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Parents’ Grief in the Context of Adult Child Mental Illness: A Qualitative Review

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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.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Beck, A., & Steer, R. (1987). Beck depression inventory. New York: Harcourt Brace Jovanovich.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • Bonanno, G., & Kaltman, S. (1999). Towards an integrative perspective on bereavement. Psychological Bulletin, 125(6), 760–776.

    Article  PubMed  Google Scholar 

  • Bonanno, G. A., & Kaltman, S. (2001). The varieties of grief experience. Clinical Psychology Review, 21(5), 705–734.

    Article  PubMed  Google Scholar 

  • Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: sadness and depression. London: Hogarth Press and Institute of Psychoanalysis.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Centre for the Advancement of Health. (2004). Report on bereavement and grief research. Death Studies, 28(6), 491–575.

    Article  Google Scholar 

  • Clausen, J. A., & Yarrow, M. R. (1955). The impact of mental illness on the family. Journal of Social Issues, 11, 3–64.

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Davies, R. (2004). New understandings of parental grief: Literature review. Journal of Advanced Nursing, 46(5), 506–513.

    Article  PubMed  Google Scholar 

  • Davis, D. J., & Schultz, C. L. (1998). Grief, parenting, and schizophrenia. Social Science and Medicine, 46(3), 369–379.

    Article  PubMed  Google Scholar 

  • Doll, W. (1976). Family coping with the mentally ill: An unanticipated problem of deinstitutionalization. Journal of Hospital and Community Psychiatry, 27, 183–185.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Eakes, G. G. (1995). Chronic sorrow: The lived experience of parents of chronically mentally ill individuals. Archives of Psychiatric Nursing, 9(2), 77–84.

    Article  PubMed  Google Scholar 

  • Ellis, J. B. (1989). Grieving the loss of the perfect child: Parents of children with handicaps. Child and Adolescent Social Work, 6, 259–270.

    Article  Google Scholar 

  • Faschingbauer, T. R., Devaul, R. D., & Zisook, S. (1977). Development of the Texas inventory of grief. The American Journal of Psychiatry, 134, 696–698.

    PubMed  Google Scholar 

  • 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.

    Chapter  Google Scholar 

  • Fraley, A. M. (1986). Chronic sorrow in parents of premature children. Children’s Health Care, 15(2), 114–118.

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • Gluhoski, V. L. (1995). A cognitive perspective on bereavement: Mechanisms and treatment. Journal of Cognitive Psychotherapy: An International Quarterly, 9(2), 75–85.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Gubman, G., & Tessler, R. (1987). The impact of mental illness on families. Journal of Family Issues, 8, 226–245.

    Article  Google Scholar 

  • Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50–55.

    PubMed  Google Scholar 

  • Hatfield, A. B. (1978). Psychological costs of schizophrenia to the family. Social Work, 23(5), 355.

    PubMed  Google Scholar 

  • Holmes, T., & Rahe, R. (1967). The social readjustment rating scale. Journal of Psychometric Research, 11, 213–218.

    Article  Google Scholar 

  • Horowitz, M. (1986). Stress response syndromes. New Jersey: Aronson.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective distress. Psychosomatic Medicine, 41(3), 209–218.

    PubMed  Google Scholar 

  • Horowitz, M., Wilner, N., Kaltreider, N., & Alvarez, W. (1980). Signs and symptoms of posttraumatic stress disorder. Archives of General Psychiatry, 37, 85–92.

    PubMed  Google Scholar 

  • Howard, P. B. (1998). The experience of fathers of adult children with schizophrenia. Issues in Mental Health Nursing, 19(4), 399–413.

    Article  PubMed  Google Scholar 

  • Jones, D. W. (2002). Myths, madness and the family: The impact of mental illness on families. Hampshire: Palgrave.

    Google Scholar 

  • Jones, D. W. (2004). Families and serious mental illness: Working with loss and ambivalence. British Journal of Social Work, 34, 961–979.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Kübler-Ross, E. (1969). On death and dying. New York: Macmillan Publishing.

    Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

    Google Scholar 

  • Lefley, H. P. (1996). Family caregiving in mental illness (Vol. 7). California: Sage.

    Google Scholar 

  • Lindemann, E. (1944). The symptomatology and management of acute grief. American Journal of Psychiatry, 101, 141–148.

    Google Scholar 

  • MacGregor, P. (1994). Grief: The unrecognized parental response to mental illness in a child. Social Work, 39(2), 160–166.

    PubMed  Google Scholar 

  • Malkinson, R. (2001). Cognitive-behavioral therapy of grief: A review and application. Research on Social Work Practice, 11(6), 671–698.

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • McCausland, M. (1987). Deinstitutionalization of the mentally ill: Oversimplification of complex issues. Advances in Nursing Science, 9(3), 24–33.

    PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • Miller, F. (1996). Grief therapy for relatives of persons with serious mental illness. Psychiatric Services, 47, 633–637.

    PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Montgomery, R. J. F., Gonyea, J., & Hooyman, N. (1985). Caregiving and experience of subjective and objective burden. Family Relations, 34, 19–26.

    Article  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Neimeyer, R. A. (2000). Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies, 24, 541–558.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • Neimeyer, R. A., Prigerson, H., & Davies, B. (2001). Mourning and meaning. American Behavioural Scientist, 46, 235–251.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Norbeck, J. S., Lindsay, A. M., & Carrieri, V. L. (1981). The development of an instrument to measure social support. Nursing Research, 30, 264–269.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Olshanksy, S. (1962). Chronic sorrow: A response to having a mentally defective child. Social Casework, 1962(43), 190–193.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • Ozgul, S. (2004). Parental grief and serious mental illness: A narrative. Australian and New Zealand Journal of Family Therapy, 25(4), 183–187.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Parker, B. (1993). Living with mental illness: The family as caregiver. Journal of Psychosocial Nursing, 31, 19–21.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Chapter  Google Scholar 

  • Perkins, D., & Tebes, J. (1984). Genuine versus simulated responses on the Impact of Event Scale. Psychological Reports, 54, 575–578.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • Rose, L. E. (1996). Families of psychiatric patients: A critical review and future research directions. Archives of Psychiatric Nursing, 10(2), 67–76.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • Scornaienchi, J. M. (2003). Chronic sorrow: One mother’s experience with two children with lissencephaly. Journal of Pediatric Health Care, 17(6), 290–294.

    Article  PubMed  Google Scholar 

  • Simpson, J. A. (1990). Influence of attachment styles on romantic relationships. Journal of Personality and Social Psychology, 59(5), 971–980.

    Article  Google Scholar 

  • Solomon, P., & Draine, J. (1995). Subjective burden among family members of mentally ill adults. American Journal of Orthopsychiatry, 65(3), 419–427.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23, 197–224.

    Article  PubMed  Google Scholar 

  • Sveinbjarnardottir, E., & de Casterli, B. D. (1997). Mental illness in the family an emotional experience. Issues in Mental Health Nursing, 18(1), 45–56.

    Article  PubMed  Google Scholar 

  • Tedeschi, R. G., & Calhoun, L. G. (2004). Helping bereaved parents: A clinician’s guide. New York: Brunner-Routledge.

    Google Scholar 

  • Thompson, E., & Doll, W. (1982). The burden of families coping with the mentally ill: An invisible crisis. Family Relations, 31, 379–388.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Worden, J. W. (1982). Grief counseling and grief therapy: A handbook for the mental health practitioner. New York: Springer.

    Google Scholar 

  • Worden, J. W. (1991). Grief counseling and grief therapy: A handbook for the mental health practitioner (2nd ed.). London: Routledge.

    Google Scholar 

  • Worden, J. W. (1996). Children and grief: When a parent dies. New York: Guilford.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

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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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