Abstract
Research indicates that parents and other family members often grieve their child or relative’s mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in Am J Psychiatry 151(8):1137–1139, 1994; Davis and Schultz in Soc Sci Med 46(3):369–379, 1998; Jones in Br J Soc Work 34:961–979, 2004; MacGregor in Soc Work 39(2):160–166, 1994; Osborne and Coyle in Couns Psychol Q 15(4):307–323, 2002; Ozgul in Aust N Z J Fam Ther 25(4):183–187, 2004; Tuck et al. in Arch Psychiatric Nurs 11(3):118–125, 1997). This paper reviews existent research in this emerging field, with a focus on parents’ grief experience in relation to their adult child’s mental disorder. Studies that explore parents’ and family members’ grief, using both qualitative and quantitative methodologies, are considered. Research evidence for the association between parents’ and family members’ grief and other outcomes are discussed. Findings concerning the prediction of grief in parents and family members who have a child or relative with a mental disorder will be reviewed. Finally, this paper considers methodological and theoretical issues associated with existent research and presents options for further study.
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References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Fourth, Text Revision Ed.). Washington, DC: American Psychiatric Association.
Atkinson, S. D. (1994). Grieving and loss in parents with a schizophrenic child. The American Journal of Psychiatry, 151(8), 1137–1139.
Baronet, A. (1999). Factors associated with caregiver burden in mental illness: A critical review of the research literature. Clinical Psychology Review, 19(7), 819–841.
Beck, A., & Steer, R. (1987). Beck depression inventory. New York: Harcourt Brace Jovanovich.
Boelen, P. A., van den Hout, M. A., & van den Bout, J. (2006). A cognitive-behavioral conceptualization of complicated grief. Clinical Psychology: Science and Practice, 13(2), 109–128.
Bonanno, G., & Kaltman, S. (1999). Towards an integrative perspective on bereavement. Psychological Bulletin, 125(6), 760–776.
Bonanno, G. A., & Kaltman, S. (2001). The varieties of grief experience. Clinical Psychology Review, 21(5), 705–734.
Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: sadness and depression. London: Hogarth Press and Institute of Psychoanalysis.
Bowlby, J., & Parkes, C. M. (1970). Separation and loss within the family. In E. J. Anthony (Ed.), The child in his family (pp. 197–216). New York: Wiley.
Bruce, E. J., Schultz, C. L., & Smyrnios, K. X. (1996). A longitudinal study of the grief of mothers and fathers of children with intellectual disability. British Journal of Medical Psychology, 69, 33–45.
Bruce, E. J., Schultz, C. L., Smyrnios, K., & Schultz, N. C. (1994). Grieving related to development: A preliminary comparison of three age cohorts of parents of children with intellectual disability. British Journal of Medical Psychology, 67, 37–52.
Burke, M. L., Hainsworth, M. A., Eakes, G. G., & Lindgren, C. L. (1992). Current knowledge and research on chronic sorrow: A foundation for inquiry. Death Studies, 16, 231–245.
Centre for the Advancement of Health. (2004). Report on bereavement and grief research. Death Studies, 28(6), 491–575.
Clausen, J. A., & Yarrow, M. R. (1955). The impact of mental illness on the family. Journal of Social Issues, 11, 3–64.
Cummings, E. M., & Davies, P. (1995). The impact of parents in their children: An emotional security perspective. In R. Vasta (Ed.), Annals of child development: A research annual (Vol. 10, pp. 167–208). London, England: Jessica Kingsley Publishers.
Damrosch, S. P., & Perry, L. A. (1989). Self-reported adjustment, chronic sorrow, and coping of parents of children with Down syndrome. Nursing Research, 38(1), 25–30.
Davies, R. (2004). New understandings of parental grief: Literature review. Journal of Advanced Nursing, 46(5), 506–513.
Davis, D. J., & Schultz, C. L. (1998). Grief, parenting, and schizophrenia. Social Science and Medicine, 46(3), 369–379.
Doll, W. (1976). Family coping with the mentally ill: An unanticipated problem of deinstitutionalization. Journal of Hospital and Community Psychiatry, 27, 183–185.
