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Children Bereaved by Parent or Sibling Death
Bereaved children, like bereaved adults, experience shock and disbelief, followed by despair, anger, a yearning for the deceased to return, and trouble concentrating, sleeping, and eating. Children's perception of death as permanent, irrevocable, and implying the complete loss of physiological function progresses. Preschoolers think and act as if a person who has died can return. Children think their ideas and feelings may cause or reverse death until they are seven.
Around age 11, when death is completely grasped, children stop caring about the deceased being cold or lonely, even though they picture an eternity in which the departed remains sensate and enjoy particular pastimes. Some children may find this comforting if they feel their deceased parent 'watches over' or cares for them. The injustice of death and philosophical issues about the meaning of life might disturb adolescents. Children who are cognitively and vocally capable or who have witnessed someone die to have a better comprehension of the notion of death.
How do Children Express their Grief?
Children's capacity to distract themselves from sadness with everyday activities such as play or social activities may cause caretakers to question whether they grieve. Young children's incapacity exacerbates this uncertainty in expressing their emotions verbally. As children age, their fascination with death will take on different forms.
Young youngsters will actively look for the deceased. Their dreams and play reflect their specific problems and preoccupations. Their feeling of loss, their caregiver's sadness, and altered daily routines might cause confusion, developmental regression, and unjustified outbursts of wrath or hostility.
Appropriate grief coexists with a speedy return to normative activity. Sleeping problems develop and are impacted by the child's age: 5-7-year-olds have difficulty falling asleep; older youngsters have nightmares, though some find consolation in thinking about the departed. When an attachment figure is close, children of all ages relax more readily. Physical signs of discomfort, such as headaches, occur around the age of eight, as do temper outbursts, argumentativeness, and attention difficulties. Children's natural interest in death might sometimes reveal underlying fears about their responsibility for what occurred. In response to their questions, parents' sadness can hush youngsters, allowing misperceptions about death to continue. Separation anxiety manifests as concerns about the fragility of loved ones.
Grief manifests in various ways, including withdrawal from family activities and seeking peer support. Adolescents may jeopardise their mortality by engaging in risky activities such as alcohol or drug usage. Their cognitive ability to reflect on their previous relationship with the deceased may provide consolation or, for those burdened by guilt or remorse, may cause further suffering. They may be assigned new family duties and obligations and face expectations of immature behaviour. A sense of duty and a desire to protect bereaved individuals may result in masked pain and confused messages to others.
Resilience and Positive Outcomes in Bereaved Children
Following grief, most children are resilient and resume their regular developmental trajectory. Although parental loss irreversibly alters a child's life path, some children and adolescents describe beneficial reactions to mourning, such as increased independence, improved school achievement, increased empathy for another's sorrow, and spiritual growth.
According to research on good bereavement outcomes, resilient children have higher coping efficacy and fewer negative evaluations than affected children. However, because resilient children are chosen based on being below a certain level of clinical disturbance, variances in their cognitive styles may reflect differences in the mental health status of resilient and 'affected' children.
Psychopathology in Bereaved Children
Changes in research inclusion/exclusion criteria, recruiting practices, and measurements employed cause changes in reported rates of psychopathology in bereaved children. According to the best-controlled research, just one in every five people would experience clinically significant disruption. Dysphoria (uneasiness), headaches, stomach pains, and separation anxiety are common grief symptoms.
The disturbance is often non-specific, with a considerable increase in the frequency and persistence of mourning symptoms that, in other bereaved children, ordinarily subside within four months after the death. A child's reported desire to die often represents the child's want to be joined with the departed. However, such remarks must be carefully investigated, especially when family suicide has happened.
Children who have lost a family member through murder or suicide may develop post-traumatic stress disorder (PTSD) and internalising problems. Rates and forms of psychopathology are comparable to other bereaved children, with a higher risk of depressive disorder up to two years following the occurrence. Suicidal activity is more likely, as are higher degrees of persistent anger, guilt, humiliation, and social isolation.
Complicated traumatic grieving (CTG) is defined by persistent intrusive and avoidant trauma symptoms that occur when the dead dies under subjectively stressful circumstances. It can result in avoiding any pleasant or bad memory of the deceased and social disengagement at school. The causes are unknown. One possible contributing aspect is that children's sense of predictability and stability may be harmed if their primary carer looks overwhelmed by the death. Attempts to distinguish disorders such as CTG and PTSD continue. Short-term trauma-based cognitive behavioural therapies (CBT) with parents and children are a viable treatment option for CTG.
Theoretical on Interventions with Bereaved Children
For interventions with grieving children, there are two major theoretical foundations. The first suggests that children must perform a series of bereavement-related tasks to address their sorrow and prevent maladaptive effects satisfactorily. These duties include accepting the inevitability of loss, creating a positive internal image of the departed and establishing new and supportive connections.
In CTG, trauma is viewed as interfering with grief resolution, demanding the treatment of traumatic symptomatology in order to complete mourning responsibilities. The second approach considers children's outcomes to result from various cumulative risk and protective variables at work in the post-death environment. Interventions under this paradigm try to promote resilience, such as through modulating children's coping methods and encouraging good parenting.
What Do Bereaved Children Need?
Children who have lost a parent benefit from precise knowledge about the death and subsequent events. It is comforting to know that they could not have changed or impacted any of them and that death primarily strikes the old. Explanations should be age-appropriate, precise, and genuine, avoiding euphemisms like "gone to sleep," which small children would take literally. There is little assistance available in cases of familial suicide or murder.
Protectiveness towards children and adult survivors' guilt and humiliation may influence the open sharing of knowledge. Adults may struggle to show sympathy and care for the departed while not implying to young children that violence or suicide are appropriate coping mechanisms.
What is Helpful for Parents?
Understandably, bereaved parents may be unsure what to tell their children and when. Often, all parents need is a chance to talk about their worries and potential solutions with an understanding and supportive adult who can give management suggestions. Unexpected deaths need rapid judgements from unprepared parents, who can be encouraged that actions they later regret will be handled.
For example, children who did not attend the funeral might have it narrated and visit the burial place. Explanations that children's sorrow can take various forms and fade over time might calm parents about the normalcy of their children's reactions. Family reminiscences about the deceased significantly benefit children who do not appear to be mourning.
The expression of sadness by bereaved children is influenced by their developmental level, as well as their age and gender. Adults may be perplexed by their grief's episodic nature. Separation from attachment figures can cause anxiety in people of all ages. Grief-related sadness is not a sign of disease. One in every five children suffers from clinical disruption. Positive and authoritative parenting promotes children's resilience.
Parents value information that normalises their children's sadness and traumatic symptoms while providing management advice. Bereaved youngsters appreciate the opportunity to express their views and feelings. Most families do not require psychological treatments. However, those bereaved by murder or suicide might benefit from further assistance. Consultation with other organisations that regularly interact with children, such as schools, helps strengthen families' supportive community networks.
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