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"The distinguishing mental features of melancholia are a profoundly painful dejection, cessation of interest in the outside world, loss of the capacity to love, inhibition of all activity, and a lowering of the self-regarding feelings to a degree that finds utterance in self-reproaches and self-revilings, and culminates in a expectation of ." —Sigmund , and Melancholia, 1917

Early parental loss affects approximately 5 percent of the population (Ellis, Dowrick & Lloyd-Williams, 2013). Because of the risks from complicated , negative effects on , including the ability to form and maintain healthy relationships, and disruption of the family system, the death of a parent in may adversely affect adult development.

Studies of adults with early parental loss show that they are more likely to experience , , and substance use disorders, and use maladaptive coping strategies, including increased levels of self-blame, self- , and emotional eating (Høeg et al., 2016). In contrast, children raised in intact homes do better on average as adults. They are more likely to do well socially and financially, enjoy a higher quality of life, have better health overall, and have fewer mental health and substance issues and greater academic achievement (e. ., Kirkpatrick & Davis, 1994; Terling-Watt, 2001; Valle & Tillman, 2014).

We would expect that early parental loss could be associated with differences in adult relationships, but there is not much research. According to Høeg and colleagues (2018), findings have been inconsistent. Existing smaller studies suggest that those with early parental loss are less likely to get married, especially women, while others found that women who experienced early parental loss tended to marry earlier. Also unclear is whether the of the deceased parent makes a difference, though the assumption has been that maternal loss is worse, or whether a younger age at the time of loss leads to poorer outcomes. Do adults who lost parents as children have shorter relationships or higher levels of divorce or separation? Does the cause of death make a difference? Is parental associated with more difficult relationships in adulthood?

To definitively address these questions, Høeg and colleagues (2018) looked at the ample data from several Danish population databases, conducting statistical analysis to look for significant patterns between early parental loss and adult relationship outcomes. They used data on 1,525,173 people in the Central Population Register for the years from 1970 to 1995 for , age, death, and family status and cross-referenced it with causes of parental death from the Register of Cause of Death, and relationship duration and outcomes from the Household and Family Register and Population Register. They included information about household income, , and illness from other state databases.

In terms of basic demographics, they found that 4.5 percent of people had experienced early parental loss. Seventy percent were due to the death of the father, and 12 percent were from suicide. About half lost parents in teenage years, and half earlier. Parental loss was more likely in families with psychiatric problems, and in families with lower income and education level.

Of the 1.5 million people in the study, nearly 430,000 men and 440,000 women had started relationships, including over 21,000 men and almost 20,000 women who had experienced the death of a parent before age 18. They found no difference in the rate of long-term relationships (married or living together) among men, but bereaved women were 9 percent more likely to have long-term relationships. Both men and women were more likely to have been in relationships if the parental death was from suicide, but the sex of the parent made no difference for relationship status.

Of those who had started a relationship during the period studied, they looked at data from nearly 209,000 men and over 218,000 women whose relationships ended in separation ( or otherwise ended a long-term relationship), with nearly 11,000 men and 12,000 women who had experienced early parental loss. Both bereaved men and women had higher rates of ending long-term relationships compared to non-bereaved people, and among bereaved people, men were more likely to have relationships end than women.

On average, relationships for people without early parental loss were two years longer, averaging six years versus four years, with modestly higher rates of separation for bereaved men (13 percent) than women (9 percent). Relationships were more likely to end earlier when the parental loss was from suicide, but there were no differences in relationship duration between maternal and paternal loss. Bereaved women were more likely to begin relationships at a younger age. People with early parental loss from suicide started relationships younger, but those relationships didn't last as long.

Surprisingly, there were no differences found between maternal versus paternal loss in terms of relationship start date or duration. Perhaps we expect this because of gender- , though more recent studies are highlighting the greater importance of fathers, especially in . But it also may be that because men are more likely to remarry, there is greater family support after maternal than paternal death. In addition, although they did not report on parent-child gender interactions, it may be that maternal and paternal loss may have different effects on boys versus girls. It is surprising that they found no difference in relationship outcomes for people who experienced loss earlier in childhood, as one might expect.

Also surprising, and reassuring, is that the overall impact of early parental loss on adult relationships was relatively low considering the magnitude of parental loss. While adults who experienced early parental loss have higher rates of health and , in general, they are able to find and maintain adult relationships, though they are somewhat less stable, suggesting a level of attachment insecurity. The low level of relationship difficulties tells a story of in the face of loss for the majority of people.

Future research could focus on the quality of relationships and attachment style and correlate relationship outcomes with mental and physical health, as a function of the quality of grieving, culture, and family coping. We would expect people with unresolved, complicated grief to have more problems in adulthood, and identifying what those issues are and who they are more likely to affect would be valuable in getting help to those most in need.

Please send questions, topics, or themes you'd like me to try and address in future blogs via my PT bio page.