Adaptive and Maladaptive Dependency in Bereavement: Distinguishing Prolonged and Resolved Grief Trajectories

Interpersonal dependency is typically viewed as a risk factor for prolonged grief among conjugally bereaved adults. However, emerging empirical evidence and theoretical advances suggest that one manifestation of interpersonal dependency – adaptive dependency – may serve as a protective factor in coping with loss. This study compared adaptive and maladaptive dependency across three matched groups: prolonged grievers, asymptomatically bereaved adults, and a married comparison group. Results suggest a link between adaptive dependency and asymptomatic bereavement, and between maladaptive dependency and prolonged grief.     

Attachment and loss: a test of three competing models on the association between attachment-related avoidance and adaptation to bereavement

It is widely assumed that emotionally avoidant or defensive individuals will have a difficult time adjusting to the loss of a loved one. However, recent research suggests that defensive individuals tend to adapt quite well to loss. Such findings pose a number of challenges to attachment theory--a theory that has traditionally held that emotional avoidance is indicative of poor psychological adjustment. In this article, the authors argue that contemporary models of individual differences in adult attachment allow the derivation of at least three competing hypotheses regarding the relationship between avoidant attachment and adaptation to loss. These hypotheses are tested using two-wave data on 59 bereaved adults. Results indicate that whereas some avoidant individuals (i.e., those who are fearfully avoidant) have a difficult time adapting to the loss of a loved one, other avoidant adults (i.e., those who are dismissingly avoidant) show a pattern of resilience to loss.     

Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events?

Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience.     

Resilience to loss and chronic grief: a prospective study from preloss to 18-months postloss

The vast majority of bereavement research is conducted after a loss has occurred. Thus, knowledge of the divergent trajectories of grieving or their antecedent predictors is lacking. This study gathered prospective data on 205 individuals several years prior to the death of their spouse and at 6- and 18-months postloss. Five core bereavement patterns were identified: common grief, chronic grief, chronic depression, improvement during bereavement, and resilience. Common grief was relatively infrequent, and the resilient pattern most frequent. The authors tested key hypotheses in the literature pertaining to chronic grief and resilience by identifying the preloss predictors of each pattern. Chronic grief was associated with preloss dependency and resilience with preloss acceptance of death and belief in a just world.     

The repressor personality and avoidant information processing: A dichotic listening study

The present research was designed to investigate the proposition that repressors, operationally defined by the conjunction of low anxiety and high defensiveness, are particularly adept at avoiding the processing of information when motivated to do so. Four groups of participants (nondefensive-low anxious, high anxious, repressors, and defensive-high anxious) were administered a dichotic listening task involving neutral or negative affective words presented in the unattended ear. Participants shadowed the material presented to the attended ear and simultaneously responded to a probe task presented on a video monitor. Results revealed that repressors made significantly fewer shadowing errors than high anxious and defensive-high anxious participants and marginally significantly fewer shadowing errors than low anxious participants for both neutral and negative words. High anxious participants, however, were later able to recognize the negative words that had been presented to the unattended ear at well above chance levels, whereas the recognition memory of repressors for such negative unattended words was at chance levels. In addition, repressors' responses to a postexperiment questionnaire indicated a significantly greater number of distracting thoughts during the experiment relative to other participants. Repressors, it seems, are indeed skillful at avoidant information processing and this capacity may well be related to the emotional memory deficits they have displayed in previous research.     

The crucial importance of empirical evidence in the development of bereavement theory: reply to Archer (2001).

In his commentary, J. Archer (2001a) argued that G. A. Bonanno and S. Kaltman's (1999) review and integration of the bereavement literature failed to consider evolutionary theory or other approaches to the origins of grief. Archer also argued that Bonanno and Kaltman had merely replaced the traditional grief work perspective with cognitive restructuring, thereby ignoring the processes related to avoidance and distancing from the loss. In this reply, the author first explains that although it was compelling to do so, Bonanno and Kaltman did not emphasize an evolutionary approach to the origins of grief reactions because in their current form these theories lack empirical and theoretical clarity. Second, the author shows that, contrary to Archer's reading, Bonanno and Kaltman's article viewed cognitive restructuring as a mechanism used primarily by extremely grieved persons and only in some cognitive domains. Last, the author shows that Bonanno and Kaltman have championed rather than ignored avoidant or distancing processes.     

Is there more to complicated grief than depression and posttraumatic stress disorder? A test of incremental validity

There is growing interest in complicated grief reactions as a possible new diagnostic category for inclusion in the Diagnostic and Statistical Manual of Mental Disorders. However, no research has yet shown that complicated grief has incremental validity (i.e., predicts unique variance in functioning). The authors addressed this issue in 2 studies by comparing grief, depression, and posttraumatic stress disorder (PTSD) symptoms with different measures of functioning (interviewer ratings, friend ratings, self-report, and autonomic arousal). The 1st study (N = 73) used longitudinal data collected at 4 and 18 months postloss, and the 2nd study (N = 447) used cross-sectional data collected 2.5-3.5 years postloss. With depression and PTSD controlled, grief emerged as a unique predictor of functioning, both cross-sectionally and prospectively. The findings provide convergent support for the incremental validity of complicated grief as an independent marker of bereavement-related psychopathology.     

Psychological resilience and dysfunction among hospitalized survivors of the SARS epidemic in Hong Kong: a latent class approach

OBJECTIVE: To examine trajectories of psychological functioning using latent class analysis on a sample of hospitalized survivors of the 2003 severe acute respiratory syndrome (SARS) epidemic in Hong Kong. DESIGN: A longitudinal study of 997 survivors, recruited from among 1,331 individuals hospitalized for SARS, were interviewed at 6, 12, and 18 months after hospitalization. MAIN OUTCOME MEASURES: Psychological and physical functioning at each time point was measured using the 12-item Medical Outcome Study Short-Form Health Survey (SF-12). RESULTS: Four latent classes were identified--chronic dysfunction, delayed dysfunction, recovery, and resilience. All groups had better physical health than the chronic group. Resilient and recovered individuals had greater social support and less SARS-related worry, and resilient individuals were more likely to be male. The resilient group also had greater social support than the delayed group and better physical functioning than the recovered group. CONCLUSION: This study demonstrated that longitudinal outcome trajectories following a major health-threat event in an Asian sample bear close resemblance to prototypical trajectories observed in trauma studies using Western samples. Unique predictors of the trajectories included factors observed in previous studies, such as social support, as well as factors of particular relevance to a major disease outbreak, such as SARS-related worry.     

Belief Change in Branching Time: AGM-consistency and Iterated Revision

We study belief change in the branching-time structures introduced in Bonanno (Artif Intell 171:144–160, 2007). First, we identify a property of branching-time frames that is equivalent (when the set of states is finite) to AGM-consistency, which is defined as follows. A frame is AGM-consistent if the partial belief revision function associated with an arbitrary state-instant pair and an arbitrary model based on that frame can be extended to a full belief revision function that satisfies the AGM postulates. Second, we provide a set of modal axioms that characterize the class of AGM-consistent frames within the modal logic introduced in Bonanno (Artif Intell 171:144–160, 2007). Third, we introduce a generalization of AGM belief revision functions that allows a clear statement of principles of iterated belief revision and discuss iterated revision both semantically and syntactically.