Review Article| Volume 66, e82-e99, September 2022

The bereavement experiences of children following sibling death: An integrative review


      • This review is the first known to synthesize the current state of the science on grief experiences of siblings.
      • We examine and integrate literature on risk and protective factors for maladaptive grief.
      • Sibling bereavement is one of the most distressing childhood life events.
      • Bereaved siblings are at risk for negative physical and psychological outcomes.
      • Sibling bereavement is influenced by individual factors and socioenvironmental contexts.



      Sibling bereavement is one of the most distressing adverse life events during childhood but has received less attention in research than other forms of childhood bereavement. This integrative review identifies potential risk and protective factors for maladaptive coping following sibling bereavement and the influence of these factors on adjustment to loss.

      Eligibility criteria

      Articles were limited to peer-reviewed studies, published in English in 2000 and beyond. Target population was bereaved siblings 0–18 years, and outcomes examined grief experiences by child self-report or parent-proxy report.


      The Whittemore and Knafl integrative framework was applied. Multidimensional Grief Theory guided the review with twenty-five studies synthesized across its domains: Separation Distress, Existential/Identity Crisis, and Circumstance-Related Distress.


      Adjustment following sibling death is a complex process associated with a host of risk and protective factors that contribute to the bereavement process for this population. Age, sex, circumstance-related factors, continuing bonds, parental distress, and limited social support were critical influencing factors.


      Definitive predictor variables were not identified but a combination of variables that influence the adjustment of bereaved siblings are discussed.


      Future research is needed to explore the risk and protective factors of maladaptive coping to inform intervention development to promote individual and family adjustment following sibling death.


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