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Death of a parent and its negative effects on   1
a child




          How does the sudden death of a parent negatively affect a child?

                                Romane Marraccini

                            University of San Francisco
Death of a parent and its negative effects on       2
a child
          A death of a parent is one of the most stressful times for someone, especially a

child. The child has to quickly mature and learn to become more independent with the

absence of their parent. Children cope with their loss differently. Depression is one of the

most common psychological problems following this traumatic event. Many different

researchers have studied different experiences feelings that a child encounters. Children

encounter feelings of being alone despite all of their family and friend support. Other

studies have shown how depressed children become or develop psychiatric disorders later

in life. In this literature review, I will describe four articles and that a sudden death of a

parent negatively affects a child.

          Researchers Gray, Weller, Fristad and Weller (2011) studied the depressive

symptoms in adolescents and young children two months immediately after their parent’s

death. Their aim was to determine if bereaved children had higher depressive symptoms

and depressive episodes versus a community control group. Risk factors for the

depressive symptoms after the death of a parent was also researched. Through a list of

names from obituaries and funeral homes, researchers gathered 325 children ranging in

ages from five to 18 years old. These children were compared to non-bereaved

community controls and non-bereaved depressed controls. Children in the community

control did not lose a parent. There were 129 children recruited from schools, community

groups and churches. For the depressed control, there were 110 children. All three groups

demographics similarly matched in that a majority of the children were ten10 to eleven

11 years old, Caucasian and male.

          The researchers proceeded to measure depression in the participants. First, the

researchers used the Diagnostic Interview for Children and Adolescent Revised to assess
Death of a parent and its negative effects on      3
a child
depression. The participants made provided self-reports through the Children’s

Depression Inventory, which measured the severity of depression in the children. The

Psychiatric Diagnostic Interview collected the parents and the child’s personal psychiatric

history. Researchers analyzed all the data twice. The first analysis included all three

groups of children. The second analysis included only one child from each group. With

all the information that the researchers collected, they created a table.

          The children who had lost their parent were more likely to have a depression

episode compared to the community control group, but were surprisingly less likely than

the depressed control group . In all the depressive symptoms shown on the table, Tthe

depressed control group had the highest percentage out of the three groups. The most

common symptoms for the three groups were dysphoria, guilt and sleep changes.

Dysphoria is when a type of person has intense depression seen in people who areand is

discontent about him or herself. About one fourth of the bereaved children had three to

four depressive symptoms following the death of their parent. The loss of a parent causes

depressive symptoms and episodes in their child following their death.

          This study was very useful but it was not descriptive in its methods of interview.

It did not state say what the type of questions they asked their participants and it did not

describe any other negative feelings other than depression. For future studies, I would

like to study more about coping methods to help cure the depression that the child faces.

Also, more longitudinal studies should be set up to see how long the depression has lasted

and if it has turned into a more serious psychological problem.

          Researchers Melhem, Walker, Moritz, and Brent (2008) studied the psychological

outcomes that children experience after a parent’s death. As described by Gray, Wellers,
Death of a parent and its negative effects on   4
a child
Fristad and Weller (2011), children show symptoms of depression and grief immediately

after their parent’s death. Males are also more likely to have difficulty coping with the

loss. For this study, the researchers addressed four questions for their own findings.

What psychiatric factors in the deceased parent are associated with suicide, accidental

death or natural death? What are the psychological developments of children whose

parent died? Is grief the only outcome of a child after their parent has passed away? Does

parental suicide have a higher risk of psychological development than the loss of a parent

due to an accident or natural death?

          To begin the study, researchers gathered 140 families with whose parent was a

deceased parent who was between the ages of 30 to 60 years old at the time of their

death. The child was aged seven to 25 years old when the parent died. The parent died

from suicide, an accident or a sudden natural death. This group was compared to a non-

bereaved control group. There were 99 families and both parents were living. Both

groups were chosen through a local newspaper advertisement. Then the researchers

proceeded with the interviews, which were held at the participant’s homes.

          The interviews were conducted approximately no more than nine months after the

parent died. The results varied differently. The children whose parent died due to suicide

were more likely to have bipolar disorder, alcohol, and substance abuse than the non-

bereaved group. In their findings, the researchers also found that children whose parent

died of an accident were more likely to develop personality disorders. As for the child

whose parent died suddenly and naturally, they had about the same likelihood as the

children whose parent died of suicide in developing bipolar disorder.

