Childhood sibling loss. A family tragedy

The loss of a significant object, the loss of a home (security, personal possessions, familiar space that has emotional meaning), the dislocation from one's home or land as occurs in wars or disasters, gives rise to stress-strain responses that may have short-term or long-term effects, eg, post-traumatic stress disorder. The hidden or neglected victims of such occurrences frequently are children--be they siblings or direct descendants. In childhood sibling loss, the effects of the loss are mediated through different members of the family. The acute stressors can give rise to later adversity unless it is recognized that there is a social context in which life and death events occur. Recognizing these individual responses in the family can lead to interventions that may prevent later difficulty. Understanding the meaning of the events to the child, appreciating the fact that events are not just single occurrences, but interact with what existed before as well as with other concomitant events, helps in our therapeutic recommendations and interventions. Sibling loss, though initially related to the death of a sibling, can now be expanded to include the loss of a sibling through chronic illness (emotional, medical, surgical, long-term hospitalization), birth injuries, disabled children (accidents or illness with body changes), chronic illness with visible as well as non-visible changes that require special parental and nursing care, medication on an ongoing basis, and restrictions in diet and activities. The impacts of these losses without death can have devastating effects.(ABSTRACT TRUNCATED AT 250 WORDS)