BACKGROUND: Children whose parents die by, or attempt, suicide are believed to be at greater risk of suicidal behaviours and affective disorders. We systematically reviewed the literature on these associations and, using meta-analysis, estimated the strength of associations as well as investigated potential effect modifiers (parental and offspring gender, offspring age).MethodWe comprehensively searched the literature (Medline, PsycINFO, EMBASE, Web of Science), finding 28 articles that met our inclusion criteria, 14 of which contributed to the meta-analysis. Crude odds ratio and adjusted odds ratio (aOR) were pooled using fixed-effects models. RESULTS: Controlling for relevant confounders, offspring whose parents died by suicide were more likely than offspring of two living parents to die by suicide [aOR 1.94, 95% confidence interval (CI) 1.54-2.45] but there were heterogeneous findings in the two studies investigating the impact on offspring suicide attempt (aOR 1.31, 95% CI 0.73-2.35). Children whose parents attempted suicide were at increased risk of attempted suicide (aOR 1.95, 95% CI 1.48-2.57). Limited evidence indicated that exposure to parental death by suicide is associated with subsequent risk of affective disorders. Maternal suicidal behaviour and younger age at exposure were associated with larger effect estimates but there was no evidence that the association differed in sons versus daughters. CONCLUSIONS: Parental suicidal behaviour is associated with increased risk of offspring suicidal behaviour. Findings suggest that maternal suicidal behaviour is a more potent risk factor than paternal, and that children are more vulnerable than adolescents and adults. However, there is no evidence of a stronger association in either male or female offspring. Language: en

The association of parental fatal and non-fatal suicidal behaviour with offspring suicidal behaviour and depression: a systematic review and meta-analysis.

The experience of bereavement by parental suicide is not well understood, as evidenced by the lack of empirically supported interventions for this underserved population This article reviews quantitative and qualitative research on the psychopathological outcomes and thematic characteristics of childhood and adolescent suicide survivorship and moderating variables such as life stressors, stigma, the manner of communication about the suicide, and the surviving parent's functioning The authors outline several approaches to intervention and address conceptual and methodological challenges within the field With the ultimate goal of efficacious intervention, recommendations for future priorities and the use of unconventional research methods are offered

Comprehending Childhood Bereavement by Parental Suicide: A Critical Review of Research on Outcomes, Grief Processes, and Interventions

Child and adolescent survivors of parental suicide experience two stressful events simultaneously: (1) the loss of a primary caregiver, and (2) suicidal death of a significant person. These youths are thought to be at increased risk for mental health problems, but a systematic review of studies on these survivors has not yet been conducted. A comprehensive search for published literature identified nine studies. The existent studies provided modest yet inconsistent evidence on the impact of parental suicide on offspring psychiatric and psychosocial outcomes. More methodologically rigorous research is needed to inform and guide postvention efforts for these survivors.

The Impact of Parental Suicide on Child and Adolescent Offspring

Background: In previous research, it has been established that a child who has experienced the death of a parent is vulnerable to a variety of concerns, including grief, distress and dysphoria, particularly in the first year following the death. In addition, one in five parentally-bereaved children is likely to develop a psychiatric disorder. As Kemshall argues, the growing body of evidence linking delinquency in adolescents to previous traumatic life experiences, such as parental loss, with a large number of children affected every year makes this is a very important area for research. This paper considers the effects of parental bereavement in childhood, and is part of a wider study exploring the future for children who experience a parent's death. We found that parentally-bereaved children are significantly more vulnerable to delinquent behaviour than those who have not experienced parental bereavement. Thus there is a need for awareness of the variables that form protectors to the vulnerability to delinquency formed, in part by the experience of a parent's death. Methods: We used secondary data from the National Child Development study from which children who had been parentally bereaved by the age of 16 were identified. The Rutter Behaviour Scale highlighted which of those children also displayed delinquent behaviours; the Pearson Chi Square was used to establish significant links between these two factors. Potential moderating factors of social class background, gender of child, gender of dead parent and age of child at the time of bereavement were also examined. Results: The findings present as a set of risk variables that increase a child's susceptibility to delinquent behaviour, with specific reference to children who have been parentally bereaved. Children who were parentally bereaved before the age of 16 were significantly more likely to display delinquent behaviour than those who were not, as indicated by scoring 9 or above, the cut off point on the Rutter Behaviour Scale (p < .001). These scores of 9+ at 16 are significantly more likely (p < .001) for children who were bereaved between the ages of 12 and 16 years. For all children (including children not parentally bereaved), boys were significantly more likely than girls to score 9+ on the Rutter Behaviour Scale at 16 (p < .001). However, gender was not a significant factor in parentally-bereaved children, indicating parentally-bereaved girls are more likely to display similar levels of delinquent behaviour to non-parentally-bereaved boys. Children from manual backgrounds are significantly more likely than those from non-manual backgrounds to be parentally bereaved (p < .001).

Childhood parental bereavement: the risk of vulnerability to delinquency and factors that compromise resilience

TOPIC: Bereavement is considered by many to be among the most stressful of life events, and it becomes particularly distressing when it concerns the suicide death of a parent. Such an event is especially traumatic for children. PURPOSE AND SOURCES: The purpose of this paper is to present a case for support group interventions designed specifically for child survivors of parental suicide. The authors provide a theoretical framework for supportive group interventions with these children and describe the structure of an 8-week bereavement support group for this special population of suicide survivors. CONCLUSIONS: A case is made for designing and implementing group interventions to meet the mental health needs of this important group of individuals. Language: en

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A Support Group Intervention for Children Bereaved by Parental Suicide

TOPIC: While bereavement is considered by many to be among the most stressful life events, it becomes even more distressing when it is related to the suicide of a loved one. Further, the death of a parent is traumatic for anyone, but it may be especially intensified for young children. This points to a strong need for the recognition and treatment of psychiatric and social problems associated with childhood bereavement. PURPOSE AND SOURCES: The purpose of this paper is to review the literature and present a synopsis of the psychosocial outcomes of childhood suicide survivor bereavement and outline communication issues that emerge when talking with young suicide survivors. CONCLUSIONS: A case is made to develop and test interventions designed to meet the mental health needs of this important group of individuals. Language: en

Lynn Brownson

Papers

A Support Group Intervention for Children Bereaved by Parental Suicide

Effective Communication With Bereaved Child Survivors of Suicide