          The researchers also took into account the families history of a depression
Death of a parent and its negative effects on   5
a child
disorder. Many of the child’s parent, or their caregiver, who was still alive also had a

history of depression or anxiety both prior and after the death of the deceased parent.

The caregivers of the children from all three groups had increased posttraumatic stress

disorder compared to the caregivers of the non-bereaved group. Overall, symptoms that

arise in both the parent and child after a parent has suddenly died are PTSD, suicidal

thoughts, depression, and anxiety.

          The bereaved groups are at a higher risk to for depression and PTSD after their

parent has died. Every category in the bereaved group had its different outcomes with the

children. The two groups that were the most similar were the parent who died from

suicide or an accident. Those children were more likely to develop a more serious

psychological disorder because of the sudden death of their parent. Whereas the child

whose parent died from natural causes had the chance to spend time with their parent

before they passed away. The researchers provide information on the best solution to

maintain healthy. After this tragic event, the child is to be continuously monitored for

depression by a their caregiver. Given that these children will mourn for the loss of their

parent, the caregiver needs to support their child. As for further research, again the

researchers should conduct longitudinal studies.

          Studies have been done on childhood depression following the death of a parent.

Researchers Pfeffer, Karus, Siegel, and Jiang (2000) studied depression, social

competence and behavioral problems in children after their parent suddenly died from

cancer or suicide. They identified young adolescents through records of the local medical

examiner whose parents had passed away about one and a half years before the study.

The adolescents were between the ages of six to 13. The focus of this study was to
Death of a parent and its negative effects on     6
a child
evaluate how children adapt after their parent has died. They gathered 16 children whose

parent died of suicide and 64 children whose parent died from cancer. Then the

researchers continued into their study and began to measure stress and depression in these

children.

          A self-report questionnaire was given out to the children to rate their symptoms of

depression. There were five categories: negative mood, interpersonal problems,

incapable, inability to feel happy and negative self-esteem. The children’s behavior

reports were collected through the Child Behavior Checklist. While conducting their tests

on the adolescents, they found both groups to be extremely similar. There was only one

difference was that ; children of suicidal parents were more depressed and angry.

          The scores of the children were reported inon a table. Overall, the child whose

parent died of suicide had slightly higher scores in all five categories. Other than

depression, there are additional other psychological distresses that children encounter but

this study did not focus on those. The living parent of the child reported the child’s

behavioral problems. This included how they were doing in school and how they

reactedinteracted in social settings with their friends and family members. There was a

high level of spirit in the children after the loss of their parent. Another finding was that a

child has a higher risk to develop a more serious emotional or behavioral problem

between one to two years after the parent has died. Lifestyle changes, such as the

caregiver remarrying after the parent has died, can trigger a major depression disorder.

          The results produced expected conclusions to the researchers. The bereaved

children whose parent died from suicide had higher levels of depression. Each child

grieves death differently and for the child who lost their parent to suicide, traumatic
Death of a parent and its negative effects on    7
a child
thoughts of sadness are high. As for children who lost their parent to cancer, their

depression was at its highest before the parent passed away because of their anticipation

of their parent’s death. Unfortunately, the children had to see their parents’ health

deteriorate before their eyes. Whereas the children whose parent died of suicide did not

have that time to anticipate their parent’s death, therefore they were on a much different

phase of grief.

          Researchers Dehlin and Martensson (2008) studied how a death of a parent affects

a young individual in every aspect. The child had to suddenly grow independent and

stress is greatly involved at this time. The researchers focused on the children’s

experiences during this tough time. In the United States, more than two2 million children

younger than 18 years of age have had the misfortune to experience a parental death. The

stage that the parent is terminally ill brings about great stress and is a traumatic

experience. They have to see their parent undergo both physical and psychological

change.

          To begin their study the researchers collected their participants from a Western

Swedish hospital where their parent had been hospitalized. The children were 13 to 15

years old when their parent had died. The death of their parent had to have occurred no

more than three years before the interviews were conducted. Five children matched this

exact criterion. The final study group was composed of two girls and three boys, ages 16

to 18.

