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Poster #103 - Continuing Bonds, Grief, and Growth in Mothers and Siblings after a Child's Death from Cancer

Thu, March 21, 12:30 to 1:45pm, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Objective: The death of a child can be traumatic for families and may be followed by prolonged grief (Gibbons, 1992). Parents and surviving siblings may find comfort through continuing bonds (CB; i.e. visiting cemetery, looking at pictures) with the deceased child; however, this may disrupt other relationships in the family (Klass, Silverman, & Nickman, 1996). Limited research has examined the influence of CB within families. We examined how the CB of one family member relates to the adjustment of other family members following a child’s death from cancer. We hypothesized that stronger CB in mothers and siblings would be associated with more grief and less grief-related growth. Additionally, stronger mother CB would be associated with grief and growth in siblings, and stronger sibling CB would be associated with grief and growth in mothers.
Methods: Bereaved siblings (N=119, 8-17 years old, Mage=13.50) and mothers (N=114, Mage=41.41) were recruited from three pediatric hospitals 3-12 months after a child’s death from cancer. Siblings and mothers reported CB with the deceased child using the Continuing Bonds Scale (CBS) at Time 1 (T1; average of one year post-death) and reported grief and grief-related growth using the Hogan Grief Reaction Checklist (HGRC) at T1 and T2 (one-year follow up). Structural equation modeling was used to test an actor-partner interdependence model, controlling for sibling age, sex, and time since death.
Results: At enrollment, mothers’ CB was associated with maternal grief, and siblings’ CB was positively associated with sibling grief and growth (Table 1). The model showed a good fit to the data, χ2(18,N=56)=17.27; p=.50; CFI=1.00; RMSEA=0.00; SRMSR=0.04 (see Figure 1 for coefficients). However, once controlling for T1 grief and growth, CB was no longer significantly associated with either outcome, with no partner or actor effects emerging. Mother and sibling grief were only significantly predicted by T1 grief, with similar findings for growth.
Conclusion: Our results suggest that grief and grief-related growth are relatively stable, particularly for siblings over the first two years of bereavement. CB did not predict change in grief or growth over time despite significant cross-sectional and longitudinal correlations. This suggests that although CB may relate to grief and growth, adjustment in the first year of bereavement is a better predictor of adjustment a year later. Surprisingly, time since death was also not related to grief, suggesting other factors may be responsible for changes in grief. Future research should examine individual and family characteristics that may better account for changes in grief and growth. Further, intervention efforts should be empirically tested that directly target grief and foster grief-related growth in the first year of bereavement as this may promote better long-term adjustment.

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