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hildren Who Witness Parental Murder Posttraumatic spects
CARL P. MALMQUIST, M.D.
In this paper the traumatic situation of children witnessing a parent being murdered isexamined. The purposes are to 1) evaluate the psychiatric consequences of such a trauma,in terms of meeting diagnostic criteria, and (2) assess the impact on the affective andcognitive functioning of the child. Methodological complications are present in such rareevents. When a parent is seriously wounded in an attempted murder but survives, thesituation is dissimilar from a parental death; when a child isdirectly involved, such as beingshot at, a key variable has changed; the response to the child may change the outcome;differences in family structure, and the clinical status of the perpetrator (e.g., was theperson psychotic and for how long?) are all relevant. This study investigated 16 childrenbetween the ages of [j and 10 who had witnessed a parental murder. The children wereassessed clinically as wellas by utilizing the Impact ofEvent Scale. Complexlegalsituationsoften arise when children are exposed to a parental homicide.The situations may involveparticipation in a criminal trial as well as civil issues involving mental distress. Both maydemand the child s participation as a witness, beyond the initial traumatic event ofwitnessing a parent murdered.
Journal of the merican cademyof Child Psychiatry 25, : ~ : 3 2 0 : ~ 2 5 986
Increasing attention is be ing paid to the effect of
trauma on people. This is especially so in the areas of
clinical treatment and research with adults, and it has
been extended into a concern for children exposed to
such situations. Diagnostically, under the generic
heading of Anxiety Disorders, there is now a specific
entity of posttraumatic stress disorder in the DSM
III The disorder can be either acute, chronic or de
layed. Although this diagnostic category was not officially recognized earlier, clinicians had been aware of
the impact of traumatic events on personality func
tioning and had made such diagnoses in a nonsys
tematic manner. The events recognized as stressors
have oft en been the expected concomitants of major
trauma, such as that associated with rape; physical
assault; military combat; natural disasters (floods,
earthquakes, tornadoes); terrorism; accidents (cars,
airplanes); or fires. Sometimes t he tr auma is a by
product of political programs (torture, death camps,
forced marches under deprivation, bombing). The dis
order is more severe and longer-lasting when th e stres
sor is of human design rather than seen as a misfor
tune in nature.
The area examined in this paper deals with a spe
cific type of traumatic situation-that of children
witnessing the murder of their parent, conceptualized
Receu ed Sep t. I. 191 2; revised Ike t 191 2; accepted Jan . 5.191 :1
Dr. Malmquist is Professor of Social Psychiatry. Department of
Sociology Unioersitv of Minnesota Minneapolis MN 55455, uherc
reprints may I , requested.
0002-71 :IH/H6/2GO:l-0:120 02.00/0 19H()by the American Academy of Child Psvchiatry.
as an extreme situation giving rise to a posttraumatic
stress disorder. Investigation of th e impact of trauma
on children requires clarification in comparison to
adul ts. However, few would argue that a child wit
nessing a parental murder would not suffer some type
of psychological trauma. A separate article has dealt
with the legal issues when the child, as a third party,
observes the event and claims to have suffered com
pensable emotional injury (Malmquist, 1985).Effor ts have been made to detail clinical psychopa
thology and intervention steps with survivors of dif
ferent kinds of t rauma. Mos t of these have not in
volved children, and those that have often dealt with
the effects of hospitalization. Investigation o f the ef
fects of other traumatic events on children has been
slow to evolve. One s tudy dea lt wi th children whose
school had been destroyed by a coal mining disaster
(Lacey, 1972). Another discussed the responses of
children to terrorism in Ireland in terms of their
proximity to th e areas of actual attack (Fraser, 1973).
Yet another dealt with the consequences on child
survivors of a dam breaking (Newman, 1976). The
effects on 23 children kidnapped together on a bus
has been discussed (Terr, 1979). The impact of a dog
bite on personality development of 3 children under
36 months has been examined (Gislason and Call,
1982). Children already enrolled in a Head Start pro
gram were surveyed for their reaction to a severe
winter s torm (Burke et aI., 1982). Most articles deal
with adult survivors of well-publicized disasters. The
Monticello tornado, the Managua earthquake, the
Wilkes-Barre flood, the Beverly Hills Supper Club fire
:120
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CHILDREN WHO WITNESS PARENTAL MURDER 321
in Kentucky, and the Buffalo Creek Dam Cohen ,
1976; Gieser et aI., 1981; Hartsough et aI., 1976; Hef
fron , 1977; Lindy et aI., 1981) are examples.