          The interviews were conducted at a hospital. The interviewsIt covered questions

on how the adolescents felt during the length of their parents illness, the time of their

death and afterwards. The questions mainly included their experiences with their parent
Death of a parent and its negative effects on     8
a child
before and after they died. The researchers asked about memories, their relationship with

the parent, their support system and how they see their future. These interviews were

emotionally hard for the participants but they were willing to continue with the study. To

correctly analyze the data from the interviews, the researchers had to look for similar

important statements. Each interview was carefully read and many found related themes

and experiences. The focus of this data analyzing section was to gather information on

differences and similarities during this particular traumatic event.

          The results of this study composed itself into three categories. In these categories,

the participants expressed how they felt during the time that their parent passed away.

The first is: the adolescence felt as if their life was under threat. They asked questions

such as why had this happened to them? In this category, they questioned the existence of

God. For some participants they began believing in God. For the rest they did not believe

that God could have done something so terribly unfair. The adolescents felt depressed

having to see their parent suffer through an illness and it changed their life forever. They

described the day that they dreaded seeing their parent dead. It was too difficult to

comprehend that their parent will no longer be there for them. They were in a state of

shock and at the same time that it all happened so quickly.

          Other thoughts and feelings that affected these adolescents was their full

understanding of their parent’s death. They could not quite grasp the concept and were

not prepared for what was going to happen next. These adolescents tried to make their

lives return to normal as much as possible. Their everyday routine lives gave them

personal security although it was not the same. They needed ways to create a good

atmosphere at home to increase their well-being. This was the time when they needed
Death of a parent and its negative effects on     9
a child
their closest friends.

          Friends were a form of escaping reality because they did not have to think of their

deceased parent. Going to school was also a relief to the participants as a way to relax

from all the sadness. Before the parent had passed away, the participants all made sure to

spend as much time as possible with their ill parent. If they had not spent that time with

their sick parent, they would have felt guilty about their death. They shared happier

memories of having spent those last moments with the parent.

          The second category was: the adolescents bear this situation alone. They felt

loneliness even though their family and close friends were there to support them in their

time of loss. To the participants that had siblings, they did not seek out to them because

everyone has their own different method of coping. Ultimately they had felt that no one

could help them. Along with feeling lonely, there was also the feeling of being singled

out. The adolescent was given more attention than any one else. They felt that everyone

around them felt sorry for them and their loss and they did not want that.

          The third category is the changed life that the participants faced. This traumatic

event was something they would never forget and will affect them for the rest of their

life. The participants expressed great sadness when they realized that their parent could

not be present for any important events that they will have in their life such as

graduations, marriage and seeing their children grow up. The participants valued their life

and appreciated it more than ever.

          This study approached the interview style as comfortablye as possible for the

adolescents. The researchers wanted to know their strong experiences and feelings. The

only error for this study was that the researchers were too specific in finding participants
Death of a parent and its negative effects on 10
a child
and found only five adolescents to represent the whole population. For future testing the

researchers should closely study these three categories and focus more on how stressful

the event was for the adolescent.

          To experience the death of a parent is a hurtful time for anyone at any age but

particularly for young children. Without their parent, the adolescent feels depressed, and

anxiety., Pand psychological and behavioral problems are more likely to arise later in life.

They lose their sense of security that their parent provided. I had previously stated future

studies that should be done which . Those include longitudinal studies and coping

methods. They should be supported by their family members and continue to feel united

during this hard time in their life. Being patient and grieving is appropriate for these

young children. No adolescent should go through this event at such a young age but it

helps him or her see the positive in their life. They will never forget this experience.
Death of a parent and its negative effects on 11
a child




                                          References

Dehlin, L. & Martensson, L. (2008). Adolescents’ experiences of a parent’s serious

          illness and death. Palliative and Supportive Care, 7, 13-25.

          doi:10.1017/S1478951509000042

Gray, L.B., Weller, R., Fristad, M., & Weller, E. (2011). Depression in children and

          adolescents two months after the death of a parent. Journal of Affective Disorders.

          135, 277–283. doi:10.1016/j.jad.2011.08.009

Melhem, N., Walker, M., Moritz, G., Brent, D. (2008). Antecedents and Sequelae of

          Sudden Parental Death in Offspring and Surviving Caregivers. Archives of

          Pediatrics & Adolescent Medicine. 162(5),403-410.

