Problem‐Solving Appraisal and Depression: Evidence for a Recovery Model

The purpose of this study was to examine whether problem‐solving appraisal plays a role in recovery from depression in a university population. It was predicted that self‐appraised effective problem solvers would be more likely to recover from a depressive episode than self‐appraised ineffective problem solvers. Consistent with this hypothesis, there was a significant Time 1 problem‐solving appraisal x Time 1 depression interaction in predicting Time 2 depression scores. More specifically, by Time 2 the self‐appraised effective problem solvers reported only mild levels of depressive symptoms (Beck Depression Inventory [BDI] = 12), whereas the self‐appraised ineffective problem solvers reported levels of depression that were moderate to severe (BDI = 20).     

The nature of grief: Loss of love relationships in young adulthood

Abstract

Grieving following the loss of a love relationship in young adulthood was examined. College students completed the loss version of the Grief Experience Inventory (GEI), another questionnaire, and an adaptation of the Texas Revised Inventory of Grief (TRIG). The results indicated that the more intimate the relationship had been, the greater the grief experienced. In addition, the more marriage had been considered, the greater the grief. Grief was disenfranchised primarily by family members, unless marriage had been considered. Few gender differences were seen, except that women both considered marriage and initiated the breakup more often. The specific feelings attached to the grieving were noted more often on the TRIG adaptation than on the GEI. The findings point to the significance of recognizing grief reactions in counseling and psychotherapy for depression in young adults.     

Preface

Abstract

Few phenomena are as widely experienced across different individuals, cultures, and contexts as that of traumatic stress. Whether as victims, perpetrators, supporters, or simply observers, most if not all people can identify to some extent with the psychological and physical consequences produced by traumatic events. Such incidents are as varied as the individuals who must deal with them: The grief produced by the sudden death of a loved one, the self-doubt present in a victim's response to rape, the loss of autonomy following a debilitating injury, and the absence of social identity in the wake of genocidal terror are just a few of the experiences that make up the subject matter of traumatic stress. The consequences of such events also reach beyond the individuals who directly suffer these ordeals. Those who interact with the victims as they attempt to overcome the traumas often endure their own costs. The child who survives the death of a sibling does so in the difficult context of the parents' grief. Individuals close to a victim of severe physical injury frequently must take on new responsibilities as they deal with a friend whose capabilities and limitations have been forever altered. The family of a man who has lost his beloved wife must attempt to find solace for themselves while still offering comfort to the one who was closest to her. The consequences of traumatic events, while certainly devastating for the most immediate victims, are therefore also experienced by the people in the social network that surrounds those victims.     

Trauma-Focused CBT for Traumatic Grief in Military Children

Although military children are typically as resilient as the general child population, the ongoing conflict has exposed military children to unusual stressors such as repeated deployment, severe injury, or the death of a parent or sibling. U.S. forces have experienced more than 5,600 casualties during Operation Iraqi Freedom and Operation Enduring Freedom, with growing numbers of suicides among Service members. These deaths have affected thousands of military children. Most bereaved military children experience adaptive grief characterized by deep sadness, longing for the deceased person, and being comforted by positive memories of the deceased. A smaller number of military children develop childhood traumatic grief, characterized by trauma symptoms that interfere with adaptive grieving. Children with traumatic grief get “stuck” on the traumatic aspects of the death such as picturing the imagined or real details of the death; imagining the pain their loved one experienced in the moments before dying; wishing for revenge; and becoming angry at those who do not understand or share the child’s thoughts and feelings about the death. These children avoid reminders of the deceased person. Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment for children with trauma symptoms including those with traumatic grief. TF-CBT may be particularly suitable for military families. This article describes the clinical application of TF-CBT for traumatic grief in military children.     

The relativity of grief: Differential adaptation reactions of younger and older persons

Abstract

A study was conducted to investigate the differential emotional and coping responses of 41 older (M = 66.5 years) and 48 younger (M = 23.5 years) respondents who had recently lost a close loved one to death. Respondents completed a questionnaire in which they gave an account of the death of their loved one, information about how they coped with this loss, and responses concerning their emotions pertaining to the loss. As predicted, older respondents reported a higher degree of account-making (i.e., story-like constructions) about their losses and confiding in close others than did younger respondents. Further, older respondents showed fewer negative and more positive responses than younger respondents. These results were interpreted to suggest that older respondents were less acutely devastated by their losses and are consistent with the idea that     

Mental ghosts and the process of grief

Abstract

Grieving the death of a loved one is an experience that many people will face at least once in their lifetime, but the lack of widely accepted guidelines as to what constitutes “normal” grieving results in mourning being a common experience with little universality. Memories may keep the deceased alive in the minds of the survivor and may even interfere with the formation of new relationships. This article considers the process of grieving the loss of a spouse and some of the individual factors, such as age, sex, and personal beliefs, that may account for variability in grief experiences. While several modeh detailing the grief process are discussed, the inappropriateness of establishing expectations for the nature and duration of grief is argued for.     

