Traumatic Stress in Adolescents Anticipating Parental Death

This qualitative study explores the traumatic stress of a child's exposure to the graphic physical, emotional and mental deterioration of a dying parent. Interviews were conducted with a community sample of 35 surviving spouses and their parentally-bereaved school-aged children.

Traumatic stress is broadly defined to include exposure to the "fact" of impending death itself, the anxiety that comes both from knowing that one may lose a close other, and from being helpless to prevent the death.

Included, as well, is an exploration of secondary traumatic stress, defined here as the stress of watching helplessly as both the dying parent and non-ailing family members succumb to terror and anxiety about the impending death.

Emphasis is placed on a teen's unique vulnerability to traumatic stressors and on the role of parenting in mediating an adolescent's exposure to parental decline. In contrast to the anticipatory grief literature which emphasizes the advantages of forewarning in cushioning post-mortem adjustment, this study documents the adverse impact of an exposure to terminal illness.

These findings underscore the need for clinicians to attend to the traumatic stress of "ordinary" anticipated deaths, rather than maintaining an exclusive grief orientation.