Pfeffer, C., Karus, D., Siegel, K., & Jiang, H. (2000). Child Survivors of Parental Death

          From Cancer Or Suicide: Depressive and Behavioral Outcomes. Psycho-

          Oncology. 9, 1–10. doi: 10.1002/(SICI)1099-1611(200001/02)9:1<1::AID-

          PON430>3.0.CO;2-5
Death of a parent and its negative effects on 12
a child

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Lr2 draft js edits[1]

  • 1. Death of a parent and its negative effects on 1 a child How does the sudden death of a parent negatively affect a child? Romane Marraccini University of San Francisco
  • 2. Death of a parent and its negative effects on 2 a child A death of a parent is one of the most stressful times for someone, especially a child. The child has to quickly mature and learn to become more independent with the absence of their parent. Children cope with their loss differently. Depression is one of the most common psychological problems following this traumatic event. Many different researchers have studied different experiences feelings that a child encounters. Children encounter feelings of being alone despite all of their family and friend support. Other studies have shown how depressed children become or develop psychiatric disorders later in life. In this literature review, I will describe four articles and that a sudden death of a parent negatively affects a child. Researchers Gray, Weller, Fristad and Weller (2011) studied the depressive symptoms in adolescents and young children two months immediately after their parent’s death. Their aim was to determine if bereaved children had higher depressive symptoms and depressive episodes versus a community control group. Risk factors for the depressive symptoms after the death of a parent was also researched. Through a list of names from obituaries and funeral homes, researchers gathered 325 children ranging in ages from five to 18 years old. These children were compared to non-bereaved community controls and non-bereaved depressed controls. Children in the community control did not lose a parent. There were 129 children recruited from schools, community groups and churches. For the depressed control, there were 110 children. All three groups demographics similarly matched in that a majority of the children were ten10 to eleven 11 years old, Caucasian and male. The researchers proceeded to measure depression in the participants. First, the researchers used the Diagnostic Interview for Children and Adolescent Revised to assess
  • 3. Death of a parent and its negative effects on 3 a child depression. The participants made provided self-reports through the Children’s Depression Inventory, which measured the severity of depression in the children. The Psychiatric Diagnostic Interview collected the parents and the child’s personal psychiatric history. Researchers analyzed all the data twice. The first analysis included all three groups of children. The second analysis included only one child from each group. With all the information that the researchers collected, they created a table. The children who had lost their parent were more likely to have a depression episode compared to the community control group, but were surprisingly less likely than the depressed control group . In all the depressive symptoms shown on the table, Tthe depressed control group had the highest percentage out of the three groups. The most common symptoms for the three groups were dysphoria, guilt and sleep changes. Dysphoria is when a type of person has intense depression seen in people who areand is discontent about him or herself. About one fourth of the bereaved children had three to four depressive symptoms following the death of their parent. The loss of a parent causes depressive symptoms and episodes in their child following their death. This study was very useful but it was not descriptive in its methods of interview. It did not state say what the type of questions they asked their participants and it did not describe any other negative feelings other than depression. For future studies, I would like to study more about coping methods to help cure the depression that the child faces. Also, more longitudinal studies should be set up to see how long the depression has lasted and if it has turned into a more serious psychological problem. Researchers Melhem, Walker, Moritz, and Brent (2008) studied the psychological outcomes that children experience after a parent’s death. As described by Gray, Wellers,
  • 4. Death of a parent and its negative effects on 4 a child Fristad and Weller (2011), children show symptoms of depression and grief immediately after their parent’s death. Males are also more likely to have difficulty coping with the loss. For this study, the researchers addressed four questions for their own findings. What psychiatric factors in the deceased parent are associated with suicide, accidental death or natural death? What are the psychological developments of children whose parent died? Is grief the only outcome of a child after their parent has passed away? Does parental suicide have a higher risk of psychological development than the loss of a parent due to an accident or natural death? To begin the study, researchers gathered 140 families with whose parent was a deceased parent who was between the ages of 30 to 60 years old at the time of their death. The child was aged seven to 25 years old when the parent died. The parent died from suicide, an accident or a sudden natural death. This group was compared to a non- bereaved control group. There were 99 families and both parents were living. Both groups were chosen through a local newspaper advertisement. Then the researchers proceeded with the interviews, which were held at the participant’s homes. The interviews were conducted approximately no more than nine months after the parent died. The results varied differently. The children whose parent died due to suicide were more likely to have bipolar disorder, alcohol, and substance abuse than the non- bereaved group. In their findings, the researchers also found that children whose parent died of an accident were more likely to develop personality disorders. As for the child whose parent died suddenly and naturally, they had about the same likelihood as the children whose parent died of suicide in developing bipolar disorder. The researchers also took into account the families history of a depression
