Scandinavian Journal of Psychology, f987, 28, 1-15
Similarities and differences in mothers'and fathers' grief
following the death of an infant
ATLE DYREGROV and STIG BERGE MATTHIESEN
Unitx.rsiry of Bcrgcn, Norutay
Dyrcgrov, A. & Matthicscn, S. B.: Similaritics and diffcrcnces in mothers' and fathcrs'
gricf following the dcath of an infant. Scandinavian Journal of Psychology, 1981, 28, l-15.
Thc difrcrcnces bctuecn mothcrs'and fathcrs'gricffolloving the death ofan infant child
ncrc inrcstigatcd. From a total samplc of ll7 parcnts, 53Ve women and 47Vc mcn,
qnsutring a survcy on different gricf rcactions I to 4 years folloving thc death, 55 families
whcrt both pannenr rcspondcd, ncrr sclcctcd. Mcasures rclating to anxiety, dcprcssion,
iirpact of cvcnt, bodily discomfort, and gcncral rvtll being utre includcd. The rcsults
dcmonstratcd fairly strong diffcrcnccs bctncen thc partncrs' rcactions, with mothcrs
typically cxpcricncing morc intcnsc and long-lasting rcactions than fathcrs. Mothcrs also
tcndcd to pcrceine their family and fricnds as lcss supportive than fathers, while fathcrs
nrrc lcast satisfied with thc suppon rcccivcd from thc hospital. Most parcnts fell thc dcath
had brought thcm closcr togcthcr, dthough a considcrable number rcported fecling morc
dislance to thcir panncr. Mothcrs scorcd significantly highcr than the fathcrs on expcricncc of recovery, statc anxicty (SIAI), dcprcssion (Bcck Depression Invcntory), bodily
symptoms (Bodily Symptom Scalc) and intrusirrc imagcs and thoughts (Impact of Evcnt
Scalc, tES tntrusion). A high scorc in onc spousc was corrclatcd with a high score in thc
othcr, and vicc rrrsa. tt is cmphasizcd that thc rcsults shoving parental differences in grief
should help us tailor psychocducational and thcrapcutical intcrrcntion for bercavcd farnilies.
A. Dyrcgroo, Forskningssentcr for Arbcidsni$6, Hclsc og Sikkcrhet, Uniuersitetet i Bcrgcn, Hans Tanks gt.
ll,5NN
Bergen, Norutc!.
The loss of a child is one of the most stressful situations a family may face. The family
have to deal with a crisis situation wherc habitual coping mechanisms most often are
inadequate. Litcrature concerning thc impact of an infant's death on the family has to a
Sreat extent focuscd on the mothcr's rcactions. Whcn authors write about both spouses,
the information seems mainly gathercd from the mother (Nixon & Peam, 1977; Lovman,
1979;
DeFrain & Ernst, l97t).
In studics eirher specifically adrcssing both parcnts neactions, or studies ofrering gencral
comments on similarities and difrercnces in parental gricf, father's are rcported to feel an
obligation to "stay strong" and support their wife folloring the loss of an infant (Berg ct
al., l97E; Standish, t982: Hclmrath & Steinitz, t97E). Fathers shov significantly lolrrcr
gricf scores(Benfieldetal., l97t)andfewcrsymptomsof depression(Wilsonetal., 1982),
than mothers. They are also reponcd to experience the situation less deeply (Bcrg et al.,
1978; Cornudl ct al., l9TI), and harrc a shorter grief-pcriod, than mothers (Helmrath &
Stcinitz, l97t; Forrest. 1983). Fathers desire to mo\re on with life when mothers still are
quite deprcsscd (Clyman et d., 1980), and fathen tcnd to "keep busy", take on additiond
jobs and workloads (Mandell ct d., 1980).
Most gricf symptoms are reponed to be cxperienccd with more intensity and have a
longcr duration in mothers compared to fathcrs (Cornwell ct al., 1977; Helmrath &
Stcinitz, l97E; Clyman ct al., 1980; Wilson ct al., 1982). The diffcrences bctnecn mothers
and fathcrs, horvcvcr, have seldom becn measured. The expcrience ofguilt feclings scems
cspccially morc frequent among mothcrs than fathcrs (Clyman ct al., 1980; Bcnfield ct al.,
1978; Hclmrath & Stciniu, 1978; Wilson et d., 1982). The scx difrercnccs in parcntal
A. Dyregrov and S. B. Manhiesen
Scend
t Rychol
rcactions arc pnesent aftcr the loss of oldcr children (Rando, 1983; Jurk ct al., l98l) and
adult childrcn (Shanficld ct al., l9E4), as w€ll as infants.
Fathcrs arre more unwilling to talk about the dead child (Wilson ct al.. 1982i Nixon &
Pcarn, 1977), and they avoid professional support more than mothers (Mandell et al..
1980). Some controversy does exist regarding fathers'grief. Kennell et al., (1970) note that
although tno fathers denied that they had grieved, several husbands appeared to have
gncved as long as, or longer than their wives, particularly men involved in the transportation and care ofthcir baby to the hospital center.
Although no thorough research has bcen conducted, several studies conclude that social
support (family & fricnds) is helpful following the loss of a child (Klaus & Kennell, 1970;
Spinetta ct al., l98l; Jurk et d., l98l; Laurell-Borulf, 1982). Some authors have commenred on how the social network in many cases makes the grief process more problematic
(Helmrath & Stcinitz, 1978; Watson, l98t). Many feel a lack of acknorledgement of rhe
baby's existence, especially when the loss occurs at, or close to birth (Hetmrath &
Steinitz, l97t; L,orell, 1983; Stringham ct d., t982). Friends initially supportive often
withdraw after a month or two, adding to the parent's sense of loneliness and isolation
(Forrest, 1983). Sex differences in hov the two parents view their social support has been
given limited attention.
Nikolaiscn & Williams (19E0) horrcver, found that fathers and married parents vieu€d
thc support thcy rcceived after a child's dcath as more positive than mothcrs and single
parents (Nikolaiscn & Williams, 1980).
Parcnts rrary grcatly in hov thcy perccive support from hcalth care providcrs in studies
conducted. lnadequate support is reflectcd in lack of physical and psychological space for
the mother in the hospital (Lovcll, l9t3), and in ncglect of parcntal aftcrcalr (Bourne,
l!l6E; Rorrc et aI., l97t; Lovell, 1983; Laurell-Borulf, 1982). Hcalth pcrsonnel are pcrceived as both inscnsitive, aloof, as well as unconcerned (Knapp & Pcppers, 1979), and as
warm and supportive (Wolff et al., 1970; Berg et al., l97E). The conflicring resulrs
probably reflect difrcrent amount of care an support received, togcther with different
methodological approaches. Whcthcr mothers and fathers vicw these matters in a similar
or difrcrent niay is not rcported.
