Table 3.

Summary of findings of five longitudinal studies

Author(year)	Location (year of the study)	Study design	Sampling	Sample description	Indicators of psychological well-being	Major findings	Moderating/mediating factors
Cluver et al. (2011) [21]	Cape Town, South Africa (2005–2009)	4-year time span, two assessments (baseline, 4- year follow-up)	Recruited from urban settlements, schools, community organization s, street-children, child-headed households	N = 71% of the baseline (N =1025) Age: 11–19 (baseline)	Standardized instruments: Depression a, anxietyb, post-traumatic stressc	AIDS orphans showed higher level of depression, anxiety, and trauma scores in either baseline or 4-year follow up than the other two groups Negative psychological well-being outcomes amongst orphans were worsen over a 4-year period	Age effect: There was a steep rise in psychological distress along with age among AIDS orphans, but no rise with age amongst other orphans and comparison children
				425 AIDS orphans; 241 other orphans, 278 comparison children (Baseline)
Rotheram-Borus et al. (2006–2001) [14, 41, 56]; Lee et al. (2007) [10]; Lester et al. (2006) [11]	New York City, USA (1993–1995)	Randomized control trial, follow-up were conducted every 3 months for 2 years and then at 6-month until 6 years	Recruited from the NYC Division of AIDS Services.	N = 413 Age: 11–18	Standardized instruments: depression and somatization w, risk behaviors, conduct problems (investigator-developed), positive expectation (investigator-developed)	Bereaved adolescents reported more somatization experienced higher levels of emotional distress about a year prior to parental death, and then declined to the level similar as non-bereaved youths by one year following parental death Parental death was not associated with externalizing problems such as substance abuse, school problems, and peer conflicts, with an exception of contact with criminal justice system. The contact with criminal justice system was also decreased after parental death Parental death predicted more sexual risk behaviors and lowed future expectation	Risk factors: Stressful life events in over a year prior to parental death, parent health symptoms, parent emotional distress Protective factors: Positive parental bonds, coping skills, social support
				44.5% AIDS orphans by three-year follow-up, 51.5% by six-year follow up
Pelton et al., (2005) [28]	New Orleans, USA	Longitudinal: 4- year time span, assessments selected according the time of maternal death	A subsample of Family Health Project (Recruited from primary public HIV clinic and private practices of physicians in the inner city)	N = 105 Age: 6–11	Standardized instruments: Internalizing and externalizing problemsz	More AIDS orphans fell into the clinical range of internalizing and externalizing problems before their mother’s death than the comparison children No differences emerged at 6 months after maternal death among the three groups More orphans had clinical level of internalizing problems 2 years after maternal death than vulnerable children	N/A
				35 maternal AIDS orphans, 35 vulnerable children, 35 comparison children
Forehand et al. (2002) [33]	New Orleans, USA (1994–2000)	Longitudinal: 4-year time span, 4 annual assessments	A subsample of Family Health Project	N = 249 at baseline, 175 follow ups Age: 6–11	Standardized instruments: Internalizing and externalizing problemsz, depressiona	Vulnerable children reported higher depressive symptoms than comparison children across four assessments, according to child report but not mother’s report There were no group differences on other measures	Protective factors: Warm and supportive mother-child relationship
				51 vulnerable children of HIV+ mother, 124 comparison children
Forehand et al. (1999) [27]	New Orleans, USA	Longitudinal: 4- year time span, two assessments: 6-month after maternal death, 2–3 years after maternal death	A subsample of Family Health Project	N = 60 Age: 6–11	Standardized instruments: Externalizing problems z, depressiona	AIDS orphans did not differ from comparison children in externalizing problems and depression across the two assessments	Protective factors: Stable family environment, a close relative (mostly maternal grandparents) becoming caregivers after mother’s death
				20 maternal AIDS orphans, 40 comparison children

Note. Refer to the Note of Table 1 for the specific instrument used in these studies.