Sample records for grief
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Bonanno, George A; Papa, Anthony; Lalande, Kathleen; Zhang, Nanping; Noll, Jennie G
2005-02-01
In this study, the authors measured grief processing and deliberate grief avoidance and examined their relationship to adjustment at 4 and 18 months of bereavement for 2 types of losses (spouse, child) in 2 cultures (People's Republic of China, United States). Three hypotheses were compared: the traditional grief work assumption, a conditional grief work hypothesis, and a view of grief processing as a form of rumination absent among resilient individuals. Although cultural differences in grief processing and avoidance were observed, the factor structure of these measures proved invariant across cultures. Consistent with the grief work as rumination hypothesis, both grief processing and deliberate grief avoidance predicted poor long-term adjustment for U.S. participants. Furthermore, initial grief processing predicted later grief processing in both cultures. However, among the participants in the People's Republic of China, neither grief processing nor deliberate avoidance evidenced clear psychological consequences. Copyright 2005 APA.
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Dementia Grief: A Theoretical Model of a Unique Grief Experience
Blandin, Kesstan; Pepin, Renee
2016-01-01
Previous literature reveals a high prevalence of grief in dementia caregivers before physical death of the person with dementia that is associated with stress, burden, and depression. To date, theoretical models and therapeutic interventions with grief in caregivers have not adequately considered the grief process, but instead have focused on grief as a symptom that manifests within the process of caregiving. The Dementia Grief Model explicates the unique process of pre-death grief in dementia caregivers. In this paper we introduce the Dementia Grief Model, describe the unique characteristics dementia grief, and present the psychological states associated with the process of dementia grief. The model explicates an iterative grief process involving three states – separation, liminality, and re-emergence – each with a dynamic mechanism that facilitates or hinders movement through the dementia grief process. Finally, we offer potential applied research questions informed by the model. PMID:25883036
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Building metaphors and extending models of grief.
VandeCreek, L
1985-01-01
Persons in grief turn to metaphors as they seek to understand and express their experience. Metaphors illustrated in this article include "grief is a whirlwind," "grief is the Great Depression all over again" and "grief is gray, cloudy and rainy weather." Hospice personnel can enhance their bereavement efforts by identifying and cultivating the expression of personal metaphors from patients and families. Two metaphors have gained wide cultural acceptance and lie behind contemporary scientific explorations of grief. These are "grief is recovery from illness" (Bowlby and Parkes) and "death is the last stage of growth and grief is the adjustment reaction to this growth" (Kubler-Ross). These models have developed linear perspectives of grief but have neglected to study the fluctuating intensity of symptoms. Adopting Worden's four-part typology of grief, the author illustrates how the pie graph can be used to display this important aspect of the grief experience, thus enhancing these models.
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Grief following childhood loss of a parent.
Johnson, P A; Rosenblatt, P C
1981-07-01
A distinction is drawn between incomplete grief and grief arising from maturational events such as life-cycle milestones. Treating maturational grief as though it were incomplete grief or using expressions of maturational grief as a sign of important childhood roots for a patient's current problems is likely to be unproductive.
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Concept clarification of grief in mothers of children with an addiction.
Zucker, Donna M; Dion, Kimberly; McKeever, Roxanna P
2015-04-01
To report an analysis of the concept of grief in mothers of children with an addiction. The concept of grief in this context is poorly understood and often synonymously used with concepts depression, loss and chronic sorrow. In the US, the core concept grief has been recently revised by both NANDA and the DSM-V in efforts to better understand and characterize the concept. The plethora of literature on grief worldwide often characterizes grief as a response to a death. Concept analysis. Search terms 'parental grief' and 'substance abuse' yielded 30 articles. A second review using terms 'grief' and 'substance abuse' yielded 323 articles, in PsychInfo, CINAHL, PubMed databases from 1980-2013. Limits for articles in English and for the terms 'death' and 'child' yielded 13 usable articles. The hybrid model of concept analysis, using a theoretical phase, an empirical phase and a final phase when a clarified definition of grief emerged. Definitions in the literature and defining characteristics of grief outline bio-psycho-social aspects of the concept. For one mother grief was accompanied by recurring feelings of sadness across time, while for the other mother grief was seen as coping, after having passed through a variety of stages of grief. For both, grief was seen to fall on a continuum. Grief is a universal concept and has a trajectory. Case study data have been essential in clarifying understandings of grief as experienced by mothers of addicted children and will provide direction for meaningful and tailored interventions. © 2014 John Wiley & Sons Ltd.
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Nielsen, Mette Kjaergaard; Neergaard, Mette Asbjoern; Jensen, Anders Bonde; Bro, Flemming; Guldin, Mai-Britt
2016-03-01
Caregivers of terminally ill patients may experience anticipatory grief or low levels of preparedness for the patient's impending death. Both concepts are related to a forewarning of the impending loss. Anticipatory grief has been suggested to be grief work before the loss, which would improve bereavement outcome, but recent studies indicate a negative impact. Hence, this review systematically investigates key issues relating to anticipatory grief and preparedness for the death; definitions, measurement tools, and potential effects on caregiver outcome. We used a systematic approach (PRISMA statement). Databases were searched for publications during 1990-2015. Studies on adult caregivers of terminally ill adult patients were included if anticipatory grief or preparedness was assessed by a measurement tool. Anticipatory grief was captured in the definition "pre-loss grief." High levels of grief and low levels of preparedness during caregiving were associated with poor bereavement outcome such as complicated grief. The assumptions that grief work before the loss would alleviate bereavement outcome was not confirmed. Thus, the concept of anticipatory grief is questioned. High preparedness was associated with improved caregiver outcome. Additional support should be given to caregivers with pre-loss grief and low preparedness. Copyright © 2016 Elsevier Ltd. All rights reserved.
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The use of pathological grief outcomes in bereavement studies on African Americans.
Granek, Leeat; Peleg-Sagy, Tal
2017-06-01
Pathological bereavement outcomes (i.e., complicated grief, traumatic grief, prolonged grief disorder) are a robust and growing research area in the psychological and medical sciences. Although grief is considered to be a universal phenomenon, it is well documented that grieving processes and outcomes are culturally and contextually bound. The objectives of this study were: (a) to examine representations of African Americans in the grief and mourning literature and to assess the extent to which this research utilizes pathological grief outcomes; and (b) to examine the characteristics of pathological grief constructs in the literature to assess their relevance for African American populations. We conducted comprehensive searches of three scientific databases including PsycNET, Medline, and CINAHL, which contain the majority of grief and mourning literature published between January 1998 and February 2014. We found 59 studies addressing grief and mourning in African Americans. Thirteen of these studies used pathological grief outcomes. Pathological grief outcomes that were constructed and validated on White populations were frequently used as outcome variables with African American participants. We discuss the implications for the grief and mourning field and argue that the failure to use culturally sensitive outcome measures in research studies is a form of epistemological violence that may have negative research and clinical implications for African Americans and other ethnic minorities.
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Neuropsychological correlates of complicated grief in older spousally bereaved adults.
O'Connor, Mary-Frances; Arizmendi, Brian J
2014-01-01
Across many research domains, evidence for complicated grief as a distinct psychopathology continues to grow. Previous research from neuropsychology has shown an increased attentional bias to emotionally relevant stimuli in those suffering from complicated grief. This study furthers our understanding of the characteristics that distinguish complicated grief. We expand on previous research by (a) testing older adults, (b) excluding those with comorbid major depressive disorder, (c) using participant-chosen grief-related stimuli, and (d) using a married, nonbereaved control group. We recruited 76 older adults in 3 groups: spousally bereaved with complicated grief, spousally bereaved with noncomplicated grief, and nonbereaved controls. Performance on the Wisconsin Card Sorting Task, Digit Span Backwards, and the emotional counting Stroop was examined. Results indicate longer reaction time across 3 blocks of grief-related words in the complicated grief group but no difference across 3 blocks of the neutral words. The 3 groups performed comparably on the other neurocognitive tasks, indicating no cognitive differences in working memory or set shifting between groups. Furthermore, these effects of complicated grief generalize to older adults and appear independent of major depression. Complicated grief has cognitive interference as a neuropsychological component highlighting it as distinct from noncomplicated grief.
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Eisma, Maarten C; Boelen, Paul A; van den Bout, Jan; Stroebe, Wolfgang; Schut, Henk A W; Lancee, Jaap; Stroebe, Margaret S
2015-11-01
This study examined the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Forty-seven bereaved individuals with elevated levels of complicated grief and grief rumination were randomly assigned to three conditions: EX (N=18), BA (N=17), or a waiting-list (N=12). Treatment groups received 6 homework assignments over 6 to 8weeks. Intention-to-treat analyses showed that EX reduced complicated grief, posttraumatic stress, depression, grief rumination, and brooding levels relative to the control group at posttreatment (d=0.7-1.2). BA lowered complicated grief, posttraumatic stress, and grief rumination levels at posttreatment (d=0.8-0.9). At 3-month follow-up, effects of EX were maintained on complicated grief and grief rumination (d=0.6-1.2), and for BA on complicated grief, posttraumatic stress, and grief rumination (d=0.8-0.9). EX reduced depression more strongly than BA (d=0.6). Completers analyses corroborated results for EX, and partially those for BA, but no group differences were detected. BA suffered from high dropout (59%), relative to EX (33%) and the waiting-list (17%). Feasibility appeared higher for EX than BA. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated grief and rumination. Copyright © 2015. Published by Elsevier Ltd.
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Health Care Proxy Grief Symptoms Before the Death of Nursing Home Residents With Advanced Dementia
Kiely, Dan K.; Prigerson, Holly; Mitchell, Susan L.
2009-01-01
Objectives The loss experienced by family members of dementia patients before their actual death is known as “predeath grief.” This study’s objectives were to identify and describe factors associated predeath grief symptoms among health care proxies (HCPs) of nursing home (NH) residents with advanced dementia, and distinguish grief symptoms from those of depression. Design Cross-sectional. Setting Twenty-one Boston-area NHs. Participants Three hundred fifteen NH residents with advanced dementia and their HCPs. Measurements Factor analysis was used to distinguish predeath grief and depression symptoms. Multivariate regression analyses identified factors associated with greater predeath grief measured on a 10-item summary scale of grief symptoms. Independent variables included sociodemographic information and health status of HCPs and residents, and depressive symptoms, physician communication, preparedness for death, and satisfaction with care of HCPs. Results Predeath grief symptoms were distinct from depressive symptoms. The mean predeath grief scores was 15.0 ± 5.6 (range, 10–49), suggesting relatively low levels of overall grief. Yearning (i.e., separation distress) was the most frequently experienced grief symptom (sometimes, 27%; often, 18%; or always, 15%). Variables associated with greater predeath grief included HCPs whose primary language was not English, HCPs who lived with a resident before institutionalization, more depressive symptoms of HCPs, less satisfaction with care of HCPs, and younger resident age. Conclusions Family members of NH residents with advanced dementia experience predeath grief symptoms, particularly separation distress. Predeath grief symptoms are associated with, but distinct from, those of depression. Several factors identified HCPs at higher risk for predeath grief and who may benefit from early interventions to reduce suffering. PMID:18669945
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Grief as pathology: The evolution of grief theory in psychology from Freud to the present.
Granek, Leeat
2010-02-01
The emergence of grief as a topic worthy of psychological study is an early 20th century invention. Freud published his influential essay on mourning and melancholia in 1917. Since he proposed the concept of "grief work," contemporary psychologists have examined his theory empirically and have claimed that grief is a pathology that should be included within the psychological domain. How, and why, has grief theory evolved within the discipline of psychology in this way? In what ways do these changes in the understanding of grief coincide with other historical developments within the discipline? In this article, I trace the development of grief, originally conceived by Freud within a psychoanalytic and nonpathological framework, to the current conceptualization of grief within the disease model. I show how grief theory has evolved within the discipline of psychology to become (a) an object worthy of scientific study within the discipline, and subsequently, (b) a pathology to be privatized, specialized, and treated by mental health professionals.
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The Course of Grief in Children Bereaved by Sudden Parental Death
Melhem, Nadine M.; Porta, Giovanna; Shamseddeen, Wael; Payne, Monica Walker; Brent, David A.
2014-01-01
Context There have been major advances in our understanding of the phenomenology and course of grief in adults. However, little is known about the course of grief in children. Objective We report on course and impact of children’s grief reactions following parental sudden death on subsequent psychiatric and functional status. Design Longitudinal study of bereaved children and families with yearly comprehensive assessments up to three years after parental death. Setting Bereaved children and their surviving parents recruited through the coroners’ records and advertisement. Participants 182 parentally bereaved children between 7 and 18 years of age whose parent died from suicide, accident, or sudden natural deaths. Main Exposure Sudden parental death. Main Outcome Measures Grief, functional impairment, incident depression. Results There were 3 distinct trajectories of grief reactions with a group, consisting of 10.4% of the sample, with increased grief reactions that showed no change 33 months post-death. Youths with prolonged grief reactions had higher rates of previous personal history of depression. Prolonged grief made unique contribution to increased levels of functional impairment even after controlling for clinical characteristics antecedent and following the death. Conversely, prolonged grief, both in youths and the surviving caregiver, predisposed to an increased hazard of incident depression. Another group (30%) showed increased grief reactions 9 months following the death, which gradually decreased over time. Despite this, grief reactions in this group were also associated with functional impairment and increased risk of incident depression. Conclusions Grief reactions abate over time for most children bereaved by sudden parental death; however, a subset show increased or prolonged grief reactions, which in turn increases the risk for functional impairment and depression. Research on interventions designed to relieve the burden of grief in bereaved children are needed. Such efforts should also assess and address grief reactions in the surviving parent. PMID:21893658
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Parental Grief Responses and Personal Growth Following the Death of a Child
ERIC Educational Resources Information Center
Riley, Linda P.; LaMontagne, Lynda L.; Hepworth, Joseph T.; Murphy, Barbara A.
2007-01-01
Conceptualizing parental grief as a psychosocial transition, this cross-sectional study of bereaved mothers (N = 35) examined the relationship of dispositional factors, grief reactions, and personal growth. More optimistic mothers reported less intense grief reactions and less distress indicative of complicated grief. Additionally, mothers who…
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Wolchik, Sharlene A.; Ma, Yue; Tein, Jenn-Yun; Sandler, Irwin N.; Ayers, Tim S.
2009-01-01
We investigated whether three self-system beliefs -- fear of abandonment, coping efficacy, and self-esteem -- mediated the relations between stressors and caregiver-child relationship quality and parentally bereaved youths’ general grief and intrusive grief thoughts. Cross-sectional (n=340 youth) and longitudinal (n=100 youth) models were tested. In the cross-sectional model, fear of abandonment mediated the effects of stressors and relationship quality on both measures of grief and coping efficacy mediated the path from relationship quality to general grief. Fear of abandonment showed a marginal prospective mediational relation between stressors and intrusive grief thoughts. After excluding the mediators, relationship quality showed a direct prospective relation to intrusive grief thoughts. PMID:18924290
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Divergent Gene Expression Responses to Complicated Grief and Non-complicated Grief
Irwin, Michael R.; Arevalo, Jesusa M. G.; Cole, Steven W.
2014-01-01
The “widowhood effect” (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2 years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss. PMID:24380850
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Grief among Family Members of Nursing Home Residents with Advanced Dementia
Givens, Jane L.; Prigerson, Holly G.; Kiely, Dan K.; Shaffer, Michele L.; Mitchell, Susan L.
2011-01-01
Objectives To describe pre-loss and post-loss grief symptoms among family members of nursing home (NH) residents with advanced dementia, and to identify predictors of greater post-loss grief symptoms. Design Prospective cohort study. Setting 22 NHs in the greater Boston area. Participants 123 family members of NH residents who died with advanced dementia. Measurements Pre-loss grief was measured at baseline, and post-loss grief was measured 2 and 7 months post-loss using the Prolonged Grief Disorder scale. Independent variables included resident and family member sociodemographic characteristics, resident comfort, acute illness, acute care prior to death, family member depression, and family member understanding of dementia and of resident’s prognosis. Results Levels of pre-loss and post-loss grief were relatively stable from baseline to 7 months post-loss. Feelings of separation and yearning were the most prominent grief symptoms. After multivariable adjustment, greater pre-loss grief and the family member having lived with the resident prior to NH admission were the only factors independently associated with greater post-loss grief 7 months after resident death. Conclusions The pattern of grieving for some family members of NH residents with advanced dementia is prolonged and begins before resident death. Identification of family members at risk for post-loss grief during the pre-loss period may help guide interventions aimed at lessening post-loss grief. PMID:21606897
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The impact of bereaved parents' perceived grief similarity on relationship satisfaction.
Buyukcan-Tetik, Asuman; Finkenauer, Catrin; Schut, Henk; Stroebe, Margaret; Stroebe, Wolfgang
2017-06-01
The present research focused on bereaved parents' perceived grief similarity, and aimed to investigate the concurrent and longitudinal effects of the perceptions that the partner has less, equal, or more grief intensity than oneself on relationship satisfaction. Participants of our longitudinal study were 229 heterosexual bereaved Dutch couples who completed questionnaires 6, 13, and 20 months after the loss of their child. Average age of participants was 40.7 (SD = 9.5). Across 3 study waves, participants' perceived grief similarity and relationship satisfaction were assessed. To control for their effects, own grief level, child's gender, expectedness of loss, parent's age, parent's gender, and time were also included in the analyses. Consistent with the hypotheses, cross-sectional results revealed that bereaved parents who perceived dissimilar levels of grief (less or more grief) had lower relationship satisfaction than bereaved parents who perceived similar levels of grief. This effect remained significant controlling for the effects of possible confounding variables and actual similarity in grief between partners. We also found that perceived grief similarity at the first study wave was related to the highest level of relationship satisfaction at the second study wave. Moreover, results showed that perceived grief similarity was associated with a higher level in partner's relationship satisfaction. Results are discussed considering the comparison and similarity in grief across bereaved partners after child loss. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Treatment for complicated grief: state of the science and ways forward.
Doering, Bettina K; Eisma, Maarten C
2016-09-01
There is increasing recognition that a minority of bereaved persons experiences persistent and disabling grief symptoms, also termed complicated grief. We review currently proposed criteria for complicated grief in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11), highlight controversies with regard to establishing complicated grief as a psychiatric disorder, summarize recent complicated grief treatment research within a cognitive behavioral treatment framework, and establish a novel and systematic research agenda for complicated grief treatment. Clinicians should be wary of overdiagnosis and misdiagnosis of complicated grief. Recent changes to definitions of complicated grief may threaten generalizability and clinical application of research findings. Universal treatment, treatment for at-risk groups and preventive complicated grief treatment appear ineffective. Although medication is often prescribed to bereaved persons, evidence for its effectiveness is equivocal. Face-to-face and internet-based cognitive behavioral therapy techniques appear most effective in targeting complicated grief. However, little is known about what, how, and for whom treatment works best. In light of these findings, we recommend systematic investigation of: what works best in complicated grief treatment, by conducting well designed, stepped effectiveness trials and treatment component dismantling studies; how it works, by conducting investigations on therapeutic theories and examining mediators of therapeutic change; and for whom it works, by examining potential moderators of treatment effects.
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The Grief Account: Dimensions of a Contemporary Bereavement Genre
ERIC Educational Resources Information Center
Dennis, Michael Robert
2008-01-01
The genre of the grief account is identified to include published narratives of surviving grief. Thematic analysis of Andrew Holleran's (2006) "Grief: A Novel," Lolly Winston's (2004) "Good Grief: A Novel," Joan Didion's (2005) "The Year of Magical Thinking," and J. Canfield and M. V. Hansen's (2003) "Chicken Soup for the Grieving Soul: Stories…
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Nam, I S
2016-01-01
Complicated grief is a distinct psychological response of individuals facing the loss of a loved one and can lead to many types of adverse health outcomes. Although social support may be beneficial, few studies have examined the beneficial effects of helpful support on complicated grief following bereavement. A randomized controlled trial was conducted. Bereaved participants and supporters were randomized to psychoeducation on complicated grief and helpful social support or psychoeducation on complicated grief. The primary outcome was the Inventory of Complicated Grief. The results showed that psychoeducation of supporters of bereaved individuals has significant beneficial effects. Particularly, symptoms of complicated grief were decreased in bereaved individuals with supporters that received psychoeducation. The results highlight the potential of psychoeducation to facilitate helpful social support and reduce complicated grief.
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Bereavement and Complicated Grief
Ghesquiere, Angela; Glickman, Kim
2013-01-01
Bereavement is a common experience in adults age 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7% of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition, and evidenced-based treatments for CG. Greater attention to complicated grief detection and treatment in older adults is needed. PMID:24068457
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Autonomy and social norms in a three factor grief model predicting perinatal grief in India.
Roberts, Lisa R; Lee, Jerry W
2014-01-01
Perinatal grief following stillbirth is a significant social and mental health burden. We examined associations among the following latent variables: autonomy, social norms, self-despair, strained coping, and acute grief-among poor, rural women in India who experienced stillbirth. A structural equation model was built and tested using quantitative data from 347 women of reproductive age in Chhattisgarh. Maternal acceptance of traditional social norms worsens self-despair and strained coping, and increases the autonomy granted to women. Greater autonomy increases acute grief. Greater despair and acute grief increase strained coping. Social and cultural factors were found to predict perinatal grief in India.
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Spirituality and religious coping are related to cancer-bereaved siblings' long-term grief.
Lövgren, Malin; Sveen, Josefin; Steineck, Gunnar; Wallin, Alexandra Eilegård; Eilertsen, Mary-Elizabeth B; Kreicbergs, Ulrika
2017-12-20
Many bereaved siblings have still not come to terms with their grief many years after the loss, but few studies have focused on what can help. The aims of this study were to identify cancer-bereaved adolescents' and young adults' ways of coping with grief after loss of a sibling, and examine whether these ways of coping were related to their experience of having worked through their grief. This nationwide survey of 174 cancer-bereaved siblings (73% participation rate) is based on one open-ended question about coping with grief ("What has helped you to cope with your grief after your sibling's death?") and one closed-ended question about siblings' long-term grief ("Do you think you have worked through your grief over your sibling's death?"). The open-ended question was analyzed with content analysis; descriptive statistics and Fisher's exact test were used to examine the relation between type of coping and siblings' long-term grief. Result The siblings described four ways of coping: (1) thinking of their dead brother/sister and feeling and expressing their grief; (2) distracting or occupying themselves; (3) engaging in spiritual and religious beliefs/activities; and (4) waiting for time to pass. One of these categories of coping with grief, namely, engaging in spiritual and religious beliefs and activities, was associated with siblings' experience of having worked through their grief two to nine years after the loss (p = 0.016). Significance of results Those siblings who had used spirituality, religious beliefs, and activities to cope were more likely to have worked through their grief than those who had not.
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Abnormal Grief: Should We Consider a More Patient-Centered Approach?
Moayedoddin, Babak; Markowitz, John C
2015-01-01
Grief, the psychological reaction to the loss of a significant other, varies complexly in its cause, experience, evolution, and prognosis. Although most bereaved individuals experience a normal grieving process, some develop complicated grief (CG) or major depressive disorder (MDD). The DSM-5, which controversially altered the nosology, recognizes grief-related major depression (GRMD) as a diagnostic subtype if a patient meets MDD criteria two weeks post bereavement. The (DSM-5) tries to distinguish between grief and MDD, but remains a symptom-based, centered approach to grief that is not patient centered. This article reviews grief in its normal and abnormal dimensions. Using an illustrative clinical case in which interpersonal psychotherapy (IPT) was employed, we discuss the need for a more patient-centered approach to treating abnormal grief, considering the patient's personal history, perceptions, experiences of bereavement, and interpersonal environment. Clinical studies need to better identify subgroups of individuals susceptible to abnormal grief and to evaluate their response to early interventions.
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A concept analysis of nurses' grief.
Wisekal, Ashley E
2015-10-01
The psychological and personal well-being of nurses can change the way they care for patients. If nurses' grief is not properly managed, the nursing shortage will continue to grow. Consequently, a need exists for the identification of nurses' grief and effective interventions to manage grief to ensure the successful development and growth of the nursing profession. This concept analysis sought to properly define nurses' grief and the role it plays in the day-to-day requirements of nurses. A review of the literature was conducted using CINAHL®, BioMed, EBSCOhost, and MEDLINE® and the following key words. Nurses' grief must be incorporated into the nursing curriculum and addressed by employers. In particular, facility leaders should help promote a healthy work environment and address the need for proper grief management. Educators, managers, and nurses can benefit from acknowledging the current gap in managing nurses' grief.
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"It May Not Be Pretty, but It's Honest": Examining Parental Grief on the Callapitter Blog
ERIC Educational Resources Information Center
DeGroot, Jocelyn M.; Carmack, Heather J.
2013-01-01
Following the death of a child, parents are turning to alternative means of communication to express their grief. In this instrumental case study, the authors explore how 1 woman, Amy Ambrusko, communicates her grief experience on her blog, emotionally negotiating loss and parental grief. Guided by M. S. Miles's (1984) parental grief model, the…
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Yu, Nancy Xiaonan; Chan, Cecilia L W; Zhang, Jianxin; Stewart, Sunita M
2016-01-01
Spousal bereavement is closely linked to prolonged grief, that is, significant adjustment symptoms that last for more than six months after the loss. This article focused on potential risk and protective factors that may influence bereavement outcomes. Participants in this study were surviving spouses of individuals who died of acquired immune deficiency syndrome (AIDS). These participants were themselves living with human immunodeficiency syndrome. In this cross-sectional study, 120 bereaved participants completed measures of grief, quality of dying and death of the deceased, negative conceptions of death resulting from AIDS, death attitudes, and personal resilience. The results showed that one-third (35.0%) of the bereaved participants reported grief levels above the prolonged grief cut-off scores, and can be categorized as the "prolonged grief" group. Although quality of dying and death was not associated with the intensity of grief, negative conceptions of death from AIDS, fear of death and resilience independently predicted grief symptoms in the regression models. Our findings provide insight into the grief process for the surviving spouse of AIDS victims in rural China. Since resilience is malleable, developing resilience interventions to enhance adjustment to bereavement may be a promising direction in grief counselling and therapies.
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Saavedra Pérez, Heidi C; Direk, Nese; Milic, Jelena; Ikram, Mohammed Arfan; Hofman, Albert; Tiemeier, Henning
2017-05-01
Few studies have focused on the effect of complicated grief-unresolved and prolonged grief-on the neuroendocrine systems. The present study examined the association of complicated grief and normal grief with the diurnal cortisol patterns in a large population-based study. This study was set in the Rotterdam Study and comprised 2084 persons aged older than 55 years (mean [SD] age, 64.9 [5.5] years). Participants were assessed with the Complicated Grief Inventory and classified into no grief (n = 1922), normal grief (n = 131), or complicated grief (n = 31) if they experienced the loss in the past 2 years. Saliva samples were collected to measure cortisol levels. Morning cortisol and summary measures (area under the curve and the slope) were studied to account for the diurnal pattern of cortisol. Persons with depressive disorders were excluded, and analyses were additionally adjusted for depressive symptoms. Compared to normal grievers, participants with complicated grief showed lower levels of morning cortisol (11.26 vs 15.51 nmol/L; difference, -4.24; 95% confidence interval [CI] = -7.87 to -0.62; p = .022), and lower levels of overall diurnal cortisol (6.89 vs 8.98 nmol/L; difference, -2.09; 95% CI = -3.81 to -0.37; p = .017). No difference was observed in slope between both groups. Participants with complicated grief also showed lower levels of morning cortisol than the nongrievers (11.26 vs 14.71; difference, -3.46; 95% CI = -6.78 to -0.13; p = .042). In contrast, cortisol secretion patterns did not differ between persons with normal grief and nongrieving controls. Participants with complicated grief showed low levels of morning cortisol and low overall diurnal cortisol levels characteristic for a chronic stress reaction.
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Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.
2015-01-01
Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434
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Rees, Susan J; Tay, Alvin Kuowei; Savio, Elisa; Maria Da Costa, Zelia; Silove, Derrick
2017-01-01
Previous studies have identified high rates of explosive anger amongst post-conflict populations including Timor-Leste. We sought to test whether explosive anger was integrally associated with symptoms of grief amongst the Timorese, a society that has experienced extensive conflict-related losses. In 2010 and 2011 we recruited adults (n = 2964), 18-years and older, living in an urban and a rural village in Timor-Leste. We applied latent class analysis to identify subpopulations based on symptoms of explosive anger and grief. The best fitting model comprised three classes: grief (24%), grief-anger (25%), and a low symptom group (51%). There were more women and urban dwellers in the grief and grief-anger classes compared to the reference class. Persons in the grief and grief-anger classes experienced higher rates of witnessing murder and atrocities and traumatic losses, ongoing poverty, and preoccupations with injustice for the two historical periods of conflict (the Indonesian occupation and the later internal conflict). Compared to the reference class, only the grief-anger class reported greater exposure to extreme deprivations during the conflict, ongoing family conflict, and preoccupations with injustice for contemporary times; and compared to the grief class, greater exposure to traumatic losses, poverty, family conflict and preoccupations with injustice for both the internal conflict and contemporary times. A substantial number of adults in this post-conflict country experienced a combined constellation of grief and explosive anger associated with extensive traumatic losses, deprivations, and preoccupations with injustice. Importantly, grief-anger may be linked to family conflict in this post-conflict environment.
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Rees, Susan J.; Tay, Alvin Kuowei; Savio, Elisa; Maria Da Costa, Zelia; Silove, Derrick
2017-01-01
Previous studies have identified high rates of explosive anger amongst post-conflict populations including Timor-Leste. We sought to test whether explosive anger was integrally associated with symptoms of grief amongst the Timorese, a society that has experienced extensive conflict-related losses. In 2010 and 2011 we recruited adults (n = 2964), 18-years and older, living in an urban and a rural village in Timor-Leste. We applied latent class analysis to identify subpopulations based on symptoms of explosive anger and grief. The best fitting model comprised three classes: grief (24%), grief-anger (25%), and a low symptom group (51%). There were more women and urban dwellers in the grief and grief-anger classes compared to the reference class. Persons in the grief and grief-anger classes experienced higher rates of witnessing murder and atrocities and traumatic losses, ongoing poverty, and preoccupations with injustice for the two historical periods of conflict (the Indonesian occupation and the later internal conflict). Compared to the reference class, only the grief-anger class reported greater exposure to extreme deprivations during the conflict, ongoing family conflict, and preoccupations with injustice for contemporary times; and compared to the grief class, greater exposure to traumatic losses, poverty, family conflict and preoccupations with injustice for both the internal conflict and contemporary times. A substantial number of adults in this post-conflict country experienced a combined constellation of grief and explosive anger associated with extensive traumatic losses, deprivations, and preoccupations with injustice. Importantly, grief-anger may be linked to family conflict in this post-conflict environment. PMID:28430793
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Smid, Geert E; Kleber, Rolf J; de la Rie, Simone M; Bos, Jannetta B A; Gersons, Berthold P R; Boelen, Paul A
2015-01-01
Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components.
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[The Application of Grief Theories to Bereaved Family Members].
Wu, Lee-Jen Suen; Chou, Chuan-Chiang; Lin, Yen-Chun
2017-12-01
Loss is an inevitable experience for humans for which grief is a natural response. Nurses must have an adequate understanding of grief and bereavement in order to be more sensitive to these painful emotions and to provide appropriate care to families who have lost someone they love deeply. This article introduces four important grief theories: Freud's grief theory, Bowlby's attachment theory, Stroebe and Schuts' dual process model, and Neiyemer's meaning reconstruction model. Freud's grief theory holds that the process of grief adaptation involves a bereaved family adopting alternative ways to connect with the death of a loved one and to restore their self-ego. Attachment theory holds that individuals who undergo grieving that is caused by separation from significant others and that triggers the process of grief adaptation will fail to adapt if they resist change. The dual process model holds that bereaved families undergo grief adaptation not only as a way to face their loss but also to restore normality in their lives. Finally, the meaning reconstruction model holds that the grief-adaptation strength of bereaved families comes from their meaning reconstruction in response to encountered events. It is hoped that these theories offer nurses different perspectives on the grieving process and provide a practical framework for grief assessment and interventions. Additionally, specific interventions that are based on these four grief theories are recommended. Furthermore, theories of grief may help nurses gain insight into their own practice-related reactions and healing processes, which is an important part of caring for the grieving. Although the grieving process is time consuming, nurses who better understand grief will be better able to help family members prepare in advance for the death of a loved one and, in doing so, help facilitate their healing, with a view to the future and to finally returning to normal daily life.
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Grief related to the experience of being the sibling of a child with cancer.
Jenholt Nolbris, Margaretha; Enskär, Karin; Hellström, Anna-Lena
2014-01-01
Few studies have described the well siblings' experience of grief when a brother or sister is treated for cancer. Knowing how sibling grief is expressed will guide clinician and family efforts to provide appropriate support. The aim of this study was to describe siblings' reports of grief related to the experience of having a brother or sister with cancer. A qualitative descriptive method was chosen based on open-ended interviews with 29 siblings aged 8 to 24 years. Qualitative content analysis was applied to the interview data. Four categories of grief were identified: anticipatory grief after receiving information about the cancer diagnosis, grief and concern about the ill sibling's loss of a normal life, grief about being unimportant and forgotten in the family, and grief that continues after the sibling's death as a kind of bond. Despite variations in age and gender among participating siblings, their thoughts were similar. Grief was experienced differently from the time of the diagnosis onward, in the form of concerns related to the illness and situation of the ill sibling. Grief related to sibling bonds remained after death. This study recommends offering siblings realistic information about their ill sibling and support for them in their situation from diagnosis and continuously thereafter. To meet the needs of well siblings, it is necessary to ask the siblings about their thoughts and discuss with them their emotions and worries.
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Grief and loss for patients before and after heart transplant.
Poole, Jennifer; Ward, Jennifer; DeLuca, Enza; Shildrick, Margrit; Abbey, Susan; Mauthner, Oliver; Ross, Heather
2016-01-01
The purpose of the study was to examine the loss and grief experiences of patients waiting for and living with new hearts. There is much scholarship on loss and grief. Less attention has been paid to these issues in clinical transplantation, and even less on the patient experience. Part of a qualitative inquiry oriented to the work of Merleau-Ponty, a secondary analysis was carried out on audiovisual data from interviews with thirty participants. Patients experience loss and three forms of grief. Pre-transplant patients waiting for transplant experience loss and anticipatory grief related to their own death and the future death of their donor. Transplanted patients experience long-lasting complicated grief with respect to the donor and disenfranchised grief which may not be sanctioned. Loss as well as anticipatory, complicated and disenfranchised grief may have been inadvertently disregarded or downplayed. More research and attention is needed. Copyright © 2016 Elsevier Inc. All rights reserved.
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Disrupted Prefrontal Activity during Emotion Processing in Complicated Grief: an fMRI Investigation
Arizmendi, Brian; Kaszniak, Alfred W.; O’Connor, Mary-Frances
2015-01-01
Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O’Connor & Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=−10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief. PMID:26434802
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Disrupted prefrontal activity during emotion processing in complicated grief: An fMRI investigation.
Arizmendi, Brian; Kaszniak, Alfred W; O'Connor, Mary-Frances
2016-01-01
Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O'Connor and Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=-10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief. Copyright © 2015 Elsevier Inc. All rights reserved.
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Parent Grief 1–13 Months After Death in Neonatal and Pediatric Intensive Care Units
Youngblut, JoAnne M.; Brooten, Dorothy; Glaze, Joy; Promise, Teresita; Yoo, Changwon
2016-01-01
Objective Describe changes in mothers’ and fathers’ grief from 1 to 13 months after infant/child neonatal/pediatric intensive care unit death and identify factors related to their grief. Methods Mothers (n = 130) and fathers (n = 52) of 140 children (newborn-18 years) completed the Hogan Grief Reaction Checklist at 1, 3, 6, and 13 months post-death. Results Grief decreased from 3 to 13 months for mothers and from 3 to 6 months for fathers. Grief was more intense for: mothers of deceased adolescents and mothers whose child was declared brain dead. Conclusion Mothers’ and fathers’ grief intensity may not coincide, resulting in different needs during the 13 months after infant/child death. PMID:28239302
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... Staying Safe Videos for Educators Search English Español Death and Grief KidsHealth / For Teens / Death and Grief What's in this article? What Is ... the reaction we have in response to a death or loss. Grief can affect our body, mind, ...
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Development of the Grief Experience Questionnaire.
ERIC Educational Resources Information Center
Barrett, Terence W.; Scott, Thomas B.
1989-01-01
Developed Grief Experience Questionnaire (GEQ) to measure various components of grief. Initial results suggest GEQ's potential to differentiate grief reactions experienced by suicide survivors from those experienced by survivors of accidental death, unexpected natural death, and expected natural death. (Author/NB)
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Trauma in the workplace: grief counseling 101.
Zanni, Guido R
2014-01-01
Trauma in the workplace can be precipitated by a number of tragedies, but death of an employee is the most common occurrence. Bereavement, mourning, and grief are common reactions. In most cases, people successfully cope with the death within two months, but some develop chronic grief, which is also referred to as complicated grief. Principles of grief counseling are outlined along with the need for employee training on trauma.
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Grief and Palliative Care: Mutuality
Moon, Paul J
2013-01-01
Grief and palliative care are interrelated and perhaps mutually inclusive. Conceptually and practically, grief intimately relates to palliative care, as both domains regard the phenomena of loss, suffering, and a desire for abatement of pain burden. Moreover, the notions of palliative care and grief may be construed as being mutually inclusive in terms of one cueing the other. As such, the discussions in this article will center on the conceptualizations of the mutuality between grief and palliative care related to end-of-life circumstances. Specifically, the complementarity of grief and palliative care, as well as a controvertible view thereof, will be considered. PMID:25278758
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Grief following pet and human loss: Closeness is key.
Eckerd, Lizabeth M; Barnett, James E; Jett-Dias, Latishia
2016-01-01
The authors compared grief severity and its predictors in two equivalent college student samples who had experienced the death of a pet (n = 211) or a person (n = 146) within the past 2 years. The human death sample reported higher grief severity, p < .01, but effect sizes were small (ds = .28-.30). For both samples, closeness to the deceased was overwhelmingly the strongest predictor of grief severity; other predictors generally dropped out with closeness added to the model. Results highlight the importance of including closeness to deceased in grief research, and its centrality in understanding grief counseling clients.
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Anticipatory grief in new family caregivers of persons with mild cognitive impairment and dementia.
Garand, Linda; Lingler, Jennifer H; Deardorf, Kaitlyn E; DeKosky, Steven T; Schulz, Richard; Reynolds, Charles F; Dew, Mary Amanda
2012-01-01
Anticipatory grief is the process of experiencing normal phases of bereavement in advance of the loss of a significant person. To date, anticipatory grief has been examined in family caregivers to individuals who have had Alzheimer disease (AD) an average of 3 to 6 years. Whether such grief is manifested early in the disease trajectory (at diagnosis) is unknown. Using a cross-sectional design, we examined differences in the nature and extent of anticipatory grief between family caregivers of persons with a new diagnosis of mild cognitive impairment (MCI, n=43) or AD (n=30). We also determined whether anticipatory grief levels were associated with caregiver demographics, caregiving burden, depressive symptoms, and marital quality. The mean anticipatory grief levels were high in the total sample, with AD caregivers endorsing significantly more anticipatory grief than MCI caregivers. In general, AD caregivers endorsed difficulty in functioning, whereas MCI caregivers focused on themes of "missing the person" they once knew. Being a female caregiver, reporting higher levels of objective caregiving burden, and higher depression levels each had independent, statistically significant relationships with anticipatory grief. Given these findings, family caregivers of individuals with mild cognitive deficits or a new AD diagnosis may benefit from interventions specifically addressing anticipatory grief.
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Caregiver anticipatory grief: phenomenology, assessment and clinical interventions.
Coelho, Alexandra; de Brito, Maja; Barbosa, António
2018-03-01
This review aims to synthesize recent findings on anticipatory grief in caregivers, referring to its phenomenology, assessment and clinical interventions. Recent literature illustrates the wide scope of the current use of the term anticipatory grief, reflecting caregivers' experiences in different end-of-life trajectories. The anticipation of death is the distinctive aspect of anticipatory grief in the predeath grief continuum, encompassing several progressive losses, past and future. Recently developed assessment instruments capture key aspects of this experience, such as separation anxiety, anticipation of death and future absence of the person, denial and relational losses. Recent findings on prevalence of clinically significant predeath symptoms in caregivers range from 12.5 to 38.5%. Beyond personal and relational factors, difficult circumstances of end-of-life care significantly interfere in adjustment to anticipatory grief. Useful therapeutic interventions were identified, such as validation of grief feelings, increased coping and self-care, anticipation of future losses and reframing roles. However, rigorous interventional studies are needed to create guidelines and the manualization of specific therapeutic approaches to caregiver anticipatory grief. Findings suggest that anticipatory grief dynamics in different end-of-life trajectories should be recognized and adequately assessed. Clinical interventions considered useful to support anticipatory grief caregivers are presented, but further research is needed to verify effectiveness.
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Anticipatory Grief in New Family Caregivers of Persons with Mild Cognitive Impairment and Dementia
Garand, Linda; Lingler, Jennifer H.; Deardorf, Kaitlyn E.; DeKosky, Steven T.; Schulz, Richard; Reynolds, Charles F.; Dew, Mary Amanda
2011-01-01
Anticipatory grief is the process of experiencing normal phases of bereavement in advance of the loss of a significant person. To date, anticipatory grief has been examined in family caregivers to individuals who have had Alzheimer’s Disease (AD) an average of 3 to 6 years. Whether such grief is manifested early in the disease trajectory (at diagnosis) is unknown. Using a cross-sectional design, we examined differences in the nature and extent of anticipatory grief between family caregivers of persons with a new diagnosis of mild cognitive impairment (MCI, n=43) or AD (n=30). We also determined whether anticipatory grief levels were associated with caregiver demographics, caregiving burden, depressive symptoms and marital quality. Mean anticipatory grief levels were high in the total sample, with AD caregivers endorsing significantly more anticipatory grief than MCI caregivers. In general, AD caregivers endorsed difficulty functioning whereas MCI caregivers focused on themes of “missing the person” they once knew. Being a female caregiver, reporting higher levels of objective caregiving burden and higher depression levels each bore independent, statistically significant relationships with anticipatory grief. Given these findings, family caregivers of individuals with mild cognitive deficits or a new AD diagnosis may benefit from interventions specifically addressing anticipatory grief. PMID:21946013
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Parental Grief Following the Death of a Child from Cancer: The Ongoing Odyssey.
Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah; Baker, Justin N
2016-09-01
The death of a child is a devastating event that results in profound grief and significant psychosocial and physical morbidities in parents. The parental grief journey is a complex phenomenon necessitating the utilization of newer models of bereavement with a focus on relationships and exploration of parents' perceived meanings of the experience. To further characterize the grief journey of parents whose child died from cancer in order to better identify parents who can benefit from additional bereavement support and design strategies to improve bereavement services for these parents. We conducted focus group sessions with 11 bereaved parents. The parents were given two prompts to describe their grief journey before and after their child's death, and their responses in a narrative form were audio-recorded. The responses were coded and studied independently by semantic content analysis. Collation and analysis of the coded responses to both prompts results in the emergence of four concepts from the parental narratives: (1) description of the grief trajectory and evolution of grief over time, (2) mechanisms of parental coping throughout the grief journey, (3) factors that exacerbate parental grief, and (4) sources of parental support throughout the grief journey. The narratives highlighted that parents whose child died of cancer experience a unique and evolving form of grief and they wish to continue their bond with the deceased child. We recommend that healthcare providers and institutions incorporate support systems into a comprehensive bereavement program for families of children who die from cancer. © 2016 Wiley Periodicals, Inc.
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Physiological and psychological symptoms of grief in widows.
Kowalski, Susan D; Bondmass, Mary D
2008-02-01
In this cross-sectional descriptive survey of 173 widows, we describe their grief symptoms using an open-ended questionnaire and the Revised Grief Experience Inventory. Self-reported physical symptoms included pain, gastro-intestinal problems, medical/surgical conditions, sleep disturbances, and neurological/circulatory issues. Psychological symptoms were reported as depression, anxiety, and loneliness. The mean total grief score was 71.4 +/- 30.2 (possible range 22-132). Physical symptoms were significantly correlated with the total mean grief score, and subscales of physical distress, depression, existential tension, and guilt. When the subjects were grouped by years since loss, (range 1-5 years), there was no significant decrease found in overall grief scores, suggesting symptoms of grief experienced by widows may continue up to at least 5 years. (c) 2007 Wiley Periodicals, Inc.
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Grief after second-trimester termination for fetal anomaly: a qualitative study
Maguire, Marguerite; Light, Alexis; Kuppermann, Miriam; Dalton, Vanessa K.; Steinauer, Jody E.; Kerns, Jennifer L.
