Complicated Grief and Bereavement in Young Adults Following Close Friend and Sibling Loss

Mash, Holly B. Herberman; Fullerton, Carol S.; Ursano, Robert J.

doi:10.1002/da.22068

Cited by 65 publications

(64 citation statements)

References 90 publications

(176 reference statements)

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“…We fully acknowledge the needs of other high-risk bereaved populations who are often profoundly impacted by military-related deaths. These include bereaved siblings of deceased military service members, for which there is a growing literature derived from civilian populations (e.g., Herberman-Mash, Fullerton, & Ursano, 2013), as well as bereaved parents and grandparents of deceased military members. We also note an important inter-generational asymmetry: The intense grief and suffering of parents who lose an adult child in combat may greatly exceed the intensity of grief reactions commonly experienced by adult children who lose a parent due to illness or old age .…”

Section: Multidimensional Grief Theorymentioning

confidence: 99%

Using Multidimensional Grief Theory to Explore the Effects of Deployment, Reintegration, and Death on Military Youth and Families

Kaplow

Layne

Saltzman

et al. 2013

Clin Child Fam Psychol Rev

114

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To date, the U.S. military has made major strides in acknowledging and therapeutically addressing trauma and Posttraumatic Stress Disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (Multidimensional Grief Theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death—especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD.

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Section: Multidimensional Grief Theorymentioning

confidence: 99%

Using Multidimensional Grief Theory to Explore the Effects of Deployment, Reintegration, and Death on Military Youth and Families

Kaplow

Layne

Saltzman

et al. 2013

Clin Child Fam Psychol Rev

114

View full text Add to dashboard Cite

show abstract

“…The outcomes of this study were dependent on treatment seeking and thus do not capture all health outcomes in the population. Administrative data cannot assess certain emotional consequences such as complicated grief, which may be highly prevalent in bereaved siblings. Post‐traumatic stress disorder represents another outcome that is not accurately captured in the datasets; this is a significant limitation given the traumatic nature of sibling loss.…”

Section: Discussionmentioning

confidence: 99%

Bereavement after sibling death: a population‐based longitudinal case‐control study

Bolton

Château

et al. 2016

World Psychiatry

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The objective of this study was to examine mental disorders and treatment use among bereaved siblings in the general population. Siblings (N57243) of all deceased children in the population of Manitoba, Canada who died between 1984 and 2009 were matched 1:3 to control siblings (N521,729) who did not have a sibling die in the study period. Generalized estimating equations were used to compare the two sibling groups in the two years before and after the index child's death on physician-diagnosed mental disorders and treatment utilization, with adjustment for confounding factors including pre-existing mental illness. Analyses were stratified by age of the bereaved (<13 vs. 131). Results revealed that, in the two years after the death of the child, bereaved siblings had significantly higher rates of mental disorders than control siblings, even after adjusting for pre-existing mental illness. When comparing the effect of a child's death on younger versus older siblings, the rise in depression rates from pre-death to post-death was significantly higher for siblings aged under 13 (p<0.0001), increasing more than 7-fold (adjusted relative rate, ARR57.25, 95% CI: 3.65-14.43). Bereaved siblings aged 131 had substantial morbidity in the two years after the death: 25% were diagnosed with a mental disorder (vs. 17% of controls), and they had higher rates of almost all mental disorder outcomes compared to controls, including twice the rate of suicide attempts (ARR52.01, 95% CI: 1.29-3.12). Siblings in the bereaved cohort had higher rates of alcohol and drug use disorders already before the death of their sibling. In conclusion, the death of a child is associated with considerable mental disorder burden among surviving siblings. Pre-existing health problems and social disadvantage do not fully account for the increase in mental disorder rates.Key words: Sibling, bereavement, epidemiology, depression, suicide, mental disorder (World Psychiatry 2016;15:59-66) Most children have a sibling 1 . While fertility rates are lower in Western nations and family sizes have diminished in recent decades, the majority of households with children in the U.S. in 2010 had two or more children 2 . Each year more than 40,000 children and adolescents die in the U.S., leaving a substantial number of bereaved siblings 3 .Sibling bereavement is an experience with a very sparse literature and thus the consequences of losing a sibling are unclear. A series of Swedish national cohort studies revealed increased mortality of bereaved siblings when compared to non-bereaved controls 4-8 . These analyses, however, were restricted to adult sibling populations and did not examine outcomes other than death.Other smaller studies have examined bereavement experiences related to specific causes of sibling death, namely cancer and suicide, with mixed findings 9-12 . One study of cancerrelated bereavement showed no differences in anxiety and depression between bereaved and non-bereaved siblings 13 , while other descriptive case series found anxiety, substance mis...

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“…Siblings of children with cancer might experience this lack of attention already during the sibling's cancer illness, leading to feelings of loneliness, jealousy, anger, and guilt . Bereaved siblings showed prolonged grief; higher rates of mental disorders, ie, depression, anxiety, and substance use disorder; and higher rates of suicide attempts compared with nonbereaved siblings . After a major life crisis, like the death of a family member, individuals might also experience a positive change, as indicated by reports of personal or posttraumatic growth (PTG) after parental or sibling loss …”

Section: Introductionmentioning

confidence: 99%

Psychosocial outcomes in cancer‐bereaved children and adolescents: A systematic review

2018

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Complicated Grief and Bereavement in Young Adults Following Close Friend and Sibling Loss

Abstract: Complicated grief and depression are common among bereaved young adults. Sibling loss is particularly distressing to young adults, due in part to the high level of relationship depth, and is associated with increased psychological and physical symptoms postloss.

Cited by 65 publications

References 90 publications

Using Multidimensional Grief Theory to Explore the Effects of Deployment, Reintegration, and Death on Military Youth and Families

Using Multidimensional Grief Theory to Explore the Effects of Deployment, Reintegration, and Death on Military Youth and Families

Bereavement after sibling death: a population‐based longitudinal case‐control study

Psychosocial outcomes in cancer‐bereaved children and adolescents: A systematic review

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