Several consequences follow from explicit psychi
atric recognition of posttraumatic disorders. can bepredicted that there will be an increase in publ ished
reports. This will provide added data to rework some
of our ambiguous concepts. Second, there will be an
impact outside the strict area of clinical impressions.
The impact will influence sociological thinking and
research which also has a keen interest in the impact
of trauma and disasters. These kinds of situations can
also be anticipated to give rise to an array of lawsuits
and utilization of clinical material in courts. Finally,
the entire field requires a clarification in our thinking
regarding the impact of severe trauma on children.
The same symptomatic picture is not necessarily elab
orated in children exposed to the same trauma. There
is the added element of an underdeveloped psychological state in which the traumatic events may elicit
different responses than in adults. Different develop
mental levels are a significant variable. There is also
the surprising lack of early aftereffects in some chil
dren Lebovici, 1974). Closeness to the event may also
playa critical role in determining response. The anal
ogy has been used of the response of a pond full of
frogs in which a stone is thrown into the middle; the
frogs in the middle experience fear and those at the
rim experience the ripple as anxiety Black, 1982).
Witnessing a parental death can occur in different
ways. The child my be present and actually view the
event, or be in the immediate vicinity and within a
short period of time be a primary reactor to it. is
significant how few of these children receive psychi
atric attention subsequent to such a trauma. Attention
is often first directed to the children at the time legalissues arise, and there may then be a realization that
an exper t witness is needed. Whether this represents
another example of the need to deny some of the
aftereffects of traumatic events on children by the
participants, until forced to do so by those not directly
involved with the children, is not clear. What can be
stated affirmatively is that most of the cases seem tohave had minimal or no psychiatric intervention prior
to the raising of legal issues. Perhaps this requires abackhanded extens ion of appreciation to the legal
profession who force our attention to these cases eventhough their interests are not clinical.
Research Issues
Witnessing a parental murder is categorized as arare event. Hence, generalizations supported by sta
t is tical measures to draw conclusions about signifi
cance are difficult to attain. In any type of rare event,
subtle differences exist between seemingly similar and
traumatic events. Consider some of the following fac
tors which complicate any research conclusions:
1. the parent who has been assaulted in an attempted murder survives, does this make a significant
difference in terms of the psychological impact on the
child? We would be ignoring a crucial variable if we
did not maintain that a live parent alters the group of
survivor children from those where a parent has beenkilled . Perhaps such differences in themselves would
be minimal, and if we could accumulate sufficient
cases with a rigorous methodology over an extended
period of time, we might be able to draw conclusions
about differences between the two outcomes following
a murderous assault.
2. The problem of family violence has been exposed
to increasing discussion. Diverse methodological dif
ficulties exist in these studies. Some studies of violence
within family units have defined violence as including
incidents of slapping while others have extended the
definition to maiming. The whole array of episodes
varying from slappings to homicide may then be
lumped together and conclusions offered about family
violence. We must be wary of extending conclusions
from these sources to the traumatic impact on a child
being privy to a parental death by violence. The cau
tion is not because these diverse situations may not
give rise to an assortment of psychopathological re
actions; some indicate up to one third of children who
witness interparental violence have behavioral or emo
tional problems Hilberman and Munson , 1978; Lev
ine , 1975). However the types of reaction and problemsensuing in such situations may be quite different from
when a parent is murdered.