Intolerance of uncertainty and emotional distress following the death of a loved one

Abstract

Research has shown that intolerance of uncertainty (IU) – the tendency to react negatively to situations that are uncertain – is involved in worry and generalized anxiety disorder, as well as in other anxiety symptoms and disorders. To our knowledge, no studies have yet examined the association between IU and emotional distress connected with the death of a loved one. Yet, it seems plausible that those who have more difficulties to tolerate the uncertainties that oftentimes occur following such a loss experience more intense distress. The current study examined this assumption, using self-reported data from 134 bereaved individuals. Findings showed that IU was positively and significantly correlated with symptom levels of complicated grief and posttraumatic stress disorder (PTSD), even when controlling for time since loss (the single demographic/loss-related variable associated with symptom levels), and for neuroticism and worry, which are both correlates of IU. Furthermore, IU was specifically related with worry and symptom levels of PTSD, but not complicated grief, when controlling the shared variance between worry, complicated grief severity, and PTSD-severity. The present findings complement prior research that has shown that IU is a cognitive vulnerability factor for worry, and indicate that it may also be involved in emotional distress following loss.     

Treatment of grief and mourning through EMDR: Conceptual considerations and clinical guidelines

IntroductionEye Movement Desensitization and Reprocessing (EMDR) is an empirically-supported psychotherapeutic approach for treating trauma, which is also applicable to a wide range of other experientially-based clinical complaints. It is particularly useful in treating grief and mourning.Literature findingsEMDR is guided by the Adaptive Information Processing Model (AIP), which conceptualizes the effects of traumatic experiences in terms of dysfunctional memory networks in a physiologically-based information processing system. Numerous empirical studies have demonstrated EMDR's efficacy.DiscussionThe death of a loved one can be very distressing, with memories and experiences associated with the loss becoming dysfunctionally stored and preventing access to adaptive information, including positive memories of the deceased. EMDR can be utilized to integrate these distressing experiences and facilitate the assimilation and accommodation of the loss and movement through the mourning processes.ConclusionApplying the eight phases of EMDR to grief and mourning can yield potent clinical results in the aftermath of loss.     

The Clergy,the Clinician,and the Narrative of Violent Death

When death of a loved one occurs, humans use stories as a way of processing their grief and releasing their emotional attachment. In the case of traumatic and violent death, the story telling process is distorted, and focuses intensely and sometimes obsessively, on a often fantasized reenactment of the dying. Violent dying grief is often complicated further by the public and legal processes that surround violent death. The bereaved who get stuck in this dynamic may constitute a new psychiatric diagnosis called “prolonged grief disorder” and the author describes the criteria for this disorder. Clergy can play a key role in stabilizing and meditating the effects of trauma by inviting the bereaved to refocus their story telling, to a story of the loved one’s life. In a case the author illustrates many of the techniques used in this process of working with a prolonged grief disorder.     

Goodbye,Daddy: An Autoethnographic Journey Through the Grief and Mourning Process

The purpose of this article is to present an autoethonographic study in how I experienced and communicated parts of the mourning process when my father died at the age of 73. The article highlights the stages of grief experienced during the first year. Autoethnographic means are used chronologically to explore how the loss of a family member impacts the stages of grief that are present and how they overlap. In particular, I highlight the events that carried meaning or provided an outlet to express one of the stages of grief. It is hoped that this article can be used to understand why grieving is not an overnight process, but rather is drawn out through the highs and lows of remembering a loved one.     

Self-defining memories in complicated grief

There is increasing attention to the mechanisms underpinning maladaptive responses to bereavement. This study indexed self-defining memories in bereaved individuals with and without complicated grief (CG). Participants with and without complicated grief (N = 40) were asked to describe three self-defining memories. Results showed that CG participants provided more self-defining memories involving the deceased. Both groups were equally likely to report their loved one's death as a self-defining moment, however, the no-CG group showed more evidence of benefit finding in their memory narratives and experienced less negative emotion on recall. The findings suggest that CG is associated with distinctive patterns of autobiographical memory that are linked to self-identity. The pattern is consistent with self-memory system models of autobiographical remembering, and suggests that grieving individuals who experience ongoing yearning for their loved one view their self-identity as more closely linked to the deceased are more distressed by memories involving the loss.     

Grief,Death, and Longing in Stoic and Christian Ethics

The Stoic rejection of the passion of grief strikes many ethicists writing on dying as inhuman, selfish, or lacking appreciation for the world. This essay argues that Stoics rejected grief and the fear of death because these passions alienated one from the present through sorrow or anxiety for the future, disrupting one's ability to fulfill obligations of care for others and to feel gratitude for the gift of loved ones. Early Christian writers on death, such as Ambrose, maintained much of the substance of Stoic doctrine but transformed it through their belief in the resurrection and their corresponding revaluation of the future. While these writers rejected grief as an affective response to death, they affirmed longing for lost loved ones. These authors provide an example of how contemporary religious ethicists can use Stoic insights for recovering the tradition of the art of dying.     

