Abstract
Objectives
Bereaved siblings experience more externalizing problems compared to non-bereaved peers and norms; however, the mechanisms explaining this phenomenon have not been empirically examined. This study tested the serial indirect effects of sibling bereavement on adolescents’ externalizing problems through parent distress (i.e., internalizing symptoms) and parenting (i.e., parenting behaviors, parent-adolescent communication).
Methods
During home visits, 72 bereaved adolescents (ages 10–18) whose brother/sister died from cancer and 60 comparison peers reported about their externalizing problems and their mothers’ and fathers’ parenting behaviors (warmth, behavioral control, psychological control) and parent-adolescent communication (open communication, problematic communication). Mothers and fathers reported their own internalizing symptoms.
Results
Bereaved siblings reported more externalizing problems (p = 0.048) and bereaved mothers reported more internalizing symptoms relative to the comparison group (p = 0.015). Serial multiple mediation models indicated that elevated externalizing problems were partially explained by both bereaved mothers’ internalizing symptoms and parenting and communication (less warmth [CI: 0.04, 0.86], more psychological control [CI: 0.03, 0.66], and more problematic mother-adolescent communication [CI: 0.03, 0.79]), with a significant indirect effect also emerging for open mother-adolescent communication [CI: 0.05, 1.59]. Bereaved fathers did not significantly differ in internalizing symptoms from comparison fathers (p = 0.453), and no significant indirect effects emerged for fathers.
Conclusions
Elevated externalizing problems in bereaved siblings may result from mothers’ distress and the impact on their parenting and communication. Targeting adjustment and parenting in bereaved mothers following a child’s death may reduce externalizing problems in bereaved siblings. Research to evaluate family-centered interventions is needed.
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Acknowledgements
This research was supported by grants from the National Institutes of Health (R01 CA98217), The Research Institute at Nationwide Children's Hospital, and Cincinnati Children's Hospital Medical Center. Portions of this work were presented at the 16th Biennial Meeting of the Society for Research on Adolescence, Baltimore, Maryland (April, 2016). The authors would like to thank the families who generously participated in this work.
Author Contributions
KMHS: analyzed the data and wrote the paper. EAM: assisted with data analyses and contributed to writing and editing of the final manuscript. MCK: assisted with data analyses and contributed to writing and editing of the final manuscript. AMW: assisted with data analyses and contributed to writing and editing of the final manuscript. MB: collaborated in the execution of the study and editing of the final manuscript. MJG: collaborated in the execution of the study and editing of the final manuscript. TFA: collaborated in the execution of the study and editing of the final manuscript. BEC: collaborated in the execution of the study. DLF: collaborated in the execution of the study and management of the data. BD: collaborated in the design of the study and editing of the final manuscript. NH: collaborated in the design of the study and editing of the final manuscript. KV: collaborated in the design and execution of the study. CAG: designed and executed the study and contributed to editing of the final manuscript.
Funding
Grants from the National Institutes of Health (grant number R01 CA98217), The Research Institute at Nationwide Children's Hospital, and Cincinnati Children’s Hospital Medical Center.
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Howard Sharp, K.M., Meadows, E.A., Keim, M.C. et al. The Influence of Parent Distress and Parenting on Bereaved Siblings’ Externalizing Problems. J Child Fam Stud 29, 1081–1093 (2020). https://doi.org/10.1007/s10826-019-01640-0
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DOI: https://doi.org/10.1007/s10826-019-01640-0