Adolescent Grief

Abstract

In the United States, more than 2 million children and adolescents (3.4%) younger than 18 years have experienced the death of a parent. When death can be anticipated, as with a terminal illness, and even when the death is sudden, as in the September 11, 2001, attacks on the World Trade Center and Pentagon, physicians and other health care professionals have an opportunity to ameliorate the impact of the loss. Developmental factors shape adolescents' reactions and responses to the death of a parent. Recent research in childhood and adolescent bereavement shows how health professionals can support the adolescent's coping strategies and prepare the family to facilitate an adolescent's mastery of adaptive tasks posed by the terminal phase of the parent's illness, the death, and its aftermath. Robert, a bereaved 14-year-old, illustrates some of these adaptive challenges.

Mortality after Parental Death in Childhood: A Nationwide Cohort Study from Three Nordic Countries

“…We also observed that short-term mortality from external causes varied with the child's age at bereavement, with the youngest age group suffering most, which indicates lack of intense care immediately after bereavement for very young children. The above observations highlight the fact that children's coping mechanisms and their understanding of death are related to their age-dependent developmental capacity [41],[49]. Yet, the overall risk of death remained high for more than 20 years independently of age at bereavement.…”

“…In addition, social-behavioral consequences of parental death, such as the loss of a care giver, misbehaviors, and functioning impairment [20],[41]–[45] can increase the risk of death from injuries or other external causes. For example, parental suicide was associated with more transport accident deaths in our population.…”

“…For example, parental suicide was associated with more transport accident deaths in our population. Furthermore, psychosocial stressors embedded with parental death in childhood [20],[41]–[44] can interact with genetic susceptibility to create psychiatric problems [46],[47], which may lead to more deaths from external causes. Unnatural parental death impacted child's mortality more than natural parental death, which may be explained by the fact that unexpected or sudden parental death has more severe psychosocial consequences [15],[20],[41],[48].…”

Early indicators of problematic grief trajectories following bereavement

“…A possible explanation could be that the nature of the sample and losses differed between both studies. Children’s grief reactions are strongly shaped by their developmental capacities and may therefore be expressed differently than adult’s reactions (Christ, Siegel, & Christ, 2002; Miller, 2009). Furthermore, it is known that the cause of death may influence bereavement outcome (Djelantik et al, 2017).…”

Psychotropic Medication Use in Human Immunodeficiency Virus-Infected Youth Receiving Treatment at a Single Institution

“…Shame, isolation, secrecy, survivor guilt, economic deprivation, and cultural factors often stand as barriers to critically needed mental health services leaving youngsters more vulnerable to negative psychiatric sequelae. Ideally, mental health professionals can help support adaptive coping strategies and prepare the family to facilitate an adolescent's mastery of adaptive tasks posed by the terminal phase of the parent's illness, the death, and its aftermath (Christ et al 2002). At a minimum, bereavement counseling should be provided to facilitate constructive mourning followed by monitoring of the child's mental health over time.…”