2015-01-01
Objectives We aimed to qualitatively evaluate factors that contribute to and alleviate grief associated with termination of a pregnancy for a fetal anomaly and how that grief changes over time. Study design We conducted a longitudinal qualitative study of decision satisfaction, grief and coping among women undergoing termination (dilation and evacuation or induction termination) for fetal anomalies and other complications. We conducted three postprocedure interviews at 1–3 weeks, 3 months and 1 year. We used a generative thematic approach to analyze themes related to grief using NVivo software program. Results Of the 19 women in the overall study, 13 women’s interviews were eligible for analysis of the grief experience. Eleven women completed all three interviews, and two completed only the first interview. Themes that contributed to grief include self-blame for the diagnosis, guilt around the termination decision, social isolation related to discomfort with abortion and grief triggered by reminders of pregnancy. Social support and time are mechanisms that serve to alleviate grief. Conclusions Pregnancy termination in this context is experienced as a significant loss similar to other types of pregnancy loss and is also associated with real and perceived stigma. Women choosing termination for fetal anomalies may benefit from tailored counseling that includes dispelling misconceptions about cause of the anomaly. In addition, efforts to decrease abortion stigma and increase social support may improve women’s experiences and lessen their grief response. Implications The nature and course of grief after second-trimester termination for fetal anomaly are, as of yet, poorly understood. With improved understanding of how women grieve over time, clinicians can better recognize the significance of their patients’ suffering and offer tools to direct their grief toward positive coping. PMID:25499590
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The effects of temperament, character, and defense mechanisms on grief severity among the elderly.
Gana, Kamel; K'Delant, Pascaline
2011-01-01
The aims of this study were to examine the relationships between Cloninger's psychobiological model of personality, defense styles, and severity of grief, and to identify the influential temperament and character dimensions that differentiate subjects with prolonged grief from those without prolonged grief. A sample of 72 bereaved elderly persons for whom the loss of a loved one occurred on average 2.58 years (SD = 1.92) prior to participation in this study were assessed using the Inventory of Complicated Grief-Revised, the Temperament and Character Inventory, and the Defense Styles Questionnaire. Using the algorithm developed by Prigerson et al. (2009) for diagnosing prolonged grief, 18 of our participants were identified as having this disorder. A multiple regression analysis revealed that time since loss, persistence, an immature defense style, and the age of the bereaved person positively predicted severity of grief, whereas cooperativeness and the age of the deceased loved one negatively predicted severity of grief. A binary logistic regression showed that gender, a close kinship relation to the deceased, time since loss, self-directedness (SD), and self-transcendence (ST) were predictors of prolonged grief, whereas the age of the deceased and cooperativeness (CO) were negatively related to prolonged grief. Our sample was small. Self-report measures of grief were not supplemented with clinical evaluation. Our results suggest that only character dimensions (high SD and ST, and low CO) are involved in the psychopathology of prolonged grief. Also, according to Cloninger's character cube (Cloninger, 2004), high SD and ST scores, and low CO scores are indicative of a fanatical character. Copyright © 2010 Elsevier B.V. All rights reserved.
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Nielsen, Mette Kjaergaard; Neergaard, Mette Asbjoern; Jensen, Anders Bonde; Vedsted, Peter; Bro, Flemming; Guldin, Mai-Britt
2017-12-01
Severe grief symptoms in family caregivers during end-of-life cancer trajectories are associated with complicated grief and depression after the loss. Nevertheless, severe grief symptoms during end-of-life caregiving in caregivers to cancer patients have been scarcely studied. We aimed to explore associations between severe preloss grief symptoms in caregivers and modifiable factors such as depressive symptoms, caregiver burden, preparedness for death, and end-of-life communication. We conducted a population-based prospective study of caregivers to 9512 patients registered with drug reimbursement due to terminal illness, and 3635 caregivers responded. Of these, 2865 caregivers to cancer patients completed a preloss grief scale (Prolonged Grief 13, preloss version). Associations with factors measured during end-of-life caregiving were analyzed using logistic regression. Severe preloss grief symptoms were reported by 432 caregivers (15.2%). These symptoms were associated with depressive symptoms (adjusted odds ratio [OR] = 12.4; 95% CI, 9.5-16.3), high caregiver burden (adjusted OR = 8.3; 95% CI, 6.3-11.1), low preparedness for death (adjusted OR = 3.3; 95% CI, 2.5-4.4), low level of communication about dying (adjusted OR = 3.2; 95% CI, 2.2-4.4), and "too much" prognostic information (adjusted OR = 2.8; 95%, 1.7-4.6). Severe preloss grief symptoms were significantly associated with distress, low preparedness, and little communication during caregiving. Thus, severe preloss grief symptoms may be a key indicator for complications in caregivers of cancer patients in an end-of-life trajectory. Targeted interventions are needed to support family caregivers with severe preloss grief symptoms. Development of preloss grief assessment tools and interventions should be a priority target in future research. Copyright © 2017 John Wiley & Sons, Ltd.
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Nielsen, Mette Kjaergaard; Neergaard, Mette Asbjoern; Jensen, Anders Bonde; Vedsted, Peter; Bro, Flemming; Guldin, Mai-Britt
2017-03-01
Complicated grief and depressive symptoms in bereaved caregivers have been associated with female gender, spousal relation, and preloss psychological distress, but population-based, prospective studies are scarce. We aimed to investigate whether severe preloss grief and depressive symptoms, caregiver burden, preparedness for death, communication about dying, and socioeconomic factors predicted complicated grief and postloss depressive symptoms. We conducted a population-based, prospective Danish survey of caregivers. Questionnaires for their closest caregiver were mailed to patients registered with drug reimbursement for terminal illness. Of the 3635 (38%) responding caregivers, 2420 were bereaved within six months. Of these, 2215 (88%) completed a postloss follow-up questionnaire. Associations between complicated grief (Prolonged Grief-13), postloss depressive symptoms (Beck Depression Inventory-II), and predictive factors were analyzed with mutually adjusted multivariable logistic regression models. At six-month follow-up, 7.6% reported complicated grief and 12.1% reported postloss depressive symptoms, whereas the levels of grief and depressive symptoms were higher preloss. Complicated grief and postloss depressive symptoms were predicted by severe preloss grief symptoms (adjusted odds ratio [OR] = 3.8, 95% CI: 2.4-6.1), preloss depressive symptoms (adjusted OR = 5.6, 95% CI: 3.5-9.0), being a partner (adjusted OR = 2.2, 95% CI: 1.2-3.7), and low educational level (adjusted OR = 2.0, 95% CI: 1.2-3.7). Complicated grief was not predicted by age and gender, whereas postloss depressive symptoms were predicted by young age, female gender, and low preparedness for death. Severe preloss grief and depressive symptoms were key predictors of postloss complicated grief and depressive symptoms. Systematic assessment may identify caregivers with a high risk profile who need targeted support. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Supiano, Katherine P; Andersen, Troy C; Haynes, Lara Burns
2015-01-01
Caring for a person with Alzheimer's disease is challenging and often has negative health and mental health effects that, for 7-20% of caregivers, persist into bereavement in the form of complicated grief. Complicated grief is a state of prolonged and ineffective mourning. An under-recognized phenomenon in dementia care and bereavement is "sudden-on-chronic death." In these situations, the caregiver is preparing for a gradual dying process from dementia, but the care recipient dies instead from a sudden death. In this study, an application of complicated grief group therapy for bereaved dementia caregivers with complicated grief is presented, and the effect of therapy with two bereaved caregivers who experienced the sudden death of their spouses who had a diagnosis of dementia is described. The unique treatment elements of complicated grief group therapy facilitated resolution of the 'trauma-like" features of bereavement and progression to a healthy grief process.
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Paun, Olimpia; Farran, Carol J.
2013-01-01
Research reveals that Alzheimer’s disease (AD) caregivers (CGs) do not relinquish their role after placing a family member in long-term care. Caregivers report increased emotional upset around the time of placement, with sustained losses over time leading to chronic grief. Chronic grief increases caregivers’ risk for depression and suicide. There are no documented interventions designed to decrease CGs chronic grief post placement. The Chronic Grief Management Intervention (CGMI) builds on existing evidence to target caregiver chronic grief in the transition of a family member into long-term care. The intervention is structured into three major components: 1) knowledge, 2) skill in communication and conflict resolution, and 3) chronic grief mangement skill. The 12-week intervention was pilot tested with thirty four caregivers for feasibility and preliminary effects on caregiver skill, knowledge, chronic grief, and depression. This article presents a general study description while focusing on the development and implementation of the CGMI. PMID:22084962
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Grief Experiences Among Female American and Arab Undergraduate College Students.
Varga, Mary Alice; McClam, Tricia M; Hassane, Sofoh
2015-01-01
The purpose of this study was to compare the incidence of grief among American and Arab female undergraduate students, the effects of their grief, and risk of prolonged grief disorder. A total of 471 female undergraduate students, 308 (65.4%) from the United Arab Emirates and 163 (34.6%) from the United States, completed a survey about their grief experiences. Students experiencing a significant loss also completed the Prolonged Grief Disorder Questionnaire. Findings revealed that overall approximately 38.4% (n = 181) of all 471 students experienced the loss of a significant person in their lives within the past 24 months; a similar percentage was found in each sub group. Students reported various grief effects with American students experiencing more effects related to sleep, relationships, academics, physical well-being, religion/spirituality, and outlook on life than Arab students. Only a small number (10, 5.52%) of students met the criteria for prolonged grief disorder; however, most students were female Arab students. Limitations of the study and recommendations for future research are provided.
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Ecological grief as a mental health response to climate change-related loss
NASA Astrophysics Data System (ADS)
Cunsolo, Ashlee; Ellis, Neville R.
2018-04-01
Climate change is increasingly understood to impact mental health through multiple pathways of risk, including intense feelings of grief as people suffer climate-related losses to valued species, ecosystems and landscapes. Despite growing research interest, ecologically driven grief, or `ecological grief', remains an underdeveloped area of inquiry. We argue that grief is a natural and legitimate response to ecological loss, and one that may become more common as climate impacts worsen. Drawing upon our own research in Northern Canada and the Australian Wheatbelt, combined with a synthesis of the literature, we offer future research directions for the study of ecological grief.
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Designing personal grief rituals: An analysis of symbolic objects and actions.
Sas, Corina; Coman, Alina
2016-10-01
Personal grief rituals are beneficial in dealing with complicated grief, but challenging to design, as they require symbolic objects and actions meeting clients' emotional needs. The authors reported interviews with 10 therapists with expertise in both grief therapy and grief rituals. Findings indicate three types of rituals supporting honoring, letting go, and self transformation, with the latter being particularly complex. Outcomes also point to a taxonomy of ritual objects for framing and remembering ritual experience, and for capturing and processing grief. Besides symbolic possessions, the authors identified other types of ritual objects including transformational and future-oriented ones. Symbolic actions include creative craft of ritual objects, respectful handling, disposal, and symbolic play. They conclude with theoretical implications of these findings, and a reflection on their value for tailored, creative co-design of grief rituals. In particular, several implications for designing grief rituals were identified that include accounting for the client's need, selecting (or creating) the most appropriate objects and actions from the identified types, integrating principles of both grief and art/drama therapy, exploring clients' affinity for the ancient elements as medium of disposal in letting go rituals, and the value of technology for recording and reflecting on ritual experience.
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Symptoms of prolonged grief and posttraumatic stress following loss: A latent class analysis.
Maccallum, Fiona; Bryant, Richard A
2018-04-01
Individuals vary in how they respond to bereavement. Those who experience poor bereavement outcomes often report symptoms from more than one diagnostic category. This study sought to identify groups of individuals who share similar patterns of prolonged grief disorder and posttraumatic stress disorder symptoms to determine whether these profiles are differentially related to negative appraisals thought to contribute to prolonged grief disorder and posttraumatic stress disorder symptomatology. Participants were 185 bereaved adults. Latent class analysis was used to identify subgroups of individuals who showed similar patterns of co-occurrence of prolonged grief disorder and posttraumatic stress disorder symptoms. Multinomial regression was used to examine the extent to which appraisal domains and sociodemographic and loss factors predicted class membership. Latent class analysis revealed three classes of participants: a low symptom group, a high prolonged grief disorder symptom group, and a high prolonged grief disorder and posttraumatic stress disorder symptom group. Membership of the prolonged grief disorder group and prolonged grief disorder and posttraumatic stress disorder group was predicted by higher mean negative self-related appraisals. Demographic and loss-related factors did not predict group membership. These findings have implications for understanding co-occurrence of prolonged grief disorder and posttraumatic stress disorder symptoms following bereavement. Findings are consistent with theoretical models highlighting the importance of negative self-related beliefs in prolonged grief disorder.
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The relationship between grief adjustment and continuing bonds for parents who have lost a child.
Ronen, Rama; Packman, Wendy; Field, Nigel P; Davies, Betty; Kramer, Robin; Long, Janet K
This article presents findings from a study on the impact of a child's death on parents. We explored the prominence and adaptiveness of parents' continuing bonds expressions, psychological adjustment, and grief reactions. A qualitative case study methodology was used to describe six cases. Participants were classified into two groups based on scores on the Inventory of Complicated Grief. Commonalities in themes on the Continuing Bonds Interview and projective drawings were assessed. Those in the Non-Complicated Grief Group reported internalization of positive qualities and identification with the deceased child as a role model, whereas participants in the Complicated Grief Group did not report these experiences. In addition, the drawings of those in the Non-Complicated Grief Group were evaluated as more adaptive than those in the Complicated Grief Group.
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Applicability of the pre-death grief concept to dementia family caregivers in Asia.
Liew, Tau Ming
2016-07-01
Pre-death grief is prevalent among dementia family caregivers. When unaddressed, it produces adverse outcomes. With its research primarily conducted in Caucasians, its applicability to non-Caucasians is uncertain. We explore the existence and the characteristics of pre-death grief in a multi-ethnic Asian population using an established pre-death grief scale-Marwit-Meuser Caregiver Grief Inventory (MM-CGI). Seventy-two dementia family caregivers were recruited from a tertiary hospital. Existence of pre-death grief was shown by its measurability on MM-CGI, together with good internal consistency reliability and construct validity. Characteristics of pre-death grief were explored through multivariate linear regression of MM-CGI and by comparing MM-CGI scores with those from the original US study using one-sample T-test. In the Asian context, pre-death grief was measurable in a reliable and valid manner. Risk factors of pre-death grief included caring for patients with severe dementia, spousal relationship and secondary or below education. Influence of culture was palpable-Asians had more worries and felt isolation, and certain ethnicity showed more pre-death grief. Pre-death grief is applicable even to the non-Caucasian population. It bears much similarity to that in Caucasians. Yet, its expression is modified by culture. Clinicians working with non-Caucasian populations need to be sensitive to its presence and to the influence of culture on its expression. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.
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Saban, Karen L; Mathews, Herbert L; Collins, Eileen G; Hogan, Nancy S; Tell, Dina; Bryant, Fred B; Pape, Theresa Louise Bender; Griffin, Joan M; Janusek, Linda Witek
2016-01-01
Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to the profound cognitive and personality changes associated with a traumatic brain injury (TBI) in a loved one. Grief associated with the death of a loved one is related to increases in proinflammatory cytokines, yet it is not clear whether this is the case for grief experienced by individuals caring for a significant other with TBI. The purpose of this cross-sectional, exploratory study was to examine grief and its association with a proinflammatory cytokine, tumor necrosis factor α (TNF-α), in wives/partners caring for veterans with TBI. Participants completed written measures of grief, perceived stress, and depressive symptoms and provided morning saliva samples for TNF-α analysis. Participants reported levels of grief comparable to those reported in studies evaluating individuals grieving the death of a loved one. Path analysis revealed that grief was not associated with TNF-α; however, participants reporting high levels of blame/anger, a subscale of the grief scale, had higher levels of TNF-α. In addition, both grief and blame/anger were related to increased perceived stress and depressive symptoms; however, path analysis demonstrated that perceived stress and depressive symptoms did not mediate the influence of blame/anger on TNF-α. These findings suggest that blame/anger associated with grief may be related to the elevations in TNF-α exhibited by individuals caring for a loved one with TBI. © The Author(s) 2015.
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Grief-related panic symptoms in Complicated Grief.
Bui, Eric; Horenstein, Arielle; Shah, Riva; Skritskaya, Natalia A; Mauro, Christine; Wang, Yuanjia; Duan, Naihua; Reynolds, Charles F; Zisook, Sidney; Shear, M Katherine; Simon, Naomi M
2015-01-01
Although Complicated Grief (CG) has been associated with comorbid Panic Disorder (PD), little is known about panic attacks in CG, and whether panic symptoms may be grief-related. The present study examines the presence and impact of grief-related panic symptoms in CG. Individuals with CG (n=146, 78% women, mean (SD) age=52.4(15.0)) were assessed for CG, DSM-IV diagnoses, work and social impairment, and with the Panic Disorder Severity Scale modified to assess symptoms "related to or triggered by reminders of your loss" and anticipatory worry. Overall, 39.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and 32.2% reported some level of anticipatory worry about grief-related panic. Of interest, 17% met DSM criteria for PD. Among those without PD, 34.7% reported at least one full or limited-symptom grief-related panic attack over the past week, and this was associated with higher CG symptom severity (t=-2.23, p<0.05), and functional impairment (t=-3.31, p<0.01). Among the full sample, controlling for CG symptom severity and current PD, the presence of at least one full or limited-symptom grief-related panic attack was independently associated with increased functional impairment (B(SE)=4.86(1.7), p<0.01). Limitations include a lack of assessment of non-grief-related panic symptoms and examination of a sample of individuals seeking treatment for CG. Grief-related panic symptoms may be prevalent among individuals with CG and independently contribute to distress and functional impairment. Copyright © 2014 Elsevier B.V. All rights reserved.
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Financial Perils in Higher Education--Good Grief!
ERIC Educational Resources Information Center
Shaw, Kenneth A.; Britton, Thomas C.
The premise that institutions pass through a grief process in adjusting to declining resources and radical changes, is proposed. In addition, strategies that administrators can use to respond to institutional grief are suggested. Elisabeth Kubler-Ross's paradigm of five grief stages/reactions to serious loss are described: denial, anger,…
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Latinos and Anglos: Cultural Experiences of Grief Intensity.
ERIC Educational Resources Information Center
Grabowski, Jo-Anne; Frantz, Thomas T.
1993-01-01
Examined grief intensity among 50 Latino and 50 Anglo Americans. Latinos grieving sudden death had significantly greater grief intensity than Latinos grieving expected death and Anglos grieving either sudden or expected death. Funeral attendance, time since death, closeness of relationships had no significant effect on grief intensity, nor did…
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Effectiveness of a Grief Intervention for Caregivers of People With Dementia.
MacCourt, Penny; McLennan, Marianne; Somers, Sandie; Krawczyk, Marian
2017-08-01
In this article, we report on the structure and effectiveness of a grief management coaching intervention with caregivers of individuals with dementia. The intervention was informed by Marwit and Meuser's Caregiver Grief Model and considered levels of grief, sense of empowerment, coping, and resilience using five methods of delivery. Results indicate that the intervention had significant positive effects on caregivers' levels of grief and increased their levels of empowerment, coping, and resilience. The intervention was found to be effective across caregivers' characteristics as well as across five delivery modalities. Through description of this intervention, as well as outcome, this research contributes to the body of knowledge about caregivers' disenfranchised grief and ways to effectively address it.
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Potential Use of Ayahuasca in Grief Therapy.
González, Débora; Carvalho, María; Cantillo, Jordi; Aixalá, Marc; Farré, Magí
2017-01-01
The death of a loved one is ultimately a universal experience. However, conventional interventions employed for people suffering with uncomplicated grief have gathered little empirical support. The present study aimed to explore the potential effects of ayahuasca on grief. We compared 30 people who had taken ayahuasca with 30 people who had attended peer-support groups, measuring level of grief and experiential avoidance. We also examined themes in participant responses to an open-ended question regarding their experiences with ayahuasca. The ayahuasca group presented a lower level of grief in the Present Feelings Scale of Texas Revised Inventory of Grief, showing benefits in some psychological and interpersonal dimensions. Qualitative responses described experiences of emotional release, biographical memories, and experiences of contact with the deceased. Additionally, some benefits were identified regarding the ayahuasca experiences. These results provide preliminary data about the potential of ayahuasca as a therapeutic tool in treatments for grief.
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Writing projects: lessening undergraduates' unique suicidal bereavement.
Kovac, S H; Range, L M
2000-01-01
To assess if writing projects lessen undergraduates' grief following a loved one's suicide, 40 students whose loved one died by suicide in the past 2 years wrote on four occasions over 2 weeks about profound topics (e.g., events and emotions surrounding the death) or trivial topics (e.g., description of the previous meal). All participants completed pre- and posttest measures of grief and self-reported health visits, and 75% completed the same measures at 6-week mailed follow-up. As expected, individuals in the profound condition reported less grief associated with suicide at follow-up than those in the trivial condition. However, the trivial and profound groups were not significantly different in general grief or health visits. Writing about grief associated with the suicide of a loved one appeared to reduce suicidal grief associated with this event. However, this benefit did not extend to general grief or physical health.
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Xu, Wei; Fu, Zhongfang; He, Li; Schoebi, Dominik; Wang, Jianping
2015-11-30
This study explored whether attachment moderated the relationship between grief and posttraumatic growth. A total of 240 Chinese adults who have lost a family member to cancer reported on their grief (Prolonged Grief Questionnaire-13; PG-13), posttraumatic growth (Posttraumatic Growth Inventory; PTGI) and attachment (Experiences in Close Relationships; ECR). The results suggested that bereaved individuals who scored high on attachment anxiety showed a substantial and positive relationship between grief and posttraumatic growth, while their less anxiously attached counterparts showed no such association. Attachment avoidance was not significantly related to the association between grief and posttraumatic growth. Findings indicated that individuals high in attachment anxiety have the potential to benefit and gain from the process of adapting to the loss. The implications of the results for relevant research and grief counseling were discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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NASA Astrophysics Data System (ADS)
Cicchetti, Richard Jude
The study examined whether 93 master's level rehabilitation counselor trainees from select Midwestern CORE-accredited schools report having been adequately trained to identify and work with clients who are having grief-related issues from a loss or disability. Using the Grief Counseling Competency Scale (GCCS), participants showed a wide range of scores regarding personal competency related to grief; however, scores tended to be low when examining skills and knowledge relating to grief, with most respondents scoring between "this barely describes me" and "this somewhat describes me." Although presence or history of a disability was found to be related to personal competency, a number of variables were not related, including: gender, age, race/ethnicity, course work in grief theories and grief interventions, practica/internship setting, and attitudes toward people with disabilities. Implications for further research are discussed.
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Attachment, loss, and complicated grief.
Shear, Katherine; Shair, Harry
2005-11-01
Bereavement is a highly disruptive experience that is usually followed by a painful but time-limited period of acute grief. An unfortunate minority of individuals experience prolonged and impairing complicated grief, an identifiable syndrome that differs from usual grief, major depression, and other DSM IV diagnostic entities. Underlying processes guiding symptoms are not well understood for either usual or complicated grief. We propose a provisional model of bereavement, guided by Myron Hofer's question "What exactly is lost when a loved one dies?" We integrate insights about biobehavioral regulation from Hofer's animal studies of infant separation, research on adult human attachment, and new ideas from bereavement research. In this model, death of an attachment figure produces a state of traumatic loss and symptoms of acute grief. These symptoms usually resolve following revision of the internalized representation of the deceased to incorporate the reality of the death. Failure to accomplish this integration results in the syndrome of complicated grief. Copyright 2005 Wiley Periodicals, Inc.
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Acts of Resistance: Breaking the Silence of Grief Following Traffic Crash Fatalities
ERIC Educational Resources Information Center
Breen, Lauren J.; O'Connor, Moira
2010-01-01
Theoretical arguments and empirical evidence demonstrate the limited utility of a narrow construction of "normal" grief. Sudden and violent death, the young age of the deceased, and perceptions of death preventability are associated with grief reactions that extend beyond an expected grief response. Interviews were conducted with 21…
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The Grief Response Following a Homicide.
ERIC Educational Resources Information Center
Poussaint, Alvin F.
Although grief reactions have been carefully examined, little information is available on the grief response following the murder of a loved one. Impressions of homicide survivors' grief reactions were obtained by the staff of a family support center who treated ten families that had experienced the loss of a family member by homicide.…
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Childhood Traumatic Grief Educational Materials for School Personnel
ERIC Educational Resources Information Center
National Child Traumatic Stress Network, 2004
2004-01-01
This guide to childhood traumatic grief for school personnel builds on the "In-Depth General Information Guide to Childhood Traumatic Grief" and the "Brief Information on Childhood Traumatic Grief" and should be read in conjunction with them. This guide for school personnel pays special attention to the reactions and symptoms school personnel…
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Tweeting Prayers and Communicating Grief over Michael Jackson Online
ERIC Educational Resources Information Center
Sanderson, Jimmy; Cheong, Pauline Hope
2010-01-01
Death and bereavement are human experiences that new media helps facilitate alongside creating new social grief practices that occur online. This study investigated how people's postings and tweets facilitated the communication of grief after pop music icon Michael Jackson died. Drawing on past grief research, religion, and new media studies, a…
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Grief Counseling Groups for Adolescents Based on Re-Membering Practices
ERIC Educational Resources Information Center
Granados, Stephanie; Winslade, John; De Witt, Megan; Hedtke, Lorraine
2009-01-01
Focusing on "re-membering" practices is new to grief counseling. Traditional approaches to grief counseling are guided by the concepts of stages or tasks, usually to move the person toward accepting the reality of loss and to "say goodbye" to their deceased loved one. This alternative approach to grief counseling, driven by…
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Selby, Susan; Moulding, Nicole; Clark, Sheila; Jones, Alison; Braunack-Mayer, Annette; Beilby, Justin
2009-01-01
Over 200 Australian, American, and British Non-Government Organizations send aid workers overseas including missionaries. On re-entry, they may suffer psychological distress; however, there is little research about their psychosocial issues and management in the family practice setting. Research suggests loss and grief as a suitable paradigm for family practitioners dealing with psychosocial issues. The aim of this study was to explore loss and grief issues for adult Australian missionary cross-cultural aid workers during their re-entry adjustment. Mixed methods were used and this study reports the qualitative method: semi-structured interviews conducted with 15 participants. Results were analyzed using framework analysis. Themes of re-entry loss and grief were identified with sub-themes of multiple varied losses, mechanisms of loss, loss of control, common grief phenomena, disenfranchised grief, and reactivation of past grief. Theoretical and clinical implications are discussed. Findings of this study suggest that loss and grief is an appropriate paradigm for the management of these workers in the family practice setting. Further research is needed to enable appropriate care.
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Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline
2013-12-01
Pregnancy termination for foetal abnormality (TFA) can have significant psychological repercussions, but little is known about the coping strategies involved in dealing with TFA. This study examined the relationships between women's coping strategies and perinatal grief. A total of 166 women completed a survey online. Coping and perinatal grief were measured using the Brief COPE and Short Perinatal Grief Scales. Data were analysed through multiple regression analyses. Despite using mostly adaptive coping strategies, women's levels of grief were high and varied according to obstetric and termination variables. Grief was predicted by behavioural disengagement, venting, planning, religion, self-blame, being recently bereaved, being childless at the time of TFA, not having had children/being pregnant since TFA and uncertainty about the decision to terminate the pregnancy. Acceptance and positive reframing negatively predicted grief. Identifying women vulnerable to poor psychological adjustment and promoting coping strategies associated with lower levels of grief may be beneficial. This could be addressed through information provision and interventions such as Cognitive Behavioural Therapy or Acceptance and Commitment Therapy. © 2013 John Wiley & Sons, Ltd.
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Holland, Jason M; Graves, Stacy; Klingspon, Kara L; Rozalski, Vincent
2016-01-01
Prolonged grief, a severe and chronic form of grieving most commonly studied in the context of bereavement, may have relevance to losses associated with chronic illness (e.g. grief related to loss of functioning or loss of a planned future). The purpose of the present study is to examine the unique associations between prolonged grief symptoms and service utilization patterns. An online self-report assessment battery was administered among a sample of 275 older adults with at least one chronic illness that caused significant physical impairment. Even after statistically controlling for relevant physical health (e.g. severity of physical limitations, somatic symptoms, number of chronic illnesses) and psychosocial variables (e.g. social support, depression/anxiety), more severe prolonged grief symptoms were associated with a greater number of emergency room visits, overnight stays in the hospital and total nights in the hospital. These findings highlight the importance of screening for prolonged grief symptomatology with older individuals with a debilitating chronic illness. Recent evidence suggests that prolonged grief may have relevance for losses associated with physical illness. The present study shows that prolonged grief reactions related to physical illness (e.g. grieving the loss of functioning) are uniquely associated with increased hospital-based service utilization. Given the relevance of prolonged grief reactions in this population, practitioners may wish to assess for these symptoms. Future clinical research should focus on developing interventions to target prolonged grief symptoms associated with these losses.
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Do Grief Self-Help Books Convey Contemporary Perspectives on Grieving?
ERIC Educational Resources Information Center
Dennis, Michael Robert
2012-01-01
Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of…
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Disciplinary Wounds: Has Grief Become the Identified Patient for a Field Gone Awry?
Granek, Leeat
2012-12-26
In the last few decades, grief and loss research in the psychological domain has focused almost exclusively on its dysfunctional nature. I examine what is underneath these questions about pathology and suggest that our discipline is suffering from an attachment wound where we have dissociated from our historical roots when it comes to the study of grief and loss. I argue that we need to ask new questions about grief and loss and present two examples of my collaborative work to illustrate innovative ways of thinking about and researching grief.
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Are shame and self-esteem risk factors in prolonged grief after death of a spouse?
Dellmann, Thomas
2018-07-01
Although many single factors of prolonged grief have been identified in the literature, a comprehensive understanding of predictors is still lacking. This article argues that shame and low self-esteem, present risk factors in prolonged grief after spousal loss, based on a review of correlational studies. Using a practitioner-scientist approach, a developmental model of shame as a core factor in prolonged grief is proposed, outlining the progression from childhood relational trauma, to insecure attachment, shame, self-esteem contingent on spousal approval to eventual prolonged grief.
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Furnes, Bodil; Dysvik, Elin
2010-01-01
Objective: Based on the present authors’ research and several approaches to grief related to loss by death and nonmalignant chronic pain, the paper suggests a new integrated theoretical framework for intervention in clinical settings. Methods: An open qualitative review of the literature on grief theories was performed searching for a new integrated approach in the phenomenological tradition. We then investigated the relationship between grief, loss and chronic nonmalignant pain, looking for main themes and connections and how these could be best understood in a more holistic manner. Results: Two main themes were formulated, “relearning the world” and “adaptation”. Between these themes a continuous movement emerged involving experience such as: “despair and hope”, “lack of understanding and insight”, “meaning disruption and increased meaning”, and “bodily discomfort and reintegrated body”. These were identified as paired subthemes. Conclusions: Grief as a distinctive experience means that health care must be aimed at each individual experience and situation. Grief experience and working with grief are considered in terms of relearning the world while walking backwards and living forwards, as described in our integrated model. We consider that this theoretical framework regarding grief should offer an integrated foundation for health care workers who are working with people experiencing grief caused by death or chronic pain. PMID:20622913
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ERIC Educational Resources Information Center
Lai, Beatrice P. Y.; Chung, Tony K. H.; Lee, Dominic T. S.; Kong, Grace W. S.; Lok, Ingrid H.
2013-01-01
Grief following miscarriage is a complex psychological response. This study was conducted to examine the psychometric properties of the Chinese version of the Perinatal Grief Scale (PGS). A total of 280 Chinese women completed the PGS immediately following a diagnosis of miscarriage (baseline) and were reassessed at 12 months follow-up. The factor…
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Albuquerque, Sara; Narciso, Isabel; Pereira, Marco
2018-01-01
This study aimed to examine forms of dyadic coping (DC) as mediators of the association between parents' grief response and dyadic adjustment and to determine whether these indirect effects were moderated by the child's type of death, timing of death, and age. The study design was cross-sectional. The sample consisted of 197 bereaved parents. Participants completed the Prolonged Grief Disorder Scale, Revised Dyadic Adjustment Scale, and Dyadic Coping Inventory. Significant indirect effects of parents' grief response on dyadic adjustment were found through stress communication by oneself and by the partner, positive and negative DC by the partner, and joint DC. The timing of death moderated the association between grief response and dyadic adjustment and between joint DC and dyadic adjustment. Grief response was negatively associated with dyadic adjustment only when the death occurred after birth. Grief response was negatively associated with joint DC, which, in turn, was positively associated with dyadic adjustment, when the death occurred both before and after birth. However, the association was stronger in the latter. Specific forms of DC might be mechanisms through which grief response is associated with dyadic adjustment and should be promoted in clinical practice.
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Depressive symptomatology and grief in Spanish women who have suffered a perinatal loss.
Ridaura, Isabel; Penelo, Eva; Raich, Rosa M
2017-02-01
Perinatal grief differs from other types of mourning. Two goals were set: to describe the progression of the process of grief and the symptoms of depression throughout the year following perinatal loss, and to study its association with socio-economic and obstetric factors. The study involved the participation of 70 women who had suffered a medical termination of pregnancy or a prenatal/postnatal death. Three assessments were made after the loss (after 1 month, 6 months and 1 year) with the Perinatal Grief Scale (PGS) to assess grief and the Beck Depression Inventory (BDI) for depressive symptomatology. Symptoms pertaining to grief and depression were observed in the first month after the loss, and a significant decrease in scores over the two follow-ups. No significant differences were observed in grief and depression depending on the type of loss, no significant associations were found with the age of the mother, her socioeconomic level, or obstetric factors (week of gestation of the loss, having a child or having suffered a previous miscarriage). Perinatal grief is a complex construct, with multiple variables involved, and one which involves significant emotional discomfort.
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Negotiating governance in virtual worlds: grief play, hacktivism, and LeakOps in Second Life®
NASA Astrophysics Data System (ADS)
Bakioğlu, Burcu S.
2012-12-01
The acts of transgression in cyberspace have grown in visibility with grief play and griefing in virtual worlds. Briefly defined, griefing is the intentional harassment of other players. This paper argues that in recent years, griefing has developed from a set of trolling practices that manifests itself as offensive language and tasteless pranks into political initiatives with hacktivist undertones. Because the tactical nature of role-playing and gaming provides the anonymity and the cunningness required for hacktivistic initiatives, griefing bears the potential to take part in the transgressive politics of civil disobedience. Arguing that grief play and griefing are tactical uses of media that lead to transgressive politics, this paper will examine the role of such activities in influencing virtual politics. In order to demonstrate how this transformation has occurred, this paper will discuss the birth of vigilante organizations, specifically, that of Justice League Unlimited (JLU), and the operation conducted against them by The Wrong Hands. The said operation, whose intention was to leak JLU's secret papers, Brainiac Wiki, exposed a grid-wide surveillance operation that the vigilante group was conducting in Second Life®.
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Managing Loss and Change: Grief Interventions for Dementia Caregivers in a CBT-Based Trial.
Meichsner, Franziska; Schinköthe, Denise; Wilz, Gabriele
2016-05-01
Dementia caregivers often experience loss and grief related to general caregiver burden, physical, and mental health problems. Through qualitative content analysis, this study analyzed intervention strategies applied by therapists in a randomized-controlled trial in Germany to assist caregivers in managing losses and associated emotions. Sequences from 61 therapy sessions that included interventions targeting grief, loss, and change were transcribed and analyzed. A category system was developed deductively, and the intercoder reliability was satisfactory. The identified grief intervention strategies were recognition and acceptance of loss and change,addressing future losses,normalization of grief, and redefinition of the relationship Therapists focused on identifying experienced losses, managing associated feelings, and fostering acceptance of these losses. A variety of cognitive-behavioral therapy-based techniques was applied with each strategy. The findings contribute to understanding how dementia caregivers can be supported in their experience of grief and facilitate the development of a manualized grief intervention. © The Author(s) 2015.
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Treatment of complicated grief.
Rosner, Rita; Pfoh, Gabriele; Kotoučová, Michaela
2011-01-01
Following the death of a loved one, a small group of grievers develop an abnormal grieving style, termed complicated or prolonged grief. In the effort to establish complicated grief as a disorder in DSM and ICD, several attempts have been made over the past two decades to establish symptom criteria for this form of grieving. Complicated grief is different from depression and PTSD yet often comorbid with other psychological disorders. Meta-analyses of grief interventions show small to medium effect sizes, with only few studies yielding large effect sizes. In this article, an integrative cognitive behavioral treatment manual for complicated grief disorder (CG-CBT) of 25 individual sessions is described. Three treatment phases, each entailing several treatment strategies, allow patients to stabilize, explore, and confront the most painful aspects of the loss, and finally to integrate and transform their grief. Core aspects are cognitive restructuring and confrontation. Special attention is given to practical exercises. This article includes the case report of a woman whose daughter committed suicide.
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Online survey as empathic bridging for the disenfranchised grief of pet loss.
Packman, Wendy; Carmack, Betty J; Katz, Rachel; Carlos, France; Field, Nigel P; Landers, Craig
2014-01-01
The current cross-cultural study investigated grief reactions of bereaved individuals following the death of a pet. We used qualitative methodology to compare, analyze, and report responses of U.S. and French Canadian participants to the last open-ended question on our online pet loss survey. We explored the degree to which our data illustrated pet loss as disenfranchised grief and asked whether there are differences and commonalities in the expression of grief between the two samples. Four major themes emerged: lack of validation and support; intensity of loss; nature of the human pet relationship; and continuing bonds. Findings confirm that, for both the U.S. and French Canadian participants, pet loss is often disenfranchised grief and there are ways to facilitate expressions of grief. Many participants wrote that the survey was therapeutic. Our survey allowed participants to express their grief in an anonymous, safe way by serving as empathic bridging and a willingness to help others.
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Burke, Laurie A; Clark, Karen A; Ali, Khatidja S; Gibson, Benjamin W; Smigelsky, Melissa A; Neimeyer, Robert A
2015-01-01
Anticipatory grief is the process associated with grieving the loss of loved ones in advance of their inevitable death. Because anticipatory grief has been associated with a variety of outcomes, risk factors for this condition deserve closer consideration. Fifty-seven family members of terminally ill, hospice-eligible veterans receiving palliative care services completed measures assessing psychosocial factors and conditions. Elevated anticipatory grief was found in families characterized by relational dependency, lower education, and poor grief-specific support, who also experienced discomfort with closeness and intimacy, neuroticism, spiritual crisis, and an inability to make sense of the loss. Thus, in this sample, anticipatory grief appears to be part of a cluster of factors and associated distress that call for early monitoring and possible intervention.
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Disciplinary Wounds: Has Grief Become the Identified Patient for a Field Gone Awry?
GRANEK, LEEAT
2014-01-01
In the last few decades, grief and loss research in the psychological domain has focused almost exclusively on its dysfunctional nature. I examine what is underneath these questions about pathology and suggest that our discipline is suffering from an attachment wound where we have dissociated from our historical roots when it comes to the study of grief and loss. I argue that we need to ask new questions about grief and loss and present two examples of my collaborative work to illustrate innovative ways of thinking about and researching grief. PMID:24976797
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Lin, Yeh-Jen; Lin, Chi Yun; Li, Yu-Chan
2014-01-01
In 2008, the Taiwan Association for Care and Counseling for Loss organized a workshop about Horticultural Therapy, conducted as a participatory action research (PAR). Nineteen grief caregivers participated. Specific goals were designed according to a survey of participant expectations and focus-group discussions. The workshop content included lectures and interactive activities. Results demonstrated that most participants displayed an increased awareness of personal loss and meaning in grief, indicating that horticulture and nature appreciation might relieve individual grief and stress. The report introduces the rationale, evolution, execution, and results of the program development.
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Do grief self-help books convey contemporary perspectives on grieving?
Dennis, Michael Robert
2012-01-01
Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of "moving on from," "letting go of" or "achieving closure from" them. This article tracks the evolution of thought pertaining to this shift and examines its relevance to grief self-help books that may offer Americans guidance in the ways of grieving.
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Tay, A K; Rees, S; Steel, Z; Liddell, B; Nickerson, A; Tam, N; Silove, D
2017-08-01
Grief symptoms and a sense of injustice may be interrelated responses amongst persons exposed to mass conflict and both reactions may contribute to post-traumatic stress disorder (PTSD) symptoms. As yet, however, there is a dearth of data examining these relationships. Our study examined the contributions of grief and a sense of injustice to a model of PTSD symptoms that included the established determinants of trauma events, ongoing adversity and severe psychological distress. The study involved a large population sample (n = 2964, response rate: 82.4%) surveyed in post-conflict Timor-Leste. The survey sites included an urban administrative area (suco) in Dili, the capital of Timor-Leste and a rural village located an hour's drive away. Culturally adapted measures were applied to assess conflict related traumatic events (TEs), ongoing adversity, persisting preoccupations with injustice, symptoms of grief, psychological distress (including depressive symptoms) and PTSD symptoms. We tested a series of structural equation models, the final comprehensive model, which included indices of grief symptoms and injustice, producing a good fit. Locating grief symptoms as the endpoint of the model produced a non-converging model. In the final model, strong associations were evident between grief and injustice (β = 0.34, s.e. = 0.02, p < 0.01) and grief and PTSD symptoms (β = 0.14, s.e. = 0.02, p < 0.01). The sense of injustice exerted a considerable effect on PTSD symptoms (β = 0.13, s.e. = 0.03, p < 0.01). In addition, multiple indirect paths were evident, most involving grief and a sense of injustice, attesting to the complex inter-relationship of these factors in contributing to PTSD symptoms. Our findings support an expanded model of PTSD symptoms relevant to post-conflict populations, in which grief symptoms and a sense of injustice play pivotal roles. The model supports the importance of a focus on loss, grief and a sense of injustice in conducting trauma-focused psychotherapies for PTSD amongst populations exposed to mass conflict and violence. Further research is needed to identify the precise mechanisms whereby grief symptoms and the sense of injustice impact on PTSD symptoms.
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Distinguishing grief from depression during acute recovery from spinal cord injury.
Klyce, Daniel W; Bombardier, Charles H; Davis, Trevor J; Hartoonian, Narineh; Hoffman, Jeanne M; Fann, Jesse R; Kalpakjian, Claire Z
2015-08-01
To examine whether grief is a psychometrically sound construct that is distinct from depression in individuals who have recently sustained a spinal cord injury (SCI). Cross-sectional survey. Inpatient rehabilitation units at 3 geographically diverse, university-affiliated medical centers. Patients with SCI (N=206) were recruited (163 men [79.1%]). Most patients were non-Hispanic whites (n=175 [85.0%]). Most patients sustained a cervical SCI (n=134 [64.4%]). Various injury etiologies were represented, with the majority being accounted for by falls (n=72 [31.5%]) and vehicle-related accidents (n=69 [33.5%]). The mean time since injury was 53.5±40.5 days. Not applicable. An adapted version of the 12-item structured clinical interview for Prolonged Grief Disorder was used to assess symptoms of grief, and the Patient Health Questionnaire-9 was used to measure depression. Demographic and injury-related data were also collected. A principal component analysis (with direct oblimin rotation) of the grief measure suggested a 2-component solution. The content of items loading on the separate components suggested 2 subscales: loss (6 items; Cronbach α=.810) and trauma (6 items; Cronbach α=.823). Follow-up principal component analyses including both grief and depression measures suggested clear differentiation of grief-related loss from depression. The prevalence of clinically significant levels of grief was low (6%), and levels of depression were consistent with previous findings related to inpatient rehabilitation (23.5%). The items used to assess grief symptoms in patients participating in inpatient rehabilitation for recently sustained SCI appear to capture a psychometrically reliable construct that is distinct from that of depression. Research is needed on the predictive validity of early grief symptoms after SCI and the relation of grief to other psychological constructs over time. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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Hirooka, Kayo; Fukahori, Hiroki; Ozawa, Miwa; Akita, Yumi
2017-04-01
The aim of this study was to examine three hypotheses: (1) adolescents who had experienced the death of a parent would report higher grief reactions than those who had lost a grandparent; (2) adolescents who experienced the death of a parent would report higher posttraumatic growth than those who had lost a grandparent; and (3) posttraumatic growth and grief reactions are positively associated. To date, no study has investigated adolescents' posttraumatic growth by their relationship with the deceased. Cross-sectional web-based survey. Participants were adolescents who had experienced the death of a parent or grandparent in the last 5 years. Participants completed the Japanese version of the Posttraumatic Growth Inventory and grief reaction items. We conducted a web-based survey during January 2014. We used Pearson product-moment correlations to examine the association between each Posttraumatic Growth Inventory domain and each grief reaction item. Differences in the relationship with the deceased for each Posttraumatic Growth Inventory and grief reaction item were compared with an independent-sample t-test. Participants (n = 124) reported grief reactions including 'I began to get frustrated at the little things' (43·5%), 'It was difficult to go to school' (41·1%) and 'I was not able to sleep at night' (33·9%). The independent t-test indicated that parentally bereaved adolescents reported higher posttraumatic growth and grief reactions than those who had lost a grandparent. Pearson's bivariate analysis showed an association between grief reactions and posttraumatic growth. Parentally bereaved adolescents reported higher posttraumatic growth and grief reactions. Nurses should ensure bereaved adolescents receive appropriate support. © 2016 John Wiley & Sons Ltd.
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Grief interventions for people bereaved by suicide: A systematic review.