Coping with spousal loss: potential buffering effects of self-reported helping behavior

The present study examined the role of self-reported helping behavior in attenuating the helper's depression following spousal loss. Using archival data from the Changing Lives of Older Couples sample (N = 289), the study shows that among bereaved participants who had experienced high loss-related grief, helping behavior (providing instrumental support to others) was associated with an accelerated decline in depressive symptoms for the helper from 6 months to 18 months following spousal loss. This relationship between giving help and recovery from depression was independent of support received, as well as measured health, and interpersonal and demographic factors. Implications of these results for theoretical approaches to the study of close relationships and well-being are discussed.     

The evolutionary significance of depressive symptoms: different adverse situations lead to different depressive symptom patterns

Although much depression may be dysfunctional, the capacity to experience normal depressive symptoms in response to certain adverse situations appears to have been shaped by natural selection. If this is true, then different kinds of situations may evoke different patterns of depressive symptoms that are well suited to solving the adaptive challenges specific to each situation. The authors called this the situation-symptom congruence hypothesis. They tested this hypothesis by asking 445 participants to identify depressive symptoms that followed a recent adverse situation. Guilt, rumination, fatigue, and pessimism were prominent following failed efforts; crying, sadness, and desire for social support were prominent following social losses. These significant differences were replicated in an experiment in which 113 students were randomly assigned to visualize a major failure or the death of a loved one.     

The Trauma and Complicated Grief of Ambiguous Loss

Ambiguous loss is a newly identified type of loss that occurs when a loved one is physically present, but psychologically absent. Dementia is just one example. Because the lost person is here, but not here, grief is frozen, life is put on hold, and people are traumatized. With no official verification of death, no possibility of closure, and no rituals for support, there is no resolution of grief (Boss 1999). Clergy, especially pastoral counselors, can witness and provide comfort for such uncanny loss because people rely on them for support, not just from the clear loss of death, but from the ambiguous losses, catastrophic and ordinary, that inevitably will occur across the life course.     

Current and Past Maternal Depression, Maternal Interaction Behaviors, and Children’s Externalizing and Internalizing Symptoms

Relations among past maternal depressive disorder, current depressive symptoms, current maternal interaction behaviors, and children's adjustment were examined in a sample of 204 women and their young adolescent offspring (mean age = 11.86, SD = 0.55). Mothers either had (n = 157) or had not (n = 57) experienced at least one depressive disorder during the child's life. Mothers and children participated in a problem-solving task, video-taped for later coding. Mothers with current depressive symptoms and those with histories of chronic/severe depressive disorders displayed fewer positive behaviors toward their children; mothers with current depressive symptoms also showed more negative behaviors with their children. The relation between mothers' depression history and their behavior during the interaction with their child was partially mediated by mothers' current mood state. Moreover, high levels of maternal negativity and low levels of positivity during the problem-solving task were related to children's externalizing problems. Maternal positivity partially mediated the relation between maternal depression and children's externalizing symptoms. These findings highlight the importance of providing parenting interventions for depressed mothers.     

Suicidal Ideation in Elderly Bereaved: The Role of Complicated Grief

This study examined whether symptoms of complicated grief at baseline predicted suicidal ideation during a depressive episode in elderly bereaved individuals. Over a 17-month period, serial ratings of suicidal ideation, hopelessness, and symptoms of depression, anxiety, and complicated grief were obtained from 130 elderly participants who had lost their spouses within the past 2 years. Groups of active and passive suicidal ideators, as well as nonideator controls, were compared via analysis of variance (ANOVA) with respect to levels of complicated grief, depression, and anxiety. Elderly bereaved with both active and passive suicidal ideation were found to have higher symptomatic levels of depression, hopelessness, complicated grief, and anxiety, as well as lower levels of perceived social support, than nonideators at study entry. Fifty-seven percent of the patients with high complicated grief scores were found to be ideators during the follow-up versus 24% of the patients with low complicated grief scores. Patients with any suicidal ideation had higher symptom levels of depression, anxiety, and complicated grief when they were ideators as compared with periods when they denied ideation. Fifteen out of the 39 ideators had recurrent depressive episodes versus 5 of the 91 nonideators. Patients with a history of suicide attempts were more likely to be ideators after loss than other bereaved. Thus, the condition of having high levels of complicated grief symptoms and depressive symptoms appears to make bereaved individuals vulnerable to suicidal ideation. Detection of high levels of complicated grief could help clinicians identify patients who may be at heightened risk for suicide.     

They that mourn

Summary Grief is a universal phenomenon. It most notably occurs following a loss by death, but may occur following any separation. It is a definite psychiatric syndrome with a characteristic onset, course, duration, and termination. The normal period of acute grief is from six to twelve weeks, and the normal grief reaction is completed within two years. The process by which the bereaved comes to accept the separation from the loved one and to readjust to the environment in which the deceased is missing is called the grief work. The more actively one engages in the grief work, the shorter the period of grief. The physican and the minister should help the bereaved to engage actively in the grief work; the principles of doing this are presented.