Clinical features:
(1) There has been a recent death of a child.
(2) One or both parents experience severe grief.
(3) There is a failure to work through the grief process and to achieve resolution.
(4) The parents intentionally conceive a child (if unable to conceive may select a sibling to act as the substitute).
(5) The parents transfer expectations and other features from the dead child to the new child.
(6) The family may show an excessive or abnormal anniversary reaction on the date of the lost child's death.
Problems experienced by the new child:
(1) The parents may be overprotective.
(2) The parents may morbidly obsess on the lost child.
(3) The child may be expected to be perfect and conform to an unrealistic ideal.
(4) The child may not be allowed to develop his or her own identity.
(5) The child may become depressed, anxious or neurotic as a result of the unrealistic expectations.