Linde, Katja; Treml, Julia; Steinig, Jana; Nagl, Michaela; Kersting, Anette
2017-01-01
Adaption to the loss of a loved one due to suicide can be complicated by feelings of guilt, shame, responsibility, rejection, and stigmatization. Therefore people bereaved by suicide have an increased risk for developing complicated grief which is related to negative physical and mental disorders and an increased risk for suicidal behavior. Grief interventions are needed for this vulnerable population. The aim of this systematic review was to provide an overview of the current state of evidence concerning the effectiveness of interventions that focus on grief for people bereaved by suicide. We conducted a systematic literature search using PubMed, Web of Science, and PsycINFO for articles published up until November 2016. Relevant papers were identified and methodological quality was assessed by independent raters. A narrative synthesis was conducted. Seven intervention studies met the inclusion criteria. Two interventions were based on cognitive-behavioral approaches, four consisted of bereavement groups, and one utilized writing therapy. As five of the seven interventions were effective in reducing grief intensity on at least one outcome measure, there is some evidence that they are beneficial. Bereavement groups tend to be effective in lowering the intensity of uncomplicated grief, as are writing interventions in lowering suicide-specific aspects of grief. Cognitive-behavioral programs were helpful for a subpopulation of people who had high levels of suicidal ideation. On average, methodological quality was low so the evidence for benefits is not robust. The stability of treatment effects could not be determined as follow-up assessments are rare. Generalizability is limited due to homogeneous enrollments of mainly female, white, middle-aged individuals. People bereaved by suicide are especially vulnerable to developing complicated grief. Therefore, grief therapies should be adapted to and evaluated in this population. Prevention of complicated grief may be successful in populations of high risk individuals.
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Tsai, Wei-I; Prigerson, Holly G; Li, Chung-Yi; Chou, Wen-Chi; Kuo, Su-Ching; Tang, Siew Tzuh
2016-05-01
A significant minority of bereaved caregivers experience prolonged grief. However, few longitudinal studies have examined prolonged grief, especially in an Asian context. We explored longitudinal changes and factors predicting prolonged grief in bereaved caregivers of terminally ill Taiwanese cancer patients. Observational, prospective, and longitudinal. Prolonged grief symptoms were measured with the PG-13 at 6, 13, 18, and 24 months postloss. A convenience sample of 493 caregivers (83.3% participation rate) of terminally ill cancer patients was recruited from a medical center in Taiwan. The prevalence of prolonged grief decreased significantly over time from the patient's death (7.73%, 1.80%, 2.49%, and 1.85% at 6, 13, 18, and 24 months postloss, respectively, p < 0.05 at all times in reference to 6 months postloss). Caregivers' likelihood of prolonged grief was significantly higher if they had severe preloss depressive symptoms, negatively perceived their relative's dying situation, and were poorly prepared for the patient's death. However, the likelihood of prolonged grief decreased significantly with greater perceived concurrent social support and subjective caregiving burden right before the patient's death. Prolonged grief in bereavement diminished over time and was predicted by modifiable factors before, during, and after bereavement. To facilitate bereavement adjustment and avoid prolonged grief, healthcare professionals should develop and provide at-risk caregivers with effective interventions starting when patients are still alive to improve their dying experience, to facilitate preparedness for the patient's forthcoming death, to alleviate caregivers' preloss depressive symptoms, and to enhance their perceived postloss social support. © The Author(s) 2015.
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Gray, Jennifer A; Abendroth, Maryann
2016-09-01
The study explored the grief process of persons with intellectual and developmental disabilities (PWIDDs) as perceived by direct care workers (DCWs) and how such workers can guide and support PWIDDs experiencing grief. A thematic analysis approach was used to examine data from nine focus groups with 60 DCWs from five community-based organizations. Findings were supported in the context of seminal grief and bereavement theories. Three themes (i.e. reactions to loss, processing the loss and incorporating the loss) and related subthemes emerged from the data. PWIDDs are susceptible to traumatic grief, and DCWs are often key witnesses to such experiences. DCWs' perspectives can guide the development of grief and bereavement training which can lead to more tailored support systems. © 2015 John Wiley & Sons Ltd.
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1984-04-01
conclusions expressed in this document are those of the author. They are not intended and should not be thought to represent official ideas, attitudes ...death of someone very v close is called grief and that is the subject of this handbook. : Webster defines grief as "an intense emotional suffering... emotions of -: , soneone experiencing intense grief. Nor does this definition help a ’°. friend trying to comfort or understand a bereaved individual
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ERIC Educational Resources Information Center
Parker, Judith A.
Although a world of uncertainty and continual change is difficult to explain to children, by exploring and discussing the process of grief, parents can begin to understand the significance and necessity of the grief process and help their children to cope with difficult events. This booklet offers parents advice on how to talk with children about…
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They still grieve-a nationwide follow-up of young adults 2-9 years after losing a sibling to cancer.
Sveen, Josefin; Eilegård, Alexandra; Steineck, Gunnar; Kreicbergs, Ulrika
2014-06-01
The aims of this study were to assess the prevalence of unresolved grief in bereaved young adult siblings and examine possible contributing factors. The study was a Swedish population-based study of young adults who had lost a brother or sister to cancer, 2-9 years earlier. Of 240 eligible siblings, 174 (73%) completed a study-specific questionnaire. This study focused on whether the respondents had worked through their grief over the sibling's death and to what extent. A majority (54%) of siblings stated that they had worked through their grief either 'not at all' or 'to some extent' at the time of investigation. In multiple regression analyses with unresolved grief as the dependent variable, 21% of the variance was explained by lack of social support and shorter time since loss. The majority of bereaved young adults had not worked through their grief over the sibling's death. A small group of siblings reported that they had not worked through their grief at all, which may be an indicator of prolonged grief. Lack of social support and more recent loss were associated with not having worked through the grief over the sibling's death. Copyright © 2013 John Wiley & Sons, Ltd.
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Predictors of owner response to companion animal death in 177 clients from 14 practices in Ontario.
Adams, C L; Bonnett, B N; Meek, A H
2000-11-01
To identify predictors of grief and client desires and needs as they relate to pet death. Cross-sectional mail survey. 177 clients, from 14 randomly selected veterinary practices, whose cat or dog died between 6 and 43 days prior to returning the completed questionnaire. Veterinary practices were contacted weekly to obtain the names of clients whose pets had died until approximately 200 clients were identified. Clients were contacted by telephone, and a questionnaire designed to measure grief associated with pet death was mailed to those willing to participate within 1 to 14 days of their pet's death. The questionnaire measured potential correlates and modifiers of grief and included three outcome measures: social/emotional and physical consequences, thought processes, and despair. Demographic data were also collected. Approximately 30% of participants experienced severe grief. The most prominent risk factors for grief included level of attachment, euthanasia, societal attitudes toward pet death, and professional support from the veterinary team. Bivariate and multivariate analyses highlighted the impact owners' attitudes about euthanasia and professional intervention by the veterinary team had on reactions to pet death. Owners' perceptions of societal attitudes, also a predictor of grief, indicate that grief for pets is different than grief associated with other losses.
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Death of an Ex-Spouse: Lessons in Family Communication about Disenfranchised Grief
Tullis, Jillian A.
2017-01-01
The death of a loved one is an emotional-laden experience, and while grief and mourning rituals are less formal today in many communities, there remain some social norms for individuals to process loss. The death of an ex-family member, such as a former spouse, is more complicated and expectations for how to respond are fraught with uncertainty. While grief has been studied and is primarily understood as an individual cognitive process, scholars in sociology and communication are considering the ways in which grief and mourning are social and take place in dialogue with others. This manuscript explores Kenneth Doka’s concept of disenfranchised grief, which is “grief that is experienced when loss cannot be openly acknowledged, socially sanctioned, or publicly mourned” through the author’s experience of the death of her ex-husband. The narrative will recount how the author learned about her ex-husband’s death (via text message), and will challenge definitions of family and family communication about death and grief, particularly the communication strategies used to cope with this unique type of loss. PMID:28338631
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COMPLICATED GRIEF AND RELATED BEREAVEMENT ISSUES FOR DSM-5
Shear, M. Katherine; Simon, Naomi; Wall, Melanie; Zisook, Sidney; Neimeyer, Robert; Duan, Naihua; Reynolds, Charles; Lebowitz, Barry; Sung, Sharon; Ghesquiere, Angela; Gorscak, Bonnie; Clayton, Paula; Ito, Masaya; Nakajima, Satomi; Konishi, Takako; Melhem, Nadine; Meert, Kathleen; Schiff, Miriam; O’Connor, Mary-Frances; First, Michael; Sareen, Jitender; Bolton, James; Skritskaya, Natalia; Mancini, Anthony D.; Keshaviah, Aparna
2010-01-01
Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This paper focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders. PMID:21284063
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Grief and Healing in Young and Middle Age: A Widower's Journey.
Lichtenberg, Peter A
2017-02-01
The experience of grief is both uniquely personal and universal. Our personality, our relationship with the deceased, the manner in which the deceased died, our life stage, and many other contextual factors matter and impact grief, and yet there are many experiences, phases, stages of grief that are universal. Those who are grieving deeply or who are farther along in their healing are often trying to understand grief and its realities. It has been said that people die but relationships do not. As a widower twice, once at age 25 and then again nearly 30 years later, I agree with that sentiment, and it is the profound relationships with my wives Becky and Susan that propelled me to share my experiences and reflections on grief and healing. As a clinical psychologist and gerontologist I examined the grief and gerontology literature, learning new things that were useful and not as useful. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Surrogate End-of-Life Care Decision Makers' Postbereavement Grief and Guilt Responses.
Lovell, Geoff P; Smith, Trish; Kannis-Dymand, Lee
2015-01-01
This article examined differences in familial/friend surrogate decision makers' (N = 93) postbereavement grief and guilt associated with decisions to either prioritize comfort or longevity in determining end-of-life care for decisionally incapacitated adult palliative loved ones. Results demonstrated that participants prioritizing the longevity of loved ones experienced significantly and meaningfully higher levels of grief, complicated grief, and trauma related guilt than those who prioritized comfort.
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Grief as a social emotion: theoretical perspectives.
Jakoby, Nina R
2012-09-01
The article explores a sociological perspective on grief as a social emotion. Focusing on the social bond with the deceased, the self-concept of the survivor or the power of feeling rules, general sociological theories of emotions (symbolic interactionism, structural theory, behavioral theory) have the potential to deepen the understanding of grief as a social emotion. The article concludes by presenting a cognitive-structural model of grief that integrates the different theoretical elements.
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Druguet, Mònica; Nuño, Laura; Rodó, Carlota; Arévalo, Silvia; Carreras Moratonas, Elena; Gómez-Benito, Juana
2017-11-02
The aim of this study is to analyze whether the absence of farewell rituals and previous psychological vulnerability are associated with the intensity of grief following perinatal loss in monochorionic twin pregnancy. The sample comprised 28 women who experienced perinatal loss following fetal surgery. Sociodemographic and clinical data and information about farewell rituals were collected through interview. The women also completed a questionnaire about perinatal grief. A history of psychological and/or psychopharmacological treatment was associated with more intense grief following perinatal loss. Women with a history of psychological difficulties are particularly vulnerable to a complicated grief reaction after experiencing perinatal loss. However, the intensity of grief did not differ significantly according to whether or not the women performed some kind of farewell ritual. Further studies are needed to investigate these relationships and to encourage and facilitate the development of specific interventions for this population.
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Grief and mourning gone awry: pathway and course of complicated grief.
Shear, M Katherine
2012-06-01
Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. People with this condition are caught up in rumination about the circumstances of the death, worry about its consequences, or excessive avoidance of reminders of the loss. Unable to comprehend the finality and consequences of the loss, they resort to excessive avoidance of reminders of the loss as they are tossed helplessly on waves of intense emotion. People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. This paper provides a framework to help clinicans understand bereavement, grief, and mourning. Evidence-based diagnostic criteria are provided to help clinicians recognize complicated grief, and differentiate it from depression as well as anxiety disorder. We provide an overview of risk factors and basic assumptions and principles that can guide treatment.
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Grief and mourning gone awry: pathway and course of complicated grief
Shear, M. Katherine
2012-01-01
Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. People with this condition are caught up in rumination about the circumstances of the death, worry about its consequences, or excessive avoidance of reminders of the loss. Unable to comprehend the finality and consequences of the loss, they resort to excessive avoidance of reminders of the loss as they are tossed helplessly on waves of intense emotion. People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. This paper provides a framework to help clinicans understand bereavement, grief, and mourning. Evidence-based diagnostic criteria are provided to help clinicians recognize complicated grief, and differentiate it from depression as well as anxiety disorder. We provide an overview of risk factors and basic assumptions and principles that can guide treatment. PMID:22754284
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Caregiver grief in terminal illness and bereavement: a mixed-methods study.
Waldrop, Deborah P
2007-08-01
Caregivers experience multiple losses during the downhill trajectory of a loved one's terminal illness. Using mixed methods, this two-stage study explored caregiver grief during a terminal illness and after the care recipient's death. Caregiver grief was a state of heightened responsiveness during end-stage care: anxiety, hostility, depression, and trouble concentrating, remembering, and getting things done. Following the death, caregiver grief became a state of sustained reactivity: Overall distress was diminished and anxiety and hostility decreased significantly, but loneliness, sadness, and tears increased. Overwhelming responses were triggered by unforeseen visual or auditory reminders of the person. Sleep disturbances began during end-stage care and continued after the death. At both times, caregiver grief was highly influenced by the social context; relationships with family and friends (more cohesive versus conflicted) shaped responses. Social work practitioners can help caregivers who may be unaware they are experiencing grief to identify and integrate these normal responses to loss.
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Van Humbeeck, Liesbeth; Dillen, Let; Piers, Ruth; Van Den Noortgate, Nele
2016-12-01
The aim of this study was to explore how nurses and care-assistants (nursing staff) working in six Flemish nursing homes experience and describe their involvement in grief care. Although grief in older people is widely described in literature, less is known about how nursing staff in nursing homes offer and perceive grief care. A qualitative research design with elements of constructivist grounded theory was used. Loosely structured face-to-face interviews were done with fourteen nurses and care-assistants. Data were collected from October 2013-March 2014. Interview transcripts were analysed using the Qualitative Analysis Guide of Leuven (QUAGOL) method with support of NVivo 10. Grief care in nursing homes is characterized by a complex tension between two care dimensions: (1) being involved while keeping an appropriate distance; and (2) being while doing. Nursing staff described key enablers and influencing factors for grief care at the level of both the individual and the organizational context. Findings suggest an established personal sensitivity for grief care considered from the nursing staff points of view. Nevertheless, a common denominator was the necessity to further develop a supportive and multidisciplinary grief care policy ingrained in the existing care culture. Suggested components of this grief care policy are: (a) centring attention on non-death-related loss and the cumulative nature of loss in residents; (b) building capacity by means of reflective practices; and (c) the importance of self-care strategies for nursing staff. Furthermore, the findings from this study point towards a need for education and training. © 2016 John Wiley & Sons Ltd.
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Rosner, Rita; Pfoh, Gabriele; Kotoučová, Michaela; Hagl, Maria
2014-01-01
Abnormal forms of grief, currently referred to as complicated grief or prolonged grief disorder, have been discussed extensively in recent years. While the diagnostic criteria are still debated, there is no doubt that prolonged grief is disabling and may require treatment. To date, few interventions have demonstrated efficacy. We investigated whether outpatients suffering from prolonged grief disorder (PGD) benefit from a newly developed integrative cognitive behavioural therapy for prolonged grief (PG-CBT). A total of 51 patients were randomized into two groups, stratified by the type of death and their relationship to the deceased; 24 patients composed the treatment group and 27 patients composed the wait list control group (WG). Treatment consisted of 20-25 sessions. Main outcome was change in grief severity; secondary outcomes were reductions in general psychological distress and in comorbidity. Patients on average had 2.5 comorbid diagnoses in addition to PGD. Between group effect sizes were large for the improvement of grief symptoms in treatment completers (Cohen׳s d=1.61) and in the intent-to-treat analysis (d=1.32). Comorbid depressive symptoms also improved in PG-CBT compared to WG. The completion rate was 79% in PG-CBT and 89% in WG. The major limitations of this study were a small sample size and that PG-CBT took longer than the waiting time. PG-CBT was found to be effective with an acceptable dropout rate. Given the number of bereaved people who suffer from PGD, the results are of high clinical relevance. Copyright © 2014 Elsevier B.V. All rights reserved.
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Grief, Bereavement, and Coping With Loss (PDQ®)—Patient Version
Grief, bereavement (mourning), and coping with loss are common challenges following the loss of a loved one from cancer. Learn about coping and the grief process in adults and children in this expert-reviewed information summary.
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Childhood experiences and complicated grief: a study of adult children of alcoholics.
Brabant, S; Martof, M
1993-09-01
For the most part, grief research concentrates on type of loss (e.g., loss of spouse, parent, or child) and/or type of death (e.g., expected or sudden). In contrast, the present paper focuses on a category of persons generally assumed to have had troubled childhoods, adult children of alcoholics (ACOAs). Because of assumed problematic histories, the grief process of ACOAs should be expected to differ from the grief process of non-ACOAs. Using both quantitative and qualitative techniques, 27 ACOAs and 20 non-ACOAs, recruited by newspaper, radio, and word-of-mouth, are compared across characteristics generally associated with ACOAs and/or unresolved grief. Implications for counseling are presented.
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Hilliard, Russell E
2007-01-01
This study evaluated and compared the effects of Orff-based music therapy, social work, and wait-list control groups on behavioral problems and grief symptoms of bereaved school-aged children. Social work and music therapy sessions were provided weekly for one hour over an eight-week period. Participants (N = 26) attended three different public elementary schools, and each school was randomly assigned to one of the conditions. Pre and posttest measures consisted of the Behavior Rating Index for Children (BRIC) and the Bereavement Group Questionnaire for Parents and Guardians (BP). The BRIC measured behavioral distress and the BP measured grief symptoms prior to and following participation in the assigned conditions. Statistical analyses indicated that participants in the music therapy group significantly improved in the behaviors and grief symptoms, and those in the social work group experienced a significant reduction in their behavioral problems but not their grief symptoms. Participants in the wait-list control group made no significant improvements in either their grief symptoms or behavioral problems. A reduction in behavioral distress as measured by the BRIC and a reduction in grief symptoms as measured by the BP is the most desired outcome. This study supports the use of Orff-based music therapy interventions for bereaved children in a school-based grief program. Recommendations for future research are included.
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Grief, Bereavement, and Coping With Loss (PDQ®)—Health Professional Version
Grief, bereavement, and coping with loss are common issues in cancer survivors, their loved ones, and caregivers. Get detailed information about grief and bereavement in adults and children and psychosocial and pharmacologic treatment in this clinician summary.
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Grief reactions of couples to perinatal loss: A one-year prospective follow-up.
Tseng, Ying-Fen; Cheng, Hsiu-Rong; Chen, Yu-Ping; Yang, Shu-Fei; Cheng, Pi-Tzu
2017-12-01
To explore couples' perceptions of the effects of perinatal loss on their marital relationship, social support and grief 1 year postloss, and analyse what factors changed the severity of their grief. Perinatal losses are traumatic events in the lives of families and can have serious long-term consequences for the psychological health of parents and any subsequent children. A prospective follow-up study. We recruited, at a teaching hospital in southern Taiwan, a convenience sample of 30 couples whose babies either miscarried or were stillborn. At 1 month (T1), 3 months (T2), 6 months (T3) and 1 year (T4) after the pregnancy loss, all participants completed four questionnaires. To analyse the changing status of their grief and its related factors, we used a generalised estimating equation (GEE) to account for correlations between repeated observations. Postbereavement grief levels fell over the four time-points. Mothers reported feeling more grief than did the fathers. Couples with a history of infertility, no religious beliefs or no living children before the loss felt more grief from a perinatal miscarriage or stillbirth. Furthermore, couples reported more grief if their marital satisfaction level was low, if their socioemotional support from husband's parents was low or if they had never participated in a ritual for their deceased baby. Six months postloss is the crucial period for bereaved parents after a perinatal loss. Being a mother, having no previous living children and low-level socioemotional support from the husband's parents are significant high-risk factors for a high level of grief 1 year after perinatal death. We recommend that health professionals increase their ability to identify the factors that psychologically affect postloss grief. Active postloss follow-up programmes should focus on these factors to offer specific support and counselling. © 2017 John Wiley & Sons Ltd.
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Grief interventions for people bereaved by suicide: A systematic review
Steinig, Jana; Nagl, Michaela; Kersting, Anette
2017-01-01
Background Adaption to the loss of a loved one due to suicide can be complicated by feelings of guilt, shame, responsibility, rejection, and stigmatization. Therefore people bereaved by suicide have an increased risk for developing complicated grief which is related to negative physical and mental disorders and an increased risk for suicidal behavior. Grief interventions are needed for this vulnerable population. The aim of this systematic review was to provide an overview of the current state of evidence concerning the effectiveness of interventions that focus on grief for people bereaved by suicide. Methods We conducted a systematic literature search using PubMed, Web of Science, and PsycINFO for articles published up until November 2016. Relevant papers were identified and methodological quality was assessed by independent raters. A narrative synthesis was conducted. Results Seven intervention studies met the inclusion criteria. Two interventions were based on cognitive-behavioral approaches, four consisted of bereavement groups, and one utilized writing therapy. As five of the seven interventions were effective in reducing grief intensity on at least one outcome measure, there is some evidence that they are beneficial. Bereavement groups tend to be effective in lowering the intensity of uncomplicated grief, as are writing interventions in lowering suicide-specific aspects of grief. Cognitive-behavioral programs were helpful for a subpopulation of people who had high levels of suicidal ideation. Limitation On average, methodological quality was low so the evidence for benefits is not robust. The stability of treatment effects could not be determined as follow-up assessments are rare. Generalizability is limited due to homogeneous enrollments of mainly female, white, middle-aged individuals. Conclusions People bereaved by suicide are especially vulnerable to developing complicated grief. Therefore, grief therapies should be adapted to and evaluated in this population. Prevention of complicated grief may be successful in populations of high risk individuals. PMID:28644859
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Languages of Grief: a model for understanding the expressions of the bereaved
Corless, Inge B.; Limbo, Rana; Bousso, Regina Szylit; Wrenn, Robert L.; Head, David; Lickiss, Norelle; Wass, Hannelore
2014-01-01
The aim of this work is to provide an overview of the key features of the expressions of grief. Grief is a response to loss or anticipated loss. Although universal, its oral and nonverbal expression varies across cultures and individuals. Loss is produced by an event perceived to be negative to varying degrees by the individuals involved and has the potential to trigger long-term changes in a person's cognitions and relationships. The languages used by the bereaved to express grief differ from the language used by professionals, creating dissonance between the two. Data were obtained from English language Medline and CINAHL databases, from professional and personal experiences, interviews with experts, and exploration of cemetery memorials. Blog websites and social networks provided additional materials for further refinement of the model. Content analysis of the materials and agreement by the authors as to the themes resulted in the development of the model. To bridge the gap between professional language and that used by the bereaved, a Languages of Grief model was developed consisting of four Modes of Expression, four Types of Language, plus three Contingent Factors. The Languages of Grief provides a framework for comprehending the grief of the individual, contributing to clinical understanding, and fruitful exploration by professionals in better understanding the use of languages by the bereaved. Attention to the Modes of Expression, Types of Language, and Contingent Factors provides the professional with a richer understanding of the grieving individual, a step in providing appropriate support to the bereaved. The Languages of Grief provides a framework for application to discrete occurrences with the goal of understanding grief from the perspective of the bereaved. PMID:25750773
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Predicting grief intensity after recent perinatal loss.
Hutti, Marianne H; Myers, John; Hall, Lynne A; Polivka, Barbara J; White, Susan; Hill, Janice; Kloenne, Elizabeth; Hayden, Jaclyn; Grisanti, Meredith McGrew
2017-10-01
The Perinatal Grief Intensity Scale (PGIS) was developed for clinical use to identify and predict intense grief and need for follow-up after perinatal loss. This study evaluates the validity of the PGIS via its ability to predict future intense grief based on a PGIS score obtained early after a loss. A prospective observational study was conducted with 103 international, English-speaking women recruited at hospital discharge or via the internet who experienced a miscarriage, stillbirth, or neonatal death within the previous 8weeks. Survey data were collected at baseline using the PGIS and the Perinatal Grief Scale (PGS). Follow-up data on the PGS were obtained 3months later. Data analysis included descriptive statistics, Cronbach's alpha, receiver operating characteristic curve analysis, and confirmatory factor analysis. Cronbach's alphas were ≥0.70 for both instruments. PGIS factor analysis yielded three factors as predicted, explaining 57.7% of the variance. The optimal cutoff identified for the PGIS was 3.535. No difference was found when the ability of the PGIS to identify intense grief was compared to the PGS (p=0.754). The PGIS was not inferior to the PGS (AUC=0.78, 95% CI 0.68-0.88, p<0.001) in predicting intense grief at the follow-up. A PGIS score≥3.53 at baseline was associated with increased grief intensity at Time 2 (PGS: OR=1.97, 95% CI 1.59-2.34, p<0.001). The PGIS is comparable to the PGS, has a lower response burden, and can reliably and validly predict women who may experience future intense grief associated with perinatal loss. Copyright © 2017 Elsevier Inc. All rights reserved.
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Prevalence and predictors of parental grief and depression after the death of a child from cancer.
McCarthy, Maria C; Clarke, Naomi E; Ting, Cheng Lin; Conroy, Rowena; Anderson, Vicki A; Heath, John A
2010-11-01
To investigate patterns of grief and depression in a sample of parents whose child had died of cancer, and to examine factors related to burden of illness and end-of-life care as potential predictors of parental grief and depression outcomes. Fifty-eight parents completed standardized self-report questionnaires measuring prolonged grief disorder (Inventory of Complicated Grief-Revised [ICG-R]) and depression (Beck Depression Inventory-Second Edition [BDI-II]) and participated in structured interviews designed to elicit their perceptions of their child's end-of-life care and burden of illness. The majority of participants were mothers (84%) and the mean length of time since child death was 4.5 (standard deviation [SD] = 2.4) years (range, 1.0-9.8 years). Rates of prolonged grief disorder (PGD) were similar to those reported in other bereaved populations (10.3%); however, 41% of parents met diagnostic criteria for grief-related separation distress. Twenty-two percent of parents reported clinically significant depressive symptoms. Time since death and parental perception of the oncologist's care predicted parental grief symptoms but not depressive symptoms. Perceptions of the child's quality of life during the last month, preparedness for the child's death, and economic hardship also predicted grief and depression outcomes. A minority of parents met criteria for PGD and depression, however, almost half the sample was experiencing significant separation distress associated with persistent longing and yearning for their child. Time since death is a significant predictor of parental psychological distress. This study also highlights the importance of end-of-life factors in parents' long-term adjustment and the need for optimal palliative care to ensure the best possible outcomes for parents.
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Huh, Hyu Jung; Kim, Kyung Hee; Lee, Hee-Kyung; Chae, Jeong-Ho
2017-01-01
ABSTRACT Background: Previous studies on the influence of different types of attachment on grief responses have yielded contradictory outcomes. Little research has been conducted to identify the psychological processes that moderate the relationship between attachment representations and patterns of grief in disaster-related grief. Objective: The present study examines the effects of different attachment types on the grief responses of parents bereaved by loss of a child in a ferry accident, along with the moderating role of coping strategies. Methods: Bereaved parents (n = 81) completed self-report questionnaires evaluating attachment, coping strategies, complicated grief, and shame/guilt. We performed correlational analyses to examine the associations among variables. We also conducted hierarchical regression analyses and simple slope analyses to examine the moderation effects of coping strategies. Results: Anxious attachment was associated with severe shame/guilt, and avoidant attachment correlated with complicated grief. Anxious attachment was positively associated with all types of coping strategies, and avoidant attachment was negatively related to problem- and emotion-focused coping. The use of problem-focused coping strategies was a significant moderator of the relationship between the avoidant attachment dimension and shame/guilt. Avoidant attachment had a significant effect on shame/guilt in groups with a high level of problem-focused coping. In contrast, none of the coping strategies significantly moderated the relationship between anxious attachment and grief response. Conclusions: The results suggest that people with highly avoidant attachment might be overwhelmed by shame and guilt when they try to use problem-focused coping strategies. This finding suggests that grief interventions should be organized with consideration of individual differences in attachment representations. PMID:29372009
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Huh, Hyu Jung; Kim, Kyung Hee; Lee, Hee-Kyung; Chae, Jeong-Ho
2017-01-01
Background : Previous studies on the influence of different types of attachment on grief responses have yielded contradictory outcomes. Little research has been conducted to identify the psychological processes that moderate the relationship between attachment representations and patterns of grief in disaster-related grief. Objective : The present study examines the effects of different attachment types on the grief responses of parents bereaved by loss of a child in a ferry accident, along with the moderating role of coping strategies. Methods : Bereaved parents ( n = 81) completed self-report questionnaires evaluating attachment, coping strategies, complicated grief, and shame/guilt. We performed correlational analyses to examine the associations among variables. We also conducted hierarchical regression analyses and simple slope analyses to examine the moderation effects of coping strategies. Results : Anxious attachment was associated with severe shame/guilt, and avoidant attachment correlated with complicated grief. Anxious attachment was positively associated with all types of coping strategies, and avoidant attachment was negatively related to problem- and emotion-focused coping. The use of problem-focused coping strategies was a significant moderator of the relationship between the avoidant attachment dimension and shame/guilt. Avoidant attachment had a significant effect on shame/guilt in groups with a high level of problem-focused coping. In contrast, none of the coping strategies significantly moderated the relationship between anxious attachment and grief response. Conclusions : The results suggest that people with highly avoidant attachment might be overwhelmed by shame and guilt when they try to use problem-focused coping strategies. This finding suggests that grief interventions should be organized with consideration of individual differences in attachment representations.
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Languages of Grief: a model for understanding the expressions of the bereaved.
Corless, Inge B; Limbo, Rana; Bousso, Regina Szylit; Wrenn, Robert L; Head, David; Lickiss, Norelle; Wass, Hannelore
2014-01-01
The aim of this work is to provide an overview of the key features of the expressions of grief. Grief is a response to loss or anticipated loss. Although universal, its oral and nonverbal expression varies across cultures and individuals. Loss is produced by an event perceived to be negative to varying degrees by the individuals involved and has the potential to trigger long-term changes in a person's cognitions and relationships. The languages used by the bereaved to express grief differ from the language used by professionals, creating dissonance between the two. Data were obtained from English language Medline and CINAHL databases, from professional and personal experiences, interviews with experts, and exploration of cemetery memorials. Blog websites and social networks provided additional materials for further refinement of the model. Content analysis of the materials and agreement by the authors as to the themes resulted in the development of the model. To bridge the gap between professional language and that used by the bereaved, a Languages of Grief model was developed consisting of four Modes of Expression, four Types of Language, plus three Contingent Factors. The Languages of Grief provides a framework for comprehending the grief of the individual, contributing to clinical understanding, and fruitful exploration by professionals in better understanding the use of languages by the bereaved. Attention to the Modes of Expression, Types of Language, and Contingent Factors provides the professional with a richer understanding of the grieving individual, a step in providing appropriate support to the bereaved. The Languages of Grief provides a framework for application to discrete occurrences with the goal of understanding grief from the perspective of the bereaved.
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Parental control, partner dependency, and complicated grief among widowed adults in the community.
Johnson, Jeffrey G; Zhang, Baohui; Greer, Joseph A; Prigerson, Holly G
2007-01-01
Data from the Yale Bereavement Study, a community-based longitudinal study, were used to investigate the association of 192 widowed individuals' recollections of parenting affection and control during childhood with dependency on the deceased spouse and the development of severe grief symptoms following bereavement. The hypothesis that dependency on the deceased spouse mediates the association of parental affection and control during childhood with the development of severe grief following bereavement was investigated. Findings indicated that a high level of perceived parental control during childhood was associated with elevated levels of dependency on the deceased spouse and with symptoms of complicated grief. Dependency on the deceased spouse mediated the association of perceived parental control with the development of complicated grief following bereavement.
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Impact of A Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial
Rosenbaum, Joan L.; Smith, Joan R.; Yan, Yan; Abram, Nancy; Jeffe, Donna B.
2014-01-01
This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby’s death in our Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, we measured grief change from 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD-viewers with DVD-non-viewers and controls. DVD-viewers reported higher grief at 3-month interviews compared with DVD-non-viewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care. PMID:25530502
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Strengthening Grief Support for Children with Developmental Disabilities
ERIC Educational Resources Information Center
Sormanti, Mary; Ballan, Michelle S.
2011-01-01
Although a sizable literature investigates and describes children's grief, the majority of information focuses on typically developing children. Far less has been published about the loss and grief of children with developmental disabilities (DD), even though this population experiences significant and multiple losses, increasing their…
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[Grief in Children und Adolescents as a Result of Acute Traumatization].
Juen, Barbara; Werth, Manuela; Warger, Ruth; Nindl, Sandra
2017-01-01
Grief in Children und Adolescents as a Result of Acute Traumatization Specifities of grief in children after trauma will be presented as well as potential reactions to acute traumatization and resulting needs of children and adolescents in order to discuss adequate interventions.
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The Grief Resolution Process in Divorce.
ERIC Educational Resources Information Center
Crosby, John F.; And Others
1983-01-01
Compares grief in divorce to the Kubler-Ross model of grief resolution in bereavement in 17 persons who wrote essays about their divorce. The results suggested a conceptual model based on three chronological stages with linear progression through the stages, characterized by circularity within each stage. (JAC)
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Grief: Helping Young Children Cope
ERIC Educational Resources Information Center
Wood, Frances B.
2008-01-01
In their role as caregivers supporting the children they teach, it is important for teachers to understand the grieving process and recognize symptoms of grief. The author explains Elisabeth Kubler-Ross's five stages of grief and offers 10 classroom strategies to help young children cope with their feelings.
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[Bereavement and complicated grief: towards a definition of Prolonged Grief Disorder for DSM-5].
Lombardo, Luigi; Lai, Carlo; Luciani, Massimiliano; Morelli, Emanuela; Buttinelli, Elena; Aceto, Paola; Lai, Silvia; D'Onofrio, Marianna; Galli, Federico; Bellizzi, Fernando; Penco, Italo
2014-01-01
Mourning is a natural response to a loss and a condition which most people experience several times during their lives. Most individuals adjust adequately to the loss of a relative, neverthless, a small but noteworthy proportion of bereaved individuals experience a syndrome of prolonged psychological distress in relation to bereavement. Prolonged distress and disability in connection with bereavement has been termed Complicated Grief (CG) or Prolonged Grief Disorder (PGD). The purpose of this paper is to analyze the literature on loss and mourning making a review of the main studies published between 1993 and 2013, identified through a search conducted on Medline/PubMed, in order to describe the epidemiological and clinical aspects of "normal" grief and "complicated" grief, pointing out the path of the clinical definition of PGD and proposed diagnostic criteria for inclusion in the next edition of the Diagnostic and Statistic Manual of Mental Disorders, Fifth edition (DSM-5). The two main diagnostic systems proposed by Horowitz and Prigerson are also compared.
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Complicated grief in a two-and-a-half-year-old child.
Mendhekar, D N; Lohia, D
2010-02-01
The concept of "absence of grief" in children has been embedded in psychoanalytic literature since its beginning. The clinical phenomenon of grief in a toddler is rarely described or analysed in the psychiatric literature. Early theorists felt that grieving does not occur until adolescence due to a younger child's psychological structure, including poor object-relations development. However, data on grief reaction in preschool children has mostly been under-reported or neglected, especially since most of the studies on childhood grief have been conducted on school-age children. We present a two-and-a-half-year-old girl, whose emotional and behavioural reactions to the loss of her grandfather became a focus of clinical attention. This report shows that even toddlers can mourn for their loved ones, although the expression and process of grief differ from that of older children and may occasionally draw clinical attention. Suggestions on how to investigate this phenomenon more closely and how to avoid it in socio-cultural contexts are proposed.
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A systematic writing program as a tool in the grief process: part 1.
Furnes, Bodil; Dysvik, Elin
2010-12-06
The basic aim of this paper is to suggest a flexible and individualized writing program as a tool for use during the grief process of bereaved adults. An open, qualitative approach following distinct steps was taken to gain a broad perspective on the grief and writing processes, as a platform for the writing program. Following several systematic methodological steps, we arrived at suggestions for the initiation of a writing program and its structure and substance, with appropriate guidelines. We believe that open and expressive writing, including free writing and focused writing, may have beneficial effects on a person experiencing grief. These writing forms may be undertaken and systematized through a writing program, with participation in a grief writing group and with diary writing, to achieve optimal results. A structured writing program might be helpful in promoting thought activities and as a tool to increase the coherence and understanding of individuals in the grief process. Our suggested program may also be a valuable guide to future program development and research.
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Effects of euthanasia on the bereaved family and friends: a cross sectional study.
Swarte, Nikkie B; van der Lee, Marije L; van der Bom, Johanna G; van den Bout, Jan; Heintz, A Peter M
2003-07-26
To assess how euthanasia in terminally ill cancer patients affects the grief response of bereaved family and friends. Cross sectional study. Tertiary referral centre for oncology patients in Utrecht, the Netherlands. 189 bereaved family members and close friends of terminally ill cancer patients who died by euthanasia and 316 bereaved family members and close friends of comparable cancer patients who died a natural death between 1992 and 1999. Symptoms of traumatic grief assessed by the inventory of traumatic grief, current feelings of grief assessed by the Texas revised inventory of grief, and post-traumatic stress reactions assessed by the impact of event scale. The bereaved family and friends of cancer patients who died by euthanasia had less traumatic grief symptoms (adjusted difference -5.29 (95% confidence interval -8.44 to -2.15)), less current feeling of grief (adjusted difference 2.93 (0.85 to 5.01)); and less post-traumatic stress reactions (adjusted difference -2.79 (-5.33 to -0.25)) than the family and friends of patients who died of natural causes. These differences were independent of other risk factors. The bereaved family and friends of cancer patients who died by euthanasia coped better with respect to grief symptoms and post-traumatic stress reactions than the bereaved of comparable cancer patients who died a natural death. These results should not be interpreted as a plea for euthanasia, but as a plea for the same level of care and openness in all patients who are terminally ill.
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Maternal Resolution of Grief After Preterm Birth: Implications for Infant Attachment Security
Clements, Melissa; Poehlmann, Julie
2011-01-01
OBJECTIVE: This study explored the association between mothers' unresolved grief regarding their infant's preterm birth and infant-mother attachment security. We hypothesized that mothers with unresolved grief would be more likely to have insecurely attached infants at 16 months and that this association would be partially mediated by maternal interaction quality. METHODS: This longitudinal study focused on 74 preterm infants (age of <36 weeks) and their mothers who were part of a larger study of high-risk infants. The present analysis included assessment of neonatal and socioeconomic risks at NICU discharge; maternal depression, Reaction to Preterm Birth Interview findings, and quality of parenting at a postterm age of 9 months; and infant-mother attachment at postterm age of 16 months. Associations among findings of grief resolution with the Reaction to Preterm Birth Interview, quality of parenting interactions, and attachment security were explored by using relative risk ratios and logistic and multivariate regression models. RESULTS: The relative risk of developing insecure attachment when mothers had unresolved grief was 1.59 (95% confidence interval: 1.03–2.44). Controlling for covariates (adjusted odds ratio: 2.94), maternal feelings of resolved grief regarding the preterm birth experience were associated with secure infant-mother attachment at 16 months. Maternal grief resolution and interaction quality were independent predictors of attachment security. CONCLUSION: Maternal grief resolution regarding the experience of preterm birth and the quality of maternal interactions have important implications for emerging attachment security for infants born prematurely. PMID:21242223
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Grief and Women: Stillbirth in the Social Context of India
Roberts, Lisa R.; Anderson, Barbara A.; Lee, Jerry W.; Montgomery, Susanne B.
2015-01-01
INTRODUCTION Few in Western society would argue the potentially devastating impact of stillbirth related grief; but in many developing countries where stillbirth remains the highest in the world, perinatal grief is barely recognized as an issue. The purpose of this study was to explore how poor, rural central Indian women perceive and cope with stillbirths. METHODS Seventeen key informant interviews and two focus groups (N = 33) with local health care providers, family members, and women who experienced stillbirth were conducted over a 1-month period in 2011 and then systematically coded for emerging themes using grounded theory methods to explore how women experienced stillbirth. RESULTS Although usually never talked about and not recognized as an issue, perinatal grief emerged as a significant shared experience by all. The perceptions of stillbirth-related grief emerged in three major themes and bear evidence of gender and power issues and indicate that local social norms negatively factor heavily into their perinatal grief experiences. DISCUSSION The findings in this richly textured study add to the limited literature regarding rural, central Indian women's experiences with stillbirth and factors influencing their resulting perinatal grief. In light of the void of recognition of this phenomenon in Indian society, a better understanding of the context in which poor Indian women experience perinatal grief will be a first step toward developing much needed culturally rooted interventions to positively impact the women's abilities to better cope with stillbirth in the context of their realities. PMID:26594592
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Maternal resolution of grief after preterm birth: implications for infant attachment security.
Shah, Prachi E; Clements, Melissa; Poehlmann, Julie
2011-02-01
This study explored the association between mothers' unresolved grief regarding their infant's preterm birth and infant-mother attachment security. We hypothesized that mothers with unresolved grief would be more likely to have insecurely attached infants at 16 months and that this association would be partially mediated by maternal interaction quality. This longitudinal study focused on 74 preterm infants (age of <36 weeks) and their mothers who were part of a larger study of high-risk infants. The present analysis included assessment of neonatal and socioeconomic risks at NICU discharge; maternal depression, Reaction to Preterm Birth Interview findings, and quality of parenting at a postterm age of 9 months; and infant-mother attachment at postterm age of 16 months. Associations among findings of grief resolution with the Reaction to Preterm Birth Interview, quality of parenting interactions, and attachment security were explored by using relative risk ratios and logistic and multivariate regression models. The relative risk of developing insecure attachment when mothers had unresolved grief was 1.59 (95% confidence interval: 1.03-2.44). Controlling for covariates (adjusted odds ratio: 2.94), maternal feelings of resolved grief regarding the preterm birth experience were associated with secure infant-mother attachment at 16 months. Maternal grief resolution and interaction quality were independent predictors of attachment security. Maternal grief resolution regarding the experience of preterm birth and the quality of maternal interactions have important implications for emerging attachment security for infants born prematurely.
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Adult Children of Dysfunctional Families: Treatment from a Disenfranchised Grief Perspective.
ERIC Educational Resources Information Center
Zupanick, Corinne E.
1994-01-01
Generalizes concept of disenfranchised grief to understanding of recovery process for adult children of dysfunctional families. Describes recovery process of this population as parallel to grief process. Identifies two layers of unrecognized loss: loss of one's childhood and loss of one's fantasized and idealized parent. Suggests specific…
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Grief: The Unrecognized Parental Response to Mental Illness in a Child.
ERIC Educational Resources Information Center
MacGregor, Peggy
1994-01-01
Notes that parents whose son or daughter develops serious mental illness experience grief that is often neither recognized by society nor addressed by mental health professionals. Describes some common elements of parental bereavement, losses experienced with mental illness, consequences of ignoring grief, and appropriate interventions for mental…
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The Grief Grapevine: Facebook Memorial Pages and Adolescent Bereavement
ERIC Educational Resources Information Center
Frost, Mardi
2014-01-01
How adolescents use the social networking site Facebook to express grief is a growing area of research. In reviewing current literature, it is evident that many questions still remain unanswered. Additionally, this ever-evolving platform for grief, mourning and bereavement may hold many implications for educators, policy developers and school…
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The Child in Grief: Implications for Teaching.
ERIC Educational Resources Information Center
Hare, Jan; And Others
The purpose of this paper is to increase teachers' understanding of children's conceptualizations of death to enable them to respond to the symptoms of grief in both early and middle childhood. John Bowlby's theoretical framework of childhood mourning is elaborated, and research on teachers' facilitation of children's grief is briefly noted. The…
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ERIC Educational Resources Information Center
Parker, Judith
1995-01-01
Although death is the one certainty in life, death or the grieving process is rarely discussed. Grief includes physical, emotional, spiritual, and psychological reactions to loss, and is not limited to feelings about death. Grief can be the response to loss of home or country, separation or displacement, and changes resulting from new life stages.…
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Parents' Grief Following Pregnancy Loss: A Comparison of Mothers and Fathers.
ERIC Educational Resources Information Center
Stinson, Kandi M.; And Others
1992-01-01
Examined gender differences in bereavement following miscarriage, ectopic pregnancy, stillbirth, and neonatal death. Interviewed 56 couples using Perinatal Grief Scale. Women scored significantly higher than men on most dimensions of grief at two months, one year, and two years postloss, except on dimension indicating most serious consequences of…
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Maintaining connections in children's grief narratives in popular film.
Sedney, Mary Anne
2002-04-01
Children's grief narratives in popular films were examined for their portrayal of connection-maintaining strategies with the deceased. Comparisons were made between strategies found in actual parentally bereaved children and in child characters in films. Implications of these filmed grief narratives for models of grieving and for practice are discussed.
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Songs for the Soul: A Program to Address a Nurse's Grief .
