{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T04:47:20Z","timestamp":1785646040366,"version":"3.56.0"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014Brasil","doi-asserted-by":"crossref","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"https:\/\/ror.org\/00x0ma614","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Center for Research in Social Technologies"},{"name":"Portuguese National Funds","award":["UID\/00317\/2025"],"award-info":[{"award-number":["UID\/00317\/2025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Femicide-related orphanhood exposes children and adolescents to psychological distress and may disrupt their health-related quality of life (HRQoL). This study examined the relationships between anxiety, depression, and HRQoL among children and adolescents orphaned by femicide and tested whether depressive symptoms mediate the association between anxiety and HRQoL. Methods: A cross-sectional study was conducted with 57 children and adolescents aged 8 to 18 years who had been orphaned by femicide and were residing in the Federal District of Brazil. Participants completed the Revised Child Anxiety and Depression Scale (RCADS-25) to assess anxiety and depressive symptoms and the KIDSCREEN-27 to evaluate HRQoL. Data were analyzed using Spearman correlation coefficients, linear regression models with bootstrap procedures, and mediation analyses to explore direct and indirect relationships among variables. Results: Depressive symptoms were negatively associated with HRQoL, while anxiety symptoms showed a weaker negative association with HRQoL. In the regression analysis, depression emerged as the only significant predictor of HRQoL. Mediation analysis indicated that the relationship between anxiety and HRQoL was largely explained by depressive symptoms, suggesting a partial indirect effect of anxiety through depression. Conclusions: The findings indicate that depressive symptoms may play a central role in the relationship between anxiety and perceived quality of life among children and adolescents orphaned by femicide. These results highlight the importance of assessing both anxiety and depression in this population and suggest that interventions addressing depressive symptomatology may contribute to improving psychosocial well-being and HRQoL following exposure to severe family violence.<\/jats:p>","DOI":"10.3390\/children13081021","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:20:18Z","timestamp":1785486018000},"page":"1021","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship Between Mental Health and Health-Related Quality of Life of Orphans of Femicide"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3582-2458","authenticated-orcid":false,"given":"Erick","family":"Fontenele","sequence":"first","affiliation":[{"name":"Graduate Program in Clinical Psychology and Culture, Institute of Psychology, University of Bras\u00edlia, Bras\u00edlia 70710-907, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8012-8893","authenticated-orcid":false,"given":"Cristiane","family":"Faiad","sequence":"additional","affiliation":[{"name":"Graduate Program in Clinical Psychology and Culture, Institute of Psychology, University of Bras\u00edlia, Bras\u00edlia 70710-907, Brazil"},{"name":"Centre for Research in Social Technologies (CEPATS), University of Bras\u00edlia, Bras\u00edlia 70710-907, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1776-2442","authenticated-orcid":false,"given":"Ana Isabel","family":"Sani","sequence":"additional","affiliation":[{"name":"Faculty of Human and Social Sciences, University Fernando Pessoa (UFP), Pra\u00e7a 9 de Abril, 349, 4249-004 Porto, Portugal"},{"name":"Research Centre on Child Studies (CIEC), University of Minho, 4710-057 Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.18316\/redes.v10i2.7828","article-title":"Impactos de feminic\u00eddios em familiares: Sa\u00fade mental, justi\u00e7a e respeito \u00e0 mem\u00f3ria","volume":"10","author":"Chagas","year":"2022","journal-title":"Rev. Eletr\u00f4nica Direito Soc.\u2013REDES"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3077","DOI":"10.1590\/1413-81232017229.11412017","article-title":"Feminic\u00eddios: Conceitos, tipos e cen\u00e1rios","volume":"22","author":"Meneghel","year":"2017","journal-title":"Ci\u00eanc. Sa\u00fade Coletiva"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Serra, G.S.S.J., Arato, C.V.B., Oliveira, C.A.B., Puello, S.C.P., Aparici, E.Z., Guerra, L.M., and Gondinho, B.V.C. (2025). Consequences of femicide on orphaned children: An integrative literature review. Rev. Interam. Psicol., 59.","DOI":"10.30849\/ripijp.v59(2025).e2130"},{"key":"ref_4","first-page":"43","article-title":"\u00d3rf\u00e3os do feminic\u00eddio: Crian\u00e7as e adolescentes entre a invisibilidade e a prote\u00e7\u00e3o integral no Brasil","volume":"63","author":"Silva","year":"2025","journal-title":"Zenodo"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"22691","DOI":"10.15294\/ulj.v11i1.22691","article-title":"Children, justice, and femicide: Assessing victim rights in Indonesia\u2019s legal system","volume":"11","author":"Aminah","year":"2025","journal-title":"Unnes Law J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s12142-025-00739-w","article-title":"Making children visible: Femicide and child protection under the UNCRC","volume":"26","author":"Brunke","year":"2025","journal-title":"Hum. Rights Rev."},{"key":"ref_7","unstructured":"F\u00f3rum Brasileiro de Seguran\u00e7a P\u00fablica (2025). Anu\u00e1rio Brasileiro de Seguran\u00e7a P\u00fablica, FBSP. [19th ed.]. Available online: https:\/\/forumseguranca.org.br\/wp-content\/uploads\/2025\/07\/anuario-2025.pdf."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1590\/S1413-81232009000500018","article-title":"Impacto da viol\u00eancia na sa\u00fade de fam\u00edlias em Fortaleza, Cear\u00e1","volume":"14","author":"Vieira","year":"2009","journal-title":"Ci\u00eancia Sa\u00fade Coletiva"},{"key":"ref_9","first-page":"43","article-title":"Crian\u00e7as e adolescentes \u00f3rf\u00e3os do feminic\u00eddio: An\u00e1lise sobre aspectos culturais e a hist\u00f3ria do adolescente Isaac","volume":"6","author":"Oliveira","year":"2023","journal-title":"Cad. Humanid. Perspect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1007\/s10896-024-00721-z","article-title":"Applying a socio-ecological model to understanding the needs of children and young people bereaved by intimate partner homicide across their life course","volume":"41","author":"Kurdi","year":"2024","journal-title":"J. Fam. Violence"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Prieto, N., Zurcher, K., Guyot, L., Galia, P., Robinson, P., Fernandez, A., Askenazy, F., Chauliac, N., and Vignaud, P. (2025). Children co-victims of intimate partner homicide: The first 72 decisive hours. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1494289"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Cabal Aguirre, L.V., Jaramillo, A.K., Saucedo Victoria, T.E., and Botero Carvajal, A. (2024). Mental health consequences of parental death and its prevalence in children: A systematic literature review. Heliyon, 10.","DOI":"10.1016\/j.heliyon.2024.e24999"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1521\/psyc.2012.75.1.76","article-title":"Bereavement and mental health after sudden and violent losses: A review","volume":"75","author":"Kristensen","year":"2012","journal-title":"Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/j.1524-4733.2007.00291.x","article-title":"The KIDSCREEN-52 quality of life measure for children and adolescents: Psychometric results from a cross-cultural survey in 13 European countries","volume":"11","author":"Gosch","year":"2008","journal-title":"Value Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.cpr.2015.11.007","article-title":"Quality of life in children: A critical examination of concepts, approaches, issues, and future directions","volume":"45","author":"Wallander","year":"2016","journal-title":"Clin. Psychol. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hays, R.D., and Reeve, B.B. (2017). Measurement and modeling of health-related quality of life. International Encyclopedia of Public Health, Elsevier.","DOI":"10.1016\/B978-0-12-803678-5.00271-X"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Alisic, E., Groot, A., Snetselaar, H., and Stroeken, T. (2025). Raising a child bereaved by domestic homicide: Caregivers\u2019 experiences. Eur. J. Psychotraumatol., 16.","DOI":"10.1080\/20008066.2025.2463277"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/21582440241252311","article-title":"Bereaved by intimate partner homicide: Consequences and experiences of support","volume":"14","author":"Enander","year":"2024","journal-title":"SAGE Open"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Cinquegrana, V., Rossi, C., Borrelli, G., Scognamiglio, C., Perrella, R., and Galdi, S. (2026). Witnessing the murder of their mother: Sex differences and psychological and behavioral consequences in orphans from intimate partner femicide. J. Fam. Violence.","DOI":"10.1007\/s10896-026-01050-z"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1007\/s10567-015-0193-7","article-title":"Children\u2019s mental health and well-being after parental intimate partner homicide: A systematic review","volume":"18","author":"Alisic","year":"2015","journal-title":"Clin. Child Fam. Psychol. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Farias J\u00fanior, J.C., Loch, M.R., Lima Neto, A.J., Sales, J.M., and Lima Ferreira, F.E.L. (2017). Reprodutibilidade, consist\u00eancia interna e validade de construto do KIDSCREEN-27 em adolescentes brasileiros. Cad. Sa\u00fade P\u00fablica, 33.","DOI":"10.1590\/0102-311x00131116"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1037\/a0027283","article-title":"The Revised Child Anxiety and Depression Scale\u2013Short Version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor","volume":"24","author":"Ebesutani","year":"2012","journal-title":"Psychol. Assess."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18401\/2019.9.2.1","article-title":"Cross-cultural adaptation and psychometric assessment of the Revised Child Anxiety and Depression Scale in Brazilian youth","volume":"9","author":"Fontana","year":"2019","journal-title":"J. Asia Pac. Couns."},{"key":"ref_24","unstructured":"Hayes, A.F. (2022). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach, Guilford Press. [3rd ed.]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"152","DOI":"10.15689\/ap.2020.1902.05","article-title":"Apoio social como fator de prote\u00e7\u00e3o para vitimiza\u00e7\u00f5es e desempenho escolar","volume":"19","author":"Faria","year":"2020","journal-title":"Aval. Psicol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1586\/14737167.5.3.353","article-title":"KIDSCREEN-52 quality-of-life measure for children and adolescents","volume":"5","author":"Gosch","year":"2005","journal-title":"Expert Rev. Pharmacoecon. Outcomes Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s00127-008-0388-z","article-title":"Gender differences in depression and anxiety across the adult lifespan: The role of psychosocial mediators","volume":"43","author":"Leach","year":"2008","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Thurston, C., Murray, A.L., Franchino-Olsen, H., Silima, M., Hemady, C.L., and Meinck, F. (2025). Prospective longitudinal associations between adverse childhood experiences and adult mental health outcomes: Systematic review and meta-analysis. Trauma Violence Abus., Online Advanced Publication.","DOI":"10.1177\/15248380251358223"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.jad.2024.10.044","article-title":"Childhood violence exposure and anxiety and depression of children and adolescents","volume":"369","author":"Wang","year":"2025","journal-title":"J. Affect. Disord."},{"key":"ref_30","first-page":"153","article-title":"Health-related quality of life of adolescents: Relations with positive and negative psychological dimensions","volume":"23","author":"Freire","year":"2016","journal-title":"Int. J. Adolesc. Youth"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e75","DOI":"10.1111\/j.1528-1167.2011.03133.x","article-title":"The impact of depression and anxiety disorder symptoms on the health-related quality of life of children and adolescents with epilepsy","volume":"52","author":"Stevanovic","year":"2011","journal-title":"Epilepsia"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1021\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T04:18:03Z","timestamp":1785644283000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":31,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13081021"],"URL":"https:\/\/doi.org\/10.3390\/children13081021","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}