3. There is an overlap with problems of abused
children. Yet, the reaction of a child who has been
physical ly abused by a parental figure not even in
cluding the controversial question of emotional ne
glect), is not analogous to the child who witnesses the
murderous assault on a parent .
etho
In this study, six young children between the ages
of 5 to 10 separately witnessed a parental murder.There were four boys and two girls. In addition a
series of 10 children were present during an act offamilicide in which a family member attempted to kill
all the members of the family Malmquist, 1980). The
details of the situations were often horrifying to the
adults exposed to them. The situations will be briefly
summarized.
s e 1. A boy of 10 years, an only child, heardunusual noises in the kitchen of his home. On going
into the ki tchen to check things, he found his father
beating his mother on the head with a frying pan. The
mother was on the floor screaming. After a few sec-
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322 C. P. MALMQUIST
onds, th e boy ran from th e house, returning in 20 to
25 minutes. He then saw a crowd gathered outside an d
a police car. Th e actual incident involved th e mother s
head being smashed in, an d she died short ly after
arrival in th e emergency room from a subdural he
matoma. Th e solution provided by relatives was to
send th e boy immediately a thousand miles away to
live with relatives. Th e father was diagnosed as having
a major depressive episode with psychotic delusions
about his s infulness an d guilt over some minor
transgressions from years earlier.
ses 2 n 3. Tw o brothers, 6 an d 9 years, returned
from a weekend custody visitation with their divorced
father. On entering their mother s home through an
open front door, they stumbled onto th e scene of their
dead mother, lying in a pool of blood with multiple
stab wounds holes all over he r body ). Smelling gas,
t he y r an to th e garage an d found th e motor of her ca r
st il l running, with t he m ot he r s boyfriend slumped
over th e steeringwheel. He was later pronounced dead.
se 4.A lO-year-old girl, arriving home from school
in midafternoon, found h er m ot he r an d father both
shot. A note revealed th e f ather had acceded to killing
his wife who had been diagnosed as having a malig
nancy, a nd t he n tu rn ed t he gun on himself.
se 5. An 8-year-old girl heard her mother engaged
in an argument with her separated father. Th e father
ha d been released from a psychiatric hospital a short
t ime earlier. Upon hearing shots, she ra n to th e scene
from he r bedroom an d saw h er f at he r with a gun inhis hand a nd the mother lying on th e floor bleeding.
Th e father at that point turned toward th e girl, shot
at he r bu t missed, an d ran from th e house.
se 6. A boy of 5 years was sitting on his mother s
lap in a chair when he r former boyfriend barged into
th e home. The boyfriend fired several shots at th e
mother which killed her. One shot grazed th e boy.
Although emergency room repor ts noted his wound
was no t serious, it stated he bled quite vigorously.
ses 7-16. A series of cases of familicide ha d 10
children exposed to th e homicidal scene. Some of these
children were shot at, an d others survived by hidingor running.
A number of points can be no ted from these cases
of children being exposed to t he t rauma of witnessing
a parental murder. They i llustrate how diverse th e
situations ca n be: 1) Some families are i nt ac t a nd
some not. 2) Some of th e perpetrators were acutely
psychotic in a psychiatric diagnostic sense at th e time
of th e act. If so, a different se t of antecedents had
been present which presumably operated before th e
homicide in comparison to th e situation of a child
with a nonpsychotic parent. 3) A suicide by th e
perpetrator following a killing changes th e variable of
a survivingparent. 4) Th e presence of ongoing mental
illness, in one or both par ents such as paranoid de
lusions, needs consideration. 5) Different handling of
th e children following th e event may change th e clin
ical picture in th e child subsequent to th e event. 6)
Th e l ength of time elapsed between th e event an d
some type of professional intervention may alter th e
natural history. 7) W heth er t he child was wounded
or shot at in an y way during th e episode may be a
significant variable. These variables ca n all effect th e
reaction to such an event. They are signposts to make
th e evaluations of conclusions all tentative even if a
larger group was available.
In terms of meeting DSM-III diagnostic criteria for
a posttraumatic stress disorder, all of these children
easily did so. They had r ecur rent thoughts about th e
episode which came back, sometimes at unpredictable
an d unwanted moments. Hence, some of their intru-
sive thoughts occurred when they were sitting in a
classroom or even in th e middle of recitation in class.