Wc do not have solid cmpirical knollcdge about possible parcntal differenccs. From a
thcoretical pcrspcctive rvc nccd more knor,ledge about hov thc two sexcs react to, and
copc with unforcseen life evcnts. From a clinical pcrspcctive increascd knowledge about
any difrcreoces in gricf, can be ofhelp in bercavcment counsclling following such cvcnts.
In this study nrc address the following questions: Will mothcrs and fathers difrcr with
rcgard to their cmotional rpactions (anxicty, angcr, sclf-reproach, sadness, restlessness,
nork inrolvcment, intrusive thoughts and slcep disturbanccs) in the pcriod following the
loss ofan infant child (as thcy subjcctivcly remcmbcred them I to 4 ycars after the loss)?
WiIl therc be difrerences in hou mothers and fathcrs pcrccive thcir partncr's rcacrions,
and the rtactions and support they rcccive from family, fricnds and health carc profcssionals? Finally, will the mother's and fathcr's psychological hcalth starus l-4 years folloving
thc loss bc diffcrent, as measurcd by invcntories on anxicty, depression, bodily symptoms,
impact of crcnt and gencral urcll-bcing?
METHODS
Subjects
Thc study rryas catricd out al Thc Unirtrsity Hospital of Bcrgci. This hospiul provides scrviccs ro
femilics living on thc rrrstern coast of Nor*ay. At thc Dcpanment of Obstctrics thcrc ar€ rround
4 fl10 dcliwries pcr ycar, and thc Department of Pcdiarrics trcat 3 6fi) inpatients and l 5 m0 ourparients
annually. All fanilics who had sufrcrcd thc loss of rhcir child duc to stillbirth or nconaral dcath ta
28
(t
Scrnd, Pryctol 28 (t9g?)
Similarities and differences in parcntal
living child tnnsfcrrcd to thc Nconaral Intcnsirc
carc unit who tatcr dicd) at thc Dcpanment of
obstetrics and thc Dcparrrncnt of Pcdiatri* *lrrtn
r lcar pcriJwi-i"ina"i in the study. In
addition Suddcn Infant D:ath Syndromc
" llar
tSfOSl ianifics
camc i"
Depenmcrr of
Pcdiatrics in rclation to thc dcsrh
i""i"a"a. ir,ir group constituted around t0% of all farnitics
that lost a child in SIDS during rhe rimc pcrioa
corcrca tU"roC on aar" torn tf,c L;iiregstcrl.
e toral
of 2t farnilies uerc excludcd.when othir tvp".
madc ir cthically and clinicalty dimcult to
subject them b thc inwstigation, such
family siiu"ti.r,, .. ri..xpccrarion of
a ncw child in thc ncar fururc.
A totaf of 214 parcnts who had losr a child t2 to 48
months earlier (M=27.02 mnths, sD=9.20),
n*circd a qucstionnaire. of thcsc, lt7 parcnts t"iu,nia ,rr" quortion*j-;.
pcrrccnr r+!rc
nomcn' In 55 pairs both parenrs respondcd.
Thc samp.rc anaryscd
55 pairs.
Tbciragc rangcd from 19 to 49 ycars|M=29.4, SD:5.7-:,).6yVoof
thc parcnts u€re younger rhan 30
vears. Stvo lirad in urban arcas. Rcgarding cducarion, 23vo had
eril;;;;ooia;ihcrr highesr revel
of cducarion, 56%had hig}.school oril,"-"cui;"il'and2lvorraa
uni,rcisiry i""fgrouna.
Thc sample consistcd of thrcc gtoupt or bc.."oJ'pLn,t.
These thrce Sroups rilcre l) a stillbirth
group (/v= 15 pairs), 2) a nconaral gloup (N=26
parn), and 3) a SIDS gro,; it'= li;n..r.
d;;;;;c
,*r
oi"l...
"r;;r;;;itadrcrsc
;d;;"
h;;;#;ir-;ithcsc
All parcnts ntrc offercd.assistancc aiicr ttre inrcitigtion.
en intcrinuo'n
uras stancd at
thc same timc as this invcstigation, uut,
i 3i5s r"rili"", non. r,"o
systematic hctp
beforc the inwstigation.
Qualitathrc .iiniJ'au"
,rt. intc.rcntion proSram have becn uscd ro
illustratc somc of thc statistical obscrvations.
"rc"fil- i.r
o-*i
,"JlJ
Measures
All subjccts rrcrc askcd to complcte a writtcn qucstionnairc.
Morher and fathcr in cach family fillcd
out scparare qucstionnaires.
qucstionnaire
d;sJ;;;;idc
t;;;;;-r]--'"g
The
tontained rhrec parts
r) sociode_
mographic informaaion,2) data rclatcd to thc loss
itsctfincluding thc family rcactions to thc loss, and
ttr. rirn" .l ,t"ail i
rhc toss.
"r from the litcraturc on family rcactions
Qucstions for thc instrumcnt rrcrc adaptcd
ro thc dcath of a
child (Kcnnelt ct at., t90; Cullbcrg, rc66;
g.n
ci a,.l-tcze,
i"H cr al., t978; Comucil er at.,
Mandcll ct al', 1980), and frori cxplorar"rvlnrc*ic*s
and mcctings with parcnrs who had lost a
3) data on psvchic and somaric discomfott
n;-
lfi;
To obtain information on thc parcnts'rcactions
in rhc tinc pcriod folloving thc loss, thc qucstionnairc prescntcd them with a lisiof common gti"i
(anxicry, angcr, dcprcssion, resgessncss
ctc" scc Tablc I for format of questions) ror wrricl irrcv rrrrc
asked to inaicatc th" d"g"." thcy had
r";tilr
cxpcricnccd thc rcaction in qrsdon. Thc qucstionnaire
also incrudcd qucstions on thc parents,
pcrccptio-n.o-fpanncr' family, fricnds
and lcaittr care professionats (gucstionnaire format in
Tables 2
and 3)' whilc thc data from thc qucstionnaires
r"i"'r"J ,o thc frcquency with which thc parenrs
cxpcricnccd differcnt cmotional rcactions, qualilatirc
information colrectcd through thc intcrrrcntion
proSram garc additionar informatior
on thc. dificrcnr rypcs of reacrio;.;G;;;;il ily ,t. p"n.n,r.
To inrrcstigatc long tcrm adaprion to 0t"
iJr.att as crrcntual'difrcrcn.".'ln tong,"*
adaption,
final guestionnairc also includcd rfreioUoring inrentorics:
_the
l. Thc Impact
of Ercnt Scale 0ES) CforowiJcr af-. ,''tng; An*recr
al., t9B2) which providc a
mcasure of intrusirrc thinking and pcriods or
aroiaancc associatcd with traumatic lifc crants. cronbach's Alpha
*ni,
IES Inrrusion
-0.ti, IEs eroiaancc
=o.zt. A[ c,o;L;h's'"rirr"-.l"ruo, rcrare ro
rcsults from this study.
. 2. Thc 20 itcm vcrsion of the Goldbcrg General
Hcalth eucstionnairc (GHe) (Goldbcrg, l97E) r{8s
u'"d to asscss psychorogicar impairmcni of h"J,rr.-i-nu"rr's
Arpha -0.92.