Dyregrov, A., & Matthiesen, S. B. (1987). Similarities and differences in mothers’ and fathers’ grief following the death of an infant. Scandinavian Journal of Psychology, 28, 1–15.
Eakes, G. G. (1995). Chronic sorrow: The lived experience of parents of chronically mentally ill individuals. Archives of Psychiatric Nursing, 9(2), 77–84.
Ellis, J. B. (1989). Grieving the loss of the perfect child: Parents of children with handicaps. Child and Adolescent Social Work, 6, 259–270.
Faschingbauer, T. R., Devaul, R. D., & Zisook, S. (1977). Development of the Texas inventory of grief. The American Journal of Psychiatry, 134, 696–698.
Folkman, S. (2001). Revised coping theory and the process of bereavement. In M. Stroebe, R. Hansson, W. Stroebe, & H. Schut (Eds.), Handbook of bereavement: Consequences, coping and care (pp. 563–584). Washington, DC: American Psychological Association.
Fraley, A. M. (1986). Chronic sorrow in parents of premature children. Children’s Health Care, 15(2), 114–118.
Freud, S. (1917/1957). Mourning and melancholia. In J. Stratchey, A. Freud, A. Stratchey & A. Tyson (Eds.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 14, pp. 239–260). London: Hogarth Press & Institute of Psychoanalysis (Original work published 1917).
Freud, S. (1953). Mourning and melancholia. In J. Stratchey, A. Freud, A. Stratchey, & A. Tyson (Eds.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 14, pp. 239–258). London: Hogarth Press.
Gluhoski, V. L. (1995). A cognitive perspective on bereavement: Mechanisms and treatment. Journal of Cognitive Psychotherapy: An International Quarterly, 9(2), 75–85.
Godress, J., Ozgul, S., Owen, C., & Foley-Evans, L. (2005). Grief experiences of parents whose children suffer from mental illness. Australian and New Zealand Journal of Psychiatry, 39, 88–94.
Grad, J., & Sainsbury, P. (1968). The effects that patients have on their families in a community care and a control psychiatric service—A two year follow-up. British Journal of Psychiatry, 114, 265–278.
Gubman, G., & Tessler, R. (1987). The impact of mental illness on families. Journal of Family Issues, 8, 226–245.
Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50–55.
Hatfield, A. B. (1978). Psychological costs of schizophrenia to the family. Social Work, 23(5), 355.
Holmes, T., & Rahe, R. (1967). The social readjustment rating scale. Journal of Psychometric Research, 11, 213–218.
Horowitz, M. (1986). Stress response syndromes. New Jersey: Aronson.
Horowitz, M., Krupnick, J., Kaltreider, N., Wilner, N., Leong, A., & Marmar, C. R. (1981). Initial psychological response to parent death. Archives of General Psychiatry, 38, 316–323.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective distress. Psychosomatic Medicine, 41(3), 209–218.
Horowitz, M., Wilner, N., Kaltreider, N., & Alvarez, W. (1980). Signs and symptoms of posttraumatic stress disorder. Archives of General Psychiatry, 37, 85–92.
Howard, P. B. (1998). The experience of fathers of adult children with schizophrenia. Issues in Mental Health Nursing, 19(4), 399–413.
Jones, D. W. (2002). Myths, madness and the family: The impact of mental illness on families. Hampshire: Palgrave.
Jones, D. W. (2004). Families and serious mental illness: Working with loss and ambivalence. British Journal of Social Work, 34, 961–979.
Kaltreider, N., Wallace, A., & Horowitz, M. (1979). A field study of the stress response syndrome: Young women after hysterectomy. Journal of American Medical Association, 242, 1499–1503.
Kübler-Ross, E. (1969). On death and dying. New York: Macmillan Publishing.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Lefley, H. P. (1996). Family caregiving in mental illness (Vol. 7). California: Sage.
Lindemann, E. (1944). The symptomatology and management of acute grief. American Journal of Psychiatry, 101, 141–148.
MacGregor, P. (1994). Grief: The unrecognized parental response to mental illness in a child. Social Work, 39(2), 160–166.