Phillips, Carolyn; Welcer, Barbara
2017-04-01
When caring for patients with cancer, a number of situations arise that cause nurses to grieve. Nurses need time and space to grieve to prevent the untoward effects of cumulative grief. While providing a safe space for nurses to be vulnerable in grief, Songs for the Soul combines the healing effects of expressive writing, storytelling, and music to help nurses address the grief and suffering they experience in their work. The use of storytelling through music portrays an expression of their grief that matches the intensity of their caregiving experience.
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Hypnotherapy for traumatic grief: janetian and modern approaches integrated.
van der Hart, O; Brown, P; Turco, R N
1990-04-01
Traumatic grief occurs when psychological trauma obstructs mourning. Nosologically, it is related to pathological grief and posttraumatic stress disorder (PTSD). Therapeutic advances from both fields make it clear that the trauma per se must be accessed before mourning can proceed. The gamut of psychotherapies has been employed, but hypnosis appears to be the most specific. Pierre Janet provided a remarkably modern conceptual basis for diagnosis and treatment based on a dissociation model. His approach is combined with contemporary innovations to present a systematic and integrated account of hypnotherapy for traumatic grief.
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Evaluation of individual and group grief and trauma interventions for children post disaster.
Salloum, Alison; Overstreet, Stacy
2008-07-01
This study evaluated a community-based grief and trauma intervention for children conducted postdisaster. Fifty six children (7 to 12 years old) who reported moderate to severe levels of symptoms of posttraumatic stress were randomly assigned to group or individual treatment. Treatment consisted of a manualized 10-session grief- and trauma-focused intervention and a parent meeting. Measures of disaster-related exposure, posttraumatic stress symptoms, depression, traumatic grief, and distress were administered at preintervention, postintervention, and 3 weeks postintervention. There was a significant decrease in all outcome measures over time, and there were no differences in outcomes between children who participated in group intervention and those who participated in individual intervention. Results suggest that this intervention using either treatment modality may be effective for addressing childhood grief and trauma postdisaster.
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The American Indian Holocaust: healing historical unresolved grief.
Brave Heart, M Y; DeBruyn, L M
1998-01-01
American Indians experienced massive losses of lives, land, and culture from European contact and colonization resulting in a long legacy of chronic trauma and unresolved grief across generations. This phenomenon, labeled historical unresolved grief, contributes to the current social pathology of high rates of suicide, homicide, domestic violence, child abuse, alcoholism and other social problems among American Indians. The present paper describes the concept of historical unresolved grief and historical trauma among American Indians, outlining the historical as well as present social and political forces which exacerbate it. The abundant literature on Jewish Holocaust survivors and their children is used to delineate the intergenerational transmission of trauma, grief, and the survivor's child complex. Interventions based on traditional American Indian ceremonies and modern western treatment modalities for grieving and healing of those losses are described.
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An attachment-based model of complicated grief including the role of avoidance
Monk, Timothy; Houck, Patricia; Melhem, Nadine; Frank, Ellen; Reynolds, Charles; Sillowash, Russell
2009-01-01
Introduction Complicated grief is a prolonged grief disorder with elements of a stress response syndrome. We have previously proposed a biobehavioral model showing the pathway to complicated grief. Avoidance is a component that can be difficult to assess and pivotal to treatment. Therefore we developed an avoidance questionnaire to characterize avoidance among patients with CG. Methods We further explain our complicated grief model and provide results of a study of 128 participants in a treatment study of CG who completed a 15-item Grief-related Avoidance Questionnaire (GRAQ). Results of Avoidance Assessment Mean (SD) GRAQ score was 25. 0 ± 12.5 with a range of 0–60. Cronbach's alpha was 0.87 and test re-test correlation was 0.88. Correlation analyses showed good convergent and discriminant validity. Avoidance of reminders of the loss contributed to functional impairment after controlling for other symptoms of complicated grief. Discussion In this paper we extend our previously described attachment-based biobehavioral model of CG. We envision CG as a stress response syndrome that results from failure to integrate information about death of an attachment figure into an effectively functioning secure base schema and/or to effectively re-engage the exploratory system in a world without the deceased. Avoidance is a key element of the model. PMID:17629727
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Livingston, Kathy
2010-01-01
This article explores the concepts of unmourned and disenfranchised grief as a way to understand the experiences of adult children of Nazi perpetrators, who grew up with cultural norms of grieving alone or in silence. The scholarly literature on descendants of Nazis reflects a group unlikely to warrant empathy or support from others because of the stigma surrounding their family's possible involvement in the Holocaust atrocities. This article uses, as a case study approach, the testimony given by Monika Hertwig, the adult daughter of a high ranking Nazi, who appears in the documentary film, Inheritance. From the perspective of disenfranchised grief, defined as grief that is not socially recognized or supported, the article links Monika's testimony with existing research from in-depth interviews with other descendants of Nazis to suggest that, as a group, they lacked permission to grieve their deceased parents, acknowledgment of their grief, and opportunities to mourn. Based on the theory that the effects of grief can be transgenerational, the disenfranchisement experienced by the "children of the Third Reich" does not have to pass to subsequent generations if opportunities for mourning are made possible and some resolution of grief occurs. Studies have shown that ongoing dialogue groups between Holocaust survivors and descendants of Nazis provide opportunities for mourning to both groups.
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Prolonged grief and post-traumatic growth after loss: Latent class analysis.
Zhou, Ningning; Yu, Wei; Tang, Suqin; Wang, Jianping; Killikelly, Clare
2018-06-06
Bereavement may trigger different psychological outcomes, such as prolonged grief disorder or post-traumatic growth. The relationship between these two outcomes and potential precipitators remain unknown. The current study aimed to identify classes of Chinese bereaved individuals based on prolonged grief symptoms and post-traumatic growth and to examine predictors for these classes. We used data from 273 Chinese individuals who lost a relative due to disease (92.3%), accident (4.4%) and other reasons (1.8%). Latent class analysis revealed three classes: a resilient class, a growth class, and a combined grief/growth class. A higher level of functional impairment was found for the combined grief/growth class than for the other two classes. Membership in the combined grief/growth class was significantly predicted by the younger age of the deceased and the death of a parent, child or spouse. Subjective closeness with the deceased and gender were marginally significant predictors. When the four variables were included in the multinomial regression analysis, death of a parent, child or spouse significantly predicted the membership to the combined grief/growth class. These findings provide valuable information for the development of tailored interventions that may build on the bereaved individuals' personal strengths. Copyright © 2018. Published by Elsevier B.V.
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Spuij, Mariken; Prinzie, Peter; Dekovic, Maja; van den Bout, Jan; Boelen, Paul A
2013-11-20
There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8-18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. We aim to contribute to the improvement of mental health care for children and adolescents suffering from loss. By comparing Grief-Help with supportive counselling, and by investigating mediators and moderators of its effectiveness we hope to provide new insights in the effects of interventions for bereaved children, and their mechanisms of change. Netherlands Trial Register NTR3854.
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Effects of euthanasia on the bereaved family and friends: a cross sectional study
Swarte, Nikkie B; van der Lee, Marije L; van der Bom, Johanna G; van den Bout, Jan; Heintz, A Peter M
2003-01-01
Objective To assess how euthanasia in terminally ill cancer patients affects the grief response of bereaved family and friends. Design Cross sectional study. Setting Tertiary referral centre for oncology patients in Utrecht, the Netherlands. Participants 189 bereaved family members and close friends of terminally ill cancer patients who died by euthanasia and 316 bereaved family members and close friends of comparable cancer patients who died a natural death between 1992 and 1999. Main outcome measures Symptoms of traumatic grief assessed by the inventory of traumatic grief, current feelings of grief assessed by the Texas revised inventory of grief, and post-traumatic stress reactions assessed by the impact of event scale. Results The bereaved family and friends of cancer patients who died by euthanasia had less traumatic grief symptoms (adjusted difference -5.29 (95% confidence interval -8.44 to -2.15)), less current feeling of grief (adjusted difference 2.93 (0.85 to 5.01)); and less post-traumatic stress reactions (adjusted difference -2.79 (-5.33 to -0.25)) than the family and friends of patients who died of natural causes. These differences were independent of other risk factors. Conclusions The bereaved family and friends of cancer patients who died by euthanasia coped better with respect to grief symptoms and post-traumatic stress reactions than the bereaved of comparable cancer patients who died a natural death. These results should not be interpreted as a plea for euthanasia, but as a plea for the same level of care and openness in all patients who are terminally ill. PMID:12881258
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Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick
2016-03-01
Definitions of complicated grief vary across diagnostic systems, being represented as persistent complex bereavement (PCB) in DSM-5 and prolonged grief disorder (PGD) in the proposed revision of the ICD system. A past study in a high-income country has identified a six-factor structure for complicated grief, but there are no data testing this or any other model across cultures. The present study reports findings from a survey amongst West Papuan refugees (n = 230, response rate = 92 %) residing in Port Moresby, Papua New Guinea. We applied culturally adapted measures of conflict-related traumatic event (TEs) (drawing specifically on domains of conflict and loss), symptoms of complicated grief adapted and modified to the culture, and a multidimensional psychosocial index of the broader effects of conflict and displacement. Confirmatory factor analysis yielded a single higher order construct of complicated grief comprising six factors of yearning/preoccupation; shock/disbelief; anger/negative appraisal; behavioural change; estrangement from others/impairment; and a novel dimension of confusion/diminished identity. In contrast, our analysis failed to support DSM or ICD models of PCB or PGD. A Multiple Indicators Multiple Causes (MIMIC) model revealed that traumatic loss and the sense of injustice each were associated with the unitary construct of complicated grief and its subdomains of yearning/preoccupation; shock/disbelief; anger/negative appraisal (exclusive to injustice); and estrangement from others/social impairment (exclusive to TE domain of conflict and loss). Conflict and loss associated with feelings of injustice may be especially pathogenic in generating the anger/negative appraisal component of complicated grief amongst refugees.
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Screening for Complicated Grief in a Military Mental Health Clinic.
Delaney, Eileen M; Holloway, Kathryn J; Miletich, Derek M; Webb-Murphy, Jennifer A; Lanouette, Nicole M
2017-09-01
Bereavement is one of the most common and stressful life experiences one can endure. Typical grief reactions follow a course of recovery in which individuals come to terms with the loss and resume functioning within weeks to months. However, for some, grief remains indefinitely distressing. Complicated Grief (CG) refers to significant chronic impairment that stems from bereavement. Military service members experience myriad factors that likely increase their risk for developing CG. Such factors include unique bonds between service members, exposure to constant and extreme levels of stress, multiple losses, separation from family and loved ones, witnessing/learning about sudden violent and traumatic deaths, and handling human remains. The aim of this project was to explore the practicality and efficiency of screening for CG within a busy military mental health clinic, and also explore relationships between contextual variables related to a death that might be associated with screening positive for CG. As part of a clinical needs assessment, patients from a single mental health clinic at Naval Medical Center San Diego completed a brief grief survey that asked if they experienced a death of a person close to them, collected metrics related to losses they have experienced and included validated screeners for CG (The Brief Grief Questionnaire [BGQ] and the Inventory for Complicated Grief [ICG]). No data concerning gender, age, marital status, socioeconomic status, diagnosis, or purpose of visit (i.e., initial or follow-up visit) were collected. Institutional review board approval was obtained. In our sample of service members presenting to an adult outpatient military mental health clinic, 43.5% reported having experienced a loss that still impacts them. Of that group, 61.7% screened positive on the BGQ, 59.2% screened positive on the ICG using a cutoff of 25, and 46.1% screened positive on the ICG using the cutoff of 30. These findings suggest that military service members seeking mental health treatment who endorsed experiencing a loss are at high risk for experiencing persisting, impairing grief. Additionally, patients who either lost a fellow service member and/or experienced loss while on deployment reported significantly higher scores on the BGQ or ICG than if they did not report those factors. Furthermore, correlations between total number of losses and ICG scores suggest that service members who experienced multiple losses may be more susceptible to CG symptoms. The findings from this preliminary investigation suggest that many service members receiving care in military mental health care are experiencing grief-related symptoms and distress, and a brief screen for grief can help capture many of those with grief related impairment. Research shows that CG needs to be directly targeted to treat its symptoms and associated impairment. We recommend that military mental health clinics consider adding some type of grief screener to their standard intake as well as making providers aware of the importance of monitoring potential grief reactions in their patients. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
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Personal Fear of Death and Grief in Bereaved Mothers
ERIC Educational Resources Information Center
Barr, Peter; Cacciatore, Joanne
2008-01-01
The study explored the relation of fear of death (Multidimensional Fear of Death Scale) to maternal grief (Perinatal Grief Scale-33) following miscarriage, stillbirth, neonatal death, or infant/child death. The 400 women participants were recruited from the website, e-mail lists, and parent groups of an organization that supports bereaved parents.…
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Postabortion Grief: Evaluating the Possible Efficacy of a Spiritual Group Intervention
ERIC Educational Resources Information Center
Layer, Susan Dyer; Roberts, Cleora; Wild, Kelli; Walters, Jan
2004-01-01
Objective: Although not every woman is negatively affected by an abortion, researchers have identified a subgroup of women susceptible to grief and trauma. The primary providers for postabortion grief (PAG) groups are community faith-based agencies. Principle features of PAG are shame and post-traumatic stress disorder (PTSD) symptoms. Method:…
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Grief Counseling Groups in a Medium-Security Prison
ERIC Educational Resources Information Center
Olson, Margaret J.; McEwen, Margaret A.
2004-01-01
The authors discuss their facilitation of four grief counseling groups with male inmates in a state prison over a two-year period. Worden's Tasks of Mourning were used as a guide for the group process. Disenfranchised grief and gender and cultural issues in grieving are explored. Catalytic exercises are described, and written feedback from inmates…
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Development and Validation of a Christian-Based Grief Recovery Scale
ERIC Educational Resources Information Center
Jen Der Pan, Peter; Deng, Liang-Yu F.; Tsai, S. L.; Chen, Ho-Yuan J.; Yuan, Sheng-Shiou Jenny
2014-01-01
The purpose of this study was to develop and validate a Christian-based Grief Recovery Scale (CGRS) which was used to measure Christians recovering from grief after a significant loss. Taiwanese Christian participants were recruited from churches and a comprehensive university in northern Taiwan. They were affected by both the Christian faith and…
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Staff Grief Resolution and Care for the Elderly: Artificial Intelligence Analysis.
ERIC Educational Resources Information Center
Seibert, Phyllis M.; Pastorello, Thomas
Literature on health professionals describes the problems associated with unresolved or poorly resolved grief. Previous research has indicated that the most important reason why health professionals stay in their jobs is their relationship to patients. This study examined how nursing home personnel resolve their grief following deaths of clients.…
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Caregiver Grief in Terminal Illness and Bereavement: A Mixed-Methods Study
ERIC Educational Resources Information Center
Waldrop, Deborah P.
2007-01-01
Caregivers experience multiple losses during the downhill trajectory of a loved one's terminal illness. Using mixed methods, this two-stage study explored caregiver grief during a terminal illness and after the care recipient's death. Caregiver grief was a state of heightened responsiveness during end-stage care: anxiety, hostility, depression,…
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Rhetorical Dimensions of the Post-September Eleventh Grief Process
ERIC Educational Resources Information Center
Schwartzman, Roy; Tibbles, David
2005-01-01
This essay examines Presidential rhetoric and popular culture practices in light of the stages of grief enumerated by Elisabeth Kubler-Ross. The authors find a consistent retrenchment of grief into the anger phase, where the pain of losing national invulnerability is transferred to externalized aggression. Reconciliation is suggested by means of…
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Alexithymia and Grief Reactions in Bereaved Japanese Women
ERIC Educational Resources Information Center
Nakao, Mutsuhiro; Kashiwagi, Masayo; Yano, Eiji
2005-01-01
To examine the relationship between grief reactions and alexithymia, 54 Japanese women (33 outpatients attending a psychosomatic clinic and 21 normal healthy participants) completed the Texas Inventory of Grief (TIG), the 20-item Toronto Alexithymia Scale (TAS-20), and the Profile of Mood States (POMS). Each woman had experienced the death of a…
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Integrating Buddhist Psychology into Grief Counseling
ERIC Educational Resources Information Center
Wada, Kaori; Park, Jeeseon
2009-01-01
The field of grief counseling has yet to see an integration of Buddhist psychology. Drawing on Buddhist psychology literature and Western models of grief, this article explores possible integrations of two approaches. To lay the foundation for this discussion, the authors introduced a brief overview of the history of Buddhism as well as a Buddhist…
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Ghesquiere, Angela
2014-01-01
Complicated Grief (CG) is a prolonged, impairing mental health condition affecting about 7% of the bereaved. CG may be especially prevalent in older adults. Though evidence-based treatments for CG have been developed, little is known about support-seeking in older adults with CG. This study used the descriptive phenomenological approach to explore the CG support-seeking process. In-depth interviews were conducted with 8 CG-positive older adults who had completed participation in a randomized clinical trial of CG treatment. Five primary themes arose: observing that grief was causing a great deal of distress and impairment; grief not meeting expectations of what grief “should be”; an important influence of social relationships on support-seeking; lack of effectiveness of grief support groups and/or care from mental health professionals prior to study enrollment; and strong reactions to the label of CG. Themes may hep inform efforts to engage older adults with CG in effective care. PMID:24547662
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Grief and its Complications in Individuals with Intellectual Disability
Brickell, Claire; Munir, Kerim
2011-01-01
Bereavement and loss have significant impact on the lives of individuals with intellectual disability (ID). Although there is a growing impetus to define the symptoms of grief that predict long-term functional impairment, little is known about maladaptive grieving among individuals with ID. We examine the literature concerning the phenomenology of traumatic grief (TG) in the general population, along with what is known about the manifestations of grief in individuals with ID. We then apply modern theories of grief and grief resolution to individuals with ID in order to highlight potential areas of vulnerability in this population and to lay the groundwork for interventions that will facilitate their adaptation to loss. We provide a theoretical framework for the proposition that individuals (including children and adults) with ID are more susceptible to TG, based on an increased risk of secondary loss, barriers to communicating about the loss, and difficulty finding meaning in the loss. We conclude that individuals with ID should be considered as potential candidates for targeted bereavement interventions. Further research is required, however, in order to develop population-appropriate measurement scales for testing these hypotheses. PMID:18306095
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Mystakidou, Kyriaki; Tsilika, Eleni; Parpa, Efi; Athanasouli, Paraskevi; Galanos, Antonis; Anna, Pagoropoulou; Vlahos, Lambros
2009-04-01
The growing interest in the psychological distress in patients with cancer has been the major reason for the conduction of this study. The aims were to assess the relationship of hopelessness, anxiety, distress, and preparatory grief, as well as their predictive power to hopelessness. Ninety-four patients with advanced cancer completed the study at a palliative care unit in Athens, Greece. Beck Hopelessness Scale, the Greek version of the Hospital Anxiety and Depression (HAD) scale, and the Preparatory Grief in Advanced Cancer Patients scale were administered. Information concerning patients' treatment was acquired from the medical records, whereas physicians recorded their clinical condition. Hopelessness correlated significantly with preparatory grief (r = .630, P < .0005), anxiety (r = .539, P < .0005), depression (r = .642, P < .0005), HAD-Total (r = .686, P < .0005), and age (r = -.212, P = .040). Multiple regression analyses showed that preparatory grief (P < .0005), depression (P < .0005), and age (P = .003) were predictors of hopelessness, explaining 58.8% of total variance. In this patient sample, depression, preparatory grief, and patients' age were predictors of hopelessness.
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Childhood traumatic grief: an exploration of the construct in children bereaved on September 11.
Brown, Elissa J; Goodman, Robin F
2005-06-01
This study is an exploration of the measurement and correlates of childhood traumatic grief (CTG). Eighty-three children of uniformed service personnel who died during the World Trade Center attack on September 11, 2001, were assessed using measures of demographic characteristics, trauma exposure (physical proximity, emotional proximity, and secondary adversities), use of coping strategies, psychiatric symptoms (posttraumatic stress disorder [PTSD], general anxiety, depression), self-esteem, and traumatic grief. An exploratory factor analysis of the Extended Grief Inventory (EGI; Layne, Savjak, Saltzman, & Pynoos, 2001) indicated distinct constructs of normal versus traumatic grief. CTG factor scores were correlated with secondary adversities from the traumatic event, symptoms of PTSD, anxiety, depression, and coping responses, underscoring the theoretical and clinical utility of the content of the measure. Study limitations and future research recommendations are discussed.
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Creating philanthropic foundations to deal with grief: case studies of bereaved parents.
Rossetto, Kelly R
2014-01-01
The current study involves the analysis of six bereaved parents' stories and argues that the development of philanthropic foundations helped these parents make meaning of their children's deaths and find purpose in the midst of their grief. Furthermore, philanthropy, as a way of making meaning and finding purpose, is a mutually beneficial process because it helps both the bereaved founders and the communities the organizations reach. Connections between these narratives and the bereavement literature help us better understand the individual/family grief process and meaning making, as well as how internal grief states intersect with communities.
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Pathological grief and the activation of latent self-images.
Horowitz, M J; Wilner, N; Marmar, C; Krupnick, J
1980-10-01
The authors studied the case material for patients treated with either psychoanalysis or brief therapy to examine the basis for the various states of pathological grief after berevavement. They view these states as intensifications or unusual prolongations of states found in normal grief and describe them in terms of the reemergence of self-images and role relationship models that had been held in check by the existence ofthe deceased person. This conclusion concerning preexisting mental schemata leads to an elaboration and partial revision of theories of regression, ambivalence, and introjection as causes of pathological grief.
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The grief process for patient, family, and physician.
Bruce, Christine A
2002-09-01
In the grieving process, patient, family, and health professionals have the same needs-rest, relaxation, nourishment, a sense of security, trust, hope in the future, and humor among them. Grief, defined as a shared, universal, and natural neuropsychobiologic expression in response to loss, is distinct from mourning, a practice that varies in expression across diverse cultures. To aid in an understanding of grief and its effects, the author looks at the models for grief proposed by Kubler-Ross, Bowlby, Parkes, Worden, and Wolfelt. Addressing patients' concerns requires physicians be empathic, attentive, and respective and have willingness to take time, be present, and listen.
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Burnout After Patient Death: Challenges for Direct Care Workers.
Boerner, Kathrin; Gleason, Hayley; Jopp, Daniela S
2017-09-01
Direct care workers in long-term care can develop close relationships with their patients and subsequently experience significant grief after patient death. Consequences of this experience for employment outcomes have received little attention. To investigate staff, institutional, patient, and grief factors as predictors of burnout dimensions among direct care workers who had experienced recent patient death; determine which specific aspects of these factors are of particular importance; and establish grief as an independent predictor of burnout dimensions. Participants were 140 certified nursing assistants and 80 homecare workers who recently experienced patient death. Data collection involved comprehensive semistructured in-person interviews. Standardized assessments and structured questions addressed staff, patient, and institutional characteristics, grief symptoms and grief avoidance, as well as burnout dimensions (depersonalization, emotional exhaustion, and personal accomplishment). Hierarchical regressions revealed that grief factors accounted for unique variance in depersonalization, over and above staff, patient, and institutional factors. Supervisor support and caregiving benefits were consistently associated with higher levels on burnout dimensions. In contrast, coworker support was associated with a higher likelihood of depersonalization and emotional exhaustion. Findings suggest that grief over patient death plays an overlooked role in direct care worker burnout. High supervisor support and caregiving benefits may have protective effects with respect to burnout, whereas high coworker support may constitute a reflection of burnout. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Prolonged grief: where to after Diagnostic and Statistical Manual of Mental Disorders, 5th Edition?
Bryant, Richard A
2014-01-01
Although there is much evidence for the construct of prolonged grief, there was much controversy over the proposal to introduce a prolonged grief diagnosis into Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and it was finally rejected as a diagnosis in DSM-5. This review outlines the evidence for and against the diagnosis, and highlights the implications of the DSM-5 decision. Convergent evidence indicates that prolonged grief characterized by persistently severe yearning for the deceased is a distinct construct from bereavement-related depression and anxiety, is associated with marked functional impairment, is responsive to targeted treatments for prolonged grief, and has been validated across different cultures, age groups, and types of bereavement. Although DSM-5 has rejected the construct as a formal diagnosis, evidence continues to emerge on related mechanisms, including maladaptive appraisals, memory and attentional processes, immunological and arousal responses, and neural circuitry. It is most likely that the International Classification of Diseases (ICD-11) will introduce a diagnosis to recognize prolonged grief, even though DSM-5 has decided against this option. It is probable that the DSM-5 decision may result in more prolonged grief patients being incorrectly diagnosed with depression after bereavement and possibly incorrectly treated. The DSM-5 decision is unlikely to impact on future research agendas.
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ERIC Educational Resources Information Center
Lin, Xiuyun; Fang, Xiaoyi; Chi, Peilian; Li, Xiaoming; Chen, Wenrui; Heath, Melissa Allen
2014-01-01
A group of 124 children orphaned by AIDS (COA), who resided in two orphanages funded by the Chinese government, participated in a study investigating the efficacy of a grief-processing-based psychological group intervention. This psychological intervention program was designed to specifically help COA process their grief and reduce their…
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ERIC Educational Resources Information Center
Hedman, A. S.
2012-01-01
Students' comfort discussing death with faculty, views regarding faculty's likelihood to provide accommodations to grief-affected students, and perceived empathy of faculty were assessed. Undergraduate students (n = 371) attending a Midwestern university completed the Student Survey on Grief Issues. Twenty-six percent reported the death of at…
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A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan
ERIC Educational Resources Information Center
Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu
2012-01-01
To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant…
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Engaging Parents of Students with Disabilities: Moving beyond the Grief Model
ERIC Educational Resources Information Center
Allred, Keith W.
2015-01-01
Educators in many Western nations have used the Kübler-Ross stage model of grief for five decades as a lens to explain parental response to disability. A recent article in "Improving Schools," representing this deficit model, asserted that the grief lens is useful in understanding parent's response to learning that their child qualified…
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ERIC Educational Resources Information Center
Wilson, John; Gabriel, Lynne; James, Hazel
2014-01-01
This positional paper originates from our need as researcher/practitioners to establish a meaningful epistemological framework for research into bereaved people's journey through loss and grief over time. We describe how the field of grief research has a long and established biological basis, in keeping with a positivist epistemology.…
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Distinguishing Symptoms of Grief and Depression in a Cohort of Advanced Cancer Patients
ERIC Educational Resources Information Center
Jacobsen, Juliet C.; Zhang, Baohui; Block, Susan D.; Maciejewski, Paul K.; Prigerson, Holly G.
2010-01-01
Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer…
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Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions
ERIC Educational Resources Information Center
Edgar-Bailey, Meredith; Kress, Victoria E.
2010-01-01
This article presents a review of creative interventions that can be helpful in facilitating the resolution of traumatic grief in children and adolescents. Traumatic grief is conceptualized as a condition in which a person loses a close loved one (e.g., a parent or a sibling) in a traumatic manner, and ensuing trauma-related symptoms disrupt the…
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Radical Acceptance: A Nondual Psychology Approach to Grief and Loss
ERIC Educational Resources Information Center
Theriault, Brian
2012-01-01
This article explores the application of nondual psychology in transforming grief and loss into the experience of nondual consciousness. Nondual consciousness is the collapse of the dualistic notions of self and other through the direct realization of the stateless state of no-self. The experience of grief and loss serves as a catalyst to this…
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Bylund-Grenklo, T; Fürst, C J; Nyberg, T; Steineck, G; Kreicbergs, U
2016-07-01
The early loss of a parent is a tragedy and a serious life event. This study investigated grief resolution and morbidity in cancer-bereaved teenagers 6 to 9 years after the loss of a parent to cancer. In a nationwide population-based study of 622 of 851 (73 %) youths who as teenagers 6 to 9 years earlier had lost a parent to cancer, we explored the magnitude of unresolved grief and its association with psychological and physiological morbidity. Participants answered a study-specific anonymous questionnaire including questions about if they had worked through their grief and about their current health. Six to nine years post-loss 49 % reported unresolved grief (8 % no and 41 % a little grief resolution). They had, in comparison with youths reporting resolved grief, statistically significantly elevated risks, e.g. for insomnia (sons' relative risk (RR) 2.3, 95 % CI 1.3-4.0; daughters' RR 1.7, 95 % CI 1.1-2.7), fatigue (sons' RR 1.8, 95 % CI 1.3-2.5; daughters' RR 1.4, 95 % CI 1.1-1.7) and moderate to severe depression, i.e. score >9, PHQ-9 (sons' RR 3.6, 95 % CI 1.4-8.8; daughters' RR 1.8, 95 % CI 1.1-3.1). Associations remained for insomnia in sons, exhaustion in daughters and fatigue in both sons and daughters when depression, negative intrusive thoughts and avoiding reminders of the parents' disease or death were included in a model. Approximately half of cancer-bereaved youth report no or little grief resolution 6 to 9 years post-loss, which is associated with fatigue, sleeping problems and depressive symptoms.
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Shear, Katherine; Newth, Christopher J.L.; Harrison, Rick; Berger, John; Zimmerman, Jerry; Anand, K.J.S.; Carcillo, Joseph; Donaldson, Amy E.; Dean, J. Michael; Willson, Douglas F.; Nicholson, Carol
2011-01-01
Abstract Objective We previously demonstrated that parents whose children die in a pediatric intensive care unit (PICU) have a high level of complicated grief symptoms 6 months after the death. In this study, we investigate the change in the extent of complicated grief symptoms among these parents between 6 and 18 months postdeath and identify factors predicting improvement. Methods One hundred thirty-eight parents of 106 children completed surveys at 6 and 18 months. Surveys included the Inventory of Complicated Grief (ICG), measures of grief avoidance, attachment, caregiving and social support, and demographics. Multivariable analysis was performed using generalized estimating equations to identify characteristics independently associated with improvement in ICG score. Results ICG scores were 33.4 ± 13.6 at 6 months and 28.0 ± 13.5 at 18 months, representing an improvement in ICG score of 5.4 + 8.0 (95% confidence interval [CI] 4.1–6.8, p < 0.001). Variables independently associated with greater improvement in ICG score included traumatic death and greater grief avoidance. Variables independently associated with less improvement included being the biological parent and having more responsive caregiving. Parents with one or two surviving children had more improvement in ICG score than those with no surviving children whereas parents with three or more surviving children had less improvement. Conclusion Complicated grief symptoms decrease among parents between 6 and 18 months after their child's death in the PICU; however, high symptom levels persists for some. Better understanding of the trajectory of complicated grief will allow parents at risk for persistent distress to receive professional support. PMID:21281122
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Culinary Grief Therapy: Cooking for One Series.
Nickrand, Heather L; Brock, Cara M
2017-02-01
Although loss of loved ones is a universal experience, individuals who experience this loss grieve in different ways. Complicated grief involves the development of trauma symptoms, such as flashbacks, anxiety, and fear associated with daily activities after a death that disrupts the healthy grieving process. Daily activities such as eating, meal planning, grocery shopping, managing finances, and household maintenance can become painful and isolating for those experiencing complicated grief. Cognitive behavioral therapy is used to address irrational beliefs, feelings of depression or anger, and avoidance or numbing behaviors with a goal of leading the individual to adapting to a life, which no longer includes the lost loved one. As part of the bereavement counseling program in a hospice, a need was identified in individuals who had lost loved ones and were having difficulty with adjusting to meal planning, grocery shopping, and cooking for one. To address this need for grief counseling centered on meal planning, grocery shopping, meal preparations, and eating meals alone, "Culinary Grief Therapy: Cooking for One Series" was developed with a local Culinary Arts Program. Partnering with a local community college culinary arts program, the Cooking for One Series provides an interactive venue for cognitive behavioral therapy centered on meal planning and meal times. Along with demonstrations and hands-on experiences, participants are engaged in bereavement counseling with hospice staff. Initial reactions to Culinary Grief Therapy have been positive. Many attendees have participated in multiple workshops, and the number of participants grows for each offering. Culinary Grief Therapy is a novel approach to the needs of those experiencing the loss of a loved one and may reduce or prevent complicated grief associated with meal planning, grocery shopping, and cooking for one.
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Clinical features distinguishing grief from depressive episodes: A qualitative analysis.
Parker, Gordon; McCraw, Stacey; Paterson, Amelia
2015-05-01
The independence or interdependence of grief and major depression has been keenly argued in relation to recent DSM definitions and encouraged the current study. We report a phenomenological study seeking to identify the experiential and phenomenological differences between depression and grief as judged qualitatively by those who had experienced clinical (n=125) or non-clinical depressive states (n=28). Analyses involving the whole sample indicated that, in contrast to grief, depression involved feelings of hopelessness and helplessness, being endless and was associated with a lack of control, having an internal self-focus impacting on self-esteem, being more severe and stressful, being marked by physical symptoms and often lacking a justifiable cause. Grief was distinguished from depression by the individual viewing their experience as natural and to be expected, a consequence of a loss, and with an external focus (i.e. the loss of the other). Some identified differences may have reflected the impact of depressive "type" (e.g. melancholia) rather than depression per se, and argue for a two-tiered model differentiating normative depressive and grief states at their base level and then "clinical" depressive and 'pathological' grief states by their associated clinical features. Comparative analyses between the clinical and non-clinical groups were limited by the latter sub-set being few in number. The provision of definitions may have shaped subjects׳ nominated differentiating features. The study identified a distinct number of phenomenological and clinical differences between grief and depression and few shared features, but more importantly, argued for the development of a two-tiered model defining both base states and clinical expressions. Copyright © 2015 Elsevier B.V. All rights reserved.
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Factors Underlying the Relationship Between Parent and Child Grief.
Cipriano, David J; Cipriano, Madeline R
2017-01-01
The death of a parent in a child's life is a significant risk factor for later mental and physical health problems. While much has been written about the surviving parent's functioning and its effects on their bereaved children, little work has been done to look into factors underlying this effect such as how the parent copes. The present study recruited 38 parent-child dyads from a community-based grief support center. Parent and child, independently, completed various measures of emotional functioning, including grief symptoms and coping such as social support and locus of control. The results indicated that parental coping did have an impact on children's grief symptoms. This represents a unique view of adaptation in bereaved children: Parental coping strategies can have an impact on the child, independent of the child's coping strategies. By focusing on parent coping, we have highlighted another possible pathway through which parental functioning affects children's grief.
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Suicide bereavement and complicated grief
Tal Young, Ilanit; Iglewicz, Alana; Glorioso, Danielle; Lanouette, Nicole; Seay, Kathryn; Ilapakurti, Manjusha; Zisook, Sidney
2012-01-01
Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide. PMID:22754290
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Craving love? Enduring grief activates brain's reward center.
O'Connor, Mary-Frances; Wellisch, David K; Stanton, Annette L; Eisenberger, Naomi I; Irwin, Michael R; Lieberman, Matthew D
2008-08-15
Complicated Grief (CG) occurs when an individual experiences prolonged, unabated grief. The neural mechanisms distinguishing CG from Noncomplicated Grief (NCG) are unclear, but hypothesized mechanisms include both pain-related activity (related to the social pain of loss) and reward-related activity (related to attachment behavior). Bereaved women (11 CG, 12 NCG) participated in an event-related functional magnetic resonance imaging scan, during grief elicitation with idiographic stimuli. Analyses revealed that whereas both CG and NCG participants showed pain-related neural activity in response to reminders of the deceased, only those with CG showed reward-related activity in the nucleus accumbens (NA). This NA cluster was positively correlated with self-reported yearning, but not with time since death, participant age, or positive/negative affect. This study supports the hypothesis that attachment activates reward pathways. For those with CG, reminders of the deceased still activate neural reward activity, which may interfere with adapting to the loss in the present.
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Smith, Andrew J; Abeyta, Andrew A; Hughes, Michael; Jones, Russell T
2015-03-01
This study tested a conceptual model merging anxiety buffer disruption and social-cognitive theories to predict persistent grief severity among students who lost a close friend, significant other, and/or professor/teacher in tragic university campus shootings. A regression-based path model tested posttraumatic stress (PTS) symptom severity 3 to 4 months postshooting (Time 1) as a predictor of grief severity 1 year postshootings (Time 2), both directly and indirectly through cognitive processes (self-efficacy and disrupted worldview). Results revealed a model that predicted 61% of the variance in Time 2 grief severity. Hypotheses were supported, demonstrating that Time 1 PTS severity indirectly, positively predicted Time 2 grief severity through undermining self-efficacy and more severely disrupting worldview. Findings and theoretical interpretation yield important insights for future research and clinical application. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
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Children's cancer camps: a way to understand grief differently.
Laing, Catherine M; Moules, Nancy J
2015-01-01
A philosophical hermeneutic study was conducted as part of the first author's doctoral research to understand the meaning of children's cancer camps for the child with cancer and the family. Twenty family members from six families were interviewed in order to bring understanding to this topic. This article will detail the finding related to the experience of grief that often accompanies a cancer diagnosis, and how camp seems to allow children and families to understand their grief differently. The interesting thing about this particular cancer camp is that families of children who have died continue to attend the camp yearly, and there are events to memorialize the many children known to all the campers who no longer attend camp. This is not a grief camp but a cancer camp where grief is allowed presence as it necessarily has to in the world of childhood cancer.
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Diagnostic and clinical considerations in prolonged grief disorder.
Maercker, Andreas; Lalor, John
2012-06-01
This review focuses on the similarities and differences between prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). It highlights how a PTSD-related understanding aids the investigation and clinical management of PGD. Grief has long been understood as a natural response to bereavement, as serious psychological and physiological stress has been regarded as a potential outcome of extreme or traumatic stress. PTSD was first included in DSM-III in 1980. In the mid-1980s, the first systematic investigation began into whether there is an extreme or pathological form of mourning. Meanwhile, there is much research literature on complicated, traumatic, or prolonged grief This literature is reviewed in this article, with the following questions: Is it possible to distinguish normal from non-normal grief? Which clinical presentation does PGD have-and how does this compare with PTSD? Finally, diagnostic, preventive, and therapeutic approaches and existing tools are presented.
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Diagnostic and clinical considerations in prolonged grief disorder
Maercker, Andreas; Lalor, John
2012-01-01
This review focuses on the similarities and differences between prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). It highlights how a PTSD-related understanding aids the investigation and clinical management of PGD. Grief has long been understood as a natural response to bereavement, as serious psychological and physiological stress has been regarded as a potential outcome of extreme or traumatic stress. PTSD was first included in DSM-III in 1980. In the mid-1980s, the first systematic investigation began into whether there is an extreme or pathological form of mourning. Meanwhile, there is much research literature on complicated, traumatic, or prolonged grief This literature is reviewed in this article, with the following questions: Is it possible to distinguish normal from non-normal grief? Which clinical presentation does PGD have—and how does this compare with PTSD? Finally, diagnostic, preventive, and therapeutic approaches and existing tools are presented. PMID:22754289
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Nakajima, Satomi; Masaya, Ito; Akemi, Shirai; Takako, Konishi
2012-01-01
Violent death, such as homicide, accident, and suicide, is sudden, unexpected, and caused by intentional power, The prevalence of complicated grief among those bereaved by violent death is 12,5% to 78,0%. The factors affecting this prevalence rate are considered to be comorbid mental disorders, lack of readiness for the death, difficulty in making sense of the death, high level of negative appraisal about the self and others, and various social stressors. Post-traumatic stress disorder is, in particular, considered to contribute to the development of complicated grief by suppressing function of the medial prefrontal cortex and the anterior cingulate cortex, which works at facilitating the normal mourning process. An understanding of the mechanism and biological basis of complicated grief by violent death will be helpful in developing effective preventive intervention and treatment. PMID:22754294
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Anxiety Sensitivity in Bereaved Adults with and without Complicated Grief
Robinaugh, Donald J.; McNally, Richard J.; LeBlanc, Nicole J.; Pentel, Kimberly Z.; Schwarz, Noah R.; Shah, Riva M.; Nadal-Vicens, Mireya F.; Moore, Cynthia W.; Marques, Luana; Bui, Eric; Simon, Naomi M.
2014-01-01
Complicated grief (CG) is a bereavement specific syndrome chiefly characterized by symptoms of persistent separation distress. Physiological reactivity to reminders of the loss and repeated acute pangs or waves of severe anxiety and psychological pain are prominent features of CG. Fear of this grief-related physiological arousal may contribute to CG by increasing the distress associated with grief reactions and increasing the likelihood of maladaptive coping strategies and grief-related avoidance. Here, we examined anxiety sensitivity (i.e., the fear of anxiety-related sensations; AS) in two studies of bereaved adults with and without CG. In both studies, bereaved adults with CG exhibited elevated AS relative to those without CG. In Study 2, AS was positively associated with CG symptom severity among those with CG. These findings are consistent with the possibility that AS contributes to the development or maintenance of CG symptoms. PMID:25075646
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How do attachment dimensions affect bereavement adjustment? A mediation model of continuing bonds.
Yu, Wei; He, Li; Xu, Wei; Wang, Jianping; Prigerson, Holly G
2016-04-30
The current study aims to examine mechanisms underlying the impact of attachment dimensions on bereavement adjustment. Bereaved mainland Chinese participants (N=247) completed anonymous, retrospective, self-report surveys assessing attachment dimensions, continuing bonds (CB), grief symptoms and posttraumatic growth (PTG). Results demonstrated that attachment anxiety predicted grief symptoms via externalized CB and predicted PTG via internalized CB at the same time, whereas attachment avoidance positively predicted grief symptoms via externalized CB but negatively predicted PTG directly. Findings suggested that individuals with a high level of attachment anxiety could both suffer from grief and obtain posttraumatic growth after loss, but it depended on which kind of CB they used. By contrast, attachment avoidance was associated with a heightened risk of maladaptive bereavement adjustment. Future grief therapy may encourage the bereaved to establish CB with the deceased and gradually shift from externalized CB to internalized CB. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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Suicide survivors' mental health and grief reactions: a systematic review of controlled studies.
Sveen, Carl-Aksel; Walby, Fredrik A
2008-02-01
There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified by searching the PsychINFO and MEDLINE databases. Forty-one studies met the eligibility criteria. A qualitative data analysis was performed. There were no significant differences between survivors of suicide and other bereaved groups regarding general mental health, depression, PTSD symptoms, anxiety, and suicidal behavior. The results regarding the overall level of grief are less clear, depending on whether general grief instruments or suicide-specific instruments are used. Considering specific grief variables, suicide survivors report higher levels of rejection, shame, stigma, need for concealing the cause of death, and blaming than all other survivor groups.
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Facial expressions of emotion and the course of conjugal bereavement.
Bonanno, G A; Keltner, D
1997-02-01
The common assumption that emotional expression mediates the course of bereavement is tested. Competing hypotheses about the direction of mediation were formulated from the grief work and social-functional accounts of emotional expression. Facial expressions of emotion in conjugally bereaved adults were coded at 6 months post-loss as they described their relationship with the deceased; grief and perceived health were measured at 6, 14, and 25 months. Facial expressions of negative emotion, in particular anger, predicted increased grief at 14 months and poorer perceived health through 25 months. Facial expressions of positive emotion predicted decreased grief through 25 months and a positive but nonsignificant relation to perceived health. Predictive relations between negative and positive emotional expression persisted when initial levels of self-reported emotion, grief, and health were statistically controlled, demonstrating the mediating role of facial expressions of emotion in adjustment to conjugal loss. Theoretical and clinical implications are discussed.
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Role of attachment in response to pet loss.
Field, Nigel P; Orsini, Lisa; Gavish, Roni; Packman, Wendy
2009-04-01
This study examined the impact of attachment on grief severity following the death of a pet. Seventy-one participants who had lost a dog or cat within the past year completed a set of measures that included an attachment measure assessing individual differences in attachment anxiety and avoidance, strength of the past attachment to the pet, the continuing bond with the deceased pet, social support, and complicated grief symptoms. Attachment anxiety and strength of the past attachment to the pet were each uniquely predictive of more severe grief. Furthermore, the continuing bond to the deceased pet partially mediated the impact of strength of the past attachment to the pet on grief severity. No significant mediators of the effect of attachment anxiety on grief were found, however. The results highlight the importance of distinguishing strength of attachment from attachment security in examining the effect of attachment on response to pet loss.
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Attachment, social support, and responses following the death of a companion animal.
King, Loren C; Werner, Paul D
This research tested hypotheses concerning attachment, social support, and grief responses to the loss of animal companionship. Participants whose companion cat or dog had recently died (N = 429) completed the Attachment Style Questionnaire, the Inventory of Complicated Grief, and the Multidimensional Health Profile-Psychosocial Functioning questionnaires. Both attachment anxiety and attachment avoidance were found to be positively associated with respondents' grief, depression, anxiety, and somatic symptoms. Social support was found to be negatively associated with these outcomes as well as with attachment anxiety and attachment avoidance. In multiple regression analyses, attachment anxiety incrementally predicted grief, anxiety and somatic symptoms, attachment avoidance incrementally predicted grief and depression, and social support incrementally predicted all outcomes. Interaction effects of attachment and social support in relation to outcomes were not found. The present study's implications and limitations are discussed, as are directions for future research.