3. Thc sratc venion of rhc,sratc-Trait Anxict
---' (SIAI) (Spiclbcrgcr ct al., 1970) to asscss
dcgrcc of rcsidual amicty. Cronbach's abfra
.-1'
loaly symptom Scalc (BSS)(Pcn-n c sjou"tg, tggt) tras cmploycd to prwidc a mcasunc
of bodily discomfons. Cronbach's Alpha
=0.93.
5. Thc short form of thc Beck Depression lnrcnrory (BDt) (Bcck
& Bcck, 192) rryas emptoycd ro
prorridc a mcasurr of deprcssion. Cronbacb's
ebha
T:
grief
i;;.,y
=Ai.
=O-SE.
Procedure
on1 *1k.nrior to scnding the gucstionnairc, a lcncr nras
scnt informing thc parents of thc study. Thc
thc sludy rrtrc explaincd.
main objcctircs srarca nrrc incrcasing hcalrh pcrsonncls.
9*lt.o{
Jhc
knorlcdgc offamily rcactions aftcr thc loss ofa ciilo,
as t*cu as to improrrc supporl for such familics.
Thrrc u€cks after rccciving thc origina! qu"rrionn;J,ioi-rcsponding
families'rrcrc scnr a follov-up
lcttcr tcquesting thcir responsc. In alt communications with
thc familics., parcnts urcre offcred thc
,'
)
.
1,lL:7.;
i-:r=.r:
1
y!.
;::',*T
qu;:ffi :: TI'F*
'tffi
B.Llattfiesen
-i
:
psvchorogisr (rhe
n61
or rccrrss conccrning
u,thor)'.should
"uF
ff1::::319?-g,:
*ln:ru::F?H_",ifj:jn"H"t?k:
irFff-S:"#rtrffi
Scrnd J psychot 28
ttcv fect thc necd for askins
#i#Hff"ff.::::til;J.ff::
g1ff#j#'ny;;:.*trjffi
,H,""TTl;"fli:ltr
ff ffi.H:'i:ffi
::*l:.],,ff
ff tri,tr;1{;Hi*#ffi in#:ffi
ffi
Ttrlrfr :.f*jil:,#1ixit
Srarrbrr.cs
B:,HmHfi::i:llJ$ffoff;0.ff0
cntcrcd on a pcrmancnr
data nrc. spSS (Nic
et ar..
RESUITS
lbout ltalf
64 .7vo)
responding
of
theparenrs returned rhr
guestionnaire. Based
on hospital records,
_:.
"""-ro*lir", ffiH
g;;rft -o
gn' ;:m*
t":',Tf;t:
ffi
?,r:#:
JHrffi',:;
and wherhcr trre iirnoiry
of the chitd, the morher,s
uvea in-rir*lr;;ilit_]1:::pan
age,
from the 55 couptes and
included uotr,
the additionar z
rotili
',.iialifr.lf.t 31"tt,t
Earb griefreactions
To asscss the parcnd grief
reacdons in rhe n
#ffi;t1;'Ll-ry"':l;;;.,}lff*i"J1ffi:JTl,il,lllll;1ffi
rauc I
ovcrview.rn"-.r,""*"
;;;;;#Hl;.
crpcrienccd
(}rr alt qucstions
gives an
ii*n
the parents
tt
*,il'*":T"',t:;
.U*im;3.k-:",Fi*-#"T","t'G;li:ffi
rn"-oiil*"i"i
se"iri"-i;;;;f,H
il:;"" rhe parents
1i
*:fjhtffH:o.
indicaring anxrery as
ff."'T;;#;ll.T:*
an
r.x"',il;ffi
"TIHl,ffiJH
i,;r3",*,T:'ff ::*::T,.rhanrarhcrso;;;;]:"thisandthe
morhers
or probrcm). In 26
*rffi; T"j:,::" spccrfic reacdons
i,ri,..'sf,ore, and in rj
il"l,ffi#,I',iliifl"
I"lffirg:,11o'11J "lookins at rhe perccnag!
Sovo of thc *omcn
;;;;#:?',ITlv'.wl*men had *o"i."t?,*n,
srro,u anxicry.;j'#?il1|,Tflffitff
o. oo
:rJl"
whcrc he is at r
lnow
*a,,.,
go''
J*"-ii'ifi!i1!:ffi#.1;?il:;f:';r;:i
lll1Ti"u*ET:ff :r"' r ect atnosr'rr;;; n" c,". iu-,-ini: ;il;,, commcnt)
ry'..tnothcs *pott a ;;
*ate,Trh
ea,rs
_f*iHT{,J,"ffi
$1ii:1il:oi,r,,o,"pr"reponcdhavingcxpcrienced
jil:.i*,$i:.*.H::Hi*i"jlll,il.,X#.",,"H*,,,#
mT"#ffi
pairs *cre cvcntv
cistrifui"i-*r'*#"e morhers
-o r"*;* ti","rtl;L:.T.::[|
j
*"'i3,,l?:ffi**"1T,:.:Tff
;;...-;'j:'T:::l:yt_|9,
fu:-S:
;"j#il.:,ff"T,g.,ysexes.rherarhersbramed
more sclf-reproacrr uat-oc
In 25 pain rhe mother indicatcd
father' and in only u
reproach rhan theo,orh"rht
fathcr reponcd more
A mother commcnted after
serfa sIDs ocati:
v:: *n pick up thc chitcl
,n", ,r
when
it
happens,,hc
picked him up,
*lr
oii. t
hc noutd j :.f"ut
if I had
have been
rt'"
p";;;;;;:.'*
mine todav
"",
cd significandy in rhc
ocbee or.eacdng
';iiloi"*
,i#1"
with
sadnessafrer
&c
{
J
hychol2E
uts
dcoth
reactions in parents after their child's
rhe usc of wilcoxon matchcd'pairs
with
significancc
for
tcstcd
Dificrenccs bctrrecn molhcr and fathcr
signcd ranks tcst (for rrLtcd samplcs)
l. Early grief
Tabtc
Dircction of
Mothcr
gm
difrcrcnccs
ual
Iw
within pairs"
l8
Qucstion
il.,
To what dcgrec did You rcact with
A. Anxicty
Vo
L
Not at all
l9
2.
Somc
23
3. Much
E
4. Vcry much
3
<7
35.8
41.4
t5. I
B. Angcr
t
34.0
28.0
22.0
ll
l.
Not at all
26
51.0
t9
:s.
2.
Somc
l7
33.3
26
6
ie'
:t1S
3. Much
4. Vcry much
l.
Not at all
2. Somc
3. Much
4. Vcry much
lls
ad
D.
ItS
ler
26
l9
44.9
38.8
a)
6
12.2
8
n.7
l4.t
4.1
l5
27.E
,,
Not at all
0
0
Somc
7
12.7
32
58.2
29.1
t6
Rcstlcssncss
7
12.7
t<
45.5
3. Much
9
4
t7.0
l4
u.5
7.5
9
16.4
35
6E.6
!.