  • 5. Death of a parent and its negative effects on 5 a child disorder. Many of the child’s parent, or their caregiver, who was still alive also had a history of depression or anxiety both prior and after the death of the deceased parent. The caregivers of the children from all three groups had increased posttraumatic stress disorder compared to the caregivers of the non-bereaved group. Overall, symptoms that arise in both the parent and child after a parent has suddenly died are PTSD, suicidal thoughts, depression, and anxiety. The bereaved groups are at a higher risk to for depression and PTSD after their parent has died. Every category in the bereaved group had its different outcomes with the children. The two groups that were the most similar were the parent who died from suicide or an accident. Those children were more likely to develop a more serious psychological disorder because of the sudden death of their parent. Whereas the child whose parent died from natural causes had the chance to spend time with their parent before they passed away. The researchers provide information on the best solution to maintain healthy. After this tragic event, the child is to be continuously monitored for depression by a their caregiver. Given that these children will mourn for the loss of their parent, the caregiver needs to support their child. As for further research, again the researchers should conduct longitudinal studies. Studies have been done on childhood depression following the death of a parent. Researchers Pfeffer, Karus, Siegel, and Jiang (2000) studied depression, social competence and behavioral problems in children after their parent suddenly died from cancer or suicide. They identified young adolescents through records of the local medical examiner whose parents had passed away about one and a half years before the study. The adolescents were between the ages of six to 13. The focus of this study was to
  • 6. Death of a parent and its negative effects on 6 a child evaluate how children adapt after their parent has died. They gathered 16 children whose parent died of suicide and 64 children whose parent died from cancer. Then the researchers continued into their study and began to measure stress and depression in these children. A self-report questionnaire was given out to the children to rate their symptoms of depression. There were five categories: negative mood, interpersonal problems, incapable, inability to feel happy and negative self-esteem. The children’s behavior reports were collected through the Child Behavior Checklist. While conducting their tests on the adolescents, they found both groups to be extremely similar. There was only one difference was that ; children of suicidal parents were more depressed and angry. The scores of the children were reported inon a table. Overall, the child whose parent died of suicide had slightly higher scores in all five categories. Other than depression, there are additional other psychological distresses that children encounter but this study did not focus on those. The living parent of the child reported the child’s behavioral problems. This included how they were doing in school and how they reactedinteracted in social settings with their friends and family members. There was a high level of spirit in the children after the loss of their parent. Another finding was that a child has a higher risk to develop a more serious emotional or behavioral problem between one to two years after the parent has died. Lifestyle changes, such as the caregiver remarrying after the parent has died, can trigger a major depression disorder. The results produced expected conclusions to the researchers. The bereaved children whose parent died from suicide had higher levels of depression. Each child grieves death differently and for the child who lost their parent to suicide, traumatic
  • 7. Death of a parent and its negative effects on 7 a child thoughts of sadness are high. As for children who lost their parent to cancer, their depression was at its highest before the parent passed away because of their anticipation of their parent’s death. Unfortunately, the children had to see their parents’ health deteriorate before their eyes. Whereas the children whose parent died of suicide did not have that time to anticipate their parent’s death, therefore they were on a much different phase of grief. Researchers Dehlin and Martensson (2008) studied how a death of a parent affects a young individual in every aspect. The child had to suddenly grow independent and stress is greatly involved at this time. The researchers focused on the children’s experiences during this tough time. In the United States, more than two2 million children younger than 18 years of age have had the misfortune to experience a parental death. The stage that the parent is terminally ill brings about great stress and is a traumatic experience. They have to see their parent undergo both physical and psychological change. To begin their study the researchers collected their participants from a Western Swedish hospital where their parent had been hospitalized. The children were 13 to 15 years old when their parent had died. The death of their parent had to have occurred no more than three years before the interviews were conducted. Five children matched this exact criterion. The final study group was composed of two girls and three boys, ages 16 to 18. The interviews were conducted at a hospital. The interviewsIt covered questions on how the adolescents felt during the length of their parents illness, the time of their death and afterwards. The questions mainly included their experiences with their parent
