Trajectories of Grief in Suddenly Bereaved Children

Peter Roy-Byrne, MD

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In This Article

Abstract and Introduction

Abstract

Half of bereaved children work out their grief in the first year, but others struggle, with 10% failing to resolve their grief within 3 years.

Introduction

One in 20 U.S. children suffers the death of a parent before age 18. In a carefully done, population-based, longitudinal study in Pittsburgh, researchers studied 183 parentally bereaved children (age range, 7–18 years) whose parents died by suicide, unintentional injury, or unexpected natural causes.

Through interviews at 9, 21, and 33 months after the death, the researchers identified three trajectories of grief reactions distinguished by grief severity and its changes over time. Group 1 (n=107) had the lowest Inventory of Complicated Grief (ICG) scores, which declined significantly over time. Group 2 (n=56) had intermediate ICG scores, which declined gradually. Group 3 (n=19) had the highest ICG scores, which showed no change over time. Compared with group 1, groups 2 and 3 had almost three times the rate of incident depression, earlier onset of depression, and worse functioning during the 3-year period. Group 2 and 3 membership was predicted by death from unintentional injury and by the child's self-reported depression at 9 months after the parent's death. Group 3 membership was further predicted by a history of depression, functional impairment at 9 months, and incident post-traumatic stress disorder. ICG severity and complicated grief in the surviving parent independently predicted depression risk.

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