No t only did all of th e children dream about th e event,
bu t 14 of 16 ha d nightmares. Th e nightmares were
part of a larger picture of having fears which were
present before going to sleep, or of going into rooms
alone, particularly after dark. Two of th e boys were
frightened about going into a bathroom alone unless
someone first went in an d checked it out. Although
none of these children repor ted feeling as if another
murder was about to occur, they did report associa
tions about th e murder. In this connection, one of th echildren reported going by a certain neighborhood an d
feeling sad. Another connected a persistent depressive
mood with respect to a television program which ha d
a theme of homicide occurring within a family. Fo r
some of th e children th e inescapable presence of pic
tures of th e deceased induced sa d moods. Although
adults might have removed pictures or belongings of
th e deceased from th e children, they could no t effec
tively remove every picture or article.
In terms of a numbing response to their environ
ment, these children were at th e opposite en d of th e
continuum compared to adul ts . Their anxiety, restlessness, hyperalertness, vigilance, an d difficulty con
centrating were prominent. Varying degrees of school
difficulties appeared a nd t he ir trouble concentrating
an d memory impairment were noted in school records.
Th e possibility of diverse outcomes was seen in school
performance. In th e year following th e event all bu t
one ha d a significant decline in their school perform
ance. However, one of th e children went in th e oppo
site direction an d took on a new-found studiousness
following th e parental death . While this might no t
surprise us clinically in terms of th e possibilities of
diametrically opposed outcomes being possible, it is
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CHILDREN WHO WITNESS PARENTAL MURDER 323
the type of possibility that often gets obscured in group
data.
Impact of vent Scale
The Impact of Event Scale was developed by Ho
rowitz et al. 1980 to assess a person s recognition ofstates of stress in the 7 days since an event occurred.
Although the instrument was developed for adults, the
i tems seem appl icable to chi ldren who have been ex
posed to a stressful event as well see Table 1 . Pangs
of emotion about the event, preoccupation with it, and
intrusive ideas related to it were the most commonly
reported signs and symptoms with these children. For
children, the questions were asked to them and about
them. A clinical judgment was then made about their
interactions on a 4-point scale from 0 to 5, with 15
items as Horowitz did with adults.
eneral SymptomPicture
Apart from the descriptive criteria meeting DSM
standards for a diagnosis of stress disorders, pres
en t in all of the children, there was a need to under
stand the diverse factors that were operating. The
descriptive symptoms will be elaborated upon from
that perspective. Anxiety and/or nightmares were
present in all of the children. They were described as
exhibiting marked anxiety compared to their pretrau
matic selves. Descriptions from school personnel and
the surviving parent when available were consistent
in this respect. The picture was of generalized res t-
lessness and jumpiness. For one boy, going back to the
house where the incident occurred 2 months earlier to
get belongings, led to periods of restless sleep, periodic
awakening, and nightmares for 10 straight nights.
Nightmares were replays of the scene of discovery bu t
with seemingly minor changes which gave a differentoutcome. Some of the dreams were more diffuse and
less structured. Shapes and hulks chased them, faces
were without features, or other scary features were
prominent in content. A 9-year-old boy, who had
shown no interest in comic books before the death of
his mother, became obsessed with them and began
spending hours a day reading them. Collecting comic
books had become his hobby. An 8-year-old girl who
had expressed minimal interest in drawing before the
episode thereafter became immersed in drawing; the
content varied from extremes of blandness and hap
piness, such as a sun with a shining face, to scenes of
darkness and roads leading nowhere without people.
