The broken heart phenomenon: An examination of the mortality of bereavement

Bereaved people are at greater risk of losing their lives than the non-bereaved. This paper explores the evidence on this ‘bereavement—mortality relationship’, to establish who among the bereaved are most vulnerable to such dire consequences of loss. Information is drawn from several sources, including epidemiological research on sociodemographic variables, analyses of causes of death and recent empirical studies that have identified differences between bereaved decedents and survivors. The survey shows that risk factors interact in complex ways to determine level of vulnerability. A simple explanation in terms of ‘broken heart’ cannot account for the pattern of results. Some bereaved subgroups are more vulnerable to death than others, excess risk occurs across a variety of causes of death (suggesting different underlying processes), and personal characteristics in combination with circumstantial factors lead to high vulnerability. It is concluded that two types of process underlie the bereavement–mortality relationship. These are related: (a) to the direct effects of grief (broken heart); and (b) to secondary consequences associated with the stress of bereavement.     

Religiosity as a predictor of mortality: A retrospective cohort study in 1519 rural citizens in Greece

Objective: Investigating the role of religiosity in mortality.

Design: A retrospective cohort study (mean follow-up period 131.2 ± 30.8 months) in 1519 rural citizens in Greece (57.1% women, mean age 56.9 ± 20.4 years).

Main outcome measures: Measurements included education, disease status, body mass index, lifestyle, sleep-quality and self-rated health (SRH). Religiosity was assessed as composite score of praying and church attendance. Cox proportional hazard models were used to calculate adjusted hazard ratios (aHR) for all-cause and cardiovascular mortality.

Results: A total of 293 deaths were recorded, 59.2% of which had occurred due to cardiovascular diseases, followed by cancer diseases (17%). All-cause mortality was found increased for older people (aHR: 1.10, 95%CI: 1.08–1.11, p < .0001), for males (aHR: 1.44, 95%CI: 1.14–1.83, p = .002), for people reporting good SRH (aHR: .66, 95%CI: .51–.87, p = .003). Moreover, with increasing age the practice of regular exercise decreases all-causes mortality by approximately 3.5% by each year. Participants in the moderate category of religiosity were found to have decreased risk for all-cause mortality (aHR: .61, 95%CI: .46–.83, p = .001) compared to those in the low religiosity category. Cardiovascular mortality was also significantly associated with SRH and religiosity.

Conclusion: Religiosity predicts mortality, in a rural population in Greece. Deciphering the mediators of religiosity and mortality relationship could facilitate future health policies.     

Predictive value of psychosocial assessment for the mortality of patients waiting for liver transplantation

Selecting suitable candidates for liver transplantation is the most challenging task of pre-transplant evaluation. In addition to somatic assessment, psychosocial evaluation has been proven important in identifying patients at high risk of potential failure. The Transplant Evaluation Rating Scale (TERS) is a widely used rating instrument for the assessment of psychosocial risk factors before liver transplantation. The aim of this study was to explore the predictive value of TERS for mortality in liver transplant patients before and after transplantation. The medical records of patients referred for psychiatric evaluation before liver transplantation between 2003 –2013 were analysed. Administering TERS was part of the pre-transplant evaluation. The TERS scores of patients who died before and after transplantation were compared with those who survived following transplantation. One hundred and sixteen patients were referred for pre-transplant psychiatric evaluation. Patients with successful liver transplants scored significantly lower on TERS than those who died before transplantation (30.65 ± 6.06 vs. 34.75 ± 8.25, p = .031). Patients who died after transplantation scored significantly better on TERS than those who died before transplantation (28.79 ± 2.81 vs. 34.75 ± 8.25, p = .003). There was no significant difference between the deceased and surviving transplanted patients’ TERS scores (28.79 ± 2.81 vs. 31.19 ± 6.66, p = .365). TERS appears to be a suitable rating instrument to help select candidates who have higher chance to survive prior to transplantation but it could not predict post-transplant mortality.     

Premature termination as a function of intake data based on ethnicity, gender, socioeconomic status, and income

Although it is acknowledged that premature termination is detrimental to the therapy process, there is limited information on how to utilize client demographic data to indicate which clients have greatest potential to prematurely terminate. The study assessed how client ethnicity interacts with client gender, therapist gender, therapist ethnicity, and client socioeconomic status (education and income) to affect premature termination. The study consisted of 527 cases which received therapy services from the Auburn University Marriage and Family Therapy Center from October 1993 to October 1999. The three definitions of premature termination used were termination after one session, prior to six sessions, and by therapist report. Results indicated that interactions of client income and ethnicity and therapist gender and ethnicity were the most useful demographic data indicators of premature termination.     

The effects of personal and collective mortality salience on individualism: Comparing Australians and Japanese with higher and lower self-esteem

The cross-cultural generality of terror management theory was examined in Australia and Japan. Based on previous research suggesting that individualism is stronger in Australia than in Japan, mortality salience was predicted to enhance individualism in Australia, but to reduce it in Japan. The results supported this prediction. Consistent with the theory, the cultural pattern of worldview defense was found only among Australians and Japanese with low self-esteem. We also found preliminary evidence that collective mortality (death of one’s in-group) has a greater impact than personal mortality (personal death) in Japan. Although the cultural worldview and self-esteem may serve terror management functions in both cultures, there may be differences between cultures in the type of mortality that produces the greatest levels of anxiety and the manner in which a given worldview is used to cope with anxiety about mortality.     

