People who experienced the death of a parent during childhood have twice the risk of suicide in the long-term compared to others, say researchers from Aarhus University in Denmark. The risk is three-fold higher among those whose parents died of suicide, indicated the study results.

“One targeted preventive strategy would be to monitor distress in bereaved children and provide support to help highly distressed children cope with bereavement,” concluded the authors of this new study.

How does a child experience grief?

Grief is profound at any age, but when a parent’s death happens during childhood, the tragic event may shape a child’s world view. When asked about lessons learned following the death of a family member, for example, 72 percent of grieving children said, “Life is not fair,” according to a poll conducted by the National Alliance for Grieving Children (NAGC). Among the grief reactions recorded by this small-scale survey, 41 percent of grieving children said they have acted in ways they knew might not be good for them (physically, mentally, or emotionally), while 45 percent reported trouble concentrating on school work and 39 percent trouble sleeping.

Sadly, a third of the children surveyed indicated they had said “hurtful things to others after the death,” while just under half believed their life would be “harder” compared to others.

“The one variable that most strongly affects the functioning of a child after loss is the functionality of the surviving parent,” said Dr. J. William Worden, co-principal investigator for Harvard's Child Bereavement Study, in an interview with Hospice Foundation of America. “If that parent is depressed, if he or she is not able to maintain a consistency within the home… that child is going to have a much more difficult time adjusting to the loss.”

Among the most significant findings from the Child Bereavement Study is many of the negative consequences do not appear in children for as long as two years after the death of a parent, explained Worden. Certainly, the new Aarhus University study provides support to this observation.

Study Results

To examine the long-term risks of suicide after parental death, a team of researchers led by Dr. Mai-Britt Guldin, a clinical psychologist in the department of public health, used registry data from Denmark, Sweden, and Finland between the years 1968 and 2008 to identify 189,094 children (2.6 percent of a total 7.3 million people) who had a parent die before turning 18. Next, the team matched these bereaved children with 10 other children who did not have a parent die. Then, the researchers compared 40 years of data concerning people in both the bereaved group and the reference group to understand long-term risks of suicide.

During the follow-up period, 265 bereaved group people (0.14 percent) and 1,342 reference group people (0.07 percent) died from suicide. For people who experienced a parent’s death while still a child, the absolute risk of suicide was four per every 1,000 people for boys and two per every 1,000 for girls. The highest risk (in the bereaved group) was found among children whose parent committed suicide, first-born children, boys whose mother died, and children who experienced death before age 6, the results showed. Suicide, it would appear, may be a long-delayed response to a parent's death.

Based on his research, Worden generally breaks down responses into three categories based on a child's age.

How does a child express grief?

During the first year after death, pre-schoolers and very young children may regress to an earlier developmental stage. For example, a young child may suddenly lose their toilet-training abilities or even their language skills.

For school-aged kids, grief may involve a number of symptoms or behaviors.

“One finding in the Harvard study that has always fascinated me was how many children this age somaticize grief — headaches and stomach aches are very prevalent,” said Worden, who said aggression can also factor into the equation at this age. Explaining how some children may want to spend more time with a surviving parent, clinging can become a problem. “With intervention, there is always that fine line between supporting the child’s wishes and promoting a behavior that may not be healthy.” 

When it comes to teens, Worden finds their grief is expressed in a manner similar to that of adults. Despite this possible similarity, the Aarhus study would suggest the impact on teens is greater than for adults.

The NAGC provides many resources to those wishing to help grieving children: please click here.

Source: Guldin MB, Li J, Søndergaard  Pedersen H, et al. Incidence of Suicide Among Persons Who Had a Parent Who Died During Their ChildhoodA Population-Based Cohort Study. JAMA Psychiatry. 2015.