Psychological adjustment among bereaved parents: individual and interpersonal predictors

Abstract

Bereaved parents are a highly vulnerable group. Nevertheless, considerable individual differences exist between parents who have lost their child. The aim of this thesis was to identify factors that can predict which parents will be at particularly elevated risk for problematic adjustment after the loss of their child. I focused on three types of factors: (1) characteristics of parents, the child and circumstances of the death (2) attachment styles (psychological adjustment of insecurely attached parents, both avoidant and anxious attached) and (3) interpersonal processes (i.e., the impact of the convergence or divergence of partners' coping styles on their adjustment; marital satisfaction). A longitudinal study was conducted with 219 couples, who participated at 6, 13 and 20 months post-loss. Adjustment was studied in terms of both grief and depression. Use of multilevel regression analyses enabled assessment of the impact of several predictors and facilitated analysis of factors that were either shared by parents or that were individual ones. Furthermore, the use of the Actor Partner Interdependence Model enabled assessment of both actor as well as partner effects, and permitted differentiating according to gender of the parent. Several factors were found to contribute significantly to the prediction of grief and depression symptoms. Of the objective characteristics, grief was predicted mainly by factors that were equal for both parents: child's age, cause and unexpectedness of death, and number of remaining children in the family. By contrast, depression was predicted by individual parent factors: gender, religious affiliation, and professional help-seeking. Importantly, the feeling of having had said goodbye to the child and presenting the body for viewing at home were associated with lower levels of parents' grief. Results of the study on the relation between avoidant attachment and psychological adjustment of were contrary to previous research, and challenge the notion that this group is resilient. In the interpersonal context, results indicated that for men, having a female partner high in restoration-oriented coping was related to positive adjustment. Conclusions: A broad range of factors have been found to predict individual differences within the psychological adjustment processes of bereaved parents. Among these predictors were characteristics of the child, circumstances of the death, and insecure attachment styles of the parents. A clear distinction appeared in predicting depression and grief: Grief was mainly predicted by bereavement related factors, while depression was only predicted by individual factors of the parent. The main findings of these studies are published in five journal articles.