosocial and economic resources. Expanding this reflection and based on the findings, it seems that these children wished eagerly to found a new home, to find new balance, because people have the need to belong.
The authors conclude in the study that when the father dies, the mother tends to protect older females, while when the mother dies the child steps in the mother’s role. Moreover, the evidence of the study suggests that both the child and the surviving parent substitute the deceased parent, which is not always the case in Western cultures. Finally, the children who lost both parents, the double orphans, are the most affected ones and the most vulnerable. These findings reflect that the parental loss is not only the loss of a parent, but it is also the loss of the person who supported financially the family or the loss of the person who did the housework or the loss of the family as it used to be… the loss of the reality that the child used to have.
A parental loss is a parental loss whether the family lives in Sweden, in Norway, in the UK or in the Indian Ocean or the sub-Saharan Africa. The bond of the child with each one of the parents is a unique one and as every child and every person is different, the effects of a parental death cannot be predicted and uniformed. However, there exists a vast literature on the subject, providing useful and thought-provoking findings. After examining and analyzing these findings, it seems that the gender and the personality of the child are major factors for the impact of parental death. A parental death leads possibly to emotional disorders, behavioural problems and poor educational attainment and the effects differ between females and males; females tend to create their own family when they lose both parents by marrying early or they have early sexual relationships. On the other hand, males receive less education and work to make their living. Each gender seems to be keen to follow the social role given and this remark by no means relates to social stereotypes, but rather to the specific needs of everyday life and reality.
Amato and Anthony, Estimating the Effects of Parental Divorce and Death With Fixed Effects Models, J Marriage Fam. 2014 Apr 1; 76(2): 370–386
Andriessen, Draper, Dudley & Mitchell (2016) Pre- and postloss features of adolescent suicide bereavement: A systemayitic review, Death Studies, 40:4, 229-246
Berg et al., Parental death during childhood and subsequent school performance, Pediatrics, Volume 133, Number 4, April 2014
Berg L., Rostila M., JanSaarela, and Hjern A., Parental Death During Childhood and Subsequent School Performance, PEDIATRICS Volume 133, Number 4, April 2014
Cas A.G., Frankenberg E., Suriastini W., Thomas D., The impact of parental death on child well-being: evidence from the Indian Ocean Tsunami, Demography (2014) 51: 437-457
Chi and Li, Impact of Parental HIV/AIDS on Children’s Psychological Well-Being: A Systematic Review of Global Literature, AIDS Behav . 2013 September ; 17(7): 2554–2574
Douek, Roederer, Koup, Emerging Concepts in the Immunopathogenesis of AIDS, Annu. Rev. Med. 60: 471-84
Ellis J., Dowrick C. and Lloyd-Williams M., The long-term impact of early parental death: lessons from a narrative study, J R Soc Med. 2013 Feb; 106(2): 57–67
Fauth B., Thompson M., Penny A., Associations between childhood bereavement and children’s background, experiences and outcomes, 2009
Fronstin P, Greenberg D, Robins P, Parental disruption and the labour market performance of children when they reach adulthood, Journal of Population Economics, 2001;14:137–172
Gilmore and Meersand, The Little Book of Child and Adolescent Development, Oxford University Press, 2014
Guldin, Li, Søndergaard Pedersen, Obel, Agerbo, Gissler, Cnattingius, Olsen, Vestergaard, Incidence of Suicide Among Persons Who Had a Parent Who Died During Their Childhood, JAMA Psychiatry, 2015
Hamdan et al., Alcohol and Substance Abuse in Parentally Bereaved Youth, J Clin Psychiatry 2013 Aug; 74(8): 828-833
Hatim A., Adolescent Bereavement in Joav Merrick, Ariel Tenenbaum & Hatim A. Omar (Eds.), School, Adolescence, and Health Issues, 97-108 (2014)
Melhem N., Walker M., Moritz G., Brent D., Antecedents and Sequelae of Sudden Parental Death in Offspring and Surviving Caregivers, Arch Pediatr Adolesc Med. 2008;162 (5):403-410
Nickerson, A., Bryant, R. A., Aderka, I. M., Hinton, D. E., & Hofmann, S. G., The Impacts of Parental Loss and Adverse Parenting on Mental Health: Findings From the National Comorbidity Survey-Replication in Psychological Trauma: Theory, Research, Practice, and Policy, (2011, October 17) as cited at <http://www.goodtherapy.org/blog/parent-death-during-childhood>, The Lifelong Effects for a Child After the Death of a Parent, October 24, 2011, A GoodTherapy.org News Summary [last access: 19 June 2016]
Nyirenda M., McGrath N. and Newell M-L., Gender differentials in the impact of parental death: Adolescent’s sexual behavior and risk of HIV infection in rural South Africa, Vulnerable Children and Youth Studies Vol. 5, No. 3, September 2010
Phillips F., Adolescents living with a parent with advanced cancer: a review of the literature, Psycho-Oncology 23: 1323–1339 (2014)
Razaz et al., Children and adolescents adjustment to parental multiple sclerosis: a systematic review, Neurology 2014, 14:107
Searles McClatchey, Vonk, Lee & Bride (2014) Traumatic and Complicated Grief Among Children: One or Two Constructs?, Death Studies, 38:2
Shaffer, D. R., & Kipp, K. (2014). Developmental psychology: Childhood and adolescence (9th ed.). Belmont, CA: Cengage
Sharp, Jardin, Marais and Boivin, Orphanhood by AIDS_related causes and child mental health: A developmental psychopathology approach, J HIV AIDS 1 (3) 2015
Shear K., Complicated Grief, New England Journal of Medicine, January 8, 2015
Shear K., Grief and Depression: Treatment Decisions for Bereaved Children and Adults, The American Journal of Psychiatry; Jul 2009; 166, 7; ProQuest Social Sciences Premium Collection 746
Silverman P.R., Raising Grieving Children, What is lost when a parent dies, Psychology Today, posted on Aug 30, 2010 on <www.psychologytoday.com>, available online at https://www.psychologytoday.com/blog/raising-grieving-children/201008/what-is-lost-when-parent-dies [last access: 19 June 2016]
Steele et al., Consequences of Family Disruption on Children’s Educational Outcomes in Norway, Demography. 2009 Aug; 46(3): 553–574
Van Lissa, Hawk, Branje, Koot, Meeus, Divergence between adolescent and parental perceptions of conflict in relationship to adolescent empathy development, J Youth Adolesc. 2015 Jan;44(1):48-61
Weller, Fristad, and Weller, Depression in children and adolescents two months after the death of a parent, Journal of Affective Disorders 135 (2011)
Wilcox H.C., Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death, J Am Acad Child Adolesc Psychiatry, 2010 Aug; 49(8):858-9