Signs and symptoms of major affective d isorder
were present, with the children exhibiting persistent
disturbances in mood. Denial of painful affect worked
only up to a point. One boy, who had dreamed he
thought he saw his deceased mother, stated a year
after the event that he had accidentally come across a
picture of her which was inside a book. He told no one
of this bu t when alone, he began to get the book to
t ake out the picture, look at it, and cry. He described
this in the course of his treatment with deep sobbingTABLE 1
S.D.roup Meancale
Impact of Event Scale Response and Clinical Assessment in Subjects Who Witnessed a Parental Homicide N 16_ • - _ __ • _ _ •
Percent Positive
Endorsed
Intrusion Items
I had waves of strong feelings about it 100 4.60 0.87
Things I saw or heard suddenly reminded me of it 100 4.00 1.17
I thought about it when I didn t mean to 88 3.86 U8
Images related to it popped into my mind 88 4.71 0.71
Any reminder brought back emotions related to it [ 6 2.89 1.61
I have difficulty falling asleep because of images or 88 4.87 1.69
thoughts related to the event
I had bad dreams related to the event 81 ::l OO 1.7[
Avoidance Items
I knew that a lot of unresolved feelings were still 6:1 3.20 1.08
there, but I kept them under wraps
I avoided let ing myself ge l emot iorial when I f,O 4.00 1.00
thought about it or was reminded of it
I wished to banish it from my store of memories [ O 4.60 0.80
I made an effort to avo id talking about it. 98 3.86 1.38
I felt unrealistic about it, as if it hadn t happened 6:1 3.20 1.66
or as if it wasn t real
I stayed away from things or situations that might 69 4.46 0.89
remind me of it
My emotions related to it were kind of numb [ O 1.1:1 2.35
I didn t let myself have thoughts related to it 7[ 4.[ 0 0.87 a Scale: ;; is severe; is moderate; I is mild; 0 not at all.
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C HI LD RE N W HO W IT NE SS PARENTAL M UR DE R 325
therapeutic context as well. Bergin 1958 described
such details in a 4-year-old girl who ha d witnessed he r
father murder he r mother.
iscussion
Throughout th e evaluation of these 16 cases, th equestion of systematic themes in th e children ha s been
in th e background. It is exceedingly complex to eval
uate th e impact of a specific traumatic event on a
child even when it is so striking as witnessing a parent
murdered. The reactions do no t easily lend themselves
to generalizations that ca n withstand critical evalua
tion. E ve n w it h severe trauma difficulties arise from
unsystematized impressions which lead to hypotheses
that are difficult to t es t a nd refute.
An effort has been made in this ar ticle to assess
empirically th e consequences of one discrete example
of extreme stress. t would be most difficult to conceptualize an event that raises th e possibili ty of having
more potential adverse consequences than being privy
to a parent being murdered. Th e need to be cognizant
of diverse factors which may be operating anteced
ently, causing th e individual child to be left vulnerable,
is important in addition to th e presence of th e provoc
ative event itself.
With these caveats, what might be offered about
children exposed to such a situation? Based on this
sample, there appears to be a great diversity in their
responses. Although they all fit th e minimal empirical
criteria as found in a posttraumatic stress disorder, agood deal of resilience is wi tnessed in t h ei r adapt a
tions. Despite th e presence of diverse symptom pic
tures, indicating distressing signs of anxiety, they did
no t collapse into psychotic states. Perhaps th e key lies
in th e strength of t heir ant eced en t object relations
an d self-esteem which allows them to h an dl e s uc h a
traumatic event an d loss without a massive abandon
ment of ego funct ionings an d defenses beyond th e
clinical picture with which they presented.
All of th e variables connected with a chi ld dealing
with an y type of major object loss ar e present in this
group of children. The situation is also complicatedby th e presence of t he t raumat ic aspects connected
with th e loss to begin with, as well as p er ha ps t he
need to participate as a witness subsequently in crim
inal an d civil proceedings. My impression is that th e
capacity to continue to function, an d eventually over
come th e stress disorder, resides in t he s treng th an d
comforting role of internalized objects. Either these
have been present an d available prior to th e incident,
or in their absence th e chi ld is left qui te vulnerable.
Only if th e child has comforting internal agents, an d
ha s been exposed earlier to minor traumas with which
he ha s been able to cope , ca n he deal with th e possi
bility of a major trauma. The linchpin appears to be
th e suffering of earlier object losses in graduated doses,
an d th e self-esteem system that evolved therefrom.
The children who appear able to cope with such ahorror an d disappointment in their lives ar e those who
ca n still affirm their own value an d worth. Alterna
tively, th e child who is exposed to such a situation in
th e absence of such bulwarks, is likely to remain prone
to episodes of anxiety an d depression long a fte r t he
traumatic episode. Confirmation of this hypothesis
will need testing in th e diverse types of traumatic
situations to which children may be exposed.
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