Not at
dl
ll
37.0
5.9
5
1
9.3
3-9
9-18+lll=
25-16+ll7=
-3,63tt'
26-/5+fU=
-3.28t.r
17-ll0+D6=
-
3.7
1.65
-1.47
l7-19+D4=
G. lntrusivc thoughts
'
about thc child
l. Not 8t dl
2.
7
3.8
Somc
l9
36.5
30.8
28.E
t5
No
Mcan
the
50.0
20
)
t6
nd
a1
2r.6
3
3. Much
tif
@.1
l?.0
4. Vcry much
:lf-
3E
58.5
F. Workcd morc
-3.37tr'
7.t
9
red
:cd
2t.6
3l
4. Vcry much
at
red
l3
Somc
8e
:ry
9rs
0
Not 8t
3. Much
4. Vcry much
Gd
0
1
l.
dl
26-7+ll5=
16.7
9
2.
2. Somc
nr)
3
l.
t5
to
J
3.9
2.
E.
rts
an
he
r 1.8
Sadncss
3. Much
4. Vcry much
of
37.3
51.0
5.9
5.9
2'
C. Sclf-rcProach
z
16.0
l7
l4
ls,
on
Wilcoxon'
Slccp disturbanccs
Not at sll
2. Somc
3. Much
4. Vcry much
Mcan
l4
33
2.r5
H.
l.
3
3
5.1
5.7
26.4
62.3
3.45
73
4t.4
lt
m.4
20
17.0
0
11.2
0
l0
9.4
t3
lE.5
24.r
t(
t.76
_3.23..r
?5-16+119=
2.6
-t.12"
8-lt+ll6=
ofrhc partncrs haw
o rotal N arc 55 for both mothcrs, fathers and pairs. Hontrar, when onc or both
failcd to ansrocr a qucstion,
soorc than
rhan thc
had highcr scorc
score rhan thc
a
higlrcr
had
tattt"r
tttc
*ttei
pAt"
of
fathcr. Ptus dificrcnces (+) inl-iJro o"
p"no"; had thc samc scorcs is indicatcd by a tic scorc:
morhcr. and tbe nuo,U., of poiJ*i"r" ;rh
o"ittu"itrt"tb$"TJryllIlllt-,Yrtj'r,""cr
t
lif":: ffi;#Si:Til'"ffi:Tff; ffi;r;;;;-;,hcr
iutii
111* *u"oton mstchcd-psits
signcd'ranks rcst' 'P<0'05'
"p(0'01'
o-pr(0'(X)l'
A. Dyrcgrov and S. B.
Manhiaen
ffi *,Tll,i,lll;,11",1,*"*
scerhat almost all
mothirs reporrcd much
or
hear mothers say; "r
rrom the pcrcenbges we
rr uas usuat ro
cry ro "j.11.
much, T":,an.
it i, e".n ni$tening
o* $]:tt.,z.lf'
* "0"" ,*"J:7*::
'
I
mysctf'.
of the parents cxpericnced
resilessness
^Yy,I E, F). Althoueh,l.r"
(Tabte
;;;;;;,"iil_Tl*le
tno guestions than th
td;;il,;"Trs'scorins
arnounr of
fect UAE
tiki ar open nound.
'vL'
.
&ese_ *""01-o9:'
. _--ions, and
the
dincnnces.
Mothcrs had cxpcn
r"trr"rriiijiiin:il';:*to
inoi""tJti"'ff
*nn,i oJ
to
rcponed that they unrked
more
histrer than the fathers
oo tr,"."
"llill,,J.?.*l,l::o.,!ijl1,iTi,*""1"I:
more "intrusitx thoushrs"
about the deceased
chitd, than
"::lJ,firiiii#1,1""'*",'"H,,il!1*,Ti[f"t'iT$##"'
ffi''#:n *: *,xtlll"*:fiF.rl'1of pJ;i-;ilffi;",
!1,
pcrsonnct
the blanket when
carricd
her out ofour
house.,,
reponed: .,r
the ambulancc
'ut
iil"f;':l tr"1"#',.*
4T; ilil;;:s
probrems
probrcms.
n.;;;il:
ot"Tnl,, g"bre l H). Mothers
experienccd
than fathers in 2E pairs,
in a p"i^ l;;""*lr"n""o
'oor"
,i. J# r."qu"n.y
il:#J1,fi:"Ti"ry:':'*'** that
or
as
traa cxpcricnccd
.tltc.13tt1n
to lovo of the
faoers.
rr.t, .,,,","i"rrril).demonsFate
e"st rt mucn ol tncse disturbances,
many as 35vo of
compared to close
Pcrception of other,s
rcacrions
t srrcs en indication of horv
rhe parcnrs o
I*]:.
situation. There nrre
small difrercrrcc_s;il:fiI-",rred. their social surroundings in this
Perccivcd thcir famity ana
and the fathcrs in hov
ni.nor. ro.
rhcy
lt' ToTTt
and C, most pairs checked
cateSory of ansncr.
For ail u*"
o"
sam"
trend touards morc pairs
scorcd higher rnan rhe
wherc rhe
farhers (espcc,"f1"
on qucstion c). This rrend,
did not rcach sratiitical
air"*n".-.
hourc\rcr,
rc see that a majority or uoii
mothers fctt rhat,r,"irr"rri,,
d;il":
q"*il.-"J;#i'
ffi::
ffi
i-;-r"fr"#t
Li';,iT"';Tl-T:t
ia_tffs-ana
Ll*T*Ia
ano
s, A ri;;;ffi$
JH:qfi.ffi:nffi',':*,*:
,hg h"d otnirru".lriflt us' and *a had to contact.rr... wil-*'ilI'ilerr,..
r* r.rt
Mosr;il;"#ns to us about what had happcncd".
.
and fatters, did not
ro any strong dcgree
lack suppon and
**"otent (se Table 2.,cu:s:iol
c). ; ;;;il;n
part of thc
n*
;"rn-ol,oo"#.1*,il:#11fr
"ffi .1:ly*,r,r,"r",r,",,ii"ill'#timesrackcd
,,r_::j:n:o-haddividcdperccption-.;l;.;",
hclp from others after
thothen
tparcnrs (more rhan
-'',H
the fathers nrre rcasr
thev reccived from the
hospitat. In
*dil-;ilil:i*
tr#:T#:#:*:.!'"ur,.i."o,i.ilil'#I*,T_nlll3,H*t*:..1*
rh.',u,rorbo;;;;:ff;;:lf#f
ffii,tri:,,::ri"'rh1",.";:1";L,_T;
i]o""irl, al. y-, parcnrs, h-Jercr,
utuc suppon frrom thc
hlsnirar ct"on
positirc pcrccption
of the support tfr"v ,.coiwa
iim
The parcnl s relationship
Most parenrs fctr they
y^111rr closer tqgcrhc,
raore rhan rwicc as
many fathers
"r
the hospiral.
rrad a
dcath_(Tablc 3, qucsrion
A).
