The Role of Parental Expressed Emotion and Loss-Specific Parental Responses in Children’s Loss-Related Outcomes Following Traumatic Loss: A Mixed-Methods Observational Study

Abstract There is a growing body of literature on the impact of parenting on bereaved children’s psychological outcomes. Most studies focus on broad, positive parenting (e.g., warmth). Research on parental expressed emotion (EE) (i.e., lack of emotional support, increased intrusiveness, irritation, and criticism) and loss-specific parental responses (e.g., parental positive or negative appraisals associated with the loss or lost person) remains limited. This study explored how parental EE and loss-specific parental responses relate to children’s loss-related outcomes (i.e., prolonged grief, depression, and posttraumatic stress (PTS), and health-related quality of life (HRQoL)) in the context of traumatic loss. Twenty parent-child dyads that lost a close person in a traffic accident participated (youths were 8–18 years ( Mdn = 13.50), 55% lost a parent). Parents completed the Level of Expressed Emotion questionnaire. Loss-specific parental responses – appraisals and coping strategies – during a 20-minute parent-child interaction about the loss were coded. Children’s loss-related outcomes were assessed using interview-based self-report ratings. We hypothesized that increased parental EE and negative loss-specific parental responses would be associated with worse outcomes in children, while positive loss-specific parental responses would show the opposite pattern. Bayesian Kendall’s τ correlations showed that parental criticism was positively associated with children’s depression and PTS, and that positive loss-specific appraisals were negatively associated with children’s depression and HRQoL. Although the small scale of the study warrants caution in interpretation, the findings suggest that parental criticism may be harmful, while loss-related positive appraisals seem beneficial for certain loss-related outcomes.