lit review 7

Although a common aspect of life, bereavement has been associated with a variety of
negative social, physical, and mental health outcomes, particularly anxiety. The stress of losing a loved one can be particularly difficult for bereaved children, especially those who have experienced the death of a parent. Most bereaved children experience low levels of anxiety, but a subset may experience very high levels of anxiety, which, if left untreated, can be risk marker for the development of future psychopathology. Unfortunately, there is a dearth of research examining potential predictors of anxiety among parentally bereaved children. This study examined the relations between individual (e.g., child coping, child religiosity) and environmental factors (parent coping style, parent religiosity), and level of child anxiety measured by child self-report. The sample consisted of 45 children ages 7 to 12 who experienced the death of a parent within 6 months of beginning the study and 35 of their surviving caregivers. Secondary data analysis utilized a linear mixed model to control for family effects. Results indicated that child age, child gender, child coping, child religiosity, and parent religiosity were all significantly related to child self-reported anxiety levels. These findings suggest the importance of both the parent’s and the child’s religiosity and coping in relation to child anxiety, and if replicated in a larger sample, may have critical implications for intervention efforts with bereaved youth.

Individual and Environmental Correlates of Anxiety in Parentally Bereaved Children Death is a universal aspect of humanity, yet the loss of a loved one may be one of the

most difficult and stressful events that one can experience in life. In fact, studies of grief among adult populations have found bereavement to be associated with a variety of serious negative health outcomes such as depression, suicidal ideation, mortality, overall lower quality of life, and anxiety problems (Byrne & Raphael, 1999; Grimby, 1993; Lichtenstein, Gatz, & Berg, 1998; Szanto et al., 2006). Given these findings, it is of particular concern that 3.4% of children in the United States experience the death of one or both parents before the age of 18 (U.S. Bureau of the Census, 2011). Although far fewer studies of bereaved children exist, the limited empirical research has found negative health outcomes similar to adults. For example, bereaved children have been shown to have higher levels of anxiety, depression, delinquency, dysphoria, and substance abuse compared to non-bereaved youth (Cerel, Fristad, Verducci, Weller, & Weller, 2006; Dowdney, 2000; Draper & Hancock, 2011; Kaplow, Saunders, Angold, & Costello, 2010; Weller, Weller, Fristad, & Bowes, 1991). In fact, one study found that one in five parentally bereaved children develops a psychiatric disorder (Dowdney, 2000). However, these findings are primarily among clinical samples (Cerel et al., 2006; Dowdney, 2000).

Relevance :

Moreover, although the hypothesis that parent coping strategies would be significantly associated with total child anxiety was not supported by the study findings, results did indicate that the use of denial as a parent coping strategy is significantly related to child physical anxiety symptoms. Also, it is important to note that parent denial was marginally related to total child anxiety and may have achieved significance in a larger sample. Thus, these findings suggest that the use of denial as a coping strategy by surviving parents may lead to higher anxiety and particularly somatic complaints among bereaved children. Perhaps a surviving caregiver’s denial of the death or the circumstances surrounding it may cause a bereaved child to be confused and anxious about the reality of their parent’s death. Moreover, surviving caregiver denial might model to a child that talking or thinking about the death is unacceptable. As a result, a child may express their anxieties through somatic complaints to avoid speaking or thinking about them. Furthermore, the relation between acceptance and lower total child anxiety was marginally significant, as was the relation between acceptance and lower child social anxiety. This suggests that the open acceptance of the death of a parent by a surviving caregiver may ease a child’s overall anxiety and their anxieties about interacting with others. Perhaps this is because children would be more comfortable accepting the death themselves or discussing the death with peers after having similar behavior modeled by their parents. The significance of these findings may have been limited by the study sample size. 

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