risk for mental, emotional, and behavioral problems, including clinical levels of mental health problems, substance abuse, and mental health service use (Chase-Lansdale, Cherlin, and Kiernan, 1995; Kessler, Davis, and Kindler, 1997; Maekikyroe, Sauvola, et al., 1998; Rodgers, Power, and Hope, 1997; Zill, Morrison, and Coiro, 1993; Amato, 1996).
Children who experience parental bereavement appear more likely to experience mental, emotional, and behavioral problems, such as depression, posttraumatic stress disorder, and elevated mental health problems for up to two years following the death (Worden and Silverman, 1996; Geresten, Beals, and Kallgren, 1991). These risks appear to remain after controlling for other risk factors, such as mental disorder of the deceased parent (Melhem, Walker, et al., 2008). Research has shown mixed findings concerning the mental, emotional, and behavioral problems of bereaved children when they reach adulthood (Kessler, Davis, and Kindler, 1997). However, two prospective longitudinal studies supported increased risk of depression in adult women who experienced parental bereavement as children (Reinherz, Giaconia, et al., 1999; Maier and Lachman, 2000).
Although family disruption is associated with multiple MEB disorders and problems, the majority of children who experience these major stressors adapt well. The most consistent predictive factors are interparental conflict and the quality of parenting by both the mother and the father (Kelly and Emery, 2003; Amato and Keith, 1991b). Parent–child relations that are characterized by warmth, positive communication and supportiveness, and high levels of consistent and appropriate discipline have consistently been related to better outcomes following divorce (Kelly and Emery, 2003; Amato and Keith, 1991b). High-quality parenting from both the custodial parent (usually the mother) and the noncustodial parent (usually the father) is related to lower levels of child internalizing and externalizing problems (King and Sobolewski, 2006). But interparental conflict is one of the most damaging stressors for children from divorced families. Conflict often precedes the divorce and is associated with lasting child problems following the divorce (Block, Block, and Gjerde, 1988). In some families, conflict continues long after divorce, which is particularly destructive when children are caught in the middle (Buchanan, Maccoby, and Dornbusch, 1991). Recent research has found that high-quality parenting from both parents related to lower child mental health problems even in the presence of high interparental conflict (Sandler, Miles, et al., 2008).
Several factors have been found to influence outcomes for children who experience parental bereavement. Among parentally bereaved children who had signed up for an intervention program, four factors distinguished bereaved children who had clinical levels of mental health problems from those who did not: positive parenting by the surviving caregiver, lower mental health problems of the surviving parent, the coping efficacy of