Affect dynamics,bereavement and resilience to loss

This investigation applied Zautra and colleagues’ Dynamic Model of Affect (DMA; Zautra: 2003, Emotions, Stress and Health (Oxford University Press, New York); Reich et al.: 2003, Review of General Psychology 7(1), pp. 66–83) to help understand resilience among a sample of middle-aged participants coping with the recent death of a spouse or child. We replicated and extended this model by examining interaffect correlations (individual correlations between negative and positive affect over time) in resilient versus symptomatic bereaved people. As predicted by the DMA, resilient bereaved had weaker (or less negative) interaffect correlations than symptomatic bereaved even when controlling for self-reported distress. These findings suggest that resilient individuals possess a capacity for a more complex affective experience and that this capacity serves a salutary function in the aftermath of aversive life events. The research described in this article was supported by a grant from the National Institute of Health, R29-MH57274 (George A. Bonanno).     

Long-term effects of losing a spouse or child in a motor vehicle crash

In this article we examine the long-term effects of the sudden, unexpected loss of a spouse or child. In the spouse study, interviews were conducted with 39 individuals who had lost a spouse in a motor vehicle crash 4 to 7 years ago and with 39 matched controls. In the parent study, interviews were conducted with 41 parents who had lost a child in a crash and with 41 matched controls. Control respondents were matched to bereaved respondents case-by-case on the basis of sex, age, income, education, and number and ages of children. Significant differences between bereaved spouses and controls were revealed on several indicators of general functioning, including depression and other psychiatric symptoms, social functioning, psychological well-being, reactivity to good events, and future worries and concerns. For the most part, these differences persisted when variables such as present family income and present marital status were statistically controlled. Comparisons between bereaved and control parents also revealed significant differences on some measures of general functioning (especially depression), but these were not as pervasive as the differences obtained in the spouse study. Responses to questions about current thoughts and feelings suggest that the deceased continued to occupy the thoughts and conversations of bereaved spouses and parents. Moreover, a large percentage of respondents (from 30% to 85%, depending on the question), continued to ruminate about the accident or what might have been done to prevent it, and they appeared to be unable to accept, resolve, or find any meaning in the loss. Taken together, the data provide little support for traditional notions of recovery from the sudden, unexpected loss of a spouse or child.     

Social support after the loss of an infant child: A long-term perspective

The article presents findings from a survey among 251 parents whose infant child had died. For most of the parents, the loss occurred several years ago. The survey assessed the amounts of instrumental, emotional and informational support received by these parents from various sources in connection with the death. The findings revealed that different sources provided different kinds of support. There was only one significant difference between bereaved males and females with regard to amount of support: females received more emotional support from their friends than males did. Furthermore, large amounts of support received by one spouse was associated with a similar level of support received by the other spouse. Social support in connection with the death was to some extent related to long-term psychological adaptation. Particularly support from neighbours and professionals was consistently associated with psychological adaptation. In general, however, the findings with regard to long-term effects of social support were ambiguous.     

中国丧亲个体社会支持体验的质性研究

本研究通过对28位丧亲者进行深度访谈,使用解释现象学分析法对质性数据进行分析,探索中国丧亲个体的社会支持体验。结果显示,丧亲社会支持的内容包括后事处理、情感支持、生活恢复帮助,经济与物资支持等。支持来源除家人和朋友之外,还包括同事、相同经历者,以及相关机构等。社会支持通过调节情绪、改变认知等方式促进个体对丧亲的适应。本研究结果为最新丧亲社会支持模型提供了支持,同时也反映出中国社会对丧亲人群的社会支持特色。     

Similarities and differences in mothers'' and fathers'' grief following the death of an infant

