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Parental Bereavement in Young Children Living in South Africa and Malawi: Understanding Mental Health

Macedo, A; Sherr, L; Tomlinson, M; Skeen, S; Roberts, KJ; (2018) Parental Bereavement in Young Children Living in South Africa and Malawi: Understanding Mental Health. JAIDS Journal of Acquired Immune Deficiency Syndromes , 78 (4) pp. 390-398. 10.1097/QAI.0000000000001704. Green open access

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Abstract

BACKGROUND: Parental loss is a major stressful event found to increase risk of mental health problems in childhood. Yet, some children show resilient adaptation in the face of adversity across time. SETTING: This study explores predictors of mental health resilience among parentally bereaved children in South Africa and Malawi, and their cumulative effect. The study also explores whether predictors of resilience differed between orphaned and non-orphaned children. METHODS: Consecutive attenders of community based organisations (children;4-13 years, and their caregivers) were interviewed at baseline and 15-18 month follow up (n=833). Interviews comprised of inventories on demographic information, family data, child mental health, bereavement experience and community characteristics. Mental health screens were used to operationalise resilience as the absence of symptoms of depression, suicidality, trauma, emotional and behavioural problems. RESULTS: Almost 60% of children experienced parental loss. One quarter of orphaned children showed no mental health problems at either wave and were classified as resilient. There were equal proportions of children classified as resilient within the orphaned (25%) vs. non-orphaned group (22%). Being a quick learner, aiding ill family members, positive caregiving, household employment, higher community support, and lower exposure to domestic violence, physical punishment, or stigma at baseline predicted sustained resilience. There were cumulative influences of resilience predictors among orphaned children. Predictors of resilience did not vary by child age, gender, country of residence or between orphaned and non-orphaned children. CONCLUSION: This study enhances understanding of resilience in younger children and identifies a number of potential environmental and psychosocial factors for bolstering resilience in orphaned children.

Type: Article
Title: Parental Bereavement in Young Children Living in South Africa and Malawi: Understanding Mental Health
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAI.0000000000001704
Publisher version: https://doi.org/10.1097/QAI.0000000000001704
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Parental bereavement; HIV; children; SSA; Mental Health; Resilience
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10047199
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