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Rapid Resolution of Grief with IV Infusion of Ketamine: A Unique Phenomenological Experience
Gowda, Mahesh Ramanna; Srinivasa, Preethi; Kumbar, Prabha S.; Ramalingaiah, Vinay Hosagavi; Muthyalappa, Chandrashekar; Durgoji, Sumit
2016-01-01
Ketamine, a primarily FDA-approved anaesthetic agent is also used as recreational drug. Based on preclinical findings and later the clinical observations it is noted to have rapid antidepressant effect due to its mechanisms related to NMDA antagonism. In spite of established evidence of ketamine being effective in depression with significant role in treatment resistant cases as well, there was absolute dearth of literature regarding its utility in grief-related disorders. In this context we present a case of 28-year-old graduate male who presented to us in complicated grief following death of his wife due to obstetric complications. With the patient and immediate family members consenting for use of ketamine as off-label use, patient had single IV infusion of ketamine following which he had unique phenomenological experience ultimately resolving his grief in few minutes. Through this case we highlight the enormous therapeutic promise of ketamine in complicated grief. PMID:27011405
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ERIC Educational Resources Information Center
Holland, Jason M.; Futterman, Andrew; Thompson, Larry W.; Moran, Christine; Gallagher-Thompson, Dolores
2013-01-01
Previous research has identified three distinct factors that make up the Texas Revised Inventory of Grief-Present (TRIG-Present) scale, which tap into grief-related thoughts, emotional response, and nonacceptance regarding a loss. In the present study, the authors sought to identify which of these core grief experiences in the early aftermath of…
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ERIC Educational Resources Information Center
Cowie, Keith; Quinn, Kathleen; Gunning, Michael P.; Gunning, Kristen M.
1998-01-01
Addresses the systemic needs of families of disabled students in terms of their interactions with school personnel. Argues that helping family members to understand their grief and providing support as they deal with grief issues will help the family system adjust and function optimally in collaboration with the school system. (MKA)
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Grief and Loss: Towards an Existential Phenomenology of Child Spirituality
ERIC Educational Resources Information Center
Walters, David A.
2008-01-01
Western cultures have taken on a death-denying and grief-avoiding dimension, suggesting that children in particular are to be protected from the harshness of loss and death. As a result, many children grow up without having consciously experienced the pain of major loss and grief. It is argued that having been spared from suffering, from the pain…
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ERIC Educational Resources Information Center
Kristensen, Pal; Weisaeth, Lars; Heir, Trond
2010-01-01
The authors examined predictors of complicated grief (CG) in Norwegians 2 years after bereavement in the 2004 South-East Asian tsunami. A cross-sectional postal survey retrospectively covering disaster experiences and assessing CG according to the Inventory of Complicated Grief yielded 130 respondents (35 directly disaster-exposed and 95 not…
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Predictors of Grief and Depressed Mood among Gay Men Following an Aids-Related Loss
ERIC Educational Resources Information Center
Wayment, Heidi A.; Kemeny, Margaret E.
2004-01-01
This prospective study examined the unique predictors of grief and depressed mood in a sample of gay men (34 HIV positive, 69 HIV negative) who lost a close friend to AIDS. Individuals low in self-esteem reported greater depressed mood but no differences in grief following the death. Individuals with personality factors that predispose toward…
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Granek, Leeat; Peleg-Sagy, Tal
2015-01-01
The authors examined representations of African Americans in the grief literature to assess (a) frequencies; (b) content; and (c) use of universalist or a contextualized framework. They conducted searches in 3 databases that target the grief literature published in the last 15 years. Fifty-nine articles met the criteria. There are a small number of studies published on African Americans and these tend to focus on homicide. Many studies had incomplete methods. Comparison studies were common and pathological grief outcomes that were validated on White populations were used as outcome variables with African American participants.
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Mindfulness-based Intervention for Perinatal Grief after Stillbirth in Rural India
Roberts, Lisa R.; Montgomery, Susanne B.
2015-01-01
We explored the concept of using a Mindfulness-based intervention to reduce perinatal grief among Indian women. Data were collected using mixed methods to explore concept acceptability, receptivity, modality, and feasibility of the intervention. The intervention was piloted and evaluated with measures of perinatal grief, psychosocial wellbeing, religious coping, perceived social provision of support, and mindfulness. The intervention was well received and effective in teaching skills to help women deal with high levels of grief and subsequent mental health challenges. To overcome attendance barriers modification is necessary. Partnership with a local nursing school is critical to enhance sustainability of the intervention. PMID:25898268
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The year of magical thinking: Joan Didion and the dialectic of grief.
Brennan, F; Dash, M
2008-06-01
Joan Didion is a prominent American writer. In late 2003, while her only child lay critically ill, her husband, John, died suddenly. Theirs was a marriage of great intimacy and love. Grief enveloped her. Eventually she began to write an account of the first 12 months of her bereavement and the vigil for her child: The year of magical thinking. Raw, insightful and challenging, it is a rich, generous and graceful document. Didion draws on the literature of grief, personal and professional. Here, those readings are examined and reflections are made on the singular, unique grief of the author in the context of current theories on bereavement.
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Brown, Olivia K; Symons, Douglas K
2016-01-01
This study examined attachment relationships and emotional distress after the passing of a pet. Participants were 73 university students 17-26 years of age who had lost a family pet within the past 5 years. They completed measures of attachment styles toward people and their pet, as well as complicated grief, depression, and trauma. As hypothesized, there were positive relations between attachments with people and pets, and anxiety in pet attachment was positively related to complicated grief, even when attachment with people was controlled. Results are discussed in terms of the importance of attachment style to grief over loss.
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Support program for women suffering grief after termination of pregnancy: A pilot study.
Sriarporn, Punpilai; Turale, Sue; Lordee, Nuananong; Liamtrirat, Sawanee; Hanpra, Wasana; Kanthino, Authid
2017-03-01
In this study, we preliminarily examined the effects of the Informational and Emotional Support Program for Women after Pregnancy Termination in 30 Thai women. A literature review and House's theory of social support informed the program content, which consisted of the following elements: (i) an evaluation of grief; (ii) an analysis of the problems and needs of each woman; (iii) informational and emotional support tailored to individual problems and needs; (iv) telephone support; and (v) an exit phone interview. The Grief Questionnaire for Women after Pregnancy Termination was used to measure changes in the grief levels of participants. The data were analyzed using descriptive statistics and the contingency coefficient. At the completion of the study, the participants' average grief score had decreased from the prior grief score and was in the moderate to low range. These preliminary findings indicate that the support program can be effective in real-life situations in Thailand to assist women who are grieving after the termination of pregnancy. Our findings highlight the need for nursing and emotional support to be provided to help Thai women after the TOP. © 2016 John Wiley & Sons Australia, Ltd.
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Functional neuroanatomy of grief: an FMRI study.
Gündel, Harald; O'Connor, Mary-Frances; Littrell, Lindsey; Fort, Carolyn; Lane, Richard D
2003-11-01
In this study the authors examined the functional neuroanatomy of grief, which to their knowledge has not been studied previously in functional neuroimaging research. Grief was elicited in eight bereaved women through photographs of the deceased versus a stranger, combined with words specific to the death event versus neutral words. Use of both pictures and words resulted in a 2x2 factorial design. Three brain regions were independently activated by the picture and word factors: posterior cingulate cortex, medial/superior frontal gyrus, and cerebellum. The two factors also activated distinct regions: for the picture factor, they were the cuneus, superior lingual gyrus, insula, dorsal anterior cingulate cortex, inferior temporal gyrus, and fusiform gyrus; and for the word factor, they were the precuneus, precentral gyrus, midbrain, and vermis. The interaction of the two factors showed significant activation in the cerebellar vermis. Grief is mediated by a distributed neural network that subserves affect processing, mentalizing, episodic memory retrieval, processing of familiar faces, visual imagery, autonomic regulation, and modulation/coordination of these functions. This neural network may account for the unique, subjective quality of grief and provide new leads in understanding the health consequences of grief and the neurobiology of attachment.
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Kostopoulou, Sotiria; Parpa, Efi; Tsilika, Eleni; Katsaragakis, Stylianos; Papazoglou, Irene; Zygogianni, Anna; Galanos, Antonis; Mystakidou, Kyriaki
2018-04-01
The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory-Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS). Moderate to strong statistically significant correlations were found between the 4 subscales of PDI-Gr (psychological distress, body image and role identity, self-esteem, and social support) with G-HADS, G-SAHD, and PGAC ( P < .005), while physical distress and dependency was moderately correlated with depression. Multifactorial analyses showed that preparatory grief, depression, and age influenced psychological distress, while preparatory grief, depression, and performance status influenced body image and role identity. Preparatory grief, psychological distress, and physical symptoms had significant associations with perceptions of dignity among patients with advanced cancer. Clinicians should assess and attend to dignity-distressing factors in the care of patients with advanced cancer.
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A community for grieving: affordances of social media for support of bereaved parents
NASA Astrophysics Data System (ADS)
Segerstad, Ylva Hård Af; Kasperowski, Dick
2015-04-01
The purpose of this paper was to study bereaved parents' use of a closed peer grief support community on Facebook and the features of the community that are important to them. The death of a child is an uncomfortable subject in most contemporary societies. This limits the exploration of experiences and possibilities for coping with grief. However, with the introduction of social media, this has changed. Theoretical perspectives on parental grief recognizing the importance of continued relational bonds with the lost child are used, together with the ontological assumption that social media enhance the dissolving of private/public and time/space. This study is based on questionnaire, interviews, and content from the closed peer grief support community, to which the research team has insider access. The community encompasses a diverse range of experiences and stages of grief, independent of the time elapsed since the loss of a child. Bereavement of children of all ages and from all conceivable causes of death is distributed among the members. The results show how the affordances of social media become vital resources for coping with grief in ways not available previously, comprising aspects of the closed nature of the group, shared experiences, time, and accessibility.
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2013-01-01
Background There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. Methods/Design We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8–18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. Discussion We aim to contribute to the improvement of mental health care for children and adolescents suffering from loss. By comparing Grief-Help with supportive counselling, and by investigating mediators and moderators of its effectiveness we hope to provide new insights in the effects of interventions for bereaved children, and their mechanisms of change. Trial registration Netherlands Trial Register NTR3854 PMID:24252587
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Glickman, Kim; Shear, M Katherine; Wall, Melanie
2016-01-01
The present study examines a more fine-grained analysis of anxiety-related and depression-related outcomes amongst a sample of treatment completers who were assigned to complicated grief treatment (CGT) (n = 35) or interpersonal psychotherapy (IPT) (n = 34) in a previously reported randomized controlled trial. We examined effects of antidepressant use and measures of anxiety and depression, focusing especially on guilt related to the death or deceased and grief-related avoidance in order to further understand the differential effectiveness of CGT and IPT amongst participants who received the full course of treatment. Analyses showed that CGT produced greater reductions in anxiety and depressive symptoms including negative thoughts about the future and grief-related avoidance. CGT's advantage over IPT in lowering depression was most pronounced amongst those not taking antidepressants. Our results further elucidate CGT effects and support the idea that CG and major depressive disorder are distinct conditions. Targeted treatment for complicated grief (CG) produces benefits in associated mood and anxiety symptoms and CG symptoms. Amongst patients with CG, interpersonal psychotherapy seems relatively ineffective in ameliorating depressive symptoms. Grief-related depressive symptoms may not respond to standard treatments unless CG symptoms are also addressed. Reducing grief-related symptoms, such as anxieties about the future, guilt related to the death or deceased and avoidance of reminders of the loss may be important aspects in reducing CG. Copyright © 2014 John Wiley & Sons, Ltd.
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The push and pull of grief: Approach and avoidance in bereavement.
Maccallum, Fiona; Sawday, Simon; Rinck, Mike; Bryant, Richard A
2015-09-01
Prolonged Grief (PG) is recognized as a post-bereavement syndrome that is associated with significant impairment. Although approach and avoidance tendencies have both been hypothesized to play key roles in maintaining PG symptoms, understanding of these relationships has been limited by a reliance on self-report methodology. This study applies an experimental paradigm to simultaneously investigate the relationship between PG severity and approach-avoidance behavioral tendencies. Fifty-five bereaved individuals with and without PG completed a behavioral measure of approach and avoidance responding in which they pulled or pushed a joystick in response to grief-related, positive, negative and neutral images that appeared on a computer screen. Concurrent visual feedback created the illusion that the images were either approaching or receding from the participant. Half of the participants also received a prime designed to activate their grief prior to the task. Irrespective of prime condition, PG participants pulled grief-related images more quickly than they pushed them. This difference was not observed in response to non-grief related images. Non PG participants showed no difference in their reaction times to grief-stimuli. This study was undertaken in a nonclinical setting and the majority of participants had lost a loved one due to chronic illness. Future research with treatment-seeking populations and sudden loss will be needed to explore the generalizability of the findings. The findings from this study provide preliminary evidence supporting models of PG that integrate approach and avoidance tendencies. Copyright © 2015 Elsevier Ltd. All rights reserved.
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After the death of a friend: Young Men’s grief and masculine identities
Creighton, Genevieve; Oliffe, John L.; Butterwick, Shauna; Saewyc, Elizabeth
2015-01-01
Young men can have an uncomfortable relationship with grief. Socially constructed masculine ideals dictate that men be stoic in the aftermath of loss, most often expressing their sadness and despair as anger. Perhaps because of alignment to such masculine ideals little research has been done to explore young men’s grief – and chronicle the ways they think about loss, their responses and how they go about describing their identities after a tragic event. Using qualitative individual interviews and photo elicitation methods, we investigated the ways in which 25 men aged 19–25 grieved the accidental death of a male friend. The study was conducted from April 2010–December 2011. Causes of death were diverse, and included motor vehicle accidents, adventure sports, drug overdose and fights. The findings revealed men’s predominant grief responses as emptiness, anger, stoicism and sentimentality. Participants’ description of their grief responses illustrated the ways in which they struggled to reconcile feelings of vulnerability and manly ideals of strength and stoicism. We gained insight into men’s grief practices by looking at the ways in which they aligned themselves with a post-loss masculine identity. These identities, which included the adventurer, father-figure and the lamplighter, revealed gender-specific processes through which men understood and actively dealt with their tragic loss. The results offer novel insights to men’s grief and identity work that may serve to affirm other men’s experiences as well as guide counselling services targeted to young men. PMID:23517702
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After the death of a friend: young men's grief and masculine identities.
Creighton, Genevieve; Oliffe, John L; Butterwick, Shauna; Saewyc, Elizabeth
2013-05-01
Young men can have an uncomfortable relationship with grief. Socially constructed masculine ideals dictate that men be stoic in the aftermath of loss, most often expressing their sadness and despair as anger. Perhaps because of alignment to such masculine ideals little research has been done to explore young men's grief--and chronicle the ways they think about loss, their responses and how they go about describing their identities after a tragic event. Using qualitative individual interviews and photo elicitation methods, we investigated the ways in which 25 men aged 19-25 grieved the accidental death of a male friend. The study was conducted from April 2010-December 2011. Causes of death were diverse, and included motor vehicle accidents, adventure sports, drug overdose and fights. The findings revealed men's predominant grief responses as emptiness, anger, stoicism and sentimentality. Participants' description of their grief responses illustrated the ways in which they struggled to reconcile feelings of vulnerability and manly ideals of strength and stoicism. We gained insight into men's grief practices by looking at the ways in which they aligned themselves with a post-loss masculine identity. These identities, which included the adventurer, father-figure and the lamplighter, revealed gender-specific processes through which men understood and actively dealt with their tragic loss. The results offer novel insights to men's grief and identity work that may serve to affirm other men's experiences as well as guide counselling services targeted to young men. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Kaufman, Kenneth R; Kaufman, Nathaniel D
2006-01-01
Childhood grief and mourning of family and friends may have immediate and long-lasting consequences including depression, anxiety, social withdrawal, behavioral disturbances, and school underachievement. Childhood pet bereavement is no less important, because the pet is often considered a member of the family by the child. However, society does not always acknowledge the significance of pet bereavement, which can result in unresolved grief. This article, a case analysis with literature review, addresses childhood pet bereavement in the context of multiple prior losses (K. R. Kaufman & N. D. Kaufman, 2005). This case mirrors both old and new findings in grief research and therapy: (a) beneficial response to emotional expression of grief in context of search for meaning; (b) beneficial response to cognitive approach toward grief with ability to prevent development of complicated grief even in the face of multiple losses; (c) beneficial effects associated with supportive family and with positive self-concept; (d) intensity of grief magnified by the child's degree of attachment to the pet, the suddenness of the pet's death, the multiple prior losses, and the role of the pet in the child's life; and (e) resiliency. This case further emphasizes the need for parents not to trivialize death of pets, to appreciate the role pets have in children's lives, and to assist the child in multiple approaches toward expression (be it verbal, written, or artistic). Finally, this case reinforces the ability of the child to assist in family bereavement and to serve as teacher.
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ERIC Educational Resources Information Center
Haley, Melinda; Hammond, Helen; Ingalls, Lawrence; Marín, Merranda Romaro
2013-01-01
Parental grief reactions have typically been examined in situations where parents have a child diagnosed with a major medical or mental health condition. This study used the grief and loss model as conceptualized by Kubler-Ross (1969), Lamb (1988), and Kubler-Ross and Kessler (2005) as a foundation in examining parental reactions when a child has…
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ERIC Educational Resources Information Center
Ott, Carol H.; Sanders, Sara; Kelber, Sheryl T.
2007-01-01
Purpose: The purpose of this study was to describe the grief and personal growth experience of spouses and adult children of individuals with Alzheimer's disease and related dementias and the factors contributing to these experiences. Design and Methods: We used a modification of the Marwit-Meuser-Sanders Caregiver Grief model to examine the…
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ERIC Educational Resources Information Center
Gray, Jennifer A.; Abendroth, Maryann
2016-01-01
Background: The study explored the grief process of persons with intellectual and developmental disabilities (PWIDDs) as perceived by direct care workers (DCWs) and how such workers can guide and support PWIDDs experiencing grief. Materials and Methods: A thematic analysis approach was used to examine data from nine focus groups with 60 DCWs from…
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ERIC Educational Resources Information Center
de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert
2010-01-01
Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the…
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Are the Developmental Needs of Children in America Adequately Addressed during the Grief Process?
ERIC Educational Resources Information Center
Schoen, Alexis Ann; Burgoyne, Megan; Schoen, Sharon Faith
2004-01-01
There is no debate about the natural, normal, unique, and lifelong process of the grief of the death of a loved one. The loss is an intensely individualized experience. Yet, given an understanding of human growth and development, some general predictions about the concept of death and the grief reaction can be made based upon common patterns of…
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Lövgren, Malin; Sveen, Josefin; Nyberg, Tommy; Eilegård Wallin, Alexandra; Prigerson, Holly G; Steineck, Gunnar; Kreicbergs, Ulrika
2018-02-01
A majority of cancer-bereaved siblings report long-term unresolved grief, thus it is important to identify factors that may contribute to resolving their grief. To identify modifiable or avoidable family and care-related factors associated with unresolved grief among siblings two to nine years post loss. This is a nationwide Swedish postal survey. Study-specific questions and the standardized instrument Hospital Anxiety and Depression Scale. Primary outcome was unresolved grief, and family and care-related factors were used as predictors. Cancer-bereaved sibling (N = 174) who lost a brother/sister to childhood cancer during 2000-2007 in Sweden (participation rate 73%). Seventy-three were males and 101 females. The age of the siblings at time of loss was 12-25 years and at the time of the survey between 19 and 33 years. Several predictors for unresolved grief were identified: siblings' perception that it was not a peaceful death [odds ratio (OR): 9.86, 95% confidence interval (CI): 2.39-40.65], limited information given to siblings the last month of life (OR: 5.96, 95% CI: 1.87-13.68), information about the impending death communicated the day before it occurred (OR: 2.73, 95% CI: 1.02-7.33), siblings' avoidance of the doctors (OR: 3.22, 95% CI: 0.75-13.76), and lack of communication with family (OR: 2.86, 95% CI: 1.01-8.04) and people outside the family about death (OR: 5.07, 95% CI: 1.64-15.70). Depressive symptoms (OR: 1.27, 95% CI: 1.12-1.45) and time since loss (two to four years: OR: 10.36, 95% CI: 2.87-37.48 and five to seven years: OR: 8.36, 95% CI: 2.36-29.57) also predicted unresolved grief. Together, these predictors explained 54% of the variance of unresolved grief. Siblings' perception that it was not a peaceful death and poor communication with family, friends, and healthcare increased the risk for unresolved grief among the siblings.
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Providing grief resolution as an oncology nurse retention strategy: a literature review.
Hildebrandt, Lori
2012-12-01
Oncology nurses play a pivotal role in optimizing care provided to patients at the end of life (EOL). Although oncology nurses commonly provide EOL care and witness deaths of patients that they have maintained long-standing relationships with, they are frequently excluded from grief resolution endeavors. With a worldwide shortage of oncology nurses, retention is paramount to ensuring that the care patients with cancer receive is not jeopardized. Various strategies were identified to resolve grief and increase nurse retention, including creating supportive work environments, debriefing with colleagues, providing EOL and grief education, and altering patient care assignments. Future research on emerging technologies and their effects on oncology nurse coping and retention strategies also was suggested.
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Immunological and neuroimaging biomarkers of complicated grief
O'Connor, Mary-Frances
2012-01-01
Complicated grief (CG) is a disorder marked by intense and persistent yearning for the deceased, in addition to other criteria. The present article reviews what is known about the immunologic and neuroimaging biomarkers of both acute grief and CG, Attachment theory and cognitive stress theory are reviewed as they pertain to bereavement, as is the biopsychosocial model of CG. Reduced immune cell function has been replicated in a variety of bereaved populations. The regional brain activation to grief cues frequently includes the dorsal anterior cingulate cortex and insula, and also the posterior cingulate cortex. Using theory to point to future research directions, we may eventually learn which biomarkers are helpful in predicting CG, and its treatment. PMID:22754286
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Is Higher Acceptance Associated With Less Anticipatory Grief Among Patients in Palliative Care?
Davis, Esther L; Deane, Frank P; Lyons, Geoffrey C B; Barclay, Gregory D
2017-07-01
Patients in palliative care can experience substantial psychological suffering. Acceptance-based interventions from approaches such as Acceptance and Commitment Therapy have demonstrated effectiveness in helping people cope with a range of life challenges. However, there is a dearth of research examining mechanisms of therapeutic change for patients in palliative care. To assess the relationships between acceptance, anticipatory grief, anxiety, and depression among patients in palliative care. A cross-sectional survey was verbally administered to inpatients (N = 73) receiving palliative care. Correlations revealed that acceptance had a strong relationship with anticipatory grief, anxiety, and depression. A hierarchical regression analysis on anticipatory grief showed that acceptance was the largest predictor and accounted for an additional 13% of variance in anticipatory grief over and above anxiety and depression. The present study provides preliminary data suggesting that interventions that target acceptance may be indicated in patients in palliative care. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.
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Rudd, Rebecca A; D'Andrea, Livia M
2013-01-01
The purpose of this qualitative phenomenological study examines the support needs and grief interventions professional and bereaved parents believed were helpful during different time periods in the grief process: the first 72 hours, first three to 14 days, and two weeks and beyond. Ten professionals from the following disciplines were interviewed: emergency communications, emergency medical technician, police, fireman, detective, social worker funeral director chaplain, peer support leader, and bereavement organization. Five parents and one grandparent bereaved by Sudden Infant Death Syndrome (SIDS) or Sudden Unexplained Death in Childhood (SUDC) were interviewed. This study identified 13 support need and grief interventions: contact support people, emotional and cognitive regulation, preliminary information on cause of death, time with deceased child, accommodate and advocate, human compassion and support, describe timeline and process, referrals and resources, affordable and easy access to services, communication and follow-up, community experience, professional mental health support, and memorialize. Recommendations are provided on ways to improve services to newly bereaved parents.
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A Chronic Grief Intervention for Dementia Family Caregivers in Long-Term Care
Paun, Olimpia; Farran, Carol J.; Fogg, Louis; Loukissa, Dimitra; Thomas, Peggy E.; Hoyem, Ruby
2017-01-01
Dementia caregivers do not relinquish their role after placing family members in long-term care and they experience increased chronic grief. The Chronic Grief Management Intervention (CGMI) is a12-week group-based program that uses guided discussion to deliver knowledge of Alzheimer’s or a related dementia and teach skills in communication, conflict resolution, and chronic grief management in dementia caregivers who placed their family members in long-term care. Using a quasi-experimental design, 83 caregivers from 15 long-term care facilities received either the CGMI (n = 34) or a comparison condition consisting of two check-in calls (n = 49). In this pilot study, we examined the feasibility of implementing the CGMI and evaluated the effects of the intervention on caregivers’ knowledge and skill and their chronic grief and depression. The intervention was feasible and resulted in significant improvement in caregivers’ heartfelt sadness and longing at 3 months and a significant drop in their guilt at the 6-month follow-up. PMID:24510968
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Fowler, Nicole R.; Hansen, Alexandra S.; Barnato, Amber E.; Garand, Linda
2013-01-01
Objective Measure perceived involvement in medical decision making and determine if anticipatory grief is associated with problem solving among family caregivers of older adults with cognitive impairment. Method Retrospective analysis of baseline data from a caregiver intervention (n=73). Multivariable regression models testing the association between caregivers’ anticipatory grief, measured by the Anticipatory Grief Scale (AGS), with problem solving abilities, measured by the Social Problem Solving Inventory – Revised: Short Form (SPSI-R: S). Results 47/73 (64%) of caregivers reported involvement in medical decision making. Mean AGS was 70.1 (± 14.8) and mean SPSI-R:S was 107.2 (± 11.6). Higher AGS scores were associated with lower positive problem orientation (P=0.041) and higher negative problem orientation scores (P=0.001) but not other components of problem solving- rational problem solving, avoidance style, and impulsivity/carelessness style. Discussion Higher anticipatory grief among family caregivers impaired problem solving, which could have negative consequences for their medical decision making responsibilities. PMID:23428394
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Bonanno, G A; Keltner, D; Holen, A; Horowitz, M J
1995-11-01
It has been widely assumed that emotional avoidance during bereavement leads to either prolonged grief, delayed grief, or delayed somatic symptoms. To test this view, as well as a contrasting adaptive hypothesis, emotional avoidance was measured 6 months after a conjugal loss as negative verbal-autonomic response dissociation (low self-rated negative emotion coupled with heightened cardiovascular activity) and compared with grief measured at 6 and 14 months. The negative dissociation score evidenced reliability and validity but did not evidence the assumed link to severe grief. Rather, consistent with the adaptive hypothesis, negative dissociation at 6 months was associated with minimal grief symptoms across 14 months. Negative dissociation scores were also linked to initially high levels of somatic symptoms, which dropped to a low level by 14 months. Possible explanations for the initial cost and long-term adaptive quality of emotional avoidance during bereavement, as well as implications and limitations of the findings, are discussed.
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Craving love? Enduring grief activates brain’s reward center
O’Connor, Mary-Frances; Wellisch, David K.; Stanton, Annette L.; Eisenberger, Naomi I.; Irwin, Michael R.; Lieberman, Matthew D.
2008-01-01
Complicated grief (CG) occurs when an individual experiences prolonged, unabated grief. The neural mechanisms distinguishing CG from noncomplicated grief (NCG) are unclear, but hypothesized mechanisms include both pain-related activity (related to the social pain of loss) and reward-related activity (related to attachment behavior). Bereaved women (11 CG, 12 NCG) participated in an event-related functional magnetic resonance imaging scan, during grief elicitation with idiographic stimuli. Analyses revealed that whereas both CG and NCG participants showed pain-related neural activity in response to reminders of the deceased, only those with CG showed reward-related activity in the nucleus accumbens (NA). This NA cluster was positively correlated with self-reported yearning, but not with time since death, participant age, or positive/negative affect. This study supports the hypothesis that attachment activates reward pathways. For those with CG, reminders of the deceased still activate neural reward activity, which may interfere with adapting to the loss in the present. PMID:18559294
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ERIC Educational Resources Information Center
Bellali, Thalia; Papadatou, Danai
2006-01-01
The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved…
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Social and Cultural Factors Associated with Perinatal Grief in Chhattisgarh, India
Roberts, Lisa R.; Montgomery, Susanne; Lee, Jerry W.; Anderson, Barbara A.
2017-01-01
Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N = 355) who had experienced stillbirth (n = 178) and compared to those who had not (n = 177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding—distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women. PMID:21956647
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Social and cultural factors associated with perinatal grief in Chhattisgarh, India.
Roberts, Lisa R; Montgomery, Susanne; Lee, Jerry W; Anderson, Barbara A
2012-06-01
Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N=355) who had experienced stillbirth (n=178) and compared to those who had not (n=177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding-distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women.
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Complicated grief and bereavement in young adults following close friend and sibling loss.
Herberman Mash, Holly B; Fullerton, Carol S; Ursano, Robert J
2013-12-01
This study examined the association between types of loss (i.e., sibling or close friend) and relationship quality (i.e., depth and conflict) with complicated grief, depression, somatic symptoms, and world assumptions in bereaved young adults. Participants were 107 young adults aged 17-29 years who were either bereaved or had never experienced a loss. Among bereaved participants, 66 lost a close friend and seven lost a sibling within the past 3 years (M = 1.63 years). Nineteen percent of the young adults met criteria for complicated grief and 31% had mild to severe depression. Participants with a deceased sibling reported greater depth in the relationship as compared to those who lost a friend. They were also more likely to have complicated grief (57% versus 15%) and report significantly higher levels of grief, depression, and somatic symptoms. Those who lost a sibling reported a lower sense of meaningfulness and benevolence of the world and self-worth as compared with those who lost a close friend or had not experienced a loss. Complicated grief and depression are common among bereaved young adults. Sibling loss is particularly distressing to young adults, due in part to the high level of relationship depth, and is associated with increased psychological and physical symptoms postloss. © 2013 Wiley Periodicals, Inc.
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African Americans in bereavement: grief as a function of ethnicity.
Laurie, Anna; Neimeyer, Robert A
2008-01-01
Few empirical studies have explored the grieving process among different ethnic groups within the United States, and very little is known about how African Americans and Caucasians may differ in their experience of loss. The purpose of this study was to examine the African-American experience of grief, with particular emphasis on issues of identity change, interpersonal dimensions of the loss, and continuing attachments with the deceased. Participants were 1,581 bereaved college students (940 Caucasians and 641 African Americans) attending classes at a large southern university. Each participant completed the Inventory of Complicated Grief-Revised, the Continuing Bonds Scale, and questions regarding the circumstances surrounding his or her loss. Results revealed that African Americans experienced more frequent bereavement by homicide, maintenance of a stronger continuing bond with the deceased, greater grief for the loss of extended kin beyond the immediate family, and a sense of support in their grief, despite their tendency to talk less with others about the loss or seek professional support for it. Overall, African Americans reported higher levels of complicated grief symptoms than Caucasians, especially when they spent less time speaking to others about their loss experience. Implications of these findings for bereavement support services for African Americans were briefly noted.
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Grief Symptoms in Relatives who Experienced Organ Donation Request in the ICU.
Kentish-Barnes, Nancy; Chevret, Sylvie; Cheisson, Gaëlle; Joseph, Liliane; Martin-Lefèvre, Laurent; Si Larbi, Anne Gaelle; Viquesnel, Gérald; Marqué, Sophie; Donati, Stéphane; Charpentier, Julien; Pichon, Nicolas; Zuber, Benjamin; Lesieur, Olivier; Ouendo, Martial; Renault, Anne; Le Maguet, Pascale; Kandelman, Stanislas; Thuong, Marie; Floccard, Bernard; Mezher, Chaouki; Galon, Marion; Duranteau, Jacques; Azoulay, Elie
2018-03-19
In the case of organ donation, the family is highly involved in the decision process. To assess experience of organ donation process and grief symptoms in relatives of brain dead patients who discussed organ donation in the ICU. Multicentre cross-sectional study in 28 ICUs in France. Participating subjects were relatives of brain dead patients who were approached to discuss organ donation. Relatives were followed-up by phone at 3 time points: at 1 month to complete a questionnaire describing their experience of organ donation process; At 3 months to complete the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised; At 9 months, to complete the IES-R and the Inventory of Complicated Grief. 202 relatives of 202 patients were included, of whom 158 consented and 44 refused organ donation. Interviews were conducted at 1, 3 and 9 months for 157, 137 and 117 relatives respectively. Experience was significantly more burdensome for relatives of non-donors. However there were no significant differences in grief symptoms measured at 3 and 9 months between the 2 groups. Understanding of brain death was associated with grief symptoms with higher prevalence of complicated grief symptoms in relatives who did not understand (75% vs 46.1%, p=0.026). Experience of the organ donation process varies between relatives of donor vs non-donor patients with relatives of non-donors experiencing lower quality communication, but the decision was not associated with subsequent grief symptoms. Importantly, understanding of brain death is a key element for relatives.
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Kaplow, Julie B.; Layne, Christopher M.; Saltzman, William R.; Cozza, Stephen J.; Pynoos, Robert S.
2015-01-01
To date, the U.S. military has made major strides in acknowledging and therapeutically addressing trauma and Posttraumatic Stress Disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (Multidimensional Grief Theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death—especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD. PMID:23760905
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Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah V; Baker, Justin N
2016-09-01
Bereaved parents experience significant psychosocial and health sequelae, suggesting that this population may benefit from the ongoing extension of support and resources throughout the grief journey. The interaction of hospital staff with patients and families at the end of a child's life and after death profoundly affects parental grief, offering a unique opportunity for the medical community to positively impact the bereavement experience. The current study was conducted to explore the role of the health care team and medical institutions in the grief journeys of parents whose child died a cancer-related death. Eleven bereaved parents participated in 2 focus groups. Responses to each of the 3 main prompts were coded and analyzed independently using semantic content analysis techniques. Four main concepts were identified within the parental narratives, including the importance of strong and ongoing relationships between providers and bereaved families, the importance of high-quality communication, the effect of negative experiences between providers and families on parental grief, and the importance of the institution's role in the grief journeys of bereaved parents. Bereaved parents consistently identified the critical role played by medical staff and medical institutions throughout the grief journey. Key components of bereavement support identified by parents should serve to guide the actions of providers as well as provide a template for the development of a comprehensive bereavement program within an institution. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2757-2765. © 2016 American Cancer Society. © 2016 American Cancer Society.
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Grief, traumatic stress, and posttraumatic growth in women who have experienced pregnancy loss.
Krosch, Daniel Jay; Shakespeare-Finch, Jane
2017-07-01
Pregnancy loss is common and can be devastating for those who experience it. However, a historical focus on negative outcomes, and grief in particular, has rendered an incomplete portrait of both the gravity of the loss, and the potential for growth in its wake. Consistent with contemporary models of growth following bereavement, this study explored the occurrence of posttraumatic growth following pregnancy loss and further assessed the role of core belief disruptions and common loss context factors across perinatal grief, posttraumatic stress symptoms, and posttraumatic growth. Women who had experienced a miscarriage or stillbirth (N = 328) were recruited through perinatal loss support groups and completed an online survey that assessed core belief disruption, perinatal grief, posttraumatic stress symptoms, posttraumatic growth, loss context factors, and demographics. Hypotheses were tested via hierarchical multiple regression. All hypotheses were supported. Specifically, (a) moderate levels of posttraumatic growth were reported; (b) core belief disruptions predicted perinatal grief, posttraumatic stress symptoms, and posttraumatic growth; and (c) perinatal grief predicted posttraumatic stress symptoms and growth. Findings suggest that pregnancy loss can be a traumatic event, that core belief disruptions play a significant role in posttrauma outcomes, and that other factors may contribute to grief, posttraumatic stress symptoms, and posttraumatic growth following pregnancy loss that warrant further research (e.g., rumination). Despite potential methodological and sampling limitations, the use of validated measures to assess posttraumatic growth in a large sample represents a robust attempt to quantify the occurrence of posttrauma change following pregnancy loss. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
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Simon, Naomi M.
2015-01-01
IMPORTANCE The death of a loved one is one of life’s greatest, universal stressors to which most bereaved individuals successfully adapt without clinical intervention. For a minority of bereaved individuals, grief is complicated by superimposed problems and healing does not occur. The resulting syndrome of complicated grief causes substantial distress and functional impairment even years after a loss, yet knowing when and how to intervene can be a challenge. OBJECTIVE To discuss the differential diagnosis, risk factors for and management of complicated grief based on available evidence and clinical observations. EVIDENCE REVIEW MEDLINE was searched from January 1990 to October 2012. Additional citations were procured from references of select research and review articles. Available treatment studies targeting complicated grief were included. RESULTS A strong research literature led to inclusion of complicated grief in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (termed persistent complex bereavement disorder as a subtype of other specified trauma and stressor-related disorders), although it is a condition for which more research is formally recommended, and there is still ongoing discussion about the optimal name and diagnostic criteria for the disorder. Reliable screening instruments are available, and the estimated prevalence rate is 7% of bereaved people. Randomized controlled data support the efficacy of a targeted psychotherapy including elements that foster resolution of complicating problems and facilitate the natural healing process. Preliminary studies suggest antidepressant medications may be helpful. CONCLUSION AND RELEVANCE Individuals with complicated grief have greater risk of adverse health outcomes, should be diagnosed and assessed for suicide risk and comorbid conditions such as depression and posttraumatic stress disorder, and should be considered for treatment. PMID:23917292
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Measuring Maladaptive Cognitions in Complicated Grief: Introducing the Typical Beliefs Questionnaire
Skritskaya, Natalia A.; Mauro, Christine; Olonoff, Matthew; Qiu, Xin; Duncan, Sarah; Wang, Yuanjia; Duan, Naihua; Lebowitz, Barry; Reynolds, Charles F.; Simon, Naomi M.; Zisook, Sidney; Shear, M. Katherine
2016-01-01
Objectives Maladaptive cognitions related to loss are thought to contribute to development of complicated grief and are crucial to address in treatment, but tools available to assess them are limited. This paper introduces the Typical Beliefs Questionnaire (TBQ), a 25-item self-report instrument to assess cognitions that interfere with adaptation to loss. Design Study participants completed an assessment battery during their initial evaluation and again after completing treatment at 20 weeks. Test-retest reliability was assessed on a subsample of the participants who did not show change in complicated grief severity after the first four weeks of treatment. To examine latent structure of the TBQ, an exploratory factor analysis (EFA) was performed. Setting Academic medical centers in Boston, New York, Pittsburgh and San Diego from 2010–2014. Participants 394 bereaved adults who met criteria for complicated grief. Measurements The TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support. Results The TBQ exhibited good internal consistency (α= .82) and test-retest reliability (n=105; ICC= .74). EFA indicated a five-factor structure: “Protesting the Death,” “Negative Thoughts About the World,” “Needing the Person,” “Less Grief is Wrong” and “Grieving Too Much.” The total score and all factors showed sensitivity to change with treatment. Conclusions This new tool allows a clinician to quickly and reliably ascertain presence of specific maladaptive cognitions related to complicated grief, and subsequently, to use the information to aid a diagnostic assessment, to structure the treatment, and to measure treatment outcomes. PMID:27793576
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Tang, Suqin; Chow, Amy Y M
2017-03-01
Symptoms of complicated grief are associated with a traumatic death. However, the subjective experience of whether or not the death was considered traumatic has not been substantially explored. This study first examined the difference between objective and subjective traumatic death, and then investigated their respective impacts on complicated grief and depressive symptoms following bereavement among older adults in Hong Kong. Participants were 187 Hong Kong adults aged 65 years or above who had lost a family member within the past five years. Demographic information, the Inventory of Complicated Grief (ICG), the Geriatric Depression Scale (GDS), and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) were utilized. The subjective traumatic level of the death did not differ between the objective traumatic and non-traumatic death as defined by nature of death (t = -1.554, p = 0.122). Higher subjective traumatic levels and younger age of the deceased, were positively related to complicated grief symptoms, F (10, 161) = 14.222, p < 0.001, R 2 = 0.469. Higher subjective traumatic levels and older age of the bereaved were positively associated with symptoms of depression, F (10, 160) = 2.855, p = 0.003, R 2 = 0.151. However, objective traumatic death was found to have no relation to either complicated grief or depressive symptoms. Subjective and objective traumatic death may be two distinct concepts, and the subjective experience of the death as a trauma may be a more important factor that contributes to complicated grief and depressive symptoms.
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Kaplow, Julie B; Layne, Christopher M; Saltzman, William R; Cozza, Stephen J; Pynoos, Robert S
2013-09-01
To date, the US military has made major strides in acknowledging and therapeutically addressing trauma and post-traumatic stress disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (multidimensional grief theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death--especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD.
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Assisting the bereaved: A systematic review of the evidence for grief counselling.
Waller, Amy; Turon, Heidi; Mansfield, Elise; Clark, Katherine; Hobden, Bree; Sanson-Fisher, Rob
2016-02-01
Supporting people after bereavement is a priority area for many health services. Investment in bereavement care must be supported by a rigorous evidence-base. To examine the (1) relative proportion of descriptive, measurement and intervention research in grief counselling and (2) quality and effectiveness of intervention studies. Systematic review of studies published in the area of grief counselling. MEDLINE, Embase, Cochrane Library and PsycINFO databases were searched for studies published between 2000 and 2013. Eligible papers were categorised into descriptive, measurement, review, commentaries and intervention studies. Intervention studies were assessed against the Cochrane Effective Practice and Organisation of Care methodological criteria, and papers meeting criteria were assessed for quality. The impact of interventions on grief, psychological morbidity and quality of life was examined. A total of 126 data-based papers, including 47 descriptive, 3 measurement and 76 grief counselling intervention studies were included. Only 59% (n = 45) of intervention studies met Effective Practice and Organisation of Care design criteria. Overall, study quality was poor, with the majority of interventions showing a risk of bias in several key areas. The three studies that met all criteria showed mixed effectiveness. Grief counselling interventions require a strong rationale for design, and a systematic approach to development and evaluation. Descriptive research efforts should inform this process, focusing on homogeneity in sample, identification of risk factors for complicated grief and the impact of extraneous factors on intervention effects. Interventions should include comparisons to usual care, as well as replication to confirm positive findings. © The Author(s) 2015.
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Posttraumatic Stress and Complicated Grief in Family Members of Patients in the Intensive Care Unit
Arnold, Robert M.; Angus, Derek C.; Bryce, Cindy L.
2008-01-01
Background Family members of patients in intensive care units (ICUs) are at risk for mental health morbidity both during and after a patient’s ICU stay. Objectives To determine prevalences of and factors associated with anxiety, depression, posttraumatic stress and complicated grief in family members of ICU patients. Design Prospective, longitudinal cohort study. Participants Fifty family members of patients in ICUs at a large university hospital participated. Measurements We used the Control Preferences Scale to determine participants’ role preferences for surrogate decision-making. We used the Hospital Anxiety and Depression Scale, Impact of Event Scale, and Inventory of Complicated Grief to measure anxiety and depression (at enrollment, 1 month, 6 months), posttraumatic stress (6 months), and complicated grief (6 months). Results We interviewed all 50 participants at enrollment, 39 (78%) at 1 month, and 34 (68%) at 6 months. At the three time points, anxiety was present in 42% (95% CI, 29–56%), 21% (95% CI, 10–35%), and 15% (95% CI, 6–29%) of participants. Depression was present in 16% (95% CI, 8–28%), 8% (95% CI, 2–19%), and 6% (95% CI, 1–18%). At 6 months, 35% (95% CI, 21–52%) of participants had posttraumatic stress. Of the 38% who were bereaved, 46% (95% CI, 22–71%) had complicated grief. Posttraumatic stress was not more common in bereaved than nonbereaved participants, and neither posttraumatic stress nor complicated grief was associated with decision-making role preference or with anxiety or depression during the patient’s ICU stay. Conclusions Symptoms of anxiety and depression diminished over time, but both bereaved and nonbereaved participants had high rates of posttraumatic stress and complicated grief. Family members should be assessed for posttraumatic stress and complicated grief. PMID:18780129
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2016-01-01
We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2±3.7) and adolescent with complicated grief (3.2±6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ2=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents. PMID:26770046
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Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun
2016-01-01
We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2 ± 3.7) and adolescent with complicated grief (3.2 ± 6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents.
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Rates and risks for prolonged grief disorder in a sample of orphaned and widowed genocide survivors.
Schaal, Susanne; Jacob, Nadja; Dusingizemungu, Jean-Pierre; Elbert, Thomas
2010-07-06
The concept of Prolonged Grief Disorder (PGD) has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events. The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD. 8.0% (n = 32) of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%). Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD) and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan), the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions. A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD.
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The ties that bind: a reflection on physician grief.
Giddings, Gordon
2010-10-01
Physician grief remains a prevalent yet largely unacknowledged problem in the medical profession. Several techniques can be employed to improve coping in physicians that deal frequently with patients approaching the end of life that can be integrated into medical training programs and physician practices. The author recounts his own experience of physician grief having cared for a patient on his dying journey and using it as an opportunity for personal growth.
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Anticipatory Grief: A Mere Concept?
Moon, Paul J
2016-06-01
Anticipatory grief (AG) has been studied, debated, and written about for several decades. This type of grief is also recognized in hospice and palliative care (HPC). The question, however, is whether the reality of AG is sufficiently upheld by professionals at the point of concrete service delivery. In other words, is AG a mere concept or is everyday practice of HPC duly informed of AG as evidenced by the resulting care delivery? © The Author(s) 2015.
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Treatment of childhood traumatic grief.