The differences between mothers' and fathers' grief following the death of an infant child were investigated. From a total sample of 117 parents, 53% women and 47% men, answering a survey on different grief reactions 1 to 4 years following the death. 55 families where both partners responded, were selected. Measures relating to anxiety, depression, impact of event, bodily discomfort, and general well being were included. The results demonstrated fairly strong differences between the partners' reactions, with mothers typically experiencing more intense and long-lasting reactions than fathers. Mothers also tended to perceive their family and friends as less supportive than fathers, while fathers were least satisfied with the support received from the hospital. Most parents felt the death had brought them closer together, although a considerable number reported feeling more distance to their partner. Mothers scored significantly higher than the fathers on experience of recovery, state anxiety (STAI), depression (Beck Depression Inventory), bodily symptoms (Bodily Symptom Scale) and intrusive images and thoughts (Impact of Event Scale, IES Intrusion). A high score in one spouse was correlated with a high score in the other, and vice versa. It is emphasized that the results showing parental differences in grief should help us tailor psychoeducational and therapeutical intervention for bereaved families.     

Social support, life events, and stress as modifiers of adjustment to bereavement by older adults

As part of a larger panel study, interviews were obtained from 3 samples of older adults: 45 persons who had recently lost a spouse, 40 who had lost a parent or child, and 45 who were not bereaved. Assessments were conducted before and after the deaths. In the widowed sample, health remained quite stable, but depression increased sharply, then remained elevated. Changes were minimal in the sample who had lost a parent or child and in the nonbereaved sample. Multiple regression procedures were used to identify factors that contribute to depression and health 9 months after the spouse's death. Postbereavement depression was associated with higher prebereavement depression, higher financial pressures, higher global stress, fewer new interests, and lower social support. Health was a function of prebereavement health, new interests, financial pressures, and global stress. In general, life events and resources had stronger effects in the widowed sample than in the comparison samples.     

PARTNER LOSS IN LATER LIFE: GENDER DIFFERENCES IN COPING SHORTLY AFTER BEREAVEMENT

This longitudinal study aimed to explain coping responses of older women (n = 60)and men (n = 43) at about 1 year following partner loss using a general theory of coping. The theory of mental incongruity predicts that behavioral and mental coping are responses to experienced loneliness and that they are facilitated by actual and perceived opportunities or resources. Results show that the availability of social relationships and better general health encourage coping responses among the bereaved, as well as, unexpectedly, higher social anxiety and financial stress. Results reveal opposite effects for women and men. As time elapses since the death of the partner, men more often share their emotions with others than women. Also, the results suggest that resources play different roles in coping responses of recently bereaved women and men. Among widowers financial stress may impede emotional coping responses, while among widows higher education and having a best female friend seem to function as riskfactors in coping with loss. Relative health, or the feeling one is better off than comparable others, may protect against the negative effects of partner death, particularly among recently bereaved women. It is concluded that the proposed theory offers useful concepts in understanding how recently bereaved individuals cope with partner death; however,it is not helpful in explaining the gender differences found in the present study. Further, the findings question the supposed less favorable health position of older widows and the more favorable social position of older widows and socioeconomic position of older widowers.     

Concurrent Grandparent Death and Birth of Schizophrenic Offspring: An Intriguing Finding

The finding, in the following study, of grandparent death within ± two years of birth of 41 per cent of schizophrenics (N= 70 ), a rate significantly higher than that in psychiatric (N= 45 ) and normal (N= 25 ) control groups, raises the possibility that this family stress factor may contribute to the development of schizophrenia. The implications are considered regarding the likelihood that the concurrent stresses of the death and the birth, two major events in the family life cycle, could confound and impede mourning and parenting processes. Two hypotheses are suggested: (a) that a bereaved parent may be emotionally unavailable to spouse and infant, and (b) that attention to the child may block mourning and absorb painful feelings, with the child assuming a special replacement role. The dysfunctional potential is related to other interacting variables, including biological factors, mourning resolution, and the family system. Further study is called for.     