Predictors of early vocabulary growth in children born preterm and full term: A study of processing speed and medical complications

Delays in expressive vocabulary may be harbingers of long-term language difficulties. In toddlers born full term (FT), individual differences in language processing speed are associated with variation in expressive vocabulary growth. Children born preterm (PT) are at increased risk for persistent language deficits. Here, we evaluate predictors of early vocabulary growth in PT toddlers in relation to two sources of variability: language processing speed and medical complications of prematurity. Vocabulary growth from 16 to 30 months (adjusted for degree of prematurity) was modeled longitudinally using parent reports in English-speaking FT (n = 63; ≥37 weeks, ≥2495 g) and PT (n = 69; ≤32 weeks, <1800 g) children, matched on sex and socioeconomic status. Children were tested in the “looking-while-listening task” at 18 months to derive a measure of language processing speed. Each PT child was assessed for number of medical complications (13 maximum), based on medical chart reviews. PT and FT children displayed similar vocabulary trajectories; however, birth group disparities began to emerge by 30 months. PT children were slower in language processing speed than FT children. Critically, language processing speed predicted expressive vocabulary size at 30 months; interactions with birth group were not significant (all p > .20). In PT children, faster language processing speed predicted stronger outcomes regardless of number of medical complications; slower processing speed and more medical complications predicted poorer outcomes. Faster processing speed reflected favorable neuropsychological processes associated with faster expressive vocabulary growth that overrode the impact of medical complications on language outcomes in PT children.     

Religion and Infant Mortality in the United States: A Community‐Level Investigation of Denominational Variations in Postneonatal Deaths

Although a growing body of research has detected the effects of community‐level religiosity on various health outcomes, very little scholarship has examined the influence of religious ecology on infant mortality rates (IMRs). We conduct ordinary least squares (OLS) regression analyses on postneonatal IMRs (PNIMRs) using county‐level data from the National Center for Health Statistics Linked Birth and Infant Death Data (1990, 2000, and 2006–2010), churches and church membership data, and the Area Health Resource File. We find that while overall rates of postneonatal deaths have decreased over time, the effects of religion on this outcome have become more pronounced. Specifically, we find that counties with greater proportions of mainline Protestant and Catholic adherents exhibit significantly lower PNIMRs. We further find that a greater proportion of conservative Protestants, and especially fundamentalists, increases postneonatal infant mortality. Our findings lend additional support to cultural explanations of U.S. infant mortality.     

When being far away is good: Exploring how mortality salience,regulatory mode,and goal progress affect judgments of meaning in life

Research indicates that death‐relevant thoughts (mortality salience) have a nuanced effect on judgments of life's meaningfulness. Thoughts of death diminish meaning in life only among people who lack or do not readily engage psychological structures that confer meaning. Building on this past research, the current research examined how an important source of meaning, long‐term goal progress, affects the ways that death‐relevant cognitions impact judgments of life's meaning. In Study 1 (N = 118), mortality salience decreased perceptions of meaning in life only among participants who were induced to feel closer to (vs. farther from) completing a long‐term goal. Study 2 (N = 259) extended these findings by demonstrating the moderating influence of individual differences in locomotion. Mortality salience again decreased perceptions of meaning in life among participants who felt closer to accomplishing a long‐term goal, but it only did so among people who do not quickly adopt new goals to pursue (i.e., those low in locomotion). The implications of these findings for better understanding how people maintain meaning in the face of existential concerns and how aspects of goal pursuit affect these processes are discussed.     

Oxytocin trajectories and social engagement in extremely premature infants during NICU hospitalization

Extremely premature infants, born 28 weeks gestation or less, are at high risk for impaired socioemotional development, due in part to exposure to early stressful social experiences that alter brain development. Understanding mediators that link experience with outcomes is necessary to assess premature infant responses to social experiences that are critical to brain development. The hormone oxytocin (OT), released during supportive interactions, has potential as a biomarker of the premature infant's responses to social experiences. The purpose of this study was to examine associations among infant plasma OT trajectories and maternal-infant social engagement behaviors during initial hospitalization. This study also examined demographic correlates of engagement behaviors in mothers and infants. Plasma from 28 extremely premature infants, born gestational ages 25–28 6/7 weeks, was collected at 14 days of life, then weekly until 34 weeks. Social engagement behaviors were measured by the Parent-Child Early Relational Assessment during a videotaped feeding when the infant was receiving one-quarter full oral feeds. Maternal-infant demographics were extracted from the medical record. Higher infant plasma OT was associated with lower infant social engagement, but no associations were found with maternal social engagement. Infant social engagement was positively related to maternal social engagement. Maternal parity was related to maternal social engagement, and infant demographics did not predict infant social engagement. The significant, yet negative, association between infant OT and engagement provides support for the measurement of OT as a neurobiological antecedent to infant social behaviors. Finally, this research suggests that during the earliest period of infant socio-behavioral development, premature infants are behaviorally reactive to the social engagement behaviors of their mothers.     

Mortality salience and prejudice towards ethno-religion minorities: Results and implications of a Nigerian study

The present study examined mortality salience (MS) effect on prejudice towards an ethno-religion minority group of Northern Nigeria. Participants were 120 undergraduate students (females = 41.67%) with an age range between 17 and 38 years. The students completed a Distance-(relationship)-Situation (DS) measure under alternative conditions: with MS priming and a control condition. Following a three-way mixed model ANOVA, results showed MS to predict prejudice across relationship situations of secret disclosure, business partnership, and cooperating to get a task done. Consistent with terror management theory, MS effects on ethno-cultural prejudice expression apply across relationship situations.