Mourning or early inadequate care? Reexamining the relationship of maternal loss in childhood with adult depression and anxiety

Two population enquiries in Walthamstow and Islington, London, have shown that loss of the mother before the age of 17 years, either by death or separation for a year or more, doubles the risk of depressive and anxiety disorders among adult women. Furthermore, there was a particularly high rate of adult depression among those whose mothers died before they were 6 years old, and this was associated with a measure of childhood helplessness. There was no such link of either adult disorder or childhood helplessness with age at loss under 6 years for those losing a mother by separation. Two possible explanations were explored for these contrasting results. That concerning the adequacy of mourning of the mother's death received no support. However, evidence indicated that experience with the mother before the loss (usually affected by ongoing illness) explained the link of adult depression or anxiety with her early death. The failure of age at loss to relate in the separation group was probably due to the fact that among them age of separation was not a good indication of the quality of maternal care before age 6. Indirect evidence emerged which suggested that quality of early attachment (before age 6) to the natural mother before any loss relates to childhood helplessness. This in turn relates to a higher risk of disorder in adult life.

[1]  E. Furman A Child's Parent Dies: Studies in Childhood Bereavement , 1974 .

[2]  G. Brown,et al.  Aetiology of anxiety and depressive disorders in an inner-city population. 1. Early adversity , 1993, Psychological Medicine.

[3]  Death of mother in childhood and clinical depression in adult life : a biographical approach to aetiology. , 1985 .

[4]  The Domain of Developmental Psychopathology. , 1984 .

[5]  Everett Waters,et al.  Social Competence as a Developmental Construct , 1983 .

[6]  C. C. Spiker,et al.  Child Behavior and Development: Training for Diversity , 1991 .

[7]  R. Plomin,et al.  Correlates of difficult temperament in infancy. , 1984, Child development.

[8]  G. Rochlin Griefs and discontents , 1965 .

[9]  M. Mahler On Sadness and Grief in Infancy and Childhood: Loss and Restoration of the Symbiotic Love Object , 1961 .

[10]  A. Bifulco,et al.  Childhood loss of parent, lack of adequate parental care and adult depression: a replication. , 1987, Journal of affective disorders.

[11]  J. Hurry,et al.  Epidemiology of mental disorders in Camberwell , 1981, Psychological Medicine.

[12]  M. Rutter,et al.  Depression in young people : developmental and clinical perspectives , 1986 .

[13]  P. Duncan-Jones,et al.  Depression and anxiety in the community: replicating the diagnosis of a case , 1980, Psychological Medicine.

[14]  A. Bifulco,et al.  Depression and situational helplessness/mastery in a sample selected to study childhood parental loss. , 1990, Journal of affective disorders.

[15]  Lee N. Robins,et al.  Straight and devious pathways from childhood to adulthood. , 1990 .

[16]  J. H. Stevens,et al.  Mother/Child, Father/Child Relationships. , 1978 .

[17]  J. Hurry,et al.  Parental death in childhood and risk of adult depressive disorders: a review , 1980, Psychological Medicine.

[18]  John Bowlby,et al.  Attachment and Loss. Vol. I. Attachment. , 1970 .

[19]  J. Wallerstein,et al.  The effects of parental divorce. Experiences of the preschool child. , 1975, Journal of the American Academy of Child Psychiatry.

[20]  I. Bretherton,et al.  Attachment theory: Retrospect and prospect. , 1985 .

[21]  A. Bifulco,et al.  Loss of parent in childhood and adult psychiatric disorder: the role of social class position and premarital pregnancy , 1987, Psychological Medicine.

[22]  J. B. Miller Children's Reactions to the Death of a Parent: a Review of the Psychoanalytic Literature , 1971, Journal of the American Psychoanalytic Association.

[23]  W. Yule Depression in young people: Clinical and developmental perspectives : M. Rutter, C.E. Izard and P.B. Read (Eds): Gill Yard Press, New York (1986). xvi + 550 pp. , 1989 .

[24]  D. Mechanic,et al.  Divorce, family conflict, and adolescents' well-being. , 1989, Journal of health and social behavior.

[25]  T. Crook,et al.  Parental death during childhood and adult depression: a critical review of the literature. , 1980, Psychological bulletin.

[26]  B. Tizard,et al.  IQ and behavioural adjustment of ex-institutional adolescents. , 1989, Journal of child psychology and psychiatry, and allied disciplines.

[27]  P. Surtees,et al.  Comparison of Research Diagnostic Systems in an Edinburgh Community Sample , 1983, British Journal of Psychiatry.

[28]  Jacob Cohen,et al.  Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. , 1968 .

[29]  E. M. Hetherington,et al.  Divorce: a child's perspective. , 1979, The American psychologist.

[30]  M. Wadsworth,et al.  THE INTERESTS OF CHILDREN AFTER PARENTAL DIVORCE: A LONG-TERM PERSPECTIVE1 , 1988 .

[31]  M. Ainsworth Attachments across the life span. , 1985, Bulletin of the New York Academy of Medicine.

[32]  D. Cicchetti Child maltreatment: How research on child maltreatment has informed the study of child development: perspectives from developmental psychopathology , 1989 .

[33]  Jude Cassidy,et al.  Security in infancy, childhood, and adulthood: A move to the level of representation. , 1985 .

[34]  A.‐L. Knorring,et al.  Early life experiences and psychiatric disorders: An adoptee study , 1982, Acta psychiatrica Scandinavica.

[35]  D. Cicchetti,et al.  Patterns of relatedness in maltreated and nonmaltreated children: Connections among multiple representational models , 1991, Development and Psychopathology.

[36]  J. Birtchnell Women whose mothers died in childhood: an outcome study , 1980, Psychological Medicine.

[37]  A. Bifulco,et al.  Loss of parent in childhood and adult psychiatric disorder: the role of lack of adequate parental care , 1986, Psychological Medicine.

[38]  R. Cadoret,et al.  Genetic and environmental factors in major depression. , 1985, Journal of affective disorders.

[39]  M. Ainsworth,et al.  Origins of the Sense of Security. (Book Reviews: Patterns of Attachment. A Psychological Study of the Strange Situation) , 1978 .

[40]  M. Wolfenstein How is mourning possible? , 1966, The Psychoanalytic study of the child.

[41]  G. Brown,et al.  Depression: Distress or Disease? Some Epidemiological Considerations , 1985, British Journal of Psychiatry.

[42]  A. Bifulco,et al.  Loss of parent in childhood and adult psychiatric disorder: A tentative overall model , 1990, Development and Psychopathology.

[43]  J. Bowlby THE ADOLF MEYER LECTURE CHILDHOOD MOURNING AND ITS IMPLICATIONS FOR PSYCHIATRY , 1961 .