Cohen, Judith A; Mannarino, Anthony P
2004-12-01
Childhood traumatic grief (CTG) is a condition in which trauma symptoms impinge on children's ability to negotiate the normal grieving process. Clinical characteristics of CTG and their implications for treatment are discussed, and data from a small number of open-treatment studies of traumatically bereaved children are reviewed. An empirically derived treatment model for CTG is described; this model addresses both trauma and grief symptoms and includes a parental treatment component. Future research directions are also addressed.
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The death of an animal should be acknowledged.
2016-06-22
How should nurses help clients deal with grief following the loss of an animal? Grief following the death of a pet can be significant, but such reactions can be viewed as abnormal by family, friends and professionals. Mental health training team leader Bronwen Williams and veterinary surgeon Rebecca Green, writing in Mental Health Practice, say that a lack of understanding can compound grief. Simply acknowledging the significance of the loss is key.
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[Complicated Grief in DSM-5 era].
Carmassi, Claudia; Conversano, Ciro; Pinori, Marialisa; Bertelloni, Carlo Antonio; Dalle Luche, Riccardo; Gesi, Camilla; Dell'Osso, Liliana
2016-01-01
An increasing number of data has been recently focused on recognizing pathological grief reactions and on the distinction from physiological processes. Particularly, several studies have supported Complicated Grief (CG) as an independent disorder, in order to define the failure of spontaneous physiological mourning resolution. Upon these studies, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) with the name of "Persistent Complex Bereavement Disorder". This article aims at retracing the history of clinical research about the physiological and psychopathological processes related to grief and aims at presenting the main scientific studies that have described the features of the CG defining it as a distinct disorder. Similarities and distinctions among CG and Depression, Posttraumatic Stress Disorder and Adjustment Disorder were also reported.
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Complicated grief after perinatal loss
Kersting, Anette; Wagner, Birgit
2012-01-01
The loss of an infant through stillbirth, miscarriage, or neonatal death is recognized as a traumatic life event. Predictors of development of complicated grief after prenatal loss include lack of social support, pre-existing relationship difficulties, or absence of surviving children, as well as ambivalent attitudes or heightened perception of the reality of the pregnancy. Risk of complicated grief was found to be especially high after termination of a pregnancy due to fetal abnormality. Studies have revealed that men and women show different patterns of grief, potentially exacerbating decline in a relationship. Although it is clear that prenatal loss has a large psychological impact, it is concluded that there is a substantial lack of randomized controlled studies in this field of research, PMID:22754291
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Lai, Carlo; Luciani, Massimiliano; Galli, Federico; Morelli, Emanuela; Cappelluti, Roberta; Penco, Italo; Aceto, Paola; Lombardo, Luigi
2015-12-01
The aim of the present study was to evaluate the predictive role of attachment dimensions on the risk of prolonged grief. Sixty caregivers of 51 terminally ill patients with cancer who had been admitted in a hospice were selected. Caregivers were interviewed using Attachment Scale Questionnaire, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Prolonged Grief Disorder 12 (PG-12). The consort caregivers showed higher PG-12 level compared to the sibling caregivers. Anxiety, depression, need for approval, and preoccupation with relationships levels were significantly correlated with PG-12 scores. Female gender, high levels of depression, and preoccupation with relationships significantly predicted higher levels of prolonged grief risk. © The Author(s) 2014.
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Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo.
Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala
2016-01-01
Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief.
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Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo
Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala
2016-01-01
Introduction Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. Methods We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. Results A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Conclusion Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief. PMID:27583088
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Grief after patient death: direct care staff in nursing homes and homecare.
Boerner, Kathrin; Burack, Orah R; Jopp, Daniela S; Mock, Steven E
2015-02-01
Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared the staff members were for the death of their patients, and 3) identify characteristics associated with their grief. This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression. Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being "not at all prepared" for the death and struggling with "acceptance of death" were prevalent among the staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death. Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Skritskaya, Natalia A; Mauro, Christine; Olonoff, Matthew; Qiu, Xin; Duncan, Sarah; Wang, Yuanjia; Duan, Naihua; Lebowitz, Barry; Reynolds, Charles F; Simon, Naomi M; Zisook, Sidney; Shear, M Katherine
2017-05-01
Maladaptive cognitions related to loss are thought to contribute to development of complicated grief and are crucial to address in treatment, but tools available to assess them are limited. This paper introduces the Typical Beliefs Questionnaire (TBQ), a 25-item self-report instrument to assess cognitions that interfere with adaptation to loss. Study participants completed an assessment battery during their initial evaluation and again after completing treatment at 20 weeks. Test-retest reliability was assessed on a subsample of the participants who did not show change in complicated grief severity after the first 4 weeks of treatment. To examine latent structure of the TBQ, an exploratory factor analysis (EFA) was performed. Academic medical centers in Boston, New York, Pittsburgh, and San Diego from 2010-2014. 394 bereaved adults who met criteria for complicated grief. The TBQ along with assessments of complicated grief symptoms and related avoidance, depression symptoms, functional impairment, and perceived social support. The TBQ exhibited good internal consistency (α = 0.82) and test-retest reliability (N = 105; intraclass correlation coefficient = 0.74). EFA indicated a five-factor structure: "Protesting the Death," "Negative Thoughts About the World," "Needing the Person," "Less Grief is Wrong" and "Grieving Too Much." The total score and all factors showed sensitivity to change with treatment. This new tool allows a clinician to quickly and reliably ascertain presence of specific maladaptive cognitions related to complicated grief, and subsequently, to use the information to aid a diagnostic assessment, to structure the treatment, and to measure treatment outcomes. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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Davis, Esther L; Deane, Frank P; Barclay, Gregory D; Bourne, Joan; Connolly, Vivienne
2017-07-03
The provision of psychological support to caregivers is an important part of the role of the clinical staff working in palliative care. Staff knowledge and attitudes may determine their openness to referring caregivers to a psychological intervention. We recently developed a self-help intervention for grief and psychological distress among caregivers and were interested in exploring the extent to which staff knowledge and attitudes might affect future implementation. The aims of our study were to: (1) examine the acceptability of self-help psychological intervention for caregivers among palliative care clinical staff; (2) examine potential attitudinal barriers toward prolonged grief disorder (PGD) as a diagnosis and interventions for grief; and (3) bolster staff confidence in skills and knowledge in identifying and managing caregiver psychological distress. An anonymous survey was distributed among clinical staff at two inpatient units and two community health services that assessed the acceptability of self-help interventions for caregivers, attitudes about PGD diagnosis and grief intervention, and staff confidence in skills and knowledge in assessing caregiver psychological distress. Overall, clinical staff were positively oriented toward self-help for caregivers and intervention for grief. They were also basically confident in their skills and knowledge. While it was positive PGD attitudes that were associated with acceptability of self-help for caregivers, it was both positive and negative PGD attitudes that were associated more specifically with a willingness to refer caregivers to such an intervention. Our findings are useful in highlighting the issues to be considered in the implementation of a self-help intervention within the healthcare service. Clinical staff seemed positively oriented toward engaging with a psychological intervention for caregivers and likely to act as key allies in implementation.
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End-of-life issues: difficult decisions and dealing with grief.
Loomis, Beth
2009-06-01
People face many challenging psychosocial and spiritual issues as they approach the end of their lives, and caregivers need advice on how to help them. Choosing among treatment options, handling grief, addressing unfinished business, and coping with loss of self-sufficiency are difficult for the dying person, and caregivers must deal with surrogate decision making, raw emotions in the patient and in family members, and the caregivers' own grief. Listening and coping skills are discussed.
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Disenfranchised Grief and Physician Burnout.
Lathrop, Deborah
2017-07-01
Over the span of their career, physicians experience changes to their professional role and professional identity. The process of continual adaptation in their work setting incurs losses. These losses can be ambiguous, cumulative, and may require grieving. Grief in the workplace is unsanctioned, and may contribute to physicians' experience of burnout (emotional exhaustion, depersonalization, low sense of achievement). Acknowledging loss, validating grief, and being prescient in dealing with physician burnout is essential. © 2017 Annals of Family Medicine, Inc.
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ERIC Educational Resources Information Center
Brown, Gerald B.
2016-01-01
Grief is widely defined and covers a plethora of losses that involves a range of sometimes easily discernible emotions. While grief can be the result of loss in general, it can be either prolonged or temporary and indiscriminate of age or gender. Children are no exception. When considering the loss of a significant individual such as a parent…
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Markin, Rayna D; Zilcha-Mano, Sigal
2018-03-01
This paper argues that there is a cultural taboo against the public recognition and expression of perinatal grief that hinders parents' ability to mourn and their psychological adjustment following a loss. It is proposed that this cultural taboo is recreated within the therapy relationship, as feelings of grief over a perinatal loss are minimized or avoided by the therapist and parent or patient. Importantly, it is suggested that if these cultural dynamics are recognized within the therapy relationship, then psychotherapy has the immense opportunity to break the taboo by validating the parent's loss as real and helping the parent to mourn within an empathic and affect-regulating relationship. Specifically, it is suggested that therapists break the cultural taboo against perinatal grief and help parents to mourn through: acknowledging and not pathologizing perinatal grief reactions, considering intrapsychic and cultural factors that impact a parent's response to loss, exploring cultural reenactments within the therapy relationship, empathizing with the parent's experience of loss and of having to grieve within a society that does not recognize perinatal loss, coregulating the parent's feelings of grief and loss, and helping patients to create personally meaningful mourning rituals. Lastly, the impact of within and between cultural differences and therapist attitudes on the therapy process is discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Patton, Desmond Upton; MacBeth, Jamie; Schoenebeck, Sarita; Shear, Katherine; McKeown, Kathleen
2018-01-01
There is a dearth of research investigating youths' experience of grief and mourning after the death of close friends or family. Even less research has explored the question of how youth use social media sites to engage in the grieving process. This study employs qualitative analysis and natural language processing to examine tweets that follow 2 deaths. First, we conducted a close textual read on a sample of tweets by Gakirah Barnes, a gang-involved teenaged girl in Chicago, and members of her Twitter network, over a 19-day period in 2014 during which 2 significant deaths occurred: that of Raason "Lil B" Shaw and Gakirah's own death. We leverage the grief literature to understand the way Gakirah and her peers express thoughts, feelings, and behaviors at the time of these deaths. We also present and explain the rich and complex style of online communication among gang-involved youth, one that has been overlooked in prior research. Next, we overview the natural language processing output for expressions of loss and grief in our data set based on qualitative findings and present an error analysis on its output for grief. We conclude with a call for interdisciplinary research that analyzes online and offline behaviors to help understand physical and emotional violence and other problematic behaviors prevalent among marginalized communities.
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Patton, Desmond Upton; MacBeth, Jamie; Schoenebeck, Sarita; Shear, Katherine; McKeown, Kathleen
2018-01-01
There is a dearth of research investigating youths’ experience of grief and mourning after the death of close friends or family. Even less research has explored the question of how youth use social media sites to engage in the grieving process. This study employs qualitative analysis and natural language processing to examine tweets that follow 2 deaths. First, we conducted a close textual read on a sample of tweets by Gakirah Barnes, a gang-involved teenaged girl in Chicago, and members of her Twitter network, over a 19-day period in 2014 during which 2 significant deaths occurred: that of Raason “Lil B” Shaw and Gakirah’s own death. We leverage the grief literature to understand the way Gakirah and her peers express thoughts, feelings, and behaviors at the time of these deaths. We also present and explain the rich and complex style of online communication among gang-involved youth, one that has been overlooked in prior research. Next, we overview the natural language processing output for expressions of loss and grief in our data set based on qualitative findings and present an error analysis on its output for grief. We conclude with a call for interdisciplinary research that analyzes online and offline behaviors to help understand physical and emotional violence and other problematic behaviors prevalent among marginalized communities. PMID:29636619
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Wagner, B; Müller, J; Maercker, A
2012-10-01
Despite continuing political, legal and moral debate on the subject, assisted suicide is permitted in only a few countries worldwide. However, few studies have examined the impact that witnessing assisted suicide has on the mental health of family members or close friends. A cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. Full or partial Post-Traumatic Distress Disorder (PTSD; Impact of Event Scale-Revised), depression and anxiety symptoms (Brief Symptom Inventory) and complicated grief (Inventory of Complicated Grief) were assessed at 14 to 24 months post-loss. Of the 85 participants, 13% met the criteria for full PTSD (cut-off≥35), 6.5% met the criteria for subthreshold PTSD (cut-off≥25), and 4.9% met the criteria for complicated grief. The prevalence of depression was 16%; the prevalence of anxiety was 6%. A higher prevalence of PTSD and depression was found in the present sample than has been reported for the Swiss population in general. However, the prevalence of complicated grief in the sample was comparable to that reported for the general Swiss population. Therefore, although there seemed to be no complications in the grief process, about 20% of respondents experienced full or subthreshold PTSD related to the loss of a close person through assisted suicide. Copyright © 2010 Elsevier Masson SAS. All rights reserved.
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Douglas, Heather A
2014-10-01
Genetic counselors and other health professionals frequently meet with patients who are grieving a loss. It is thus helpful for medical professionals to be familiar with approaches to bereavement counseling. Grief theory has evolved over the last few decades, from primarily stage theories of grief such as Kübler-Ross's "five stages of grief" to frameworks that promote more complex and long-term ways to cope with a loss. Herein I present one recent grief theory - meaning-making - and describe how it can be applied to help parents of children with disabilities grieve the loss of the child that they expected. In particular, I describe a scenario that many genetic counselors face - meeting with the parents of a child with Down syndrome. I outline the research done on the reactions, grief and coping experienced by parents in this circumstance, and I present suggestions for encouraging healthy coping and adjustment for parents, based on the meaning-making perspective. The meaning-making theory can also be applied to many of the other losses faced by genetic counseling patients.
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Treating childhood traumatic grief: a pilot study.
Cohen, Judith A; Mannarino, Anthony P; Knudsen, Kraig
2004-10-01
To examine the potential efficacy and specific timing of treatment response of individual child and parent trauma-focused cognitive-behavioral therapy for childhood traumatic grief (CTG), a condition in which trauma symptoms impinge on the child's ability to successfully address the normal tasks of grieving. Twenty-two children and their primary caretakers received a manual-based 16-week treatment with sequential trauma- and grief-focused interventions. Children experienced significant improvements in CTG, posttraumatic stress disorder (PTSD), depressive, anxiety, and behavioral problems, with PTSD symptoms improving only during the trauma-focused treatment components and CTG improving during both trauma- and grief-focused components. Participating parents also experienced significant improvement in PTSD and depressive symptoms. The timing of improvements in CTG and PTSD symptoms lends support to providing sequential trauma- and grief-focused interventions and to the concept that CTG is related to but distinct from PTSD. The results also suggest the benefit of individual treatment for CTG and for including parents in the treatment of CTG. Randomized, controlled trials are needed to further test the efficacy of this treatment model.
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Clinical features of pathological grief reaction in elderly patients.
Ishii, H; Tokunaga, Y; Kawatani, D; Nishizono, M
1998-12-01
The present study investigates elderly patients suffering from a pathological grief reaction to bereavement. The subjects were nine elderly inpatients with pathological grief reactions in the Department of Psychiatry in Fukuoka University Hospital between April 1991 and March 1995. Medical records of all patients were investigated retrospectively. The results were as follows: (i) all patients were female; (ii) the deceased were all husbands; (iii) most cases were sudden death; (iv) the period to onset was variable, from immediately after death to 10 years after death; (v) a delay of grief reactions was seen in many patients; (vi) the direct causes were often something other than bereavement, such as conflict with sisters, change of residence, bone fracture and daughter's malignant illness; (vii) although there was no significant difference, the ratio of those who began to live alone after bereavement was high; (viii) the number of children were insignificant; and (ix) many patients suffered the death of a parent in childhood. The paper presents observations on the results, and discusses the psychosocial factors of elderly patients with pathological grief reactions to bereavement.
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Development and validation of the Hogan Grief Reaction Checklist.
Hogan, N S; Greenfield, D B; Schmidt, L A
2001-01-01
The purpose of this article is to provide data on a recently developed instrument to measure the multidimensional nature of the bereavement process. In contrast to widely used grief instruments that have been developed using rational methods of instrument construction, the Hogan Grief Reaction Checklist (HGRC) was developed empirically from data collected from bereaved adults who had experienced the death of a loved one. Factor analysis of the HGRC revealed 6 factors in the normal trajectory of the grieving process: Despair, Panic Behavior, Blame and Anger, Detachment, Disorganization, and Personal Growth. Additional data are provided that support reliability and validity of the HGRC as well as its ability to discriminate variability in the grieving process as a function of cause of death and time lapsed since death. Empirical support is also provided for Personal Growth as an integral component of the bereavement process. The article concludes by considering the substantive as well as psychometric findings of this research for such issues as traumatic grief, anticipatory grief, change in the bereaved person's self-schema, and spiritual and existential growth.
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Grief and Solidarity Reactions 1 Week After an On-Campus Shooting.
Wayment, Heidi A; Silver, Roxane Cohen
2018-03-01
The impact of interpersonal violence extends beyond the victims and perpetrator(s). The purpose of this research was threefold: (a) to identify whether college students' very early reactions to an on-campus shooting were associated with well-known predictors of distress, (b) to examine whether grief and distress reactions were distinguishable in the early days following a shooting, and (c) to investigate whether a compassionate self-identity was uniquely associated with grief but not distress. Beginning just 3 days after an early morning shooting that killed one student and injured three others, university students ( N = 408) completed an online questionnaire. Grief, but not distress, was associated with a sense of solidarity with other students and a compassionate self-identity. General distress was associated with prior mental health difficulties and exposure to the shooting. Acute stress was positively associated with being female, having prior mental health difficulties, media exposure, perceived similarity to victims, less victim blame, social support, and social strain. Results suggest that grief reactions that arise in the early days following a collective loss may serve as important psychosocial resources in coping with interpersonal violence.
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... quality of life. The end of a significant relationship may also cause grieving. Everyone feels grief in ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...
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The myths of coping with loss in undergraduate psychiatric nursing books.
Holman, E Alison; Perisho, Jennifer; Edwards, Ada; Mlakar, Natalie
2010-12-01
Nurses often help patients cope with loss. Recent research has cast doubt on the validity of early theories about loss and grief commonly taught to nurses. We systematically examined the accuracy of information on coping with loss presented in 23 commonly used undergraduate psychiatric nursing books. All 23 books contained at least one unsupported assumption (myth) about loss and grief. In 78% of these books, authors described four or more myths and only one evidence-based finding about coping with loss. On balance most books provided details on the myths about grief and loss with minimal discussion of the current evidence. Authors of psychiatric nursing books continue to disseminate unsupported theories about grief responses without adequately acknowledging evidence challenging core assumptions underlying them. Copyright © 2010 Wiley Periodicals, Inc.
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Corr, Charles A; Coolican, Margaret B
2010-06-01
This article surveys recent literature on bereavement, grief, and mourning. It offers a review of the state of the art of current understandings of those topics to assist professionals who work in the field of organ and tissue donation and transplantation. The article's goal is to provide well-developed and up-to-date education and knowledge about bereavement, grief, and mourning to supplement the natural skills and experience of donation and transplant professionals in their work with bereaved persons.
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Rates and risks for prolonged grief disorder in a sample of orphaned and widowed genocide survivors
2010-01-01
Background The concept of Prolonged Grief Disorder (PGD) has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events. Methods The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD. Results 8.0% (n = 32) of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%). Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD) and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan), the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions. Conclusions A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD. PMID:20604936
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Healthy Lifestyle End of life A loved one's suicide can be emotionally devastating. Use healthy coping strategies — ... Clinic Staff When a loved one dies by suicide, overwhelming emotions can leave you reeling. Your grief ...
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Treatment of Amino Acid Metabolism Disorders
... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ...
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Coping with Grief: Life After Loss
... a walk or swimming, or by doing something creative like writing or painting. For others, it may ... to get caught up in certain kinds of thinking, says Shear, who studies complicated grief. They may ...
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Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F.; Frank, Ellen; Silowash, Russell
2012-01-01
Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with complicated grief (CG) differed from that of a normative sample, and to explore whether CG patients who dream of the deceased differ from CG patients who do not dream of the deceased on measures of daytime emotional distress. CG dreams were characterized by more family and familiar characters including the deceased (in women), and fewer social interactions and emotions compared to norms. Increased representations of familiar characters in CG dreams may reflect attempts to reorganize relational cognitive schemas to compensate for the loss. PMID:24524436
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Grief resolution: facilitating self-transcendence in the bereaved.
Joffrion, L P; Douglas, D
1994-03-01
1. The clinical nurse specialist (CNS) can help individuals to resolve grief that stems from personal loss and death, and encourage activities that will assist highly motivated individuals to achieve self-transcendence. 2. Self-transcendence is the ability to extend one's self beyond personal concerns and reach out to others without losing one's sense of self. The process of self-transcendence results in broader perspectives, purposes, and activities in one's life. Self-transcendent acts of giving to and/or sharing with others leads to a sense of connectedness with others, one's surroundings, and God. 3. Ultimately, the CNS encourages the bereaved person to participate in a grief resolution support group. By sharing openly and actively participating in the group process, the bereaved person learns coping skills that facilitate grief resolution and encourage the development of self-transcendency.
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Trauma, grief and depression in Nairobi children after the 1998 bombing of the American Embassy.
Pfefferbaum, Betty; North, Carol S; Doughty, Debby E; Pfefferbaum, Rose L; Dumont, Cedric E; Pynoos, Robert S; Gurwitch, Robin H; Ndetei, David
2006-01-01
Despite the increasingly dangerous world where trauma and loss are common, relatively few studies have explored traumatic grief in children. The 1998 American Embassy bombing in Nairobi, Kenya, provided an unfortunate opportunity to examine this topic. This report describes findings in 156 children who knew someone killed in the incident, assessed 8 to 14 months after the explosion. Bomb-related posttraumatic stress was associated with physical exposure, acute response, posttraumatic stress related to other negative life events, type of bomb-related loss, and subsequent loss. Grief was associated with bomb-related posttraumatic stress, posttraumatic stress related to other negative life events, and type of bomb-related loss. The study supports the developing literature on traumatic grief and the need for studies exploring the potentially unique aspects of this construct.
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Oppression of the bereaved: a critical analysis of grief in Western society.
Harris, Darcy
Bereaved individuals often experience profound social pressure to conform to societal norms that constrict the experience of grief rather than support it. This article explores grief in Western society through an analysis of the underlying structures and values that are a part of this social system, utilizing the lens of critical theory. Critical theory examines social norms and conditions in order to identify and expose oppression in various contexts. This article examines the social rules that govern the expression of grief, the role of attachment, social pain, and shame as potent forces that promote compliance with social rules, and the ways that the underlying assumptions and values in Western society shape how bereaved individuals are expected to react. Implications for clinicians who work with terminally ill or bereaved individuals are then reviewed.
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A pilot study of modified cognitive-behavioral therapy for childhood traumatic grief (CBT-CTG).
Cohen, Judith A; Mannarino, Anthony P; Staron, Virginia R
2006-12-01
This pilot study evaluated outcomes for a modified 12-session protocol of cognitive-behavioral therapy for childhood traumatic grief (CBT-CTG) conducted between March 2004 and October 2005. CTG is an emerging condition characterized by a combination of posttraumatic stress and unresolved grief symptoms. This two-module treatment model consisting of sequential trauma- and grief-focused components was shortened from a previously presented 16-session protocol. Thirty-nine children ages 6 to 17 years old with CTG and their parents received the modified 12-session protocol of CBT-CTG. CTG and posttraumatic stress disorder (PTSD) symptoms were assessed at pretreatment, after the trauma-focused module, and after the grief-focused module (at posttreatment). Child depression, anxiety, and behavioral symptoms, as well as parental depression and PTSD symptoms, were assessed at pre- and posttreatment. Children reported significant improvement in CTG, PTSD, depression, and anxiety, and parents reported significant improvement in children's PTSD, internalizing and total behavior problems, and their personal PTSD symptoms. Although PTSD significantly improved only during the trauma-focused module of treatment, CTG improved significantly during both trauma- and grief-focused modules of treatment. Child satisfaction and parent satisfaction for this treatment protocol were also high. These findings suggest that the shortened CBT-CTG protocol, which is similar in the number of sessions to what many community child bereavement programs offer, may be acceptable and efficacious for this population. The CBT-CTG model requires further evaluation in randomized, controlled treatment trials.
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Volgsten, Helena; Jansson, Caroline; Svanberg, Agneta Skoog; Darj, Elisabeth; Stavreus-Evers, Anneli
2018-06-01
Although miscarriage is common and affects up to 20% of pregnant women, little is known about these couples' short term and long term experiences after miscarriage. The aim of the present study was to study emotional experience, grief and depressive symptoms in women and men, one week and four months after miscarriage. Women, (n = 103), and their male partner (n = 78), were recruited at the gynecological clinic after miscarriage. Control women were recruited from the general population. Three validated questionnaires concerning psychological wellbeing and mental health, RIMS, PGS and MADRS-S were answered by the participants one week and four months after the miscarriage. It was shown that for women, the emotional experiences of miscarriage, grief and depressive symptoms were more pronounced than for their male partners. Grief and depressive symptoms were reduced with time, which was not the case for the emotional experiences of miscarriage. Previous children was favorable for emotional experience while previous miscarriage or infertility treatment made the emotional experience worse. Grief and depressive symptoms is reduced over time while emotional experiences such as isolation, loss of baby and a devastating event persist for longer time than four months. Lack of previous children, previous miscarriage and infertility diagnosis could increase negative emotional experiences after miscarriage, this was especially pronounced for grief reaction. The questionnaires could be used both clinically and in research to understand the emotional experiences after miscarriage. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Kalpakjian, Claire Z.; Tulsky, David S.; Kisala, Pamela A.; Bombardier, Charles H.
2015-01-01
Objective To develop an item response theory (IRT) calibrated Grief and Loss item bank as part of the Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system. Design A literature review guided framework development of grief/loss. New items were created from focus groups. Items were revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis (CFA), graded response IRT modeling and evaluation of differential item functioning (DIF). Setting We tested a 20-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital. Participants A total of 717 individuals with SCI answered the grief and loss questions. Results The final calibrated item bank resulted in 17 retained items. A unidimensional model was observed (CFI = 0.976; RMSEA = 0.078) and measurement precision was good (theta range between −1.48 to 2.48). Ten items were flagged for DIF, however, after examination of effect sizes found this to be negligible with little practical impact on score estimates. Conclusions This study indicates that the SCI-QOL Grief and Loss item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available. PMID:26010969
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Psychosocial effects of war experiences among displaced children in southern Darfur.
Morgos, Dorothy; Worden, J William; Gupta, Leila
This study focused on assessing the psychosocial effects of the long standing, high intensity, and guerrilla-style of warfare among displaced children in Southern Darfur. The goal was to better understand the etiology, prognosis, and treatment implications for traumatic reactions, depression, and grief symptoms in this population. Three hundred thirty-one children aged 6-17 from three IDP Camps were selected using a quota sampling approach and were administered a Demographic Questionnaire, Child Post Traumatic Stress Reaction Index, Child Depression Inventory, and the Expanded Grief Inventory. Forty-three percent were girls and 57% were boys. The mean age of the children was 12 years. Results found that children were exposed to a very large number of war experiences with no significant differences between genders for types of exposure, including rape, but with older children (13-17 years) facing a larger number of exposures than younger children (6-12 years). Out of the 16 possible war experiences, the mean number was 8.94 (SD = 3.27). Seventy-five percent of the children met the DSM-IV criteria for PTSD, and 38% exhibited clinical symptoms of depression. The percentage of children endorsing significant levels of grief symptoms was 20%. Increased exposure to war experiences led to higher levels of: (1) traumatic reactions; (2) depression; and (3) grief symptoms. Of the 16 war experiences, abduction, hiding to protect oneself, being raped, and being forced to kill or hurt family members were most predictive of traumatic reactions. Being raped, seeing others raped, the death of a parent/s, being forced to fight, and having to hide to protect oneself were the strongest predictors of depressive symptoms. War experiences such as abduction, death of one's parent/s, being forced to fight, and having to hide to protect oneself were the most associated with the child's experience of grief. In addition to Total Grief, Traumatic Grief, Existential Grief, and Continuing Bonds were measured in these children. Although trauma, depression, and grief often exist as co-morbid disorders, the mechanisms and pathways of these is less understood. In this study we used Structural Equation Modeling to better understand the complex interaction and trajectories of these three symptoms evolving from war exposure and loss. This study is the first of its kind to assess the psychosocial effects of war experiences among children currently living in war zone areas within Sudan. It identifies some of the most prevalent war-related atrocities and their varying impact on the children's psychological well-being and overall adjustment. Implications for planning mental health interventions are discussed.
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Pfefferbaum, Betty; Tucker, Phebe; Jeon-Slaughter, Haekyung; Allen, James R; Hammond, Donna R; Whittlesey, Suzanne W; Vinekar, Shreekumar S; Feng, Yan
2013-01-01
Trauma is thought to interfere with normal grief by superimposing symptoms of posttraumatic stress disorder. This exploratory pilot study examined the association between traumatic grief and objectively measured physiological reactivity to a trauma interview in 73 children who lost relatives in the Oklahoma City bombing as well as a potential link between children and their maternal figures in physiological reactivity. Although the authors found no association between posttraumatic stress and objectively measured physiological reactivity among children, they found significant differences in objectively measured reactivity associated with loss and grief. Children who lost "close" relatives evidenced greater objectively measured reactivity than those who lost "distant" relatives. For the most part, children with higher levels of grief evidenced greater objectively measured reactivity than those with lower levels of grief. The most interesting of the findings was the parallel pattern in objectively measured physiological reactivity between children and their maternal figures along with a positive association between children's objectively measured physiological reactivity and maternal figures' self-reported physiological reactivity. Research using larger representative samples studied early and over time is indicated to determine the potential significance of these findings.
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Hansen, Nathan B.; Vaughan, Ellen L.; Cavanaugh, Courtenay E.; Connell, Christian M.; Sikkema, Kathleen J.
2008-01-01
Objective This study evaluated a model of the impact of borderline and antisocial personality disorder indications on HIV symptoms and health-related quality of life (HRQoL) in AIDS-bereaved adults, accounting for grief severity, social support and years since HIV diagnosis. Design Structural Equation modeling was used to test the proposed model in a sample of 268 HIV-seropositive adults enrolled in an intervention for coping with AIDS-related bereavement. Main Outcome Measures Functional Assessment of HIV Infection, HIV symptoms. Results The proposed model demonstrated excellent fit with study data and all hypothesized paths were supported. Personality disorder indication was directly related to HIV symptoms and HRQoL, and indirectly related through both social support and grief severity. Social support was negatively related to HIV symptoms and positively related to HRQoL, while grief severity was positively related to HIV symptoms and negatively related to HRQoL. Finally, HIV symptoms had a direct negative relationship with HRQoL. Conclusion Personality disorders have a direct negative effect on HIV symptoms and HRQoL, and indirect effects through grief severity and social support. PMID:19290717
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Guilt in Bereavement: The Role of Self-Blame and Regret in Coping with Loss
Stroebe, Margaret; Stroebe, Wolfgang; van de Schoot, Rens; Schut, Henk; Abakoumkin, Georgios; Li, Jie
2014-01-01
Despite the apparent centrality of guilt in complicating reactions following bereavement, scientific investigation has been limited. Establishing the impact of specific components associated with guilt could enhance understanding. The aim of this study was to examine the relationships between two guilt-related manifestations, namely self-blame and regret, with grief and depression. A longitudinal investigation was conducted 4–7 months, 14 months and 2 years post-loss. Participants were bereaved spouses (30 widows; 30 widowers); their mean age was 53.05 years. Results showed that self-blame was associated with grief at the initial time-point and with its decline over time. Such associations were not found for depression. Initial levels of regret were neither associated with initial levels of grief and depression, nor were they related to the decline over time in either outcome variable. These results demonstrate the importance of examining guilt-related manifestations independently, over time, and with respect to both generic and grief-specific outcome variables. A main conclusion is that self-blame (but not regret) is a powerful determinant of grief-specific difficulties following the loss of a loved one. Implications for intervention are considered. PMID:24819238
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Assessment of Emotional Experience and Emotional Recognition in Complicated Grief
Fernández-Alcántara, Manuel; Cruz-Quintana, Francisco; Pérez-Marfil, M. N.; Catena-Martínez, Andrés; Pérez-García, Miguel; Turnbull, Oliver H.
2016-01-01
There is substantial evidence of bias in the processing of emotion in people with complicated grief (CG). Previous studies have tended to assess the expression of emotion in CG, but other aspects of emotion (mainly emotion recognition, and the subjective aspects of emotion) have not been addressed, despite their importance for practicing clinicians. A quasi-experimental design with two matched groups (Complicated Grief, N = 24 and Non-Complicated Grief, N = 20) was carried out. The Facial Expression of Emotion Test (emotion recognition), a set of pictures from the International Affective Picture System (subjective experience of emotion) and the Symptom Checklist 90 Revised (psychopathology) were employed. The CG group showed lower scores on the dimension of valence for specific conditions on the IAPS, related to the subjective experience of emotion. In addition, they presented higher values of psychopathology. In contrast, statistically significant results were not found for the recognition of emotion. In conclusion, from a neuropsychological point of view, the subjective aspects of emotion and psychopathology seem central in explaining the experience of those with CG. These results are clinically significant for psychotherapists and psychoanalysts working in the field of grief and loss. PMID:26903928
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Socially shared mourning: construction and consumption of collective memory
NASA Astrophysics Data System (ADS)
Harju, Anu
2015-04-01
Social media, such as YouTube, is increasingly a site of collective remembering where personal tributes to celebrity figures become sites of public mourning. YouTube, especially, is rife with celebrity commemorations. Examining fans' online mourning practices on YouTube, this paper examines video tributes dedicated to the late Steve Jobs, with a focus on collective remembering and collective construction of memory. Combining netnography with critical discourse analysis, the analysis focuses on the user comments where the past unfolds in interaction and meanings are negotiated and contested. The paper argues that celebrity death may, for avid fans, be a source of disenfranchised grief, a type of grief characterised by inadequate social support, usually arising from lack of empathy for the loss. The paper sheds light on the functions digital memorials have for mourning fans (and fandom) and argues that social media sites have come to function as spaces of negotiation, legitimisation and alleviation of disenfranchised grief. It is also suggested that when it comes to disenfranchised grief, and grief work generally, the concept of community be widened to include communities of weak ties, a typical form of communal belonging on social media.
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O’Donnell, Karen; Dorsey, Shannon; Gong, Wenfeng; Ostermann, Jan; Whetten, Rachel; Cohen, Judith A.; Itemba, Dafrosa; Manongi, Rachel; Whetten, Kathryn
2015-01-01
The study was designed to test the feasibility and child clinical outcomes for a group-based application of Trauma-focused Cognitive Behavior Therapy (TF-CBT) for orphaned children with unresolved grief in Moshi, Tanzania. Sixty-four orphaned children with at least mild symptoms of unresolved grief and/or traumatic stress and their guardians participated in the open trial. The evidence-based TF-CBT protocol was adapted for group delivery, resulting in 12 weekly sessions for child and guardians separately with conjoint activities and three individual visits. Using a task-sharing approach, the intervention was delivered by lay counselors with no prior mental health experience. Primary outcomes assessed were symptoms of unresolved grief and posttraumatic stress (PTS); secondary outcomes included symptoms of depression and overall behavioral adjustment. All assessments were conducted pre-treatment, post-treatment, and 3- and 12-months after the end of treatment. Results showed improved scores on all outcomes post-treatment, sustained at 3 and 12 months. Effect sizes (Cohen’s d) for baseline to post-treatment were 1.36 for child reported grief symptoms; 1.87 for child-reported PTS, and 1.15 for caregiver report of child PTS. PMID:25418514
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Macdonald, Mary Ellen; Kennedy, Kimberly; Moll, Sandra; Pineda, Carolina; Mitchell, Lisa M; Stephenson, Peter H; Cadell, Susan
2015-01-01
Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereaved parents. Employed parents may need time away from work to deal with this loss. The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereavement. Critical discourse analysis was used to examine labour policies and practices related to employment leave for bereaved parents in Canada. Results were compared to international labour standards. Universally, employment policies provide only for the practical issues of bereavement. Commonly, leave is three days, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by grief or the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policies efface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues. Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks and ceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences for which healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employee wellbeing, reintegration and workplace productivity.
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... are not able to cope with the normal responsibility of childcare. Parents should be aware of normal childhood responses to a death in the family, as well as signs when a child is having difficulty coping with grief. It is ...
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Grief responses, coping processes, and social support of widows: research with Roy's model.
Robinson, J H
1995-01-01
This ex post facto descriptive correlational design study of widows during their second year of bereavement utilizes Roy's adaptation model as a guiding framework. Contextual stimuli (social support, social network, income/education, spiritual beliefs) were related to the cognator function (coping process), which was related to adaptation outcome (grief response). Significant moderate positive relationships were found between social support and coping process, and between social network and coping process. A significant relationship was also found between coping process and grief response. The path model accounted for 18% explained variance.
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Before Kubler-Ross: lessons about grief from the book of Job.
Lyon, D S
2000-07-01
Medicine is as old as the human species, and medical literature is among the earliest writing. Current research is of great help in identifying new interventions, but a great deal of the art of medicine is showcased in ancient works. The 20th century saw a plethora of books, articles, and monographs on the subjects of grief, death and dying, and suffering, but none of these has provided greater insight than the biblical book of Job. Excerpts from Job illustrate both the nature of grief and appropriate intervention when it is confronted.
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Lenferink, Lonneke I M; Eisma, Maarten C; de Keijser, Jos; Boelen, Paul A
2017-01-01
Background : The disappearance of a loved one is a unique type of loss, also termed 'ambiguous loss', which may heighten the risk for developing prolonged grief (PG), depression, and posttraumatic stress (PTS) symptoms. Little is known about protective and risk factors for psychopathology among relatives of missing persons. A potential protective factor is self-compassion, referring to openness toward and acceptance of one's own pain, failures, and inadequacies. One could reason that self-compassion is associated with lower levels of emotional distress following ambiguous loss, because it might serve as a buffer for getting entangled in ruminative thinking about the causes and consequences of the disappearance ('grief rumination'). Objective : In a sample of relatives of missing persons we aimed to examine (1) the prediction that greater self-compassion is related to lower symptom-levels of PG, depression, and PTS and (2) to what extent these associations are mediated by grief rumination. Method : Dutch and Belgian relatives of long-term missing persons ( N = 137) completed self-report measures tapping self-compassion, grief rumination, PG, depression, and PTS. Mediation analyses were conducted. Results : Self-compassion was significantly, negatively, and moderately associated with PG, depression, and PTS levels. Grief rumination significantly mediated the associations of higher levels of self-compassion with lower levels of PG (a*b = -0.11), depression (a*b = -0.07), and PTS (a*b = -0.11). Specifically, 50%, 32%, and 32% of the effect of self-compassion on PG, depression, and PTS levels, respectively, was accounted for by grief rumination. Conclusions : Findings suggest that people with more self-compassion experience less severe psychopathology, in part because these people are less strongly inclined to engage in ruminative thinking related to the disappearance. Strengthening a self-compassionate attitude using, for instance, mindfulness-based interventions may therefore be a useful intervention to reduce emotional distress associated with the disappearance of a loved one.
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Lenferink, Lonneke I. M.; Eisma, Maarten C.; de Keijser, Jos; Boelen, Paul A.
2017-01-01
ABSTRACT Background: The disappearance of a loved one is a unique type of loss, also termed ‘ambiguous loss’, which may heighten the risk for developing prolonged grief (PG), depression, and posttraumatic stress (PTS) symptoms. Little is known about protective and risk factors for psychopathology among relatives of missing persons. A potential protective factor is self-compassion, referring to openness toward and acceptance of one’s own pain, failures, and inadequacies. One could reason that self-compassion is associated with lower levels of emotional distress following ambiguous loss, because it might serve as a buffer for getting entangled in ruminative thinking about the causes and consequences of the disappearance (‘grief rumination’). Objective: In a sample of relatives of missing persons we aimed to examine (1) the prediction that greater self-compassion is related to lower symptom-levels of PG, depression, and PTS and (2) to what extent these associations are mediated by grief rumination. Method: Dutch and Belgian relatives of long-term missing persons (N = 137) completed self-report measures tapping self-compassion, grief rumination, PG, depression, and PTS. Mediation analyses were conducted. Results: Self-compassion was significantly, negatively, and moderately associated with PG, depression, and PTS levels. Grief rumination significantly mediated the associations of higher levels of self-compassion with lower levels of PG (a*b = −0.11), depression (a*b = −0.07), and PTS (a*b = −0.11). Specifically, 50%, 32%, and 32% of the effect of self-compassion on PG, depression, and PTS levels, respectively, was accounted for by grief rumination. Conclusions: Findings suggest that people with more self-compassion experience less severe psychopathology, in part because these people are less strongly inclined to engage in ruminative thinking related to the disappearance. Strengthening a self-compassionate attitude using, for instance, mindfulness-based interventions may therefore be a useful intervention to reduce emotional distress associated with the disappearance of a loved one. PMID:29163871
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End of Life: Dealing with Grief and Confronting Painful Emotions
... who aren't prepared for the avalanche of emotions that sweep over them when the final moment ... know how challenging and devastating the raw, intense emotions of grief can be, because it's happened to ...
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Death at the Worksite: Helping Grieving Family Members
... Grief at Work Working Through Grief About Us Death at the Worksite: Helping Grieving Family Members By ... fatal heart attacks occur in the workplace. Other deaths — from accidents, for example — can also happen during ...
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ERIC Educational Resources Information Center
Doka, Kenneth J.
1990-01-01
Reminds readers that grief books intended for nonprofessional audiences may be an important theoretical tool in helping bereaved resolve grief. Briefly reviews some base self-help literature and notes the strengths and limitations of the varied genre of self-help literature. (Author)
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An interpersonal neurobiological-informed treatment model for childhood traumatic grief.
Crenshaw, David A
This article expands an earlier model of the tasks of grieving (1990, [1995], [2001]) by building on science based findings derived from research in attachment theory, neuroscience, interpersonal neurobiology, and childhood traumatic grief (CTG). The proposed treatment model is a prescriptive approach that spells out specific tasks to be undertaken by children suffering traumatic grief under the direction of a therapist who is trained in trauma-informed therapy approaches and draws heavily on the empirically derived childhood traumatic grief treatment model developed by Cohen and Mannarino (2004; Cohen, Mannarino, & Deblinger, 2006). This model expands on their work by proposing specific tasks that are informed by attachment theory research and the interpersonal neurobiological research (Schore, 2003a, 2003b; Siegel, 1999). Particular emphasis is placed on developing a coherent and meaningful narrative since this has been found as a crucial factor in recovery from trauma in attachment research (Siegel, 1999; Siegel & Hartzell, 2003).
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Grief in the initial adjustment process to the continuing care retirement community.
Ayalon, Liat; Green, Varda
2012-12-01
This paper examined the transition to continuing care retirement communities (CCRCs) within the framework of anticipatory and disenfranchised grief. Qualitative interviews with 29 residents and 19 adult children were conducted. Three major thematic categories emerged from the data. The first theme reflected ambivalence, dialectics or uncertainty about the CCRC as manifested by the various names assigned to it by respondents. The second theme reflected the acknowledgement of present and anticipatory losses and grief in response to the move. The final theme reflected respondents' disenfranchisement of their grief and loss and their view of the transition in a positive light. In their early adjustment period, residents and adult children are ambivalent about the transition, but often refrain from acknowledging their losses openly because of the image of the CCRC as a status symbol. Open acknowledgement of losses associated with the transition might be beneficial. Copyright © 2012 Elsevier Inc. All rights reserved.
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Complicated grief therapy as a new treatment approach
Wetherell, Julie Loebach
2012-01-01
Complicated grief therapy (CGT) is a relatively new psychotherapy model designed to address symptoms of complicated grief. Drawn from attachment theory and with roots in both interpersonal therapy (IPT) and cognitive-behavioral therapy, CGT includes techniques similar to prolonged exposure (repeatedly telling the story of the death and in vivo exposure activities). The treatment also involves focusing on personal goals and relationships. CGT has been demonstrated to be effective in a trial in which participants with complicated grief were randomly assigned to CGT or IPT; individuals receiving CGT responded more quickly and were more likely to respond overall (51 % vs 28%). This article briefly summarizes the conceptual underpinnings of CGT, discusses the empirical evidence for its efficacy, describes its techniques, and presents a case example of a client treated in a 16-session manualized CGT protocol. The article concludes with a description of future research directions for CGT. PMID:22754288
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Mediators of Outcome in Complicated Grief Treatment.
Glickman, Kim; Shear, M Katherine; Wall, Melanie M
2017-07-01
In this study, we examined the mechanisms of action of complicated grief treatment (CGT), an efficacious psychotherapy for complicated grief. We explored 3 putative mediators (guilt/self-blame related to the deceased, negative thoughts about the future, and avoidance) among treatment completers assigned to either CGT (n = 35) or interpersonal psychotherapy (n = 34) in a previously reported randomized controlled trial. Antidepressant use was examined as a moderator of mediation effects. A reduction in guilt/self-blame, negative thoughts about the future, and avoidance behavior each mediated the relationship between treatment group and complicated grief outcomes. Reduction in avoidance emerged as an independent mediator after controlling for all mediators. Reducing avoidance of situations and emotions connected to the loss seems to be a key mechanism of change in CGT. Revising counterfactual thinking around troubling aspects of the death may also play a role in facilitating effective adaptation to loss. © 2016 Wiley Periodicals, Inc.