Resilience to loss in bereaved spouses, bereaved parents, and bereaved gay men

Recent research has indicated that many people faced with highly aversive events suffer only minor, transient disruptions in functioning and retain a capacity for positive affect and experiences. This article reports 2 studies that replicate and extend these findings among bereaved parents, spouses, and caregivers of a chronically ill life partner using a range of self-report and objective measures of adjustment. Resilience was evidenced in half of each bereaved sample when compared with matched, nonbereaved counterparts and 36% of the caregiver sample in a more conservative, repeated-measures ipsative comparison. Resilient individuals were not distinguished by the quality of their relationship with spouse/partner or caregiver burden but were rated more positively and as better adjusted by close friends.     

Relationship satisfaction determines the association between Epstein–Barr virus latency and somatic symptoms after the loss of a spouse

The loss of a spouse is associated with a host of negative health outcomes. While bereaved individuals commonly report somatic symptoms, no investigations exist of the association between reactivation of latent Epstein–Barr virus (EBV) and somatic symptoms among this population. Further, how an individual perceives the quality of their lost relationship in retrospect may impact loss outcomes. Among 99 bereaved spouses, elevated EBV antibody titers were associated with somatic symptoms for those who retrospectively reported high or mean levels of relationship satisfaction (RS), but not among those less satisfied. Further, higher RS was associated with greater grief symptoms. This study identifies higher retrospective RS as a possible risk factor for negative physical and mental health outcomes during bereavement.     

Psychological Consequences of Pregnancy Loss and Infant Death in a Sample of Bereaved Parents

This study aimed to explore a broad range of psychological reactions to trauma in a sample of bereaved parents in order to assess whether the traumatic framework is adequate for describing the entire range of emotional reactions to infant death. A sample of bereaved parents (N = 455) who lost their child through perinatal or postnatal loss were compared to a control group of parents (N = 110) who gave birth to a healthy child. Multivariate regression analysis clearly demonstrated that bereaved parents scored significantly higher on the Depression, Anxiety, Dissociation, Sleep Disturbances, Somatization, Interpersonal Sensitivity, and Aggression subscales of the Trauma Symptom Checklist. Consistent with previous studies, the results showed that for up to 5 years postloss bereaved parents expressed elevated levels of trauma-specific and psychological outcomes, in particular interpersonal sensitivity and aggression.     

Does differential social support cause sex differences in bereavement outcome?

A study of a sample of bereaved and married individuals tested the prediction from stress theory that sex differences in bereavement outcome are due to differences in social support extended to the bereaved. Previous research had established that compared to same‐sex married controls, widowers suffer greater health deterioration following the death of a spouse than widows. Although there is some evidence that widows receive more social support than widowers, it has never been tested empirically whether differential social support is responsible for the sex difference in bereavement outcome. Two sets of tests were conducted to examine these hypotheses: first, sex differences in bereavement outcome and in the social support perceived by the bereaved were assessed by means of sex×marital status ANOVAs on depressive symptomatology, loneliness and social support; second, an ANCOVA was used to assess whether the marital status×sex interaction on distress was substantially reduced or eliminated when social support was used as a covariate. Although there was evidence of the expected sex differences in bereavement outcome and social support, there was no evidence that social support mediates the sex differences in bereavement outcome. Copyright © 1999 John Wiley & Sons, Ltd.     

Mothers continuing bonds and ambivalence to personal mortality after the death of their child--an interpretative phenomenological analysis

The main objective of this study was to identify how bereaved mothers describe their coping strategies in their own words. The literature on parental bereavement is sparse, and the present study aims to add to existing knowledge by eliciting the mothers' experiences covering a wide range of child ages including infants, younger children and adults. Semi-structured interviews were held with 13 bereaved mothers in the UK. Causes of death include accident, illness and suicide. The methodological approach was interpretative phenomenological analysis (IPA). This article reports two inter-related recurrent themes: (1) Continuing the bond with the deceased child and (2) Ambivalence to personal mortality. Participants reported that the relationship with their child was continued in a variety of ways, from tending to the grave and the child's remains, through linking objects or by establishing a symbolic representation of the child within their daily lives. All mothers talked openly about their own mortality, either demonstrating ambivalence about their own death, or expressing clear suicidal ideation. Death was seen as a release from living with the pain of loss. The presence of surviving siblings appeared to moderate suicidal ideation, but mothers expressed concerns about their ability to care adequately for other family members during times of intense grief.     