  • 8. Death of a parent and its negative effects on 8 a child before and after they died. The researchers asked about memories, their relationship with the parent, their support system and how they see their future. These interviews were emotionally hard for the participants but they were willing to continue with the study. To correctly analyze the data from the interviews, the researchers had to look for similar important statements. Each interview was carefully read and many found related themes and experiences. The focus of this data analyzing section was to gather information on differences and similarities during this particular traumatic event. The results of this study composed itself into three categories. In these categories, the participants expressed how they felt during the time that their parent passed away. The first is: the adolescence felt as if their life was under threat. They asked questions such as why had this happened to them? In this category, they questioned the existence of God. For some participants they began believing in God. For the rest they did not believe that God could have done something so terribly unfair. The adolescents felt depressed having to see their parent suffer through an illness and it changed their life forever. They described the day that they dreaded seeing their parent dead. It was too difficult to comprehend that their parent will no longer be there for them. They were in a state of shock and at the same time that it all happened so quickly. Other thoughts and feelings that affected these adolescents was their full understanding of their parent’s death. They could not quite grasp the concept and were not prepared for what was going to happen next. These adolescents tried to make their lives return to normal as much as possible. Their everyday routine lives gave them personal security although it was not the same. They needed ways to create a good atmosphere at home to increase their well-being. This was the time when they needed
  • 9. Death of a parent and its negative effects on 9 a child their closest friends. Friends were a form of escaping reality because they did not have to think of their deceased parent. Going to school was also a relief to the participants as a way to relax from all the sadness. Before the parent had passed away, the participants all made sure to spend as much time as possible with their ill parent. If they had not spent that time with their sick parent, they would have felt guilty about their death. They shared happier memories of having spent those last moments with the parent. The second category was: the adolescents bear this situation alone. They felt loneliness even though their family and close friends were there to support them in their time of loss. To the participants that had siblings, they did not seek out to them because everyone has their own different method of coping. Ultimately they had felt that no one could help them. Along with feeling lonely, there was also the feeling of being singled out. The adolescent was given more attention than any one else. They felt that everyone around them felt sorry for them and their loss and they did not want that. The third category is the changed life that the participants faced. This traumatic event was something they would never forget and will affect them for the rest of their life. The participants expressed great sadness when they realized that their parent could not be present for any important events that they will have in their life such as graduations, marriage and seeing their children grow up. The participants valued their life and appreciated it more than ever. This study approached the interview style as comfortablye as possible for the adolescents. The researchers wanted to know their strong experiences and feelings. The only error for this study was that the researchers were too specific in finding participants
  • 10. Death of a parent and its negative effects on 10 a child and found only five adolescents to represent the whole population. For future testing the researchers should closely study these three categories and focus more on how stressful the event was for the adolescent. To experience the death of a parent is a hurtful time for anyone at any age but particularly for young children. Without their parent, the adolescent feels depressed, and anxiety., Pand psychological and behavioral problems are more likely to arise later in life. They lose their sense of security that their parent provided. I had previously stated future studies that should be done which . Those include longitudinal studies and coping methods. They should be supported by their family members and continue to feel united during this hard time in their life. Being patient and grieving is appropriate for these young children. No adolescent should go through this event at such a young age but it helps him or her see the positive in their life. They will never forget this experience.
  • 11. Death of a parent and its negative effects on 11 a child References Dehlin, L. & Martensson, L. (2008). Adolescents’ experiences of a parent’s serious illness and death. Palliative and Supportive Care, 7, 13-25. doi:10.1017/S1478951509000042 Gray, L.B., Weller, R., Fristad, M., & Weller, E. (2011). Depression in children and adolescents two months after the death of a parent. Journal of Affective Disorders. 135, 277–283. doi:10.1016/j.jad.2011.08.009 Melhem, N., Walker, M., Moritz, G., Brent, D. (2008). Antecedents and Sequelae of Sudden Parental Death in Offspring and Surviving Caregivers. Archives of Pediatrics & Adolescent Medicine. 162(5),403-410. Pfeffer, C., Karus, D., Siegel, K., & Jiang, H. (2000). Child Survivors of Parental Death From Cancer Or Suicide: Depressive and Behavioral Outcomes. Psycho- Oncology. 9, 1–10. doi: 10.1002/(SICI)1099-1611(200001/02)9:1<1::AID- PON430>3.0.CO;2-5
  • 12. Death of a parent and its negative effects on 12 a child