T."I^g.
ro,l.r. l"r, ,tly
*o grown
funhcr 8pan. within
15
Scend J
tsud to
ning to
more
l
these
live with
than
it alone" (mother, sIDS). we andysed whether there were any
r blui
:d: "I
pairs sigrcd ranks tcst (for rclatcd samplcs)
rlance
Mothcr
Fathcr
Direction of
diffcrcnces
N%
Qucstion
:nccd
within pairst
A. Did your family oftcn
avoid talking abour
the dcarh?
of
l.
close
No
2l
tE.2
2. In part
3. Ycs
22
r10.0
t2
2!.E
2t
t9
t5
38.2
34.5
27.3
l4-l10+/31=
B. Did your fricnds ofrcn
avoid talking about
thc dcath?
&is
thcy
l.
arDe
the
No
t5
2E.3
2. ln pan
IE
3. Yes
20
:t4.0
37.7
suppon from othcrs after
thc bcrcawment?
l. Narcr
say,
fch
t4.5
14-llO+29=
t5
t7
27.8
l4
25.5
t.5
9
3. Somctimcs
l9
35.2
16.4
<1 1
3
5.6
29
3
3
5.5
2l-l11+DO=
D. Did you rcccivc
adcquatc
or inadcquatc support from
thc hospital folloving the
bcrcarcmcnt?
l. Vcry good support
2. Good support
kcd
.In
o6
fne
orc
3. Littlc suppon
4. Yery littlc suppon
:ry
r).
t5
23.6
4t.8
2. Rarcly
4. To a high degrcc
and
la
13
23
19
C. Did you lack hctp and
:thc
the
Wilcoxon'
z
:.'.j'.r;.,.
'
'.t ,l
.I
mone
cy of
)
relarionship
of difficulties talking about the dcath, and their experi-
Table 2. Parents' perception of support from family and others
Differcnces bcturccn mothers and fathcrs tcsted for significancc with thc use of Wilcoxon matchcd-
nners
trcr,
roth
grief
ence of distance in the marital relationship. We found a positive relationship berween
thcse two variables (r=0.26, p<0.01, Pearson product moment correlation). parenrs who
: satne
Vo
Similarities and dfurences in parental
between the parents' experience
,ificant
,
26 (t987)
pairs fathers indicatcd a more negative score than the mothers, in 7 pairs this was the other
way around, and in 33 pairs the par€nts scored thc same. The difference bctwcen the
partners was sraristicdly significanr. Those who felt that they had coped well rogerhcr,
oftcn rclatcd this to thcir ability to talk about what happened: "we managed because we
talked about it from the start. It would have bcen so much worse to bottle ir up inside and
han the
rges we
d
hychol
5
6.4
t9
4.4
IE
3E.3
t4.9
r
t2
t7
r0
r
22.0
24.0
34.0
20.0
6-Dl+ll8=
-2.54'
"
Total N arc 55 for both mothcrs. fathers and pairs. Horcrrcr, whcn one or both of thc panncrs have
failcd to answcr a qucstion, thc numbcr ofrespondcrs (pain) arc lcss than 55.
' Minus difrcrcnccs ( - ) indicatc numbcr of pairs whcrc thc mothcr had a highcr scorc than lhc fathcr.
Plus diffcrcnccs (+) indicatc thc numbcr of pairs whcre the fathcr had a highcr scorc lhatr thc mothcr,
and thc numbcr ofpairs whcrc both panncrs had rbc samc scorcs is indicatcd by a tic scorc: (=).
' Thc Wilcoxon matchcd-pairs signcd-ranks rcst.
'p<0.05.
-''
,.
'l
A. Dyretrov and S. B. Maahiesen
blkine with rheirspouse
il"tf.T fflffil*problems
apart in their marriages.
Alrhn,rah
h^-.
.L-_
a
.lg"r
Althougro more than ["r
u," rotr,"i, ;; ;;;'#ji.
difticurt
to tark togcthcr about ,rr"
o""ii,
,"*
fouo'ingthe
stared rhat
death arso
it
,^as not
tran rra'the
",n"r.
farhers acknowtedged that
I1r" ,. Parents perception of aun vs. partner,s reacfion
ff:fffi.T:ffi,T1*:Tfit"'
**"nr*.,snir,"-"e
Fathcr
Mothcr
Question
A'
Vo
wirh thc
use
orwircoxon marchcd-pairs
Dirccdon of
diffcrcnccs
within p6itrc
Wilcoxon.
z
A. Dd
thc loss lcad
you closcr togcthcr
or irnhcr apart?
I.
Closcrrqgcther
33 60.0 36
,; ,ll '1 ii
2. Samc as bcfore
3. Furthcr apan
B.
Was ir
difticulr ro
65.5
ralk togcthcr about
7-ll5+R3=
rhe dcath?
l.
No
23
2E
2. In part
3. Ycs
C. Did you rcacl
4
32
13
t0
4t.8
50.9
7.3
58.2
n.6
t8.2
17-125+lt3=
mone
stroosly, lcss strongly
orJust as much as
your spousc?
l. Rcaccd lcss
2. pqu"t rcacdons
3. Rcactcd morc
38
69.t
t6
29.1
I
2
t4
39
l.t
D. Did your rcacdons
3.6
25.5
70.9
41-2+ilO=
continuc for a loagcr,
a sioncr or the samc
lcaSrh of timc as
your spousc?
I. A shortcr timc
2. An cgual rimc
3. A loagcr timc
E. Did you and your spousc
rcect differently ro
the bercarcmcnt?
l. Quitc cquel
2. A lirrte difrercncc
3. A stroru difrcreacc
3E
t3
.,
71.7
24.5
3.E
3
t
4t
I
_5.70...
5.5
20.0
?4.5
4-D+ft=
20 36.4 t5
26 47.t 30
9 t6.{ t0
-0.24
_5,27.'.
27.3
54_5
tt.2
tl-n+R7=
t.t3
t forborh rn",h
{"*
o19
.
or
.nsriler a qu.stiot
"-I9|{
l{* j:ffiHil:l.lnr*i::ti,;'Xffit,iffi
lifl
"t" numbcr of mcm.r.* ,-II'-lTo
i#il."?ff Srh of oc panncrs har€
;ffi ff"ffJ,"ff fr tr#iftr*::id$Sffiiil:'iiiH,ii;,**rr,"nu"r"rr,o
pf,:i,l,H5ffi
*mti:*".m#ffiff#tr'HffiHr"ilff:tr#i,t""''i*lt:
fr*.Hi':iff :ff ;Hgfl ffi ffl
risncd-raots tcsr.
l*"Yufgg1d;-eau.
.p<0.05. ...p(0.(Ilt.fi:tr.Hi*fi
"HlEl:
*
iiir;ffi
bandJ hychol
th also
as not
d thar
l-pairs
,xon'
Similariies and differences in parenral grief
Scrnd J Psychol 28 (l9S/)
thcy in part found it diffrcult to talk (Table 3, question B). Among the mothers nearly one
fifth ansnrcrcd yes to the qucstion of difticulties talking together, and another fourth of
thcm in part had cxperienced diffrculries tdking with partner. The differences between the
pairs urcre not significant (see Table 3, question B).
