Journal of Adolescent Research

The author reviews research conducted in the 1980s regarding death and adolescent bereavement. Prior to 1981 little research attention was given to this subject. A plethora of material has appeared since then, with attention paid to adolescents bereaved over (a) a parent's death, (b) a sibling's death, and (c) their own impending death. Adolescent bereavement over a friend's death has mostly been overlooked Research needs in this field of inquiry include (a) longitudinal investigations to study the trajectory of adolescent bereavement, (b) development of theoretical models to explain adolescent bereavement, and (c) integration with the traditional areas of adolescence inquiry, such as cognitive developmen4 moral reasoning, gender socialization, and identify formation.

A review of the literature suggests that adolescents' understanding of death may be described in terms offour dialectical themes. The biological dialectic reflects the tension between physical and sexual maturation, and its heralding of inevitable decline. The cognitive dialectic suggests that a fuller understanding of life's possibilities contrasts with the contemplation of death. The social dialectic involves the tension between greater reliance on the peer group and an increased sense of isolation. The affective dialectic includes the emerging sense of identity, entangled with depression and the loss of self. The implications of these dialectics for death education are discussed.

This study explored positive outcomes of adolescents'experiences of grief Ninety-three late adolescents (mean age of 19.4 years) responded to the question: "What positive outcomes, if any, do you feel were the result of your grief experience(s)? Check all that apply. " The most frequent responses were (a) have deeper appreciation of life (74%o), (b) show greater caring for loved ones (67%o), (c) strengthened emotional bonds with others (56%), and (d) developed emotional strength (53%o). Only 4 of the 93 subjects responded "none " (1 subject) or left all of the choices blank (3 subjects). There were no significant differences found related to response by sex or ethnicity; however, individuals with an internal locus of control as compared to an external locus of control did respond more often that they had better communication skills as a result of their grief experience. Findings are discussed as they relate to grief education and suggestions for future research.

The long-term effects of bereavement were assessed 7 to 9 years after death by interviews with 31 adolescent siblings from 21 families who participated in a longitudinal study of home carefor children with cancer. Categorical analysis of the semistructured interviews revealed that the majority of the adolescents viewed the experience as having fostered their personal or family growth. However, about I in 6 regarded the effects of a sibling death as continuing to have a negative impact on their lives. Factors associated with a more positive outlook were good communication in the family, ability to share the death experience with others, expression of pleasure in sibling's company, and reliance on the family for emotional support. Factors associated with a more negative outlook were withdrawal from family interaction, inability to use the family as a source of support, and difficulty in discussing one's experience with death.

The authors explored the long-term consequences for adolescents of surviving a sibling afflicted with cystic fibrosis. Seventy-five adults were interviewed whose siblings had died from cystic fibrosis in the 1960s and 1970s. Subjects were drawn from case records at Children's Hospital, Boston; Children's Hospital, Oakland; and the University of California, San Francisco. For quantitative analysis, a sample wasdrawn of25 survivors who were under the age of 19 years at the time of the death. Anxiety and depression scales derived from the Hopkins checklist were used, and a 3-point scale developed for guilt. There were no significant relationships between sibling adaptation and number of siblings lost, birth order and gender, family size, or time since death of sibling. The age of the surviving sibling at the time of the death was statistically significant. Those who had been between 13 and 17 years of age at the time of the loss expressed the most symptoms. They were troubled by a global sense of guilt, guilt over their handling of the sibling's illness and death, and survival guilt. They also manifested global anxiety, bodily concerns and feelings of vulnerability, fear of intimacy, excessive concern for others, somatic complaints, and sleeping difficulties.

The experience of sibling bereavement is relatively unexamined in the literature; the long-term effects of such an experience have received even less attention. In this study, grounded theory techniques for the analysis of qualitative data were used to analyze a series of intensive, semistructured interviews with 12 adults who, in their early adolescence, lost a sibling. Long-term outcomes included psychological growth, a sense of feeling different, and withdrawal from peers. The study presents a theoretic scheme relating these outcomes. The sense of personal growth and maturity arouses feelings of being different from peers, and may result in an intolerance of the developmentally appropriate behaviors demonstrated by peers. Some siblings respond to these feelings by withdrawing from their peers at a time when peer relationships are critical to completing developmental tasks. For such siblings, feelings of sadness and loneliness become long-term.

This study presents data on a recently developed instrument assessing symptomatology in a 13-to 18-year-old community sample of bereaved adolescents. Adolescents assessed within 18 months of their sibling's death showed consistently high levels of grief symptomatology. A second sample assessed more than 18 months after their sibling's death reported lower levels of grief symptomatology. However, a significant group of adolescents in this second sample continued to have high levels of grief reactions. Groups high and low on reported grief symptoms, when the death had occurred more than 18 months earlier, were compared on the Offer Self-Image Questionnaire. The data revealed dysfunctionalpatterns of self-concept in adolescents with high grief symptom levels. This pattern was not evident in the adolescents who were able to normalize their lives despite the traumatic experience of having a brother or sister die.

Suicide is the second leading cause of death among adolescents. The peer survivors of an adolescent suicide experience a normal but individually variant grieving process. It is important that the survivors be understood and that they receive appropriate ameliorative affective attention through postvention efforts by significant adults in their environment. An important setting for this postvention is the school, where adolescents spend many of their waking hours. Components of a grief time frame for adolescent suicide survivors, referral guidelines, and factors to consider when implementing a school postvention program are discussed.

The authors present an exploratory study of grief and coping responses of students in a rural Midwestern high school 18 months after a peer's death from leukemia. Evidence indicated both continued bereavement as well as several expected patterns of immediate grief and coping responses. Qualitative and quantitative comparisons of close and more distant friends of the dead peer indicated that whereas close friends were more likely to have had frequent thoughts about death, experienced difficulty discussing death, and reported life changes following a peer's death, all students experienced some difficulty coping. Implications for individual and school system adjustment are discussed.

One of the developmental challenges that a college student may have to face is the death of a significant other-friend, spouse, relative, child, parent, or pet. The focus of this study was to examine the potential effects of bereavement on college students based on a synthesis of previously published empirical studies and a review of literature. Coping strategies specific to college students are discussed. Because the presence of suitable interventions may decrease some of the negative consequences of griefand may facilitate the developmentalprocess, institutional and individual interventions are reviewed.