Spiritual Distress and Depression in Bereavement: A Meaning-Oriented Contribution

One key focus of a meaning reconstruction model of bereavement concerns spiritual meanings attributed to the death, whether consoling or troubling. Specifically, previous studies in our research program suggest that religiously inclined violent death survivors are at risk for elevated levels of both bereavement distress and complicated spiritual grief, a crisis of faith following loss that refers to the erosion of the mourner’s relationship to God and/or the religious community. However, more research is needed to understand the convergence of depression and spiritual struggle in the context of violent and natural loss. In this study of a diverse sample of 59 American Christians bereaved less than 5 years, we sought to: (1) determine if individuals bereaved by homicide, suicide or fatal accident differed from those bereaved by natural causes in their levels of depression and spiritual coping; (2) investigate the relation between the latter constructs; and (3) ascertain if cause of death mediates the effect of religious coping on depression. We found that: (a) violently bereaved individuals endorsed more negative religious coping, and (b) depression was associated with greater spiritual struggle, particularly a sense of disrupted relationship with God. Contrary to expectations, positive religious coping was unrelated to post-loss depression, and cause of death did not mediate the relationship between spiritual coping and depressive symptomatology. A clinical case study concludes the article, illustrating the interweaving of spiritual and psychological distress in tragic bereavement, and their implications for a meaning-oriented grief therapy.     

The effects of late-life spousal bereavement over a 30-month interval

Self-report measures of grief, depression, and general psychopathology were studied in widows and widowers over a 2.5-year period following death of their partner. A comparison sample of men and women was also followed for the same period. Differences in severity of depression and psychopathology previously reported at 2 months postloss (Gallagher, Breckenridge, Thompson, & Peterson, 1983) diminished to nonsignificant levels at 12 and 30 months. However, significant differences between bereaved and comparison subjects on measures of grief were still apparent 30 months after spousal loss. A main effect of gender for depression and psychopathology (but not for grief) was found at 2 and 12 months: Women reported more distress than men regardless of bereavement status. Results indicate that the experience of grief persists for at least 30 months in both older men and women who have lost their spouse.     

Long-term effects of the death of a child on parents' adjustment in midlife.

The death of a child is a traumatic event that can have long-term effects on the lives of parents. This study examined bereaved parents of deceased children (infancy to age 34) and comparison parents with similar backgrounds (n = 428 per group) identified in the Wisconsin Longitudinal Study. An average of 18.05 years following the death, when parents were age 53, bereaved parents reported more depressive symptoms, poorer well-being, and more health problems and were more likely to have experienced a depressive episode and marital disruption than were comparison parents. Recovery from grief was associated with having a sense of life purpose and having additional children but was unrelated to the cause of death or the amount of time since the death. The results point to the need for detection and intervention to help those parents who are experiencing lasting grief.     

Post-traumatic stress disorder in a Danish population of elderly bereaved

The objectives of this study were to examine psychological sequalae of loss of a spouse in late life especially the occurrence of post-traumatic stress disorder (PTSD) and possible predictors of PTSD and symptom development. Fifty-four bereaved Danes (mean age 75 years) from five geographically different areas were studied by the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), and the Crisis Support Scale (CSS). One month after the loss, 27% of the subjects had PTSD. Six months after the loss, this number decreased to 17%; if the A2 criterion was dismissed, the number increased to 24%. Lack of expressive ability, numbing, fear of death or illness, and helplessness in relation to the loss predicted 73% of the variance of the HTQ-total scores. The study concluded that for a considerable number of elderly, losing a spouse in late life appeared to be a traumatic experience. Pre- and peritraumatic factors together with numbing were important predictors of traumatization. Research implications are discussed.