Regarding the intensity and length of grief folloring the death of a child, both sexes
agreed that mothcrs' griefhad been ofstronger intensity and longer duration than fathers'
(Table 3, questions C, D). For both these questions, the significant dilferences in the
Wilcoxon analyses were evidence of agreement that the mothers' grief reactions were
stronger and of longer duration than the fathers'.
In qualitative commcnts in the questionnaires, and through information gathered in the
intervention progxam, parents related the difrerence to the fact that the mother had carried
the child through the pregnancy: "I carried the child for 9 months. The father's feelings
appear later!" (mother, neonatal death). Regarding the duration ofgriefa mother (neonatal
death) gave the following explanation of why she grieved longer: "My reaction first came
when I recovered from the birth. I cried almost continuously for a long time". Another
mother (SIDS) reported that father's grief lasted longest, and she gave this explanation:
"He did not w:ult to talk about it, I uas more opcn, and took a shoner period before I
recovered".
There nrre only minor difrerenccs in how mothers and fathers viewed whether or nol
thcy had reacted dilferently following the loss. In t I pairs mothers felt there were more
differcnccs than the fathers, in 7 pairs fathers indicated more difrerences than thc mothers,
and in 37 pairs they indicated the same amount of differences. Around a third of the
sample perccived their rcactions as quite equal. Around half of the sample reported that
they reacted a little dillerent than their partner following the death, and a little less than
one lifth felt they reacted vcry differently. Many parcnts commentcd on the fact that
womcn more openly showcd thcirgrief. "l openly let my grief show. I cried at home and in
shops. I rcacted with apathy whcn my husband returned to work after the funeral"
(mother, SIDS). "We grieve for the same rcason, but I manage to talk more opcnly about
the loss. It is always I who start talkingabout what happened. I do think that I react more
strongly, but could it be that I shorp more of my feelings?" Her husband reports: "We
have the same thoughts and questions in connection with the dcath, but she cxperiences
stronger fcelings" (parcnts, stillbinh). "I wanted to forgct it all, while she was mone open,
and uantcd to talk about the death" (father, SIDS).
Parental differences
I to4 years follonting
the death
Table 4 shors the relative difrcrcnses betwcen the parcnts on 5 psychometric inventories
I to 4 years after the dcath. Thc data for thc Impa.ct of Event Scale is rcportcd for its two
'subscales: IES Inrrusion and IES Avoidance. In addition lhc parrnts' nesponse to a direct
question on how much they fclt they had rccovered since the dcath is included in the table.
Women rcported their situation to bc less favorablc on all mcasures. The difrerencc is
significant on 5 of 7 inventorics (with the Gxccption of GHQ and IES Avoidance. The
direction of the differences on these two mcasures urcre in the same dircction with the
mothers scoring highcr than the fathers). In significantly morc numbcr of palrs did thc
mothcr have a higher score (indicating morc "mental agony") than th€ father' Mothers
acknowlcdgcd more state anxicty, depression, somatic discomfort and intrusivc thoughts
than mcn. Thcy also subjcctivcly fclt that they to a lcsser degree rhan fathcrs had
rccovered from the loss. The following commcnt illustrates hov many womcn vicwed their
situation at thc time of study: "I hara not recovered my own sclf following the death. I am
much more anxious for cveryrhing, and I think about illness and death crrcry day"
(mother, neonatat death). "I havc become morc heavy at hcart. I constantly brood over
a'
..:'-:1i
,=
.:
,: l.
10
A. Dyregrov
and S. B. Motthiesen
Scend J Psychol 2t
my thoughts and feclings" (mother, stillbirth). We like to emphasize,
hqvcver, that for the
difrcrcnt measures a considerable amount of pairs shourcd father having
a higher score
than thc mothcr (see Tabte 4).
In order to investigate whether the two partners' score tended to go in the same
direction, we carricd out a rank order corretation anatysis by rtre hetp
of the data
managcmcnt program SIR (Robinson et al., 1980). Table 5 shows the
relationship between
the fathers and mothcrs in the 55 pairs when they are compared
directly on rhe psychomer_
ric measurts. The positivc relationship indicates rhat a high "grief score" in the
mother
was associated with a high gricf scorc in the father, or vice versa.
This relarionship was
significant for all measures (except the GHe).
DISCUSSION
Thc results dcmonstrate that the mariral partners tend to cxpcrience
dilferent amount of
gricf reactions folloving the loss of an infant, with mothcrs
reporting significanrly morc
anxiety, self-reproach, sadness, intrusive thoughts about thc ctrita,
anJ slJep disrurbances
Table 4. Parents who lost a child.
Difrcrcnccs on inrcntorics tcsrcd for significancc by the usc of Wilcoron matchcd-pairs
signcd ranks
tcst (for rclatcd samplcs)
Dircction of
Fathcr
Dcpcndcnt
rariablc
Expcricnce of rccovcry
STAI X_I
BDI
BSS
GHQ
IES intrusion
IES aroidancc
Mothcr
Mcan"
SD
l.$ 0.63
,2.5 9.3r
l.Es 2.9t
52.29 16.4
2.93 4.61
7.24 7.90
6.E2 5.93
Mcan
diffcrenccs
pairsD
-l+l=
wirhin
SD
2.tt 0.69
37.t3 11.34
3.2r 4.02
694 tE.35
3.65 4.71
t0.66 7.t8
6.39 5.t3
Wilcoxon.
Z
2l-14+ll0- -3.t9'..
33-t20+12=
?J-lll+lll= -3.(n..
-2.00.
27 -ll4+t2=
-3.30...
25-ll6+lla- - |..t8
4)-lll+17= -3.0t..
16-113+16= -0.t2
"
For all meilrs a highcr scorc indicates more distrcss.
o Minus diffcrsnccs (-)
indicatc numbcr of pairs whcrc thc morhcr had a highcr scor€ than thc fathcr.
Ptus difrcrcnccs (+) itdicatc thc nunbcr of pairs whcrt rhc fathcr ua
a rrigicr scort rtd ttrc mottrcr,
and the-nrrmbcr ofpain whcrc borh pannen had thc samc scores is indicatcd
by a tie scorc: (=).
Thc lVilcoxon mstchcd-Fairs signed-ranks rcst.
'tp<0.05., ..p<0.01.
r..p(0,001.
5. Rank order conelarion (spcarmans rho) berunenfarhcrs' and mothers' grief(the
spoutes in cach couple is comparcd dircctb)
Tabfe
lnrcilorics
Expericncc
of rccolery SIAI
X-t
IES
BDI
BSS
GHQ
.59r..
.23
intrusion
IES
avoidancc
Fether vs.
mothcr
.4{t..
.{t..
tp<0.05. .tp<0.01. ...p<0.001, rnstailcd
rcsr.
