Changing conceptions of death as a function of depression status, suicidal ideation, and media exposure in early childhood

Objective
This study characterized 3- to 6-year-old children’s understanding of death as a function of depression status, suicidal ideation (SI), and media consumption.
Method
Participants were 79 children with depression (3.0–6.11 years old) who completed a comprehensive psychiatric assessment and experimenter-led death interview and a comparison group of 60 healthy children (4.0–7.12 years old). The interview assessed children’s understanding of 5 concepts of death: universality, applicability, irreversibility, cessation, and causality. Children’s mastery of each concept and overall understanding of death was examined as a function of depression and SI status: depressed with SI (n = 22), depressed without SI (n = 57), and healthy (n = 60). Children’s observed emotional reactions to hearing about natural death, accidental death, and suicide were assessed by death-themed stories. Parent reports of children’s television and videogames/internet consumption assessed links between media exposure and understanding of death.
Results
Children with depression and SI scored higher on overall understanding of death than those with depression without SI and healthy children. They also exhibited more sad and anxious affect listening to death-themed stories and were more likely to describe death as caused by violence. Across this sample, older children also were more likely to depict death as violent. More television use was associated with less understanding of death, including the concept of irreversibility.
Conclusion
Children with depression and SI have a more advanced understanding of death than their peers, dispelling the myth that these ideations arise in the context of a poor understanding of death. The increase in violence attributions across early childhood could indicate increasing normalization of violence in children’s perceptions of death.