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Complicated grief therapy as a new treatment approach.
Wetherell, Julie Loebach
2012-06-01
Complicated grief therapy (CGT) is a relatively new psychotherapy model designed to address symptoms of complicated grief. Drawn from attachment theory and with roots in both interpersonal therapy (IPT) and cognitive-behavioral therapy, CGT includes techniques similar to prolonged exposure (repeatedly telling the story of the death and in vivo exposure activities). The treatment also involves focusing on personal goals and relationships. CGT has been demonstrated to be effective in a trial in which participants with complicated grief were randomly assigned to CGT or IPT; individuals receiving CGT responded more quickly and were more likely to respond overall (51% vs 28%). This article briefly summarizes the conceptual underpinnings of CGT, discusses the empirical evidence for its efficacy, describes its techniques, and presents a case example of a client treated in a 16-session manualized CGT protocol. The article concludes with a description of future research directions for CGT.
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Does the internet change how we die and mourn? Overview and analysis.
Walter, Tony; Hourizi, Rachid; Moncur, Wendy; Pitsillides, Stacey
The article outlines the issues that the internet presents to death studies. Part 1 describes a range of online practices that may affect dying, the funeral, grief and memorialization, inheritance and archaeology; it also summarizes the kinds of research that have been done in these fields. Part 2 argues that these new online practices have implications for, and may be illuminated by, key concepts in death studies: the sequestration (or separation from everyday life) of death and dying, disenfranchisement of grief, private grief, social death, illness and grief narratives, continuing bonds with the dead, and the presence of the dead in society. In particular, social network sites can bring dying and grieving out of both the private and public realms and into the everyday life of social networks beyond the immediate family, and provide an audience for once private communications with the dead.
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Cultural perspectives of death, grief, and bereavement.
Clements, Paul T; Vigil, Gloria J; Manno, Martin S; Henry, Gloria C; Wilks, Jonathan; Das Sarthak; Kellywood, Rosie; Foster, Wil
2003-07-01
The cultural makeup of the United States continues to change rapidly, and as minority groups continue to grow, these groups' beliefs and customs must be taken into account when examining death, grief, and bereavement. This article discusses the beliefs, customs, and rituals of Latino, African American, Navajo, Jewish, and Hindu groups to raise awareness of the differences health care professionals may encounter among their grieving clients. Discussion of this small sample of minority groups in the United States is not intended to cover all of the degrees of acculturation within each group. Cultural groups are not homogeneous, and individual variation must always be considered in situations of death, grief, and bereavement. However, because the customs, rituals, and beliefs of the groups to which they belong affect individuals' experiences of death, grief, and bereavement, health care professionals need to be open to learning about them to better understand and help.
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Grief symptoms and difficult patient loss for oncologists in response to patient death.
Granek, Leeat; Ben-David, Merav; Shapira, Shahar; Bar-Sela, Gil; Ariad, Samuel
2017-07-01
The study aimed to explore oncologist's grief symptoms over patient death and to identify why and which losses are particularly challenging when patients die. The grounded theory method was used to collect and analyze the data. Twenty-two oncologists were interviewed between March 2013 and June 2014 from three adult oncology centers in the north, center, and south of Israel. Oncologists were at different stages of their careers and varied in their sub-specialties, gender, and personal and professional backgrounds. Grief begun when the patient died, in anticipation of the patient's death, many days after the death, or when the patient received a poor prognosis. The phenomenological experience of grief for oncologists included behavioral, cognitive, physical, and emotional symptoms in response to patient death. Behavioral symptoms included crying and difficulties sleeping. Cognitive symptoms included self-doubt and rumination about the patient and the care the patient had received before death. Physical symptoms included chest pain, fatigue, and general physical discomfort. Emotional symptoms included sadness, anxiety, helplessness, guilt, relief, irritability, and loss. Difficult patient loss was caused by patient-related factors, family-related factors, and disease-related factors. Patient deaths result in behavioral, cognitive, physical, and emotional symptoms of grief in oncologists. These symptoms become particularly intense in the context of patient, family, and disease-related factors. Educational and supportive interventions for managing grief related to patient death are needed in order to support oncologists in their emotionally and mentally taxing work. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
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Büchi, Stefan; Mörgeli, Hanspeter; Schnyder, Ulrich; Jenewein, Josef; Hepp, Urs; Jina, Eveline; Neuhaus, Rachel; Fauchère, Jean-Claude; Bucher, Hans Ulrich; Sensky, Tom
2007-01-01
To assess grief and post-traumatic growth in parents 2-6 years after the death of a premature baby (24-26 weeks' gestation) and to evaluate Pictorial Representation of Illness and Self-Measure (PRISM) in the assessment of bereavement. Fifty-four parents were assessed for their experiences during hospitalization and by questionnaires regarding grief (MTS), post-traumatic growth, affective symptoms and the visual representation of the baby and the self of the parents (PRISM). Even 2-6 years after the loss of their extremely preterm infant the parents still suffer a lot from their bereavement, mothers more so than fathers (Mann-Whitney U test, U = 230.5, p < 0.05). Having another child reduced the level of grief (U = 119.0, p < 0.05). Mothers showed more post-traumatic growth than fathers (U = 140.5, p < 0.001). For all parents a shorter distance between the baby and the self (PRISM) correlated with greater grief (rho = -0.62, p < 0.001); in multiple regression analysis MTS explained 38% of the SBS-variance. Clinicians should be aware that the death of an extremely premature infant triggers not only a painful long-term process of mourning but also of individual personal growth. Adaptation processes after the death differ depending on gender, with mothers experiencing more intense grief but also more growth than fathers. The modified PRISM test is recommended as a visual, non-verbal and easy-to-use instrument to assess bereavement. Copyright 2007 S. Karger AG, Basel.
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deMontigny, Francine; Verdon, Chantal; Meunier, Sophie; Dubeau, Diane
2017-10-01
The objectives of this cross-sectional study were to determine whether depressive and perinatal grief symptoms vary according to time since miscarriage and to test whether childlessness and satisfaction with healthcare services influence symptom duration. A total of 245 women who had experienced a miscarriage answered a self-report questionnaire, indicating the date of their miscarriage and assessing their present level of depressive and perinatal grief symptoms. They also provided sociodemographic characteristics and indicated their level of satisfaction with healthcare services. One-way analyses of variance indicated that women who had miscarried within the past 6 months reported higher scores for depressive symptoms than did women who had miscarried between 7 and 12 months ago and more than 2 years ago. However, when controlling for childlessness and satisfaction with healthcare services, those differences became respectively marginal and non-significant, indicating that depressive symptoms are similar across time for more than 2 years after the loss. Regarding perinatal grief, results revealed that symptoms significantly decreased across time only for women with children and women who were satisfied with healthcare services. For childless women and those dissatisfied with healthcare services, perinatal grief symptoms did not vary according to time since miscarriage. Results suggest that, particularly for women who are childless and/or dissatisfied with healthcare services, depressive and perinatal grief symptoms persist long after a miscarriage. These results highlight the importance of paying particular attention to more vulnerable women and of improving healthcare services post-miscarriage.
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Factors of complicated grief pre-death in caregivers of cancer patients
Tomarken, Alexis; Holland, Jimmie; Schachter, Sherry; Vanderwerker, Lauren; Zuckerman, Enid; Nelson, Christian; Coups, Elliot; Ramirez, Paul Michael; Prigerson, Holly
2008-01-01
Purpose Over the past decade, Prigerson and her colleagues have shown that symptoms of ‘complicated grief’—intense yearning, difficulty accepting the death, excessive bitterness, numbness, emptiness, and feeling uneasy moving on and that the future is bleak—are distinct from depression and anxiety and are independently associated with substantial morbidity. Little is known about complicated grief experienced by family caregivers prior to the death. This study sought to examine differences in caregiver age groups and potential risk factors for complicated grief pre-death. Method Two hundred and forty eight caregivers from multiple sites nationwide (20–86 years of age) identified themselves as primary caregivers to a terminally ill cancer patient. Each caregiver was interviewed using the following measures: the Pre-Death Inventory of Complicated Grief-Caregiver Version; the Brief Interpersonal Support Evaluation List; the Structured Clinical Interview for the DSM-IV Axis I; the Life Orientation Test-Revised; the SEPRATE Measure of Stressful Life Events; the Covinsky Family Impact Survey; and mental health access questions. Results The study found that those under 60 years old had higher levels of complicated grief pre-death than caregivers 60 and older (t(246) = 2.30, p<0.05). Significant correlations were also found between levels of complicated grief pre-loss and the following psychosocial factors: perceived social support (r = −0.415, p<0.001); history of depression (r = −0.169, p<0.05); current depression (r = −0.158, p<0.05); current annual income (Spearman rho = −0.210, p<0.01); annual income at time of patient's diagnosis (Spearman rho = −0.155, p = 0.05); pessimistic thinking (r = 0.320; p<0.001); and number of moderate to severe stressful life events (Spearman rho = 0.218, p = 0.001). In a multi-variate analysis (R2 = 0.368), pessimistic thinking (Beta = 0.208, p<0.05) and severity of stressful life events (Beta = 0.222, p<0.05) remained as important factors to developing complicated grief pre-death. Conclusions These results suggest that mental health professionals who work with caregivers should pay particular attention to pessimistic thinking and stressful life events, beyond the stress of the loved one's illness, that caretakers experience. Additionally, although not reaching significance, mental health professionals should also consider younger caregivers at greater risk for complicated grief pre-loss. PMID:17443644
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Telephone Support During Overseas Deployment for Military Spouses
2015-04-01
family, and the cost can be high. Spouses’ reactions to deployment may include emotional distress, loneliness, anticipatory fear or grief, somatic...deployment may include emotional distress, loneliness, anticipatory fear or grief, somatic complaints, and depression. Spouses may also be stressed by
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Shapiro, Danielle N; Howell, Kathryn H; Kaplow, Julie B
2014-01-01
Mother-child communication may be an important factor in determining children's grief reactions following the death of the father. Using observational methods, the current study suggests that mothers' warm, sensitive, and engaged communication is associated with lower levels of maladaptive grief and depressive symptoms in children whose fathers have recently died. Further, mothers who showed a blunted emotional response to the loss, illustrated by unusually few depressive symptoms, were less effective at using these strategies than mothers with a more "normative" reaction. Findings suggest that mother-child communication may be an important intervention target for bereaved families.
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Shear, M Katherine
2010-01-01
Avoidance can be adaptive and facilitate the healing process of acute grief or it can be maladaptive and hinder this same process. Maladaptive cognitive or behavioral avoidance comprises the central feature of the condition of complicated grief. This article explores the concept of experiential avoidance as it applies to bereavement, including when it is adaptive when it is problematic. Adaptive avoidance is framed using an attachment theory perspective and incorporates insights from the dual process model (DPM). An approach to clinical management of experiential avoidance in the syndrome of complicated grief is included.
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[Compassionate care for terminally ill term and preterm infants].
Schulze, A; Wermuth, I
2007-04-01
Involvement of the family in decisions to withhold or withdraw intensive care and parental involvement in care planning for terminally ill infants does not aggravate or prolong parents' grief responses, their feelings of guilt, or the incidence of pathological grief responses. Effective physical pain and symptom management is critically important. Compassionate care plans, however, need to implement a number of other and equally important components. Parents are not uniform in their perceived needs to make various kinds of contacts with their dying infant. They should be allowed to make their individual choices regarding contact with their baby during that time. The perinatal loss of a twin infant appears to evoke no less serious stress and risks to parents' compared to the loss of a singleton. The disruption of family life during a perinatal loss affects siblings of the baby, and their specific needs should be acknowledged. Post-death or post-autopsy meetings with the family should routinely be scheduled a few weeks after death, and bereavement support should actively be offered. Parents need to be informed about differences to be expected between maternal and paternal grief responses. The risk of pathological grief variants and chronic grief should be mentioned to parents because professional help is required in such occurrence.
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Shear, M Katherine
2012-06-01
Acute grief is emotionally intense, cognitively preoccupying, and disruptive, but grief is not an illness; major depression and anxiety disorders are. Grief and mourning have a purpose. They provide an intense, focused opportunity to reregulate emotion and to engage in a learning process that is aimed at reconfiguring life without the deceased—both the internal life of the mind, and ongoing life in the world. A bereaved person needs to figure out how to find meaning, purpose, joy, and satisfaction in life without someone who has previously been central to these feelings. This reconfiguration is a very natural process that tends to occur in fits and starts as bereaved people move forward and deal with everyday life. Nevertheless, a knowledgeable, empathic and supportive clinician can foster good adjustment. Successful mourning is, however, not a given. For some people, the mourning process is derailed and acute grief is inordinately painful and prolonged. For others, the stress of bereavement triggers the onset or worsening of symptoms of MDD, an anxiety disorder or another psychiatric or medical condition, suicidality or negative health behaviors. Clinicians need to be alert to all of these problematic responses to loss. In the wake of bereavement, we need to both facilitate effective mourning and diagnose and treat co-occurring conditions.
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Kelley, Melissa M; Chan, Keith T
2012-03-01
Research has examined the relationship of styles of attachment to others and meaning with grief and the stress-related growth process. Less has been written on styles of attachment to God and patterns of religious coping and how these constructs may impact adjustment in persons dealing with loss. This study examines the roles of attachment to God, meaning, and religious coping as mediators in the grief experience for a sample of 93 individuals who experienced a significant death in the prior year. Results suggest that a more secure style of attachment to God was directly and indirectly associated with lower depression and grief and increased stress-related growth for this sample. Meaning, defined as a sense of purpose and coherence, also emerged as an important construct in this process. Overall goodness-of fit statistics were examined for competing models using structural equation modeling. Secure attachment to God, meaning, and positive religious coping were found to have significant direct and indirect effects on grief and stress-related growth. For some individuals, attachment to God may be an important construct in the experience of meaning following a significant death and may have tremendous potential in its direct and indirect effects on overall outcomes.
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The Benefits of Anticipatory Grief for the Parents of Dying Children
ERIC Educational Resources Information Center
Powers, Meredith A.
1977-01-01
The crisis of losing a child is described by a parent as she personally rethinks her experiences with terminal illness and grief, the reactions of family and friends, and her encounter with the hospital system and family counseling. (Author)
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Medical comorbidity in complicated grief: Results from the HEAL collaborative trial.
Robbins-Welty, Gregg; Stahl, Sarah; Zhang, Jun; Anderson, Stewart; Schenker, Yael; Shear, M Katherine; Simon, Naomi M; Zisook, Sidney; Skritskaya, Natalia; Mauro, Christina; Lebowitz, Barry D; Reynolds, Charles F
2018-01-01
To describe medical comorbidity in persons with Complicated Grief (CG) and to test whether medical comorbidity in individuals with CG is associated with the severity and duration of CG, after adjusting for age, sex, race, and current depressive symptoms. In exploratory analyses, we compared data from participants in an NIMH-sponsored multisite clinical trial of CG ("HEAL": "Healing Emotions After Loss") to archival data from participants matched on age, gender, and race/ethnicity, stratified by the presence or absence of current major depression. We used the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) as a measure of medical polymorbidity. We investigated the association between CG and medical comorbidity via multiple linear regression, adjusting for sociodemographic and clinical variables, including severity of depressive symptoms. Chronological age and severity of co-occurring symptoms of major depression correlated with cumulative medical polymorbidity in persons with Complicated Grief. The severity of CG and the time since loss did not correlate with global medical polymorbidity (CIRS-G score). Nor was there an interaction between severity of depressive symptoms and severity of CG symptoms in predicting global CIRS-G score. Cumulative medical comorbidity, as measured by CIRS-G scores, was greater in subjects with current major depression ("DEPRESSED") than in CG subjects, and both DEPRESSED and CG subjects had greater medical morbidity than CONTROLS. Medical comorbidity is prevalent in Complicated Grief, associated with increasing age and co-occurring depressive symptoms but apparently not with chronicity and severity of Complicated Grief per se. This observation suggests that treating depression in the context of CG may be important to managing medical conditions in individuals with Complicated Grief to attenuate or prevent the long-term medical sequelae of CG. Copyright © 2017 Elsevier Ltd. All rights reserved.
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van der Geest, Ivana M M; van den Heuvel-Eibrink, Marry M; Falkenburg, Nette; Michiels, Erna M C; van Vliet, Liesbeth; Pieters, Rob; Darlington, Anne-Sophie E
2015-05-01
The loss of a child is associated with an increased risk for developing psychological problems. However, studies investigating the impact of parents' faith and hope for a cure during the palliative phase on long-term parental psychological functioning are limited. The study's objective was to explore the role of faith and hope as a source of coping and indicator of long-term parental adjustment. Eighty-nine parents of 57 children who died of cancer completed questionnaires retrospectively, exploring faith, hope, and sources of coping, and measuring parents' current level of grief and depression. For 19 parents (21%) faith was very important during the palliative phase. The majority of parents remained hopeful for a meaningful time with their child (n=68, 76%); a pain-free death (n=58, 65%); and a cure (n=30, 34%). Their child (n=70, 79%) was parents' main source of coping. Twelve parents (14%) suffered from traumatic grief, and 22 parents (25%) showed symptoms of depression. Parents' faith was not associated with less long-term traumatic grief (OR=0.86, p=0.51) or symptoms of depression (OR=0.95, p=0.74), and parents' hope for a cure was not related to more long-term traumatic grief (OR=1.07, p=0.71) or symptoms of depression (OR=1.12, p=0.47). Faith was important for a minority of parents and was not associated with less long-term traumatic grief or symptoms of depression. The majority of parents remained hopeful. Hope for a cure was not associated with more long-term traumatic grief or symptoms of depression.
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Clifton, Shane
2014-01-01
For good reason, the trajectory of contemporary research and therapy into rehabilitation following spinal cord injury (SCI) has moved away from focusing on the pathology of depression, to highlight the contribution of resiliency, optimism, and hope to long-term well-being. This article complements this literature, exploring the analogous links between the losses of SCI and the experiences of the grief that accompanies the death of a loved one. The article uses autoethnography, drawing on the authors' writing about his own experiences as a C5 (incomplete) quadriplegic, to identify a correlation between the stages/symptoms of grief and the journey of rehabilitating from an SCI. The article highlights the "wild" and ambiguous reality of adjusting to an SCI, and so challenges the dualist tendency to assume that people are either resilient or weak, successful or unsuccessful in their recovery. It recognises that adjusting to an SCI involves complex swings in emotion--sadness, anger, and melancholy, alongside hope and determination. Drawing on strategies of grief therapy, the article suggests that constructing and reconstructing the story of one's own life is essential to learning to accept and live with an SCI. Since the losses accompanying SCI are analogous to grief, grief therapy strategies that recognise the complex and ambiguous nature of recovery can be part of rehabilitation. Therapy should encourage people to construct and reconstruct narratives--life stories--that help them mourn their loss and make sense of their new lives. The loss of an SCI is especially potent following return to the community, so storied therapy should continue beyond the period of the in-house rehabilitation.
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Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident.
Han, Hyesung; Noh, Jin Won; Huh, Hyu Jung; Huh, Seung; Joo, Ji Young; Hong, Jin Hyuk; Chae, Jeong Ho
2017-07-01
Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved family members of the Sewol ferry accident were recruited. Severity of complicated grief, post-traumatic stress disorder (PTSD) and depressive disorder was assessed through self-reporting questionnaire, inventory of complicated grief (ICG), PTSD Check List-5 (PCL-5) and Patient Health Questionnaire-9 (PHQ-9). We also included demographic, socioeconomic, health-related variables, and Functional Social Support Questionnaire (FSSQ), which affect the ICG score. Participants were divided into 4 groups based on the experience of psychotherapy or psychiatry clinic service before the accident and mental health support after the disaster. In univariate analysis, these 4 groups showed a significant difference in the mean ICG score (P = 0.020). Participants who received mental health support only after the Sewol ferry accident (group 2) showed a lower mean ICG score than those who received neither psychotherapy or psychiatry clinic service before the disaster nor mental health support after the accident (group 4). There was no significant correlation between the ICG score and other variables except for subjective health status measured 1 month after the disaster (P = 0.005). There was no significant difference in PCL-5 (P = 0.140) and PHQ-9 scores (P = 0.603) among groups, respectively. In conclusion, mental health support significantly reduced the severity of grief only in those participants who had not received any psychotherapy or psychiatry clinic service before the accident. © 2017 The Korean Academy of Medical Sciences.
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Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident
2017-01-01
Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved family members of the Sewol ferry accident were recruited. Severity of complicated grief, post-traumatic stress disorder (PTSD) and depressive disorder was assessed through self-reporting questionnaire, inventory of complicated grief (ICG), PTSD Check List-5 (PCL-5) and Patient Health Questionnaire-9 (PHQ-9). We also included demographic, socioeconomic, health-related variables, and Functional Social Support Questionnaire (FSSQ), which affect the ICG score. Participants were divided into 4 groups based on the experience of psychotherapy or psychiatry clinic service before the accident and mental health support after the disaster. In univariate analysis, these 4 groups showed a significant difference in the mean ICG score (P = 0.020). Participants who received mental health support only after the Sewol ferry accident (group 2) showed a lower mean ICG score than those who received neither psychotherapy or psychiatry clinic service before the disaster nor mental health support after the accident (group 4). There was no significant correlation between the ICG score and other variables except for subjective health status measured 1 month after the disaster (P = 0.005). There was no significant difference in PCL-5 (P = 0.140) and PHQ-9 scores (P = 0.603) among groups, respectively. In conclusion, mental health support significantly reduced the severity of grief only in those participants who had not received any psychotherapy or psychiatry clinic service before the accident. PMID:28581276
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Shen, Hui-Shan; Chen, Szu-Yin; Cheung, Denise Shuk Ting; Wang, Shu-Yi; Lee, Jung Jae; Lin, Chia-Chin
2018-02-21
No study has examined the varying family experience of palliative sedation therapy (PST) for terminally ill patients in different settings. To examine and compare family concerns about PST use and its effect on the grief suffered by terminally ill patients' families in palliative care units (PCUs) or intensive care units (ICUs). A total of 154 family members of such patients were recruited in Taiwan, of whom 143 completed the study, with 81 from the PCU and 62 from the ICU. Data were collected on their concerns regarding PST during recruitment. Grief levels were assessed at three days and one month after the patient's death with the Texas Revised Inventory of Grief. Families' major concern about sedated patients in the PCU was that "there might be other ways to relieve symptoms" (90.2%), whereas families of ICU sedated patients gave the highest ratings to "feeling they still had something more to do" (93.55%), and "the patient's sleeping condition was not dignified" (93.55%). Family members recruited from the ICU tended to experience more grief than those from the PCU (P = 0.005 at Day 3 and < 0.001 at Month 1). PST use predicted higher levels of grief in family members recruited from the PCU (P < 0.001 at Day 3 and Month 1). Family experiences with the use of PST in terminally ill patients varied in different settings. Supportive care should address family concerns about PST use, and regular attention should be paid to the grief of individuals at higher risk. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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de Heus, Annemiek; Hengst, Sophie M. C.; de la Rie, Simone M.; Djelantik, A. A. A. Manik J.; Boelen, Paul A.; Smid, Geert E.
2017-01-01
ABSTRACT Background: Bereaved individuals who have lost a loved one under traumatic circumstances can develop symptoms of Persistent Complex Bereavement Disorder (PCBD) and/or Posttraumatic Stress Disorder (PTSD). This is particularly common in refugees, as they frequently have been confronted with multiple traumatic losses. For patients with severe PTSD and traumatic grief a treatment programme was developed, embedding individual traumatic grief focused therapy in a group-based multidisciplinary day patient treatment programme. The day patient treatment comprised a weekly five-hour programme consisting of three phases with a duration of four months each. Objective: To evaluate the feasibility and potential effectiveness of the treatment programme. Method: Data were analyzed from 16 participants treated between October 2013 and March 2014. PTSD severity and PTSD/PCBD diagnoses were measured during the initial and final phases of treatment using the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Traumatic Grief Inventory Self Report (TGI-SR). One clinical case is presented in more detail. Treatment attendance was also registered and therapist satisfaction was evaluated in a focus group. Results: Thirteen patients (81%) completed the treatment. Each day of the treatment programme was attended by a mean of 76% of the participants. In the focus group, therapists noted symptom reduction in their patients and they therefore regarded Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) as an effective therapy for their patients. During treatment, significant decreases in PTSD severity as well as diagnosable PTSD and PCBD were observed. Conclusions: Results support the feasibility and potential effectiveness of the day patient treatment programme for traumatic grief. The programme appears to be particularly suitable for refugees with severe PTSD and PCBD psychopathology, who may not benefit enough from usual care. PMID:29038679
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Persistent Complex Bereavement Disorder and Culture: Early and Prolonged Grief in Nepali Widows.
Kim, Jane; Tol, Wietse A; Shrestha, Abina; Kafle, Hari Maya; Rayamajhi, Rajin; Luitel, Nagendra P; Thapa, Lily; Surkan, Pamela J
2017-01-01
Persistent complex bereavement disorder (PCBD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has not been well studied in socioculturally diverse populations. Thus, this qualitative study examined (a) how widows in Nepal understand grief, (b) whether a local construct of PCBD exists, and (c) its comparability with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), terminology. Using an adapted Explanatory Model Interview Catalogue (EMIC) framework, semistructured interviews with 25 widows and 12 key informants, as well as three focus-group discussions (n = 20), were conducted between October 2014 and April 2015. Through an inductive grounded theory-based approach, we used the constant comparative method, iteratively coding transcripts to identify themes and patterns in the data. Also, we created two lists of grief responses, one of early reactions and another all reactions to grief, based on the frequency of mention. No single term for grief was reported. Widows reported a local construct of PCBD, which was broadly compatible with DSM-5 terminology but with important variation reflecting societal influence. Surviving torture during conflict, economic and family stressors, and discrimination were mentioned as important determinants that prolong and complicate grief. Suicidal ideation was common, with about 31% and 62% of widows reporting past-year and lifetime suicidality, respectively. Findings may not be generalizable to all Nepali widows; participants were recruited from a non-governmental organization, from Kathmandu and its neighboring districts, and were primarily of reproductive age. While PCBD symptoms proposed in DSM-5 were mentioned as relevant by study participants, some components may need adaptation for use in non-Western settings, such as Nepal.
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Toward a Model of Parental Grief.
ERIC Educational Resources Information Center
Klass, Dennis; Marwit, Samuel J.
1989-01-01
Reviews literature relating to naturalistic and laboratory studies of primates, human bonding, family systems theory, psychoanalytic notions of multiple inner representations, and pathological parenting in child abuse and neglect. Attempts to understand uniqueness of parent-child attachments and unique grief experienced at death of child. Proposes…
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... would be an integral part of our society, culture, and belief systems. That is still our hope. On this website you will find the most popular tools and materials we produced over the years. From training for employers on Grief at Work to support for school professionals on Grief in ...
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Survivor-Victim Status, Attachment, and Sudden Death Bereavement.
ERIC Educational Resources Information Center
Reed, Mark D.; Greenwald, Jason Y.
1991-01-01
Examined significance of survivor-victim relationship in understanding grief following sudden death bereavement by suicide or accident. Results showed that survivor-victim attachment was more important than survivor status (parent versus sibling/child) in explaining grief reactions. Compared to accident survivors, suicide survivors experienced…
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Factors related to alcohol and drug consumption in Swedish widows.
Grimby, Agneta; Johansson, Asa K
2009-01-01
The use of alcohol and medications among Swedish widows was analyzed in relation to various background variables. In Total, 1053 widows (640 widows younger than 65 years and 413 widows older than 65 years) answered the questionnaire. Many reported increased fatigue and sleeping problems. Around one-third of the widows reported drinking alcohol for relief of grief and inadequate support. Association existed between grief and increased intake of sedatives and sleeping pills, and between grief and drinking for relief of grief, as well as increase in intake of sedatives. In widows older than 65 years, perception of bad health, negative outlook for the future, and insufficient support seemed to increase the risk of more sedatives and sleeping pills. Negative outlook for the future also tended to lead to a heightened risk for increased intake of alcohol. There seems to be remaining health problems a long time after bereavement, and counseling may be needed especially when drugs and alcohol are extensively used.
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Pfefferbaum, Betty; Vinekar, Shreekumar S; Trautman, Richard P; Lensgraf, S Jay; Reddy, Chandrashekar; Patel, Nilam; Ford, Andria L
2002-06-01
In this study, we examined the effect of trauma exposure on substance use behaviors, specifically tobacco and alcohol use, in a group of 84 individuals who sought supportive services after the 1995 Oklahoma City bombing. A self-report instrument was used to assess demographics, sensory exposure, injury, interpersonal exposure through relationship with victims, peritraumatic reaction, grief, posttraumatic stress, worry about safety, functional impairment, and changes in smoking and drinking. Those who reported increased smoking had higher scores on peritraumatic reaction, grief, posttraumatic stress, worry about safety, and trouble functioning. Those who reported increased alcohol intake had higher scores on injury, peritraumatic reaction, grief, posttraumatic stress, worry about safety, and trouble functioning. Sensory exposure and interpersonal exposure were not significantly different between those with and without increased smoking or drinking. Although no causal relationship can be assumed, our findings indicate an association of grief and posttraumatic stress with increased substance use behaviors in disaster victims.
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Maercker, Andreas; Znoj, Hansjörg
2010-01-01
Just as traumatic experiences may lead to posttraumatic stress disorder (PTSD) in some individuals, grief may also be a serious health concern for individuals who have experienced bereavement. At present, neither the DSM-IV nor the ICD-10 recognizes any form of grief as a mental disorder. The aim of this review is to summarize recent advances in definition, assessment, prevention, and treatment of complicated grief disorder (CGD) and to compare CGD with PTSD. Four areas are identified to be of importance to clinicians and researchers: (a) the recently proposed consensus criteria of CGD for DSM-V and ICD-11, (b) available assessment instruments, (c) recent prevention and treatment techniques and related effectiveness studies, and (d) emerging disorder models and research on risks and protective factors. This review focuses on the similarities and differences between CGD and PTSD and highlights how a PTSD-related understanding aids the investigation and clinical management of CGD. PMID:22893801
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Clute, Mary Ann
2017-11-01
This grounded theory study gathered descriptions the bereavement experience for adults with intellectual disabilities (IDD) through the eyes and voices of a small sample of grief counselors. The counselors described bereaved adults with IDD as individuals who faced potentially heightened effects of the broken attachment bonds, increased risk of coping obstacles, long histories of unrecognized losses, and disenfranchised grief. The participants described bereaved adults with IDD (who sought treatment) as getting pushed to the sidelines to deal with their losses in isolation and confusion. It became evident that though there are many similarities between how all people cope with loss and how people with IDD cope with loss, differences exist. Subtle variations in the experience of loss and grief appear to be driven by culture and beliefs about disability and protection for those with IDD. The participants in this dissertation study contributed foundation data for a theoretical explanation of grief for adults with IDD grounded in data from bereavement counselors.
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Sandler, Irwin; Tein, Jenn-Yun; Cham, Heining; Wolchik, Sharlene; Ayers, Tim
2016-01-01
Objective Reports on the finding from a six-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on outcomes for spousally-bereaved parents. Method Spousally-bereaved parents (N=131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (LC, N = 59). Parents were assessed at four time points, pre-test, post-test, 11-months, and six-year follow-up. Parents reported on mental health problems, grief and parenting at all four time periods. At the six-year follow-up parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Results Bereaved parents in the FBP as compared to those in the LC had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, alcohol problems, and higher coping efficacy at the six-year follow-up. Multiple characteristics of the parent (e.g., gender, age, baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome. Latent-growth modeling found that the effects of the FBP on depression, psychiatric distress and grief occurred immediately following program participation and were maintained over six-years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the six years follow-up. Mediation analysis also found that improved parenting at the six year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the six-year follow-up was partially mediated through reduced depression and grief and improved parenting. Conclusions FBP reduced mental health problems, prolonged grief and alcohol abuse and increased coping efficacy of spousally-bereaved parents six years later. Mediation pathways for program effects differed across outcomes at the six-year follow-up. PMID:27427807
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Balancing grief and survival: Experiences of children with brain tumors and their parents.
Eaton Russell, Ceilidh; Bouffet, Eric; Beaton, John; Lollis, Susan
2016-01-01
Psychosocial research about childhood brain tumors is limited because of varied abilities and prognoses, with children's voices largely absent. Research has focused on the impacts on families and their reactions; this qualitative study used constructivist grounded theory methods to explore experiences of childhood brain tumors from the perspectives of 12 children and 12 parents using semistructured interviews. Their stories illustrated efforts to maintain positivity and normalcy as they faced grief and uncertainty. The substantive grounded theory of balancing grief and survival offers a lens through which to view children's and parents' complex experiences, struggles, and coping strategies as integrated, dynamic processes.
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The suffering in silence of older parents whose child died of cancer: A qualitative study.
Van Humbeeck, Liesbeth; Dillen, Let; Piers, Ruth; Grypdonck, Mieke; Van Den Noortgate, Nele
2016-01-01
As life expectancy grows, the death of an adult child becomes a highly prevalent problem for older adults. The present study is based on nine interviews and explores the experience of parents (≥70 years) outliving an adult child. The bereaved parents described some silencing processes constraining their expression of grief. When an adult dies, the social support system nearly automatically directs its care towards the bereaved nuclear family. Parental grief at old age is therefore often not recognized and/or acknowledged. Health care providers should be sensitive to the silent grief of older parents both in geriatric and oncology care settings.
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Does knowing that a suicide was "rational" influence grief?
Brazda, Geoffrey F; Range, Lillian M; Remley, Theodore P; White, Carolyn C
2018-03-15
Counseling professionals and graduate students (N = 117) recruited online read a randomly assigned one-paragraph vignette about either a non-rational or rational suicide involving an imaginary loved one. Then, they completed the Grief Experiences Questionnaire (GEQ) about how they would feel. The non-rational suicide group expected significantly more search for explanation than the rational suicide group, but were not significantly different on the other six GEQ subscales. All participants expected few distressing reactions to either vignette, suggesting a one-paragraph vignette may not be sufficient to induce the kind of grief many experience when a loved one dies by suicide.
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Kunkel, Adrianne; Dennis, Michael Robert; Garner, Benjamin
2014-01-01
A typology of meaning reconstruction in grief-related discourse is offered as an extension to extant approaches to meaning making as a factor in relieving distress. Sensemaking, acceptance or resignation without understanding, realization of benefits via positive reappraisal, and realignment of roles and relationships are advanced as the 4 types of meaning reconstruction that are formed by the 4 intersections of Park's ( 2010 ) categorical distinctions in meaning making (i.e., searching for comprehensibility/searching for significance and assimilation/accommodation). Interpretive analysis of grief-related texts from an emotional disclosure study reveals 25 themes across the 4 types. Related theoretical insights and practical implications are discussed.
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Rack, Jessica J; Burleson, Brant R; Bodie, Graham D; Holmstrom, Amanda J; Servaty-Seib, Heather
2008-01-01
This study identifies grief management strategies that bereaved adults evaluate as more and less helpful, assesses whether the person centeredness of these strategies explains their helpfulness, and determines whether strategy helpfulness varies as a function of demographic, personality, and situational factors. Participants (105 bereaved young adults) assessed the helpfulness of 16 grief management strategies; these strategies were coded for their degree of person centeredness. Strategy person centeredness was strongly correlated with helpfulness. Strategy helpfulness varied as a function of participant gender and the disruptiveness of the decedent's death, but not as a function of need for cognition or decedent closeness.
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Transition after Traumatic Loss
ERIC Educational Resources Information Center
Kuban, Caelan
2011-01-01
Children experience grief when they suffer the loss of a close relationship. When that loss also traumatizes children, they experience additional emotional reactions. It is important that adults educate themselves and others who deal with children about typical, healthy grief reactions. Following a non-violent loss, the initial reactions of…
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Religiosity Related to Grief Levels of Bereaved Mothers and Fathers.
ERIC Educational Resources Information Center
Bohannon, Judy Rollins
1991-01-01
Examined religiosity and bereaved mothers' (n=143) and fathers' (n=129) scores on Grief Experience Inventory. High church attendance had significant inverse relationship with death anxiety. Mothers who attended church more frequently reported significantly less loss of control, rumination, depersonalization, and optimism/despair. Church attendance…
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The Emotional Experience of School Change: Resistance, Loss, and Grief.
ERIC Educational Resources Information Center
Marshak, David
1996-01-01
Ignoring the emotional experience of school change may unintentionally sabotage rational planning. Reinventing schools means attending to educators' emotional experience, particularly their expectations, sense of loss, and resulting grief. School norms must be transformed so that teachers and administrators can have meaningful conversations about…
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Music Therapy with Bereaved Youth: Expressing Grief and Feeling Better
ERIC Educational Resources Information Center
McFerran, Katrina
2011-01-01
Music therapy is a promising intervention with bereaved youth. In comparison to other programs, it appears particularly effective for promoting the resolution of grief-related feelings; providing opportunities to express and release feelings through musical participation. Descriptions from music therapy participants are supported by research…
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Race as a Factor in Teachers' Responses to Children's Grief.
ERIC Educational Resources Information Center
Atkinson, Trudie L.
1982-01-01
Investigated how teachers respond to children in death-related situations. When Black and non-Black teachers were compared, no differences were evident in attitudes toward death or belief in an afterlife. However, significant differences appeared in the responses they chose to children's grief. (Author)
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A Bridge between Traumatic Life Events and Losses by Death.
ERIC Educational Resources Information Center
Trolley, Barbara C.
1994-01-01
Provides support for connection between grief reactions and traumatic life events. Discusses reactions to life traumas (alcoholism, abuse, disability, divorce, infertility) within context of grief framework. Applies literature pertaining to responses to suicide and murder to traumatic life events. Discusses and dissolves proposed differences…
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Grief and Horses: Putting the Pieces Together
ERIC Educational Resources Information Center
Symington, Ashley
2012-01-01
The effectiveness of grief counseling may be enhanced through the utilization of equine-assisted psychotherapy (EAP). An experiential, solution-focused, and natural approach, EAP provides clients with the opportunity to discover solutions to challenges that exist within themselves. Counselors and equine specialists team with horses to provide a…
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Depressive disorder and grief following spontaneous abortion.
Kulathilaka, Susil; Hanwella, Raveen; de Silva, Varuni A
2016-04-12
Abortion is associated with moderate to high risk of psychological problems such as depression, use of alcohol or marijuana, anxiety, depression and suicidal behaviours. The increased risk of depression after spontaneous abortion in Asian populations has not been clearly established. Only a few studies have explored the relationship between grief and depression after abortion. A study was conducted to assess the prevalence and risk factors of depressive disorder and complicated grief among women 6-10 weeks after spontaneous abortion and compare the risk of depression with pregnant women attending an antenatal clinic. Spontaneous abortion group consisted of women diagnosed with spontaneous abortion by a Consultant Obstetrician. Women with confirmed or suspected induced abortion were excluded. The comparison group consisted of randomly selected pregnant, females attending the antenatal clinics of the two hospitals. Diagnosis of depressive disorder was made according to ICD-10 clinical criteria based on a structured clinical interview. This assessment was conducted in both groups. The severity of depressive symptoms were assessed using the Patients Health Questionnaire (PHQ-9). Grief was assessed using the Perinatal Grief Scale which was administered to the women who had experienced spontaneous abortion. The sample consisted of 137 women in each group. The spontaneous abortion group (mean age 30.39 years (SD = 6.38) were significantly older than the comparison group (mean age 28.79 years (SD = 6.26)). There were more females with ≥10 years of education in the spontaneous abortion group (n = 54; SD = 39.4) compared to the comparison group (n = 37; SD = 27.0). The prevalence of depression in the spontaneous abortion group was 18.6 % (95 CI, 11.51-25.77). The prevalence of depression in the comparison group was 9.5 % (95 CI, 4.52-14.46). Of the 64 women fulfilling criteria for grief, 17 (26.6 %) also fulfilled criteria for a depressive episode. The relative risk of developing a depressive episode after spontaneous abortion was significantly higher than in females with a viable pregnancy (RR = 2.19, 95 % CI, 1.05 to 4.56). After adjustment for age and period of amenorrhoea, the difference was not significant. Prevalence of complicated grief was 54.74 % (95 % CI, 46.3-63.18). The relative risk of developing a depressive episode after spontaneous abortion was not significantly higher compared to pregnant women after taking into account age and period of amenorrhoea (POA). Almost half the women developed complicated grief after spontaneous abortion. Of these, a significant proportion also had features of depressive disorder.
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Anticipatory grieving among parents living with a child with cancer.
Al-Gamal, Ekhlas; Long, Tony
2010-09-01
This paper is a report of a comparative study of anticipatory grief of parents of children newly diagnosed with cancer and those whose children were diagnosed 6-12 months earlier. Public perceptions of cancer as a fatal illness persist despite improved prognosis for children. Parents may experience feelings of despair, hopelessness, and worthlessness - the most common psychological expressions of anticipatory grief. With a focus on developing more effective therapeutic intervention, healthcare professionals have developed greater interest in the concept of anticipatory grief. One hundred and forty parents, divided between 'newly diagnosed' and '6-12 months after diagnosis' groups, were recruited in 2006 from two hospitals representative of the healthcare sector in Jordan. Structured interviews were conducted to assess anticipatory grief, using the Marwit and Meuser Caregiver Inventory: Childhood Cancer. Analysis was performed using t-tests. Fewer than half of the parents in both groups reported being at peace with themselves and their situation in life. Parents of newly diagnosed children reported more severe anticipatory grief responses than those in the second group. No statistically significant differences were found in responses between mothers and fathers. Healthcare professionals should encourage parents to discuss negative feelings related to their child's illness and potential outcome. Hospital policies need to include the provision and promotion of support group services for parents, and nurses should encourage parents to exploit such services.
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General Psychological Implications of the Human Capacity for Grief.
Brinkmann, Svend
2018-06-01
Much theorizing in psychology and related disciplines begins with a given model of the mind that is then applied in research projects to study concrete phenomena. Sometimes psychological research can be theory-driven in quite an explicit way, approaching the logic of the hypothetico-deductive method. Others reject this and prefer to work inductively, and, in the extreme case of positivism, perhaps try to avoid theorizing altogether. In this article I shall suggest another way to think of the relationship between psychological theories and psychological phenomena. My suggestion is not simply to replace the hypothetico-deductive model with an inductive one, but to argue that the most direct route to theories of the human mind that grasp its complexity is to begin with the Kantian question of transcendental philosophy: X exists - how is X possible? In the context of this article, I apply this questioning to the phenomenon of grief: Grief exists - what general psychological theory of the mind do we need in order to account for its possibility? I attempt to extract three general psychological points from the existence of grief, viz. (1) the deep relationality of the self, (2) the limitations of evolutionary accounts, and (3) the normativity of psychological phenomena. I shall argue that these are general psychological lessons to be learned from grief, although they could also be arrived at by considering several other significant psychological phenomena.
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Lichtenthal, Wendy G.; Breitbart, William
2015-01-01
Purpose of review This review describes research on meaning and meaning-making in parents who lost a child to cancer, suggesting the need for a meaning-centered therapeutic approach to improve their sense of meaning, purpose, and identity and to help with management of prolonged grief symptoms. Recent findings Several studies have demonstrated that parents bereaved by cancer experience unique meaning related challenges associated with the caregiving and illness experience, including struggles with making sense of their loss, benefit-finding, their sense of identity and purpose, disconnection from sources of meaning, and sustaining a sense of meaning in their child’s life. Meaning-Centered Grief Therapy, adapted from Meaning-Centered Psychotherapy, directly addresses these issues, highlighting the choices parents have in how they face their pain, how they honor their child and his/her living legacy, the story they create, and how they live their lives. Summary Given the important role that meaning plays in adjustment to the loss of a child to cancer, a meaning-focused approach such as Meaning-Centered Grief Therapy, may help improve parents’ sense of meaning and grief symptoms. It seems particularly appropriate for parents who lost a child to cancer because it does not pathologize their struggles and directly targets issues they frequently face. PMID:25588204
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Al-Maharma, Dua' Yousef; Abujaradeh, Hiba; Mahmoud, Khadejah Fahmi; Jarrad, Reem Ahmad
2016-07-01
The purpose of this study was to examine the relationship between maternal grieving for perinatal loss (PL) and the perception of and attachment to children born subsequent to a recent PL among mothers in Jordan. A cross-sectional, descriptive correlational design was used. A convenience sample of 190 mothers of full-term, healthy newborns born subsequent to a recent PL was recruited from seven Maternal and Child Health Care Centers in Jordan. These mothers were assessed using the Perinatal Grief Scale (L.J. Toedter, J.N. Lasker, & J.M. Alhadeff), 1988, the Maternal Postnatal Attachment Scale (J.T. Condon & C.J. Corkindale, 1998), and the Neonatal Perception Inventory II (E. Broussard, 1979). Results showed a significant negative relationship between grief intensity and the attachment level, r = -.37, p = .000, and a significant positive relationship between the attachment level and neonatal perception, r = .28, p = .000. Mothers' grief intensity was significantly affected by their demographic characteristics; however, there was no significant relationship between grief intensity and neonatal perception, r = .23, p = .23. Perinatal grief was negatively related to maternal attachment to the subsequent child. Nurses should address bereaved mothers and their children who might be at risk for developing attachment disturbances to facilitate positive adaptation to the subsequent pregnancy and parenthood. © 2016 Michigan Association for Infant Mental Health.
