Psychological disturbance and service provision in parentally bereaved children: prospective case-control study

British Medical Journal, August 7, 1999 by Linda Dowdney, Richard Wilson, B Maughan, M Allerton, P Schofield, D Skuse

Table 1 Parental report (40 parents) of emotional and behavioural problems in bereaved children using child behaviour checklist

Rating           Median (interquartile range)

Internalising             55 (46-61)
Externalising             53 (42-58)
Total problems        54.5 (46.25-61.5)

Table 2 Parental report of emotional and behavioural problems in boys and girls using child behaviour checklist. Values are median (interquartile range) unless stated otherwise

Rating              Boys (n=14)          Girls (n=26)

Internalising    56.5 (46.75-66.50)     55 (46-60,25)
Externalising    57.5 (54.25-63)      48.5 (41.25-54.50)
Total problems   58.5 (54.50-67.50)     51 (46-57.25)

                   Difference
Rating            (96% CI)(*)     P value([dagger])

Internalising    1.5 (-6 to 11)          0.45
Externalising      9 (3 to 16)          <0.01
Total problems   7.5 (2 to 15)           0.02

(*) Calculated with Wilcoxon based method.

([dagger]) Mann-Whitney U, two tailed.

Children's emotional and behavioural problems: teachers' report

Bereaved children had significantly higher internalising and total problem scores than controls (table 3). Teachers considered them to be significantly more withdrawn, anxious, depressed, aggressive, and delinquent and to show more attention and thinking difficulties. Ten bereaved children had total problem scores above the 95th centile compared with none of the controls (P = 0.002).

Table 3 Teachers' report of emotional and behavioural problems in bereaved children using teachers' report form. Values are median (interquartile range) unless stated otherwise

Rating                            Cases (n=28)      Controls (n=28)

Internalising                    56 (51-59.25)      51 (43.5-54.75)
Externalising                     52.5 (42-60)       49 (42-53.5)
Total problems                    54.5 (51-61)       49.5 (45-53)
Internalising subscales:
 Withdrawn                         57 (51-60)         51 (50-55)
 Somatic                         50 (50-59.25)        50 (50-50)
 Anxious or depressed            55 (50-59.25)       51 (50-55.75)
Externalising subscales:
 Delinquency([double dagger])      50 (50-59)        50 (50-53.75)
 Aggression                     53.5 (50-59.25)      51 (50-53.75)
Other problems subscales:
 Attention                       54.5 (51-60.5)       50 (50-52)
 Social problems                  52 (50-59.5)       50 (50-54.75)
 Thought
  difficulties([double
  dagger])                         50 (50-58)         50 (50-50)

                                   Difference
Rating                            (95% CI)(*)      P value([dagger])

Internalising                    5 (2.5 to 10)           <0.01
Externalising                   3.5 (0.5 to 8.5)          0.10
Total problems                    5 (2 to 9.5)           <0.01
Internalising subscales:
 Withdrawn                        6 (2 to 6.5)           <0.01
 Somatic                           0 (0 to 7)             0.10
 Anxious or depressed             4 (0 to 3.5)            0.05
Externalising subscales:
 Delinquency([double dagger])      0 (0 to 6)             0.05
 Aggression                      2.5 (0 to 5.5)           0.04
Other problems subscales:
 Attention                       4.5 (1 to 6.5)           0.01
 Social problems                   2 (0 to 4)             0.23
 Thought
  difficulties([double
  dagger])                        0 (0 to 4.5)           <0.01