.58...
Similarities and differences in parental grief
J Psychol
Sond J Psychol 28 (t98l)
the
than thc fathers. No significant dificrcnces were found in the amount ofangcr, rcstlessness
)re
ne
rta
en
:t,er
as
cf
:e
,s
ll
and work-involrrcmcnt betnccn the two partners. Typically both partners agreed that
mothers cxperienccd more intcnse and loog-lasting griefreactions than thc fathcrs. Mothcrs also tended to pcrccive their family and friends as somewhat less supportive than
fathcrs, while fathers were sigrrificantly less satisfied with the support they rcceived from
thc hospital.
In most marriages, the partners felt the death brought them closertogethcr. Hovever, a
considerablc group ofparents, cspecially fathers, reported feeling more distant from their
partncr folloring the loss.
The 5 psychometric measures used to evaluate the long tcrm adaption of the parents
indicated more lasting cmotional and bodily problems in mothers l-4 years after the loss.
The mothcrs dso felt they had recovered less from the loss than fathers. Our results must
be takcn as a confirmation of other rescarch sholling the death of a child to have an impact
several years following the event (Rubin, 1982; Rando, 1983), and that $/omen have more
adaption problems than men.
Following the child's dcath the mothers experienced significantly more anxiety, sadness, intrusive thoughts about thc child, and slecp disturbances than the fathers. Thcse
results are supported by other rcports (Benfield et al., 1978; Wilson et al., l9E2: Bcrg et
al., l97E; Cornnall et al,, l9TI; Helmrath & Steinitz, 1978; Forrest, l9E3).
Mothers reported significantly more "self-rcproach" than fathers. This is in agreemcnt
wirh orher rcscarch rcporting guilt to be particularly more common among women than
mcn (Clyman et al., l9B0; Benlield ct al., 1978; Hclmrath & Steiniu, l97t; Wilson ct al.,
1982). Although thcrc seldom was any objcctive causc for thcse feclings, mothcrs blamed
thcmsclves. Thcir responsibility for carrying the child through the prcgnancy, and bcing
the primary carctalccr of the child, may cxplain the exccss of guilt fcelings in mothcrs.
On all qucstions therc ncre a numbcr ofcouplcs whcrc the fathcr acknowledged more of
the rcaction or problcm than-the mothcr. The lcvcl ofdistress in fathcrs, as indicated by
their scorcs on sadness and intrusive thoughts in Table l, were dso considcrable. This
does make it important to address the father's gricf in programs of intcrvention and
suppon.
Thc causc of the difrcrenccs in mothcrs' and fathcrs' rcactions is unclcar. and from a
theorctical viavpoint scveral cxplanations scem viable;
l)
thcy may bc causcd by
a
difrerence in amount ofattachment or "bonding" to the child (for usc ofthe concept see
Raphael, 1983), 2) they may rcflcct difrercnt rcactivity to stress or difrcrcnt mcthods of
coping in mcn and women, 3) thcy may arisc bccause mcn undcrrcpon or fail to acknorrledge cmotions and rcactions, or, 4) thcy may reflect the difrcrcnt social situation the two
sexes experience following the loss. A combination of thcsc causcs is possible and
plausible. Thc data rcponcd hcrc does not clearly favor any of the diffcrcnt explanations.
Horevcr, parients in our study wrotc comments on thcir guestionnaires that could be
takcn as suppon for rhc third cxplanation, i.e. thar thc observcd scx difrcrcnccs wpre
.causcd by mcn's undcrrcporring or supprcssion of cmotions. Onc of the fathcrs put it this
uay: "Maybc I have a sFongcr ability (mcchanism) to supprcss what has happcned to the
child. This is also truc gcncrally, it is easicr for mc to forget or suppress crrcnts, as I do not
rcflect on thcm as long as my wife" (neonatal death). This is supportcd by some studies
whcre mcn have becn shorn to exprcss lcss emotions than womcn (Allcn & Haccoun,
1976; Notarius ct al., 1982; Dosser ct al., 1983). Furthcrmore it has becn shown that mcn'
in addition to a lack of ourward cxprcssion, cxpcrience lcss feelings and bodily rcactions
than womcn (Allen & Haccoun, 1976; Allen & Hamsher, 1974). These rescarchers report
that diffcrcnccs are grcatcst rcgarding o\rcrt cxprcssion but prcscnt in covcrt rcsponsivencss too. Thc differenccs rtary across cmotions, being grcatcst for fear and sadness, and
t:::t
t2
A. Dyregrov and S. B. Manhiesen
least in anger.
Scsnd J
our rcsurts arc in rine with thcse findings. Men reported
ress ,,fecrings,,
Bydrol26
as
rhan womcn. Wc atso found that thc differences
raried across
:|,:j::.Hf
emodons, with no Tp*
significant differences found in anger.
Another observation made when reviaring the guestionnaircs,
was the lack of written
commcots by fathers compared to mothers.
In aidition fathcrs often failed ro answer
opcn'ended qucstions included to get qualitative
material, while the mothers did answer
thcse gucstions' we sce this as an inoication
of the fathers unwillingness ro ir..rv express
their feelings.
clinical impressions frrom the intervcntion prognrm
suggest that even though men tend
to underrcpon their fcelings, there are real sex difrercnces
in .e"ctions expericnccd.
Thcrcfore it is diffrcult to interprct conclusively
the reported gender differcnces,
somc support is also found for the cxplanation
ofthe observed difrercnces on the basis
of the difrerent social situations the twoparents
return to folloiling the loss. The parents
often put this explanation foruard themsitves.
They both stressedihe facrthat the father
had his work to return to. Herc his thoughts
were occupicd, and there was little time
teft to
brood orar what had happcned. "I went to work
the day after he died. I know some people
thought it strange, but it nas good for me. It
kcpt my thoughts anay from what had
happened. If I had had ro stay ar home, I would
have found some work irr.o. rt herps
me
lo use my hands" (fathcr, nconatal death).
The socially more isolared tnott.,,.o, Icft with
more time to think and feer. This may be ncccssary
in ordcr to,,o.r trrrougf the grief, but
it can also rcad to social isoration ana orrcrinoutgcnce
in what has happcncd.
The diffcrcnce in intensity and duration of rJactions
nas the
ou.i
Ji.n"_ony in
many couplcs: "I felt he reactcd much lcss
than mc, and I felr hurt and aggressive because
of that, and arso b"c".rse hc did not consore,"
*h"n I fert sad. I fett he J"o"o negarivety
to my dcmands and nceds for consoration,
Evcn though my head totd me that he cared
for
or
me, my hcart told mc that hc did not care
enough,, (mothcr, n.on",rl
dcarh). One
cxplanation of thc fact that morc fathers
than mothers tendcd to rcport that rhey felt
they
grorn
had
furthcr apart courd be rhar men harboi fcerings or
ericf wiooui being abre ro
cxpress them to thcir partncrs. Thc fathcrs
may find it difticuttio cxpres, tr"ir ree[ngs
to
thcir paf,tncrs, in fcar of adding to thc mothcrs
alrcady intcnse eri"r.-cllii""xy many
fathcn cxprcsscd that they fert thcy had to bc s*ong
ro support thcir panncr. our resurts
show that intrasraritar lack of communication
the errcnt was rcrated to fcerings of
having grovm ftrrther apart.