Malkinson, R. (2001). Cognitive-behavioral therapy of grief: A review and application. Research on Social Work Practice, 11(6), 671–698.
Marsh, D. T. (1999). Serious mental illness: Opportunities for family practitioners. The Family Journal: Counseling and Therapy for Couples and Families, 7(4), 358–366.
Maurin, J. T., & Boyd, C. B. (1990). Burden of mental illness on the family: A critical review. Archives of Psychiatric Nursing, 4(2), 99–107.
McCausland, M. (1987). Deinstitutionalization of the mentally ill: Oversimplification of complex issues. Advances in Nursing Science, 9(3), 24–33.
McElroy, E. (1987). The beat of a different drummer. In A. Hatfield & H. P. Lefley (Eds.), Families of the mentally ill: Coping and adaptation. New York: Guilford.
Miller, F. (1996). Grief therapy for relatives of persons with serious mental illness. Psychiatric Services, 47, 633–637.
Miller, F., Dworkin, J., Ward, M., & Barone, D. (1990). A preliminary study of unresolved grief in families of seriously mentally ill patients. Hospital & Community Psychiatry, 41, 1321–1325.
Mohr, W. K., & Regan-Kubinski, M. J. (2001). Living in the fallout: Parents’ experiences when their child becomes mentally ill. Archives of Psychiatric Nursing, 15(2), 69–77.
Montgomery, R. J. F., Gonyea, J., & Hooyman, N. (1985). Caregiving and experience of subjective and objective burden. Family Relations, 34, 19–26.
Moore, R. (1972). The diagnosis: of alcoholism in a psychiatric hospital: A trial of the Michigan Alcohol Screening Test (MAST). American Journal of Psychiatry, 128, 1565–1569.
Neimeyer, R. A. (2000). Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies, 24, 541–558.
Neimeyer, R. A. (2003). Experience of grief and bereavement. In C. D. Bryant (Ed.), Handbook of death and dying (Vol. 2, pp. 847–854). California: Sage.
Neimeyer, R. A., Prigerson, H., & Davies, B. (2001). Mourning and meaning. American Behavioural Scientist, 46, 235–251.
Noh, S., & Avison, W. R. (1988). Spouses of discharged psychiatric patients: Factors associated with their experience of burden. Journal of Marriage and the Family, 50(2), 377–389.
Noh, S., & Turner, R. J. (1987). Living with psychiatric patients: Implications for the mental health of family members. Social Science and Medicine, 25(3), 263–271.
Norbeck, J. S., Lindsay, A. M., & Carrieri, V. L. (1981). The development of an instrument to measure social support. Nursing Research, 30, 264–269.
Northington, L. (2000). Chronic sorrow in caregivers of school age children with sickle cell disease: A grounded theory approach. Issues in Comprehensive Pediatric Nursing, 23(3), 141–154.
Olshanksy, S. (1962). Chronic sorrow: A response to having a mentally defective child. Social Casework, 1962(43), 190–193.
Osborne, J., & Coyle, A. (2002). Can parental responses to adult children with schizophrenia be conceptualized in terms of loss and grief? A case study analysis. Counselling Psychology Quarterly, 15(4), 307–323.
Osofsky, J. D. (1971). Children’s influences upon parental behavior: An attempt to define the relationship with the use if laboratory tasks. Genetic Psychology Monographs, 83(1), 147–169.
Ozgul, S. (2004). Parental grief and serious mental illness: A narrative. Australian and New Zealand Journal of Family Therapy, 25(4), 183–187.
Pai, S., & Kapur, R. (1981). The burden on the family of a psychiatric patient: Development of an interview schedule. British Journal of Psychiatry, 138, 332–335.
Parker, B. (1993). Living with mental illness: The family as caregiver. Journal of Psychosocial Nursing, 31, 19–21.
Parker, G. B., Barrett, E. A., & Hickie, I. B. (1992). From nurture to network: Examining links between perceptions of parenting received in childhood and social bonds in adulthood. The American Journal of Psychiatry, 149(7), 877–885.
