Cognitive behavioral variables mediate the associations of neuroticism and attachment insecurity with Prolonged Grief Disorder severity

Prolonged Grief Disorder (PGD) is a debilitating syndrome of grief. A recent cognitive behavioral model asserts that three processes are critical to this condition: (1) insufficient integration of the loss with autobiographical knowledge about the self and the lost person; (2) negative cognitions; and (3) anxious and depressive avoidance behaviors. These processes are assumed to contribute to PGD symptoms and to mediate the influence of personality-related vulnerabilities on the development and maintenance of these symptoms. The present study examined the mediational role of these three processes in the linkage between neuroticism, attachment anxiety, and attachment avoidance on the one hand and PGD symptom severity on the other hand. Self-reported data from 348 bereaved people were used. The results showed that the three personality variables were significantly associated with PGD symptom severity. Moreover, the results provided support for the mediating effects of indices of insufficient integration, negative cognitions, as well as avoidance behaviors - even after controlling for the shared variance between mediators. Theoretical and clinical implications are discussed.     

Cognitive behavioral variables mediate the associations of neuroticism and attachment insecurity with Prolonged Grief Disorder severity

Abstract

Prolonged Grief Disorder (PGD) is a debilitating syndrome of grief. A recent cognitive behavioral model asserts that three processes are critical to this condition: (1) insufficient integration of the loss with autobiographical knowledge about the self and the lost person; (2) negative cognitions; and (3) anxious and depressive avoidance behaviors. These processes are assumed to contribute to PGD symptoms and to mediate the influence of personality-related vulnerabilities on the development and maintenance of these symptoms. The present study examined the mediational role of these three processes in the linkage between neuroticism, attachment anxiety, and attachment avoidance on the one hand and PGD symptom severity on the other hand. Self-reported data from 348 bereaved people were used. The results showed that the three personality variables were significantly associated with PGD symptom severity. Moreover, the results provided support for the mediating effects of indices of insufficient integration, negative cognitions, as well as avoidance behaviors – even after controlling for the shared variance between mediators. Theoretical and clinical implications are discussed.     

Grief and Recovery: The Prevalence of Grief and Loss in Substance Abuse Treatment

Grief from various losses can underlie the process of recovery from substance abuse disorders. This study identified losses that clients encountered prior to abusing substances, losses that occurred as a result of addiction, and losses that occurred upon entering treatment.     

Aesthetics and the Containment of Grief

My point of departure is the observation that people ubiquitously turn to aesthetic practices in response to the loss of a loved one. I argue that profound loss catapults the bereaved person into an alternate “world” that differs in marked ways from the world we usually occupy, an alternate world lacking even the basic coherence we need to function. Aesthetic practices facilitate restoration of coherence to our experience, as well as reconnection with the social world and recovery from the breakdown that profound loss involves. While the aesthetic notion of closure is frequently invoked in connection with the needs of the bereaved, I suggest that while containing the emotions experienced in connection with loss is vital if they are to be processed, unrealistic aspirations toward closure can encourage expectations that harm the bereaved. By contrast, I suggest that the aims of aesthetically punctuating experience and communicating through aesthetic gestures are beneficial for helping the bereaved adjust to their new circumstances.     

Grief experiences and expectance of suicide

Suicide is generally viewed as an unexpected cause of death. However, some suicides might be expected to a certain extent, which needs to be further studied. The relationships between expecting suicide, feeling understanding for the suicide, and later grief experiences were explored. In total, 142 bereaved participants completed the Grief Experience Questionnaire and additional measurements on expectance and understanding. Results supported the prediction of a link between expecting suicide and understanding the suicide. Higher expectance and understanding were related to less searching for explanation and preoccupation with the suicide. There was no direct association with other grief experiences. We conclude that more attention should be brought to the relation between expecting the suicide of a loved one and later grief responses in research and in clinical practice.     

Genetic Library: Grief and Bereavement

As genetic counselors, we frequently encounter families that have experienced a significant loss, be it a pregnancy, a child, or a parent. The purpose of this Genetic Library is to introduce genetic counselors to some of the research that is currently being conducted in the areas of grief and bereavement support, as well as end-of-life care. Of course, it is impossible to capture the richness of these articles in one or two paragraphs. We therefore encourage interested genetic counselors to request and review the full version of these papers.     

Positive Aspects of Grief

Three hundred twelve adults whose loved ones had died approximately one year prior were interviewed to learn if, despite the tragedy, anything good had come about as a result of the death, what they had learned from their experience, and what they and others had done that helped during their grief. Eighty-four percent of those interviewed said that positive things had happened as a result of the death—it brought their family closer together, they learned to appreciate life more, and they found they were stronger and more capable than they had thought. The main thing other people did that helped was listen.     

Altruism, Grief, and Identity

The divide between oneself and others has made altruism seem irrational to some thinkers, as Sidgwick points out. I use characterizations of grief, especially by St. Augustine, to question the divide, and use a composition-as-identity metaphysics of parts and wholes to make literal sense of those characterizations.     

A Journey into Grief

The experience of the death of her Grandmother immerses the author in an intimate experience of grief. She reflects on her journey into grief and presents insights into grief's impact on her personal story as well as her professional life, i.e., her clinical work as a young psychoanalyst-in-training. Other metaphors and dream images, such as life, death, home, homelessness, silence, speech, story, voicelessness, aloneness and loneliness echo throughout the reflection as the author attempts to articulate an understanding of the profound Self-change birthed by death, grief and loss.     

Yearning and Its Measurement in Complicated Grief

Persistent intense yearning for the deceased is a core clinical feature of complicated grief (CG) that distinguishes it from other mental disorders that develop following loss. The Yearning in Situations of Loss Scale (YSL) is a recently developed assessment of yearning. To assess the psychometric properties of the YSL in those with CG, we administered the YSL, Inventory of Complicated Grief, and Quick Inventory of Depression Symptomatology to 303 treatment-seeking bereaved adults with CG. Our results suggest the YSL is a reliable assessment with acceptable convergent and discriminant validity as a measure of yearning in those with CG.     

个体依恋特征的二重性：特质性依恋与状态性依恋

传统依恋理论认为个体依恋心理和行为模式具有相对稳定性, 但无论在信息加工还是个体发展过程中, 个体依恋模式均表现出二重性, 即既具有相对稳定性, 又具有情境敏感性。个体在情境中所表现出的依恋模式是个体相对稳定的特质性依恋和情境特征相互作用的结果。依恋启动研究中特质性依恋特征与依恋启动效应之间的交互作用模式为理解依恋二重特征及其关系提供了窗口。依恋系统激活的两阶段模型为整合和解释这些相互作用模式提供了框架。未来研究应优化依恋二重特征关系研究中启动效应的操作检验, 考虑依恋焦虑和回避维度的交互作用, 关注高焦虑群体内的依恋差异, 以理析依恋二重特征之间的相互作用方式, 同时关注依恋策略影响依恋启动效应的时间进程, 探究依恋二重特征相互作用的机制。     

Grief intervention and sudden infant death syndrome

A program utilizing nurses to deliver grief intervention to parents losing a baby to Sudden Infant Death Syndrome (SIDS) is described. Because parents of SIDS victims experience profound feelings of guilt and especially servere crisis reactions, programs relieving guilt and providing additional support to them are felt to have significant preventive potential. Data are presented tentatively supporting the conclusion that the SIDS grief intervention program had a beneficial impact on the participants. Implications for crisis theory and preventive programming in general are also discussed.