"uou,
ctinically nrc ha'e thc
::
impression that many mothcrs tcnd to blame
thcir partncn for not
having carcd cnough about thcm, or the
discascd chitd. The fact ,rr", r",rr"., p.rccivcd
less
support from hcalth pcrsonncl and soon
qork,
tpturned to thcir
constitutes a situation very
difiercnt from thc mothers. The fathers
mav rca estrangcd by the situation at home, and
perccive a grqatcr distancc to their p"rtn"r.
It uas evidcnt that although mothers and fathers
diffcrcd in their rcactions, thcre wcre
significant positirrc corcrations betwecn
tbc reacdons of thc t*o .p.".ir. A strong
reaction in ooc spousc nas assosiatcd with
a similar r€action in thc other, a finding that
:ttgtrt ingicarc oc rcciprocar emotionar influence wirhin a rcrationship. It mighr atso
indicate that fathcrs in thcsc families in aocition
io iacing the child,s dcath also had to face
thcir partncrs' strong reactions. Clinicalty,
in families wherc one partncr shws a suong
gricf reaction, one ehould mahc surr
O"t LO panncrs receirre adcquatc carc and support.
Although not significant, there uas a trend tos,ards
.
mothcrs cxperiencing more difiicurtics with thcir fasrilics' and fricnds. rcaction
ttran rathm. If uomen truly cxperiencc
longer and stronScr reactions than men, and
at the same tirnc fcel a greater nccd to talk
about what has happcned,-lhcn others'unwi[ingncss
to do so may h fcrt'ery decpry.
From othcr studics, as urlr as our orpn ctinicar
lpc;cncc, it is cvidcnt that family and
(k
crnd J
hy$ol28
Scrnd J Prychol 28
rgs"
as
(l9m)
Similarities and diffcrences in parental
e basis
fricnds crpcct thc parents to bc "back to norural" relatively shortly after the death
(Stringhacr et al., t982). At times somc mothcns felt that fathers joined their family and
fricnds in this dclction.
In thc clinical intcrrantion program, parcnts, especidly mothcrs, have r€portcd; "it is as
if the child is deletcd from other pcople's memory". It has not been uncommon to hear
from parents taking part in the intcruention progfam that comments and reactions from
othcrs wcre the cause of distrcss: "I became cxtrcmcly iritated whcn pcople said; "Oh
rrcll, at lcast you have one child lcft", arcn if I thought so mysclf ' (mothcr, SIDS). "It
u/las painfut whcn pcople at home blamcd nre whcn they lcarned that thc baby was
seriously ill" (mother, nconatal death). "Pcople shop too much sympathy' and they
rcvive memorics" (father, neonatal death). "I feel that some of my friends do not
rarents
understand what we have gone
acrloss
writtcn
Bnswer
lnswer
xpress
In tend
€nced.
td for
throUlr" (mother, neonatal death), Some pnrents rcported
that they had to console othcrs instead of receiving support.
Horrcver, it is evident that parents vary in their perception of help and support from
others, as well as the opportunity to express thoughts and feelings in convcrsations with
family and friends. Gencrally both partncrs felt thcy did not lack support and help from
othcrs, but more than hatf of both mothers and fathers fctt that family and friends avoidcd
talking about rhc death.
Regarding support from the hospital, we found fathers to be more dissatisfied than
mothers. In our intcrvcntion program fathcrs have complaincd about bcing overlooked in
thc hospital. Usually, thcy say, it was the mothcr who was askcd hor she fclt' and rarcly
anyonc askcd how hc felt. When studies harc reportcd fathers to h rcluctant to talk about
thc dcad child or that fathcrs avoid profcssional support (Wilson ct al., t982; Nixon et d.,
t97; Mandell ct al., 1980), this may rcsult from less care and support receivcd folloving
.
the loss.
father
lcft to
pople
rt had
lps mc
ft with
ef, but
ony in
tcausc
ltivcly
One
It they
.ble to
ngs
to
many
esults
ngs
of
Somc cavcats should bc mentioncd with reenrd to thcsc findings. First of dl' about half
of the parcnts failed to return the questionnairc. The r,esponse rate was similar to othcr
studics conducted scrrcrat years aftcr the dcath ofa lorrcd one (sce Shanficld ct al., l9E4).
Thc attrition rate rcllcc$ the dirrculties in conducting follorv-up studics in berearrcmcnt
(cf. Btucglass, tgEl; Parkcs, 192). Rcscarch in bercavcmcnt (Clarke & Williams' 1979;
Coopcr, 1980) has indicated non-rcspondcnts to h morc cmotionally affccted follou'ing a
loss than rcspondents.
br not
:d
less
n
vcry
:, and
: UfCfe
rtrong
I that
t
also
o face
itrong
Ppon.
fricutience
o
talk
:cply.
Y and
The quantitativc data is gathcred rcgospcctivcly. People tcnd to forgct the painful and
rcmcmbcr thc plcasant (cf. Ericsson & Simon, l9t0).
The probablc attrition of morc cmotionally sffected rcspondcnts, and thc usc of retrospcctivc data indicarcs that it is likely that our estimatcs of emotiond neactions atl lotycr
than thc truc prevalence of rcactions arnong parents who havc lost their child'
Our incrcascd knorlcdge of difrcrcnccs in short- and long-tcrm cmotional rcactions
bctwecn pafents must bc includcd in our cfforts to tailor psychocducational and therapcutic intcrvcntion for the bcrcavcd familics' Antisipatory information about grief difrercnccs
bctwgcn moth€rs and fathers, whatcwr thc causes, can prc\rent marital diffrcultics and
hclp parcnts adapt to a major lifc stress situation. Thc large proportion of both mothcrs
and fathers indicating srong to scvcre reactions folloring the loss ofa child should lcad
hcalth carc profcssionals to bc scnsitivc to thc pr€sencc of these rcactions, in ordcr to
facilitatc care and support for thcse families. S/e need to knorv more about parental
inrcraction and coping folloring the loss of a child if r*c are to provide mot€ cfrcctive
guidance and counscling for the family.
This rescarch was supportcd by rhe Nor*tgian Rcscarch Council for Scicncc and thc Humanitics.
Thc aurhon erc gratcful to Gary R. Vandcnbos and HAkan Sundbcrg for inYaluablc hclp during thc
study. Wc thank Hol$r Ursin rnd Jeftcy T. Mitchcll for hclp wirh thc manuscript.
grief
13
jtt't,
tat,
14
A. Dyregrov
and S'
sesndtrr'lcnotrSrJ\
Matthiesen
B'
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Rcceivcd 22 Scptembcr 1986
l5
Atle Dyregrov