Parkes, C. M. (2001). A historical overview of the scientific study of bereavement. In M. Stroebe, R. O. Hansson, W. Stroebe, & H. Schut (Eds.), Handbook of bereavement research: Consequences, coping, and care (pp. 25–45). Washington, DC: American Psychological Association.
Perkins, D., & Tebes, J. (1984). Genuine versus simulated responses on the Impact of Event Scale. Psychological Reports, 54, 575–578.
Reinhard, S. C., & Horwitz, A. V. (1995). Caregiver burden: Differentiating the content and consequences of family caregiving. Journal of Marriage and the Family, 57(3), 741–750.
Rose, L. E. (1996). Families of psychiatric patients: A critical review and future research directions. Archives of Psychiatric Nursing, 10(2), 67–76.
Rothaupt, J. W., & Becker, K. (2007). A literature review of western bereavement theory: from decathecting to continuing bonds. The Family Journal: Counseling and Therapy for Couples and Families, 15(1), 6–15.
Scornaienchi, J. M. (2003). Chronic sorrow: One mother’s experience with two children with lissencephaly. Journal of Pediatric Health Care, 17(6), 290–294.
Simpson, J. A. (1990). Influence of attachment styles on romantic relationships. Journal of Personality and Social Psychology, 59(5), 971–980.
Solomon, P., & Draine, J. (1995). Subjective burden among family members of mentally ill adults. American Journal of Orthopsychiatry, 65(3), 419–427.
Solomon, P., & Draine, J. (1996). Examination of grief among family members of individuals with serious and persistent mental illness. Psychiatric Quarterly, 67(3), 221–234.
Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23, 197–224.
Sveinbjarnardottir, E., & de Casterli, B. D. (1997). Mental illness in the family an emotional experience. Issues in Mental Health Nursing, 18(1), 45–56.
Tedeschi, R. G., & Calhoun, L. G. (2004). Helping bereaved parents: A clinician’s guide. New York: Brunner-Routledge.
Thompson, E., & Doll, W. (1982). The burden of families coping with the mentally ill: An invisible crisis. Family Relations, 31, 379–388.
Tuck, I., du Mont, P., Evans, G., & Shupe, J. (1997). The experience of caring for an adult child with schizophrenia. Archives of Psychiatric Nursing, 11(3), 118–125.
Ware, J. (2001). Medical outcomes study Short-Form 36-Item Health Survey. Australian Health Outcomes Collaboration.
Wasow, M. (1995). The skipping stone: Ripple effects of mental illness on the family. Palo Alto, CA: Science and Behaviour Books.
Wiens, S. E., & Daniluk, J. C. (2009). Love, loss, and learning: The experiences of fathers who have children diagnosed with schizophrenia. Journal of Counseling & Development, 87(3), 339–348.
Wikler, L., Wasow, M., & Hatfield, E. (1981). Chronic sorrow revisited: Parents vs. professional depiction of the adjustment of parents of mentally retarded children. American Journal of Orthopsychiatry, 51(1), 63–71.
Worden, J. W. (1982). Grief counseling and grief therapy: A handbook for the mental health practitioner. New York: Springer.
Worden, J. W. (1991). Grief counseling and grief therapy: A handbook for the mental health practitioner (2nd ed.). London: Routledge.
Worden, J. W. (1996). Children and grief: When a parent dies. New York: Guilford.
Young, J., Bailey, G., & Rycroft, P. (2004). Family grief and mental health: A systematic, contextual and compassionate analysis. Australian and New Zealand Journal of Family Therapy, 25(4), 188–197.
Zilberg, N., Weiss, D., & Horowitz, M. (1982). Impact of Event Scale: A cross-validation study and some empirical evidence supporting a conceptual model of stress response syndromes. Journal of Consulting and Clinical Psychology, 50, 407–414.
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Richardson, M., Cobham, V., Murray, J. et al. Parents’ Grief in the Context of Adult Child Mental Illness: A Qualitative Review. Clin Child Fam Psychol Rev 14, 28–43 (2011). https://doi.org/10.1007/s10567-010-0075-y
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DOI: https://doi.org/10.1007/s10567-010-0075-y