Alice VIVIER – 996259 Q
M2 PCPI
Sudden Unexpected Infant Death (SUID) is the leading cause of death for infants aged 1 month to 1 year in developed countries: in France, it affects 250 to 350 children per year. SUID corresponds to the sudden and unexpected death of a child under two years old, the cause of which was not obvious before investigation. More restrictively, a Sudden Infant Death Syndrome (SIDS) is a SUID for which no cause has been found following an extensive investigation, including an autopsy. Both SUID and SIDS are totally unpredictable and disrupt young parents’ lives. Until now, no work has ever studied the coping strategies related to the emergence of Posttraumatic Growth (PTG) for parents bereaved by a SUID or SIDS. Coping strategies is the term used by Lazarus and Folkman (1984) to describe the cognitive and behavioral efforts a person deploys to manage stress. Whereas Posttraumatic growth (PTG) is a concept by Tedeshi et Calhoun (2004) that describes positive psychological change experienced as a result of struggling with highly stressful life circumstances. The authors identify five dimensions to PTG : relating to others, new possibilities, personal strength, spiritual change, and appreciation for life.
In order to promote PTG in bereaved parents, it would be interesting to observe whether coping strategies positively influence PTG. In order to do so, coping and PTG will be assessed using the Brief Cope and the Posttraumatic Growth Inventory (PTGI) in their validated French versions. A series of assessment items was also developed to look for an impact on PTG of the presence of oscillations as defined by the Dual Process Model (DPM) (Stroebe & Schut, 2010). The key idea around DPM is that the bereaved don’t go one way through grief – following stages in a sequence over time – but that instead they oscillate between being loss-oriented (i.e. focused on the memory related to the loss) and restoration-oriented (i.e. focused on the consequences of grief and avoidance of memories related to the loss).
64 women and four men responded to the online questionnaire distributed via associations of bereaved parents following a SUID and via bereaved parents’ groups on social networks. Among the 68 children involved in the study, there were 30 girls and 38 boys. The children’s ages range from 1 day to 18 months, the average age being 4 months and 26 days and the median age 4 months and 8 days. 58 of the children have at least one sibling. For 47 of the children, the death was classified as SIDS after an autopsy.
The results for this sample show a low total PTG. However, it varies according to the PTG dimensions assessed: it is very low for «spiritual change», low for «new opportunities» and «relationships with others», and moderate for «life appreciation» and «personal strength». The PTG found is slightly higher than those observed in two other studies of bereaved parents following a neonatal death. The unpredictability and suddenness of MIN deaths could explain that difference. The presence of oscillation according to the DPM model does not influence PTG. PTG was also not influenced by the presence of another child in the sibling. There is a significant difference between PTG two to five years after death and the larger PTG 10 years after death.
There is a low positive correlation between Total PTG and these four coping strategies: active coping, religion coping, positive reappraisal coping, and acceptance coping. Multiple linear regression shows that these four coping processes explain 32.8% of the variance of Total PTG. Among them, religion coping and acceptance coping have a significant positive effect. Religion coping was the most predictive coping of Total PTG (p=.002, SE =.3508).
Unlike acceptance coping, religion coping is not frequently used by parents: the psychologist will benefit from being open to this matter of the spiritual when accompanying bereaved parents. Furthermore, the psychologist must try to provide a social environment that promotes PTG. At last, it is important to remember that while experiencing PTG is an opportunity, this experience of growth is not an absence of suffering: it arises from the parents’ struggle to fight the consequences of the traumatic event that was the sudden loss of their child.
Keyterms :
- Sudden Unexpected Infant Death (SUID) : Mort Inattendue du Nourrisson
- Sudden Infant Death Syndrome (SIDS) : Mort Subite du Nourrison
- Posttraumatic Growth (PTG) : Croissance Post-Traumatique
- Dual Process Model (DPM) : modèle du double processus
- Coping strategies : stratégies de coping
Words/expressions I have learned :
- Bereavement : décrit la situation objective et factuelle du deuil : la personne « est en deuil »
- Struggling with highly stressful life circumstances : lutter contre des circonstances de vie très stressantes
- Positive reappraisal coping : coping de réppréciation ou de réévaluation positive
- Don’t go one way : ne va pas dans une seule direction
- A low positive correlation : une corrélation positive faible