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Facets of Pejorative Self-Processing in Complicated Grief
ERIC Educational Resources Information Center
Golden, Ann-Marie J.; Dalgleish, Tim
2012-01-01
Objective: Complicated grief (CG) has been proposed as a psychiatric response to bereavement distinct from established mood and anxiety disorder diagnoses. Little is known about the nature of cognitive-affective processing in CG, nor any similarities or differences compared with the processing profiles associated with other emotional disorders.…
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Notes to Parents - When Your Child Has Undergone Amputation.
ERIC Educational Resources Information Center
Pierson, Margaret Hauser
Designed to provide parents with basic information about the physical and emotional aspects of amputation, the booklet gives information about the grief response, body image, phantom limb sensation, stump care, and the prosthesis. The section on the grief process describes normal reactions to loss: denial, anger, bargaining, depression, and…
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Dream Content in Complicated Grief: A Window into Loss-Related Cognitive Schemas
ERIC Educational Resources Information Center
Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F., III; Frank, Ellen; Silowash, Russell
2013-01-01
Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with…
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The Biochemistry of Bereavement: Possible Basis for Chemotherapy?
ERIC Educational Resources Information Center
Fredrick, Jerome F.
1982-01-01
Reviews the physiological effect of acute grief and explores the increased susceptibility to infectious disease agents in terms of the altered biochemistry of the bereaved individual. Until basic reactions of grief are defined and the altered biochemistry established, psychological methods appear to offer the best therapy. (Author/JAC)
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Grief Experiences and Expectance of Suicide
ERIC Educational Resources Information Center
Wojtkowiak, Joanna; Wild, Verena; Egger, Jos
2012-01-01
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…
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Children and Grief: When a Parent Dies.
ERIC Educational Resources Information Center
Worden, J. William
The research findings on childhood grief are often inconsistent and differ among studies. This book presents major findings from the Child Bereavement Study and looks at the implications of these of these findings for intervention with bereaved children and their families. Following an introduction describing the methodology of the Child…
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... at a certain point after a loved one's death. Reminders often bring back the pain of loss. ... return on the anniversary of your loved one's death or other special days throughout the year. These ...
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Old Pain or New Pain: A Social Psychological Approach to Recurrent Grief.
ERIC Educational Resources Information Center
Brabant, Sarah
1990-01-01
Draws on work of George Herbert Mead to question premise that acute grief that continues or reoccurs two or more years following loss of loved one is pathological. Suggests that onset of intense pain years after loss may be response to "new" death or loss. (Author/NB)
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Grief Support Group Curriculum: Facilitator's Handbook.
ERIC Educational Resources Information Center
Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann
This handbook is designed for facilitators of grief support groups for mourning children. The first chapter discusses the history, philosophy, and format of a specific curriculum - the Mourning Child curriculum. This curriculum, originally written in 1986 and later expanded and revised, has been used with hundreds of children. Chapter two covers…
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Metaphor-Visual Aid in Grief Work.
ERIC Educational Resources Information Center
Schwartz-Borden, Gwen
1992-01-01
Sees use of metaphor as providing powerful and useful framework for lowering resistance to pain of bereavement for parental grief. Contends that metaphor offers graphic, nonjudgmental symbolic representation through which mourner may freely express sorrow, loss, anger, and guilt needed to accomplish tasks of grieving. Notes that neutral symbol can…
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Grief and Mourning Reactions Following Abortion and Miscarriage.
ERIC Educational Resources Information Center
Widener, Anmarie J.
1996-01-01
Explores current research on psychological reactions following induced and spontaneous abortions. Provides examples of studies wherein researchers have used a loss model to understand this experience. Explores possible reasons for the apparent inattention to grief reactions following this type of loss and offers an alternative approach to the loss…
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What Residence Hall Staff Need to Know about Dealing with Death.
ERIC Educational Resources Information Center
Jacobs, Bonita; Towns, James E.
1984-01-01
Emphasizes the responsibility for residence hall staff to understand the grief process. An adaptation of Kubler-Ross's stages of death has produced helpful techniques for successfully accepting the death. Through understanding these principles, staff can become aware of the grief process and can assist residents. (JAC)
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Letting Go with Love: The Grieving Process.
ERIC Educational Resources Information Center
O'Connor, Nancy
This book deals with death and the grieving process. The first three chapters cover several universal aspects of grieving. Four stages of grief are described and various feelings of grief (denial, anger, guilt, depression, acceptance) are examined. The next five chapters detail specific losses: death of a spouse, parent, child, friends and…
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The American Indian Holocaust: Healing Historical Unresolved Grief.
ERIC Educational Resources Information Center
Brave Heart, Maria Yellow Horse; DeBruyn, Lemyra M.
1998-01-01
Argues for the existence of historical unresolved grief among American Indians. Outlines the historical legacy of war, genocide, and boarding schools resulting in intergenerational trauma and a host of associated social problems. Suggests healing strategies that integrate modern and traditional approaches to healing at the individual, family, and…
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Grief as a Social Emotion: Theoretical Perspectives
ERIC Educational Resources Information Center
Jakoby, Nina R.
2012-01-01
The article explores a sociological perspective on grief as a social emotion. Focusing on the social bond with the deceased, the self-concept of the survivor or the power of feeling rules, general sociological theories of emotions (symbolic interactionism, structural theory, behavioral theory) have the potential to deepen the understanding of…
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Grief and Needs of Adults with Acquired Visual Impairments
ERIC Educational Resources Information Center
Murray, Shirley A.; McKay, Robert C.; Nieuwoudt, Johan M.
2010-01-01
This report aims to illuminate the complex phenomenon of grief and the needs experienced throughout the time course of their impairments by adults with acquired visual impairments. The study applied a phenomenological research strategy using 10 case studies of South African adults, visually impaired within and beyond six years. Qualitative…
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Using Narrative Approach for Anticipatory Grief Among Family Caregivers at Home
Toyama, Hiroko; Honda, Akiko
2016-01-01
Family caregivers of patients with terminal-stage cancer have numerous roles as caregivers, which can influence their anticipatory grief. The purpose of this study was to clarify how talking to family caregivers of patients with terminal illness using the narrative approach can influence such caregivers’ process of anticipatory grief. We conducted the narrative approach as an intervention with two family caregivers several times and qualitatively analyzed their narratives. The results indicated that these family caregivers had two primary roles—family member and caregiver—and that family caregivers felt trapped in their caregiver role. The narrative approach helped them transition into the role needed for coping with the loss. PMID:28462354
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"Not just a dog": an attachment perspective on relationships with assistance dogs.
Kwong, Marilyn J; Bartholomew, Kim
2011-09-01
We explored individuals' relationships with an assistance dog from an attachment-theory perspective. We used both inductive and deductive thematic methods to analyze semi-structured interviews with 25 participants who had lost an assistance dog to retirement or death. Analyses revealed attachment processes of safe haven, secure base, and separation anxiety. Although attachment dynamics were an important feature of these relationships, caregiving was equally important. When confronted with the loss of their dog, almost all participants experienced intense grief. Most grief responses were consistent with the loss of a caregiving relationship. Findings suggest that grief is a natural response to the loss of a beloved companion who fulfilled fundamental needs for attachment and caregiving.
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Grief and Grief Processing for Preschool Children.
ERIC Educational Resources Information Center
Duncan, Uyntha
Educators contribute to children's anxiety and pain when they fail to provide children with information about loss and death and ways of coping with loss and death. Children who are denied factual information about experiences of loss and death develop fantasies and misconceptions regarding the experiences and suffer more anxiety and pain than…
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Borins, M.
1995-01-01
Patients grieve the loss of loved ones, jobs, marriages, or even functioning. They seek comfort, understanding, respect, and especially hope. The "work of grief" progresses through stages. Mixed with the sadness can be feelings of anger, fear, and guilt. Psychotherapy can relieve self-destructive anger and guilt, advance the recovery phase, and stimulate psychological strength and personality growth. PMID:7647626
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Grief in Separated, Divorced, and Widowed Women: Similarities and Differences.
ERIC Educational Resources Information Center
Petiet, Carole Anne
To systematically test previous assumptions about grief in widows and divorcing women, 410 separated, divorced, or widowed women, between the ages of 23 and 76, with at least one child, completed the Multiple Affect Adjective Checklist, the Revised UCLA Loneliness Scale, the Coopersmith Self-Esteem Inventory--Form C, the Attachment Index, and the…
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Investigating Adaptive Grieving Styles: A Delphi Study
ERIC Educational Resources Information Center
Doughty, Elizabeth A.
2009-01-01
There has been an evolution in the understanding of the nature of grief since S. Freud's initial work, Mourning and Melancholia (1917/1953). Mental health practitioners and researchers have established new models to aid in the conceptualization and treatment of grief issues. The purpose of this study was to examine the opinions of experts in the…
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Innovative Moments in Grief Therapy: Reconstructing Meaning Following Perinatal Death
ERIC Educational Resources Information Center
Alves, Daniela; Mendes, Ines; Goncalves, Miguel M.; Neimeyer, Robert A.
2012-01-01
This article presents an intensive analysis of a good outcome case of constructivist grief therapy with a bereaved mother, using the Innovative Moments Coding System (IMCS). Inspired by M. White and D. Epston's narrative therapy, the IMCS conceptualizes therapeutic change as resulting from the elaboration and expansion of unique outcomes (or as we…
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A Guide to Setting up a College Bereavement Group: Using Monologue, Soliloquy, and Dialogue
ERIC Educational Resources Information Center
Prior, Alexandra
2015-01-01
Childhood grief disrupts and reshapes a developing child's primary attachments, emotional regulation system, and identity formation. Bereft college students have to build their grief identity simultaneously with their social, academic, vocational, and sexual identities. This article describes a bereavement group to help students work on these…
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Understanding Parental Grief as a Response to Mental Illness: Implications for Practice
ERIC Educational Resources Information Center
Penzo, Jeanine A.; Harvey, Pat
2008-01-01
Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…
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Sorrow and Solace: Neglected Areas in Bereavement Research
ERIC Educational Resources Information Center
Klass, Dennis
2013-01-01
The author argues that in its focus on finding positive outcomes, bereavement research has neglected or denigrated central phenomena in intense and long-term grief: sorrow and solace. Sorrow has two elements: yearning for the dead person and grief's depression. Consolation comes into sorrow in human relationships and from inner resources. The…
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Children and Grief. ERIC Digest.
ERIC Educational Resources Information Center
McEntire, Nancy
Noting that the death of a loved one brings grief to children as well as adults, this Digest draws on research to examine how children respond to death and the role of parents and teachers in helping children cope with loss. The Digest delineates children's "tasks" during mourning that are essential to their adjustment to loss, such as…
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Strengthening Grief Support for Adolescents Coping with a Peer's Death
ERIC Educational Resources Information Center
Balk, David E.; Zaengle, Donna; Corr, Charles A.
2011-01-01
This article offers suggestions for strengthening school-based grief support following an adolescent's death. Such interventions must be considered within the context of: (a) development during adolescence; (b) the role of peers in adolescent development; and (c) the fact that an adolescent peer's death is a non-normative life crisis in developed…
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Ethics at the End of Life: A Teaching Tool
ERIC Educational Resources Information Center
Wallace, Cara L.; Thielman, Kara J.; Cimino, Andrea N.; Rueda, Heidi L. Adams
2017-01-01
Social workers rarely receive education and training in the areas of grief, bereavement, and death and dying, which may lead to difficulties in compassionately and ethically addressing concerns in end-of-life or grief-related contexts. This article presents actual and potential outcomes from three challenging end-of-life case studies using…
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Complicated Grief and the Trend toward Cognitive-Behavioral Therapy
ERIC Educational Resources Information Center
Matthews, Laura T.; Marwit, Samuel J.
2004-01-01
Recently, considerable attention has been given to the cognitive processes entailed in mourning. There has been a growing understanding that the death of a loved one forces individuals to restructure and rebuild previously held assumptions about the self and the world. On the basis of this conceptualization of grief as a period of meaning…
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ERIC Educational Resources Information Center
Turetsky, Cheryl J.; Hays, Ronald E.
2003-01-01
Presents an integrated model as an appropriate intervention to enable mourning and creativity and thus help in the prevention and treatment of unresolved grief in midlife. Two examples of this model in art-psychotherapy group treatment are provided. (Contains 53 references, 1 table, and 2 figures.) (GCP)
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Depression or Grief? The Experience of Caregivers of People with Dementia.
ERIC Educational Resources Information Center
Walker, Rebecca J.; Pomeroy, Elizabeth C.
1996-01-01
Study of caregivers of people with dementia suggests that the depression so frequently described in the literature may not be as severe or clinically significant as previously thought and may be described as anticipatory grief. Results may assist practitioners in planning and evaluating the effectiveness of clinical interventions. (RJM)
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Caregiver's Anticipatory Grief in Dementia: A Pilot Study.
ERIC Educational Resources Information Center
Theut, Susan K.; And Others
1991-01-01
Administered Anticipatory Grief Scale (AGS) and Hopkins Symptom Checklist-SCL-90-R to 27 wives who were caring for their spouses suffering from dementia. Alpha coefficient for AGS was 0.84, indicating good internal consistency. AGC was positively and significantly correlated with depression, anxiety, and hostility dimensions of SCL-90-R,…
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Coping with Your Loss and Grief.
ERIC Educational Resources Information Center
Oregon State Univ., Corvallis. Cooperative Extension Service.
This guide offers advice to help people cope with a variety of losses, including losses associated with divorce, retirement, relocation, disability, or illness, and the loss of a pet, financial security, independence, or control and decision making. It discusses what one can expect when one suffers a loss and how to handle grief. Common reactions…
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Treatment of Complicated Grief Using Virtual Reality: A Case Report
ERIC Educational Resources Information Center
Botella, C.; Osma, J.; Palacios, A. Garcia; Guillen, V.; Banos, R.
2008-01-01
This is the first work exploring the application of new technologies, concretely virtual reality, to facilitate emotional processing in the treatment of Complicated Grief. Our research team has designed a virtual reality environment (EMMA's World) to foster the expression and processing of emotions. In this study the authors present a description…
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Mothers' Reactions to Their Child's ASD Diagnosis: Predictors That Discriminate Grief from Distress
ERIC Educational Resources Information Center
Wayment, Heidi A.; Brookshire, Kristina A.
2018-01-01
We examined whether grief and general distress reactions characterized mothers' reactions to their child's ASD diagnosis, and whether these two types of reactions had unique predictors. Hierarchical regression analyses were conducted on data collected from 362 mothers recruited from the Interactive Autism Network (IAN). The mothers were…
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Infusing Mindfulness-Based Interventions in Support Groups for Grieving College Students
ERIC Educational Resources Information Center
Newton, Therese L.; Ohrt, Jonathan H.
2018-01-01
Approximately 39-49% of college students have experienced grief due to death in the past 24 months. Students' grief is often complicated due to the nature of their developmental characteristics (e.g., searching for autonomy, identity development, career direction, academic pressure, and formation of intimate relationships). Group mindfulness-based…
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Development and Validation of the Hospice Professionals' Understanding of Preparatory Grief Scale
ERIC Educational Resources Information Center
Prost, Stephanie Grace
2017-01-01
Purpose: It is critical to assess hospice professionals' discrimination between adaptive and maladaptive reactions to terminal illness in persons at the end-of-life to assure targeted intervention aimed at maintaining quality of life. The proposed measure, the Hospice Professionals Understanding of Preparatory Grief scale (HPPG), contains…
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Spirituality and Loss: Approaches for Counseling Grieving Adolescents
ERIC Educational Resources Information Center
Muselman, Dannette M.; Wiggins, Marsha I.
2012-01-01
The death of a loved one has serious implications for adolescent growth and development. The authors review relevant research on the grief process and spirituality in adolescence, and they give a rationale for integrating spirituality into adolescent grief work. By way of a case illustration, they draw implications for counselors' use of…
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Reading Guidance: Death and Grief.
ERIC Educational Resources Information Center
Smith, Alice Gullen
1989-01-01
Gives guidelines for the librarian using reading guidance (similar to bibliotherapy). Provides a nine-item annotated bibliography of novels for children and adolescents on the subject of death and grief. Appends an embryo list of categories suitable for content analysis of any file librarians might wish to keep on books suitable for use in this…
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Phenomenology and Correlates of Complicated Grief in Children and Adolescents
ERIC Educational Resources Information Center
Melhem, Nadine M.; Moritz, Grace; Walker, Monica; Shear, M. Katherine; Brent, David
2007-01-01
Objective: To describe the phenomenology of complicated grief (CG) in parentally bereaved children and adolescents and to examine its correlates. Method: This is a preliminary report from an ongoing 5-year, population-based, longitudinal study of the impact of parental loss on family members. Analyses of cross-sectional data at intake are…
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Direct Care Workers' Experiences of Grief and Needs for Support
ERIC Educational Resources Information Center
Gray, Jennifer A.; Kim, Jinsook
2017-01-01
Background: A paucity of information is available on direct care workers' (DCWs') experiences with loss when their clients (people with intellectual and developmental disabilities [I/DD]) die. This study explored DCWs' grief experiences, their coping methods and their needs for support. Methods: A thematic analysis approach was used to examine…
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ERIC Educational Resources Information Center
Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.
2018-01-01
There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require…
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Loss of a companion animal: understanding and helping the bereaved.
Durkin, Anne
2009-07-01
Pet owners may face numerous animal losses in a lifetime. Grief following pet loss is often misunderstood and devalued. Nurses are likely to encounter patients and families mourning the loss of a companion animal. This article outlines the grief process and offers practical suggestions for assisting those who are bereaved.
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ERIC Educational Resources Information Center
Rack, Jessica; Burleson, Brant; Bodie, Graham; Holmstrom, Amanda; Servaty-Seib, Heather
2008-01-01
This study identifies grief management strategies that bereaved adults evaluate as more and less helpful, assesses whether the person centeredness of these strategies explains their helpfulness, and determines whether strategy helpfulness varies as a function of demographic, personality, and situational factors. Participants (105 bereaved young…
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Forgotten grievers: an exploration of the grief experiences of bereaved grandparents.
Gilrane-McGarry, Ursula; O Grady, Tom
2011-04-01
Current knowledge about bereavement has been derived mostly from the experiences of spouses, parents, and children. There is a paucity of studies on the grief of grandparents. The aims of this Irish national study were to identify and describe the bereavement experiences of grandparents following the death of a grandchild and to explore their needs and supports throughout this experience. A qualitative exploratory descriptive design was employed. A multi-pronged sampling strategy was adopted. Seventeen people participated in in-depth interviews. The data was subjected to thematic field analysis through NVivo. The small body of literature generally claims that grandparents experience 'double pain', meaning that they concurrently experience feelings of loss for their grandchild and pain associated with their own child's grief. However, this study found that grandparents experience 'cumulative pain'. That is, in addition to double pain, they also experience pain from other sources. There is a need for the complexity and intensity of the grief felt by bereaved grandparents to be recognized, acknowledged, and supported by health professionals and society in general.
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Adrian, Julie A Luiz; Deliramich, Aimee N; Frueh, B Christopher
2009-01-01
The present exploratory project represents a cross-sectional study designed to determine the percentage of people reporting significant symptoms of complicated grief (CG) and/or posttraumatic stress disorder (PTSD) in response to the death of companion pets/animals. Human participants (N = 106) were sampled from a veterinary clinic. Fifty-two percent of participants had lost one to three pets from natural causes, 60% had never lost a pet to euthanasia, and 37% had lost one to three pets to euthanasia. The study suggests that many people experience significant attachment to their pets/animals and experience significant features of grief reactions (about 20%) after the death of a pet/animal. However, the percentage of people experiencing major pathological disruption is relatively low (<5%-12%). Thus, subclinical levels of grief and sadness are relatively common human responses to the death of companion pets/animals and last 6 months or more for about 30% of those sampled. Severe pathological reactions do occur but are quite rare among human survivors. Implications for mental health clinicians working with affected populations are discussed.
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Optimism in prolonged grief and depression following loss: A three-wave longitudinal study.
Boelen, Paul A
2015-06-30
There is considerable evidence that optimism, the predisposition to have generalized favorable expectancies for the future, is associated with numerous desirable outcomes. Few studies have examined the association of optimism with emotional distress following the death of a loved one. Doing so is important, because optimism may be an important target for interventions for post-loss psychopathology. In the current study, we examined the degree to which optimism, assessed in the first year post-loss (Time 1, T1), was associated with symptom levels of prolonged grief and depression six months (Time 2, T2) and fifteen months (Time 3, T3) later, controlling for baseline symptoms and also taking into account positive automatic cognitions at T1. Findings showed that higher optimism at T1 was associated with lower concurrent prolonged grief and depression severity. Higher optimism at T1 was also inversely related with depression symptom severity at T2 and T3, but not prolonged grief severity at T2 and T3. Implications of these findings are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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[Validation of prolonged grief disorder instrument for Portuguese population].
Delalibera, Mayra; Coelho, Alexandra; Barbosa, António
2011-01-01
This study aims to validate the Portuguese population the instrument PG-13 (Prolonged Grief Disorder), created by Prigerson et al. (2007) for diagnosis of prolonged grief, whose criteria are: the experience of loss generating intense longing and yearning for the deceased that extends for a period exceeding six months; emotional, cognitive and behavioral symptoms, dysfunction and meaningful life social and occupational functioning. The population includes 102 caregivers of patients accompanied by Support Team Palliative Care, Hospital Santa Maria. The participants are mostly female (82.4%) with mean age of 58.87 (SD: 13.41) and range between 15 and 84 years. Most respondents are widowed (62.1%), and 93.2% of these people are mourning the loss of a spouse. The second largest group of subjects corresponds to married persons (29.5%) who lost one of the parental figures (64.3%) and brothers (14.3%). Deceased family members have an average age of 68.68 (SD: 11.50), with amplitude between 27 and 89 years. The gender distribution in the group of deceased patients are 57.8% male and 42.2 % female. The internal consistency in the instrument is considered very good (a=.932). We found that 22.5% of the population manifests symptoms of prolonged grief. There were no significant differences in terms of socio-demographic variables or in the circumstances of illness and death. Prolonged Grief Disorder is more prevalent in female subjects (91.3%), widowed (68.2%) and in cases where the deceased was being the spouse (65.2%).
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Cotter, Prudence; Meysner, Larissa; Lee, Christopher William
2017-01-01
ABSTRACT Background and Objective: Previous research has used quantitative methods to assess the impact of grief therapy. However, rarely have participants been asked about how they have been affected by treatment using qualitative methods. This study sought to explore participants’ experiences of two therapeutic approaches to grief: Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Method: Nineteen participants were randomly allocated to receive seven weekly therapy sessions of either CBT or EMDR. Approximately two weeks after completing therapy, a semi-structured interview was conducted with each participant. Interviews were transcribed and a thematic analysis was performed. Results: Participant reports common to both therapies included developments in insight, a positive shift in emotions, increased activity, improved self-confidence and a healthier mental relationship to the deceased. Participants also responded by describing experiences that were unique to each therapy. Those who completed CBT described the acquisition of emotion regulation tools and shifting from being in an ongoing state of grief to feeling that they were at a new stage in their lives. Participants who completed EMDR reported that distressing memories were less clear and felt more distant from such memories following treatment. Conclusions: Although both therapies resulted in some similar changes for participants, there were unique experiences associated with each therapy. These findings are discussed in terms of implications for the underlying key processes of each therapy and the processes of recovery in grief. PMID:29163856
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Cotter, Prudence; Meysner, Larissa; Lee, Christopher William
2017-01-01
Background and Objective : Previous research has used quantitative methods to assess the impact of grief therapy. However, rarely have participants been asked about how they have been affected by treatment using qualitative methods. This study sought to explore participants' experiences of two therapeutic approaches to grief: Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Method : Nineteen participants were randomly allocated to receive seven weekly therapy sessions of either CBT or EMDR. Approximately two weeks after completing therapy, a semi-structured interview was conducted with each participant. Interviews were transcribed and a thematic analysis was performed. Results : Participant reports common to both therapies included developments in insight, a positive shift in emotions, increased activity, improved self-confidence and a healthier mental relationship to the deceased. Participants also responded by describing experiences that were unique to each therapy. Those who completed CBT described the acquisition of emotion regulation tools and shifting from being in an ongoing state of grief to feeling that they were at a new stage in their lives. Participants who completed EMDR reported that distressing memories were less clear and felt more distant from such memories following treatment. Conclusions : Although both therapies resulted in some similar changes for participants, there were unique experiences associated with each therapy. These findings are discussed in terms of implications for the underlying key processes of each therapy and the processes of recovery in grief.
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Cope, Heidi; Garrett, Melanie E; Gregory, Simon; Ashley-Koch, Allison
2015-08-01
The aim of the article is to examine the psychological impact, specifically symptoms of grief, post-traumatic stress and depression, in women and men who either terminated or continued a pregnancy following prenatal diagnosis of a lethal fetal defect. This project investigated a diagnostically homogeneous group composed of 158 women and 109 men who lost a pregnancy to anencephaly, a lethal neural tube defect. Participants completed the Perinatal Grief Scale, Impact of Event Scale - Revised and Beck Depression Inventory-II, which measure symptoms of grief, post-traumatic stress and depression, respectively. Demographics, religiosity and pregnancy choices were also collected. Gender-specific analysis of variance was performed for instrument total scores and subscales. Women who terminated reported significantly more despair (p = 0.02), avoidance (p = 0.008) and depression (p = 0.04) than women who continued the pregnancy. Organizational religious activity was associated with a reduction in grief (Perinatal Grief Scale subscales) in both women (p = 0.02, p = 0.04 and p = 0.03) and men (p = 0.047). There appears to be a psychological benefit to women to continue the pregnancy following a lethal fetal diagnosis. Following a lethal fetal diagnosis, the risks and benefits, including psychological effects, of termination and continuation of pregnancy should be discussed in detail with an effort to be as nondirective as possible. © 2015 John Wiley & Sons, Ltd.
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Kristensen, Pål; Dyregrov, Kari; Dyregrov, Atle; Heir, Trond
2016-11-01
After terror attacks, the media coverage can be a potential secondary stressor for bereaved families. In the present study, we aimed to examine the level of prolonged grief (PG), and to explore the association between media exposure and PG in parents and siblings of individuals who were killed in a terror attack. Parents and siblings (n = 103) from 42 different families bereaved by the 2011 Utøya Island mass shooting participated in a survey 18 months after the attack. The survey measured the amount of media exposure experienced by the bereaved during the first month after the attack. PG was self-reported using the Inventory of Complicated Grief (ICG). Data was analyzed with multilevel methods with mixed effects models. Of the total sample of participants, 78.6% (n = 81/103) had sum scores higher than the designated cutoff >25 on ICG, indicating a probable prolonged grief disorder (PGD). Multilevel analysis showed significantly higher level of PG among those who reported high exposure to the media coverage (>4 hours daily) the first month after the attack, among females, and among those who were in contact with their son/daughter/brother/sister by telephone during the attack. With the cross-sectional design, caution should be taken about making interpretations about causal effects. Media exposure may trigger or maintain prolonged grief reactions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
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Neural Mechanisms of Grief Regulation
Freed, Peter J.; Yanagihara, Ted K.; Hirsch, Joy; Mann, J. John
2009-01-01
Background: The death of an attachment figure triggers intrusive thoughts of the deceased, sadness, and yearning for reunion. Recovery requires reduction of symptoms. We hypothesized that symptoms might correlate with a capacity to regulate attention toward reminders of the deceased, and activity in, and functional connectivity between, prefrontal regulatory regions and the amygdala. Methods: Twenty recently bereaved subjects rated intrusive thoughts of the deceased versus a capacity to avoid thoughts (grief style). Reaction time was measured while subjects completed an Emotional Stroop (ES) task contrasting deceased-related with control words during functional magnetic resonance imaging (fMRI). Subjects subsequently visualized the death of the deceased and rated induced emotions. Results: Subjects demonstrated attentional bias toward deceased-related words. Bias magnitude correlated with amygdala, insula, dorsolateral prefrontal cortex (DLPFC) activity. Amygdala activity predicted induced sadness intensity. A double dissociation between grief style and both prefrontal and amygdala subregion activity was found. Intrusiveness correlated with activation of ventral amygdala and rostral anterior cingulate (rACC); avoidance correlated with deactivation of dorsal amygdala and DLPFC. A double dissociation between regulatory region and task-dependent functional connectivity (FC) was found. High DLPFC-amygdala FC correlated with reduced attentional bias, while low rACC-amygdala FC predicted sadness intensity. Conclusions: Results are consistent with a model in which activity in and functional connectivity between the amygdala and prefrontal regulatory regions indexes differences in mourners' regulation of attention and sadness during pangs of grief, and may be used to distinguish between clinically relevant differences in grief style. PMID:19249748
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Dionne-Odom, J. Nicholas; Azuero, Andres; Lyons, Kathleen D.; Hull, Jay G.; Prescott, Anna T.; Tosteson, Tor; Frost, Jennifer; Dragnev, Konstantin H.; Bakitas, Marie A
2016-01-01
Context Little is known about whether early palliative care (EPC) support for family caregivers (CGs) impacts depressive symptoms and grief after care recipients die. Objectives To assess after-death CG depressive symptom and grief scores for early compared to delayed group CGs. Methods We conducted a randomized controlled trial (RCT) (10/2010-9/2013) of an EPC telehealth intervention for CGs (n=123) initiated at the time of care recipients' advanced cancer diagnosis (early group) or 12 weeks later (delayed group) in a rural comprehensive cancer center, affiliated clinics, and a Veterans Administration medical center. The ENABLE [Educate, Nurture, Advise, Before Life Ends] CG intervention consisted of three weekly sessions, monthly follow-up, and a bereavement call. CGs completed the Center for Epidemiological Study-Depression scale (CESD) and the Prigerson Inventory of Complicated Grief-Short Form (PG13) 8-12 weeks after care recipients' deaths. Crude and covariate-adjusted between-group differences were estimated and tested using general linear models. Results For care recipients who died (n=70), 44 CGs (early: n=19; delayed: n=25) completed after-death questionnaires. Mean depressive symptom scores (CESD) for the early group was 14.6 (standard deviation [SD]=10.7) and for the delayed group was 17.6 (SD=11.8). Mean complicated grief scores (PG13) for the early group was 22.7 (SD=4.9) and for the delayed group was 24.9 (SD=6.9). Adjusted between-group differences were not statistically significant (CESD: d=0.07, P=0.88; PG13: d=-0.21, P=0.51). Conclusion CGs' depressive symptom and complicated grief scores 8-12 weeks after care recipients' deaths were not statistically different based on the timing of EPC support. The impact of timing of CG EPC interventions on CGs bereavement outcomes requires further investigation. PMID:27265814
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Al-Gamal, Ekhlas; Long, Tony
2014-07-01
To establish the potential of a modified version of the MM-CGI Childhood Cancer to assess anticipatory grief in parents of children with cerebral palsy, to amend the existing scale for use with the specific patient group, to test the psychometric properties of the modified version (MM-CGI Cerebral Palsy) and to review the clinical potential of the new scale. Parents of children with cerebral palsy may experience reactions similar to parents of children with other enduring or life-limiting conditions, and anticipatory grief may be one such psychological reaction. While the burden of caring is sometimes balanced by positive perceptions of the child, which enhance coping ability, for many parents the outcome is damage to their physical and mental health and impaired family functioning. A cross-sectional, descriptive, correlational design. The MM-CGI Cerebral Palsy was administered in structured interviews with 204 parents. Standardised measures of caregivers' depression, stress and perceived social support were also administered. Mothers and fathers were recruited from healthcare centres and schools for special education. Cronbach's alpha was used to assess internal consistency, and Pearson's product-moment correlation was used to assess construct validity. The subscales were each found to measure a single dimension of anticipatory grief, and significant correlations were established with existing instruments. The instrument demonstrated excellent internal consistency reliability and good construct validity. The MM-CGI Cerebral Palsy could be useful for diagnosing anticipatory grief among parents of children with cerebral palsy. This preliminary work moves the programme on to testing in intervention studies. In the absence of an existing measure for the assessment of anticipatory grief, specifically in parents of children with cerebral palsy, the MM-CGI Cerebral Palsy could prove to be an effective assessment tool for clinicians and researchers. © 2013 John Wiley & Sons Ltd.
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Disenfranchised grief and nonfinite loss as experienced by the families of death row inmates.
Jones, Sandra J; Beck, Elizabeth
The families of death row inmates experience grief and loss issues that have been neglected by scholars and clinicians alike. The issues found in this population are unique and require our understanding. The present study uses the concepts of disenfranchised grief and nonfinite loss to uncover the pain experienced by the children and other family members who have a loved one on death row. Kenneth Doka's (1989) concept of disenfranchised grief is utilized to bring attention to the ways in which the circumstances surrounding an execution leave the family members of those condemned to death outside of the "grieving rules" that exist in the United States. Family members are disenfranchised from their grief, as society does not socially validate their pain. The loss that they feel is also nonfinite (Bruce & Schultz, 2001) in that it is continuous and denies the families all of the hopes, dreams, and expectations that they had for their loved one who now sits on death row. The qualitative interview method was utilized by the authors of this study to gather data from 26 family members of death row inmates who are incarcerated along the East Coast of the United States. The reactions of this group of family members are varied and complex, yet they include the following common responses: social isolation due to stigma and their own feelings of criminalization, intensified family conflict between family members who grieve differently from one another, diminished self-esteem, shame, diffused and specific feelings of guilt, and a chronic state of despair. This study explores virtually untapped terrain. An examination of the microlevel effects of the death penalty on families provides insight in to the area of death and dying, especially as it is related to disenfranchised loss and nonfinite grief. In addition, this study provides insight into the death penalty and its effects.
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Roberts, Lisa; Montgomery, Susanne
2016-04-01
Stillbirth is a significant public health problem in low-to-middle-income countries and results in perinatal grief, often with negative psychosocial impact. In low-resource settings, such as Chhattisgarh, India, where needs are high, it is imperative to utilize low-cost, effective interventions. Mindfulness-based stress reduction (MBSR) is an empirically sound intervention that has been utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The main objective of this pilot study was to explore the feasibility and effectiveness of a shortened, culturally adapted mindfulness-based intervention to address complex grief after stillbirth. We used an observational, pre-post-6-week post study design. The study instrument was made up of descriptive demographic questions and validated scales and was administered as a structured interview due to low literacy rates. We used a community participatory approach to culturally adapt the five-week mindfulness-based intervention and delivered it through two trained local nurses. Quantitative and qualitative data analyses explored study outcomes as well as acceptability and feasibility of the intervention. 29 women with a history of stillbirth enrolled, completed the pretest and began the intervention; 26 completed the five-week intervention and post-test (89.7%), and 23 completed the six-week follow-up assessment (88.5%). Pretest results included elevated psychological symptoms and high levels of perinatal grief, including the active grief, difficulty coping, and despair subscales. General linear modeling repeated measures was used to explore posttest and six-week follow up changes from baseline, controlling for significantly correlated demographic variables. These longitudinal results included significant reduction in psychological symptoms; four of the five facets of mindfulness changed in the desired direction, two significantly; as well as significant reduction in overall perinatal grief and on each of the three subscales. The shortened, culturally adapted, mindfulness-based intervention pilot study was well received and had very low attrition. We also found significant reductions of perinatal grief and mental health symptoms over time, as well as a high degree of practice of mindfulness skills by participants. This study not only sheds light on the tremendous mental health needs among rural women of various castes who have experienced stillbirth in Chhattisgarh, it also points to a promising effective intervention with potential to be taken to scale for wider delivery.
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Paris, Gisele Ferreira; Montigny, Francine de; Pelloso, Sandra Marisa
2016-01-01
To verify the association between complicated grief and sociodemographic, reproductive, mental, marital satisfaction, and professional support characteristics in women after stillbirth. Cross-sectional study with 26 women who had stillbirth in 2013, living in the city of Maringá, Brazil, and eight women who attended the Centre d'Études et de Rechercheen Intervention Familiale at the University of Quebec en Outaouais, in Canada. The instrument was administered as an interview to a small number of mothers of infants up to three months (n=50), who did not participate in the validation study. By applying the short version of the Perinatal Grief Scale, the prevalence of complicated grief in Brazilian women was found to be higher (35%) in relation to Canadian women (12%).Characteristics of the Brazilian women associated with the grief period included the presence of previous pregnancy with live birth, absence of previous perinatal loss, postpartum depression, and lack of marital satisfaction. For the Canadians it was observed that 80% of the women presenting no grief made use of the professional support group. In both populations the occurrence of complicated grief presented a higher prevalence in women with duration of pregnancy higher than 28 weeks. The women that must be further investigated during the grief period are those living in Brazil, making no use of a professional support group, presenting little to no marital satisfaction, having no religion, and of a low educational level. Verificar aassociação entre o luto complicado e as características sociodemográficas, reprodutivas, mentais, de satisfação conjugal e apoio profissional em mulheres após óbito fetal. Estudo transversal com 26 mulheres que tiveram óbito fetal no ano de 2013 residentes no município de Maringá, Brasil, e 18 mulheres participantes do Centre d'Études et de Rechercheen Intervention Familiale, na Universidade do Quebec em Outaouais, no Canadá. Por meio da aplicação da versão curta da Perinatal Grief Scale, a prevalência de luto complicado foi maior nas brasileiras (35%) em relação às canadenses (12%). As características das brasileiras associadas ao luto complicado foram a presença de gestação anterior com filho nascido vivo, não ocorrência de perda perinatal anterior, depressão pós-parto e não satisfação conjugal. Para as canadenses, foi observado que 80% das mulheres sem luto utilizaram grupo profissional de apoio. Nas duas populações a ocorrência do luto complicado foi mais frequente nas mulheres com duração na gestação maior que 28 semanas. As mulheres que mais devem ser investigadas no estado de luto são as que moram no Brasil, que não utilizam grupo profissional de apoio, não têm satisfação conjugal, não praticam religião e têm menor escolaridade.
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Developing and Evaluating the GriefLink Web Site: Processes, Protocols, Dilemmas and Lessons Learned
ERIC Educational Resources Information Center
Clark, Sheila; Burgess, Teresa; Laven, Gillian; Bull, Michael; Marker, Julie; Browne, Eric
2004-01-01
Despite a profusion of recommendations regarding the quality of web sites and guidelines related to ethical issues surrounding health-related sites, there is little guidance for the design and evaluation of sites relating to loss and grief. This article, which addresses these deficiencies, results from a community consultation process of designing…
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Predictors of Complicated Grief: A Systematic Review of Empirical Studies
ERIC Educational Resources Information Center
Lobb, Elizabeth A.; Kristjanson, Linda J.; Aoun, Samar M.; Monterosso, Leanne; Halkett, Georgia K. B.; Davies, Anna
2010-01-01
A systematic review of the literature on predictors of complicated grief (CG) was undertaken with the aim of clarifying the current knowledge and to inform future planning and work in CG following bereavement. Predictors of CG prior to the death include previous loss, exposure to trauma, a previous psychiatric history, attachment style, and the…
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Grief in Two Guises: "Mourning and Melancholia" Revisited
ERIC Educational Resources Information Center
Green, Viviane
2013-01-01
This paper is a re-reading of Freud's classic paper. The themes of mourning and melancholia are viewed in relation to children and adolescents with illustrations from case histories. Mourning is interpreted in a broader sense: not only as grief (both expectable and traumatic) but as a response to the developmental process itself as phases of…
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ERIC Educational Resources Information Center
Williams, Lee Burdette
2010-01-01
On a college campus, educators and students live on the edge of tragedy. They walk that edge everyday, aware that the possibility of death is always one misstep away. One careless move by any of the hundreds or thousands of them walking that edge, and their whole community falls into a canyon of grief from which they will climb only after weeks,…
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Noronha, Konrad Joseph
2014-01-01
Working with dreams is useful with grief and loss clients who present with dreams. Adlerian dream analysis is one-way of exploring dreams. It incorporates the life-style of the client. This case report demonstrates how Adlerian dream analysis was used with a client. Progress was noted in improved life-style once the client began to talk about her dream. PMID:25035561
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When a Grandchild Dies: What To Do, What To Say, How To Cope.
ERIC Educational Resources Information Center
Galinsky, Nadine
This paper discusses the findings from several interviews conducted with grandparents to ascertain the process of grief they experienced with the death of their grandchild. Typically, a grandparent's grief focuses on the dual loss aspect. In addition to the loss of a younger family member, grandparents must console their own child, the bereaved…
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Childhood Traumatic Grief: A Multi-Site Empirical Examination of the Construct and Its Correlates
ERIC Educational Resources Information Center
Brown, Elissa J.; Amaya-Jackson, Lisa; Cohen, Judith; Handel, Stephanie; De Bocanegra, Heike Thiel; Zatta, Eileen; Goodman, Robin F.; Mannarino, Anthony
2008-01-01
This study evaluated the construct of childhood traumatic grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, posttraumatic stress disorder (PTSD),…
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Mourning Child Grief Support Group Curriculum: Early Childhood Edition, Kindergarten-Grade 2.
ERIC Educational Resources Information Center
Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann
The Mourning Child Early Childhood grief support curriculum is intended for use with early elementary-aged children, specifically children in kindergarten through grade two, who have experienced the death of someone special to them. It is designed for use by professionals who work in schools, hospitals, hospices, mental health agencies, or any…
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Mourning Child Grief Support Group Curriculum: Middle Childhood Edition, Grades 3-6.
ERIC Educational Resources Information Center
Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann
The Mourning Child Early Childhood grief support curriculum is intended for use with late elementary and middle school-aged children, specifically children in grades three through six, who have experienced the death of someone special to them. It is designed for use by professionals who work in schools, hospitals, hospices, mental health agencies,…
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Predictors of Complicated Grief among Adolescents Exposed to a Peer's Suicide
ERIC Educational Resources Information Center
Melhem, Nadine M.; Day, Nancy; Shear, M. Katherine; Day, Richard; Reynolds, Charles F.; Brent, David
2004-01-01
The purpose of this article is to examine the predictors of complicated grief, depression, and post traumatic stress disorder (PTSD) among adolescents exposed to the suicide of a peer. One hundred and forty six peers of adolescent suicide victims were interviewed at 6, 12-18, and 36 months following the suicide. The roles of previous psychiatric…
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Trauma, Grief and Depression in Nairobi Children After the 1998 Bombing of the American Embassy
ERIC Educational Resources Information Center
Pfefferbaum, Betty; North, Carol S.; Doughty, Debby E.; Pfefferbaum, Rose L.; Dumont, Cedric E.; Pynoos, Robert S.; Gurwitch, Robin H.; Ndetei, David
2006-01-01
Despite the increasingly dangerous world where trauma and loss are common, relatively few studies have explored traumatic grief in children. The 1998 American Embassy bombing in Nairobi, Kenya, provided an unfortunate opportunity to examine this topic. This report describes findings in 156 children who knew someone killed in the incident, assessed…
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Bereavement Experiences of Mothers and Fathers over Time after the Death of a Child due to Cancer
ERIC Educational Resources Information Center
Alam, Rifat; Barrera, Maru; D'Agostino, Norma; Nicholas, David B.; Schneiderman, Gerald
2012-01-01
The authors investigated longitudinally bereavement in mothers and fathers whose children died of cancer. Thirty-one parents were interviewed 6 and 18 months post-death. Analyses revealed parental differences and changes over time: (a) employment--fathers were more work-focused; (b) grief reactions--mothers expressed more intense grief reactions…
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The Impact of Anticipatory Grief on Caregiver Burden in Dementia Caregivers
ERIC Educational Resources Information Center
Holley, Caitlin K.; Mast, Benjamin T.
2009-01-01
Purpose: Interest in anticipatory grief (AG) has typically focused on terminal diseases such as cancer. However, the issues involved in AG are unique in the context of dementia due to the progressive deterioration of both cognitive and physical abilities. The current study investigated the nature of AG in a sample of dementia caregivers and…
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A Systemic Approach to Facilitating Family Grief Resolution Following the Death of a Child.
ERIC Educational Resources Information Center
Charkow, Wendy B.
This paper provides counselors and other helping professionals with tools for assessment of and intervention in grieving families that have suffered the loss of a child or fetus through illness, accident, violence, or miscarriage. Helping professionals who don't specialize in grief issues can especially benefit from this information, as many…
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ERIC Educational Resources Information Center
Zinner, Ellen S.; And Others
1991-01-01
Administered Grief Experience Inventory (GEI) to 102 mothers of brain-injured adolescents and young adults across 3 years postinjury. Factor analysis of data was computed and compared to factors derived from original GEI General Reference Group (n=135). Found strikingly similar factor structures between modified nondeath form and original GEI.…
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Play and Healing: Therapeutic Recreation's Role in Coping with Grief.
ERIC Educational Resources Information Center
Sorensen, Beth; King, Kathryn
1999-01-01
Camp Releaf, a weekend camp in North Carolina, uses therapeutic recreation to help children in grades K-8 develop positive coping skills for dealing with the recent death of a family member. The camp's therapeutic activities are described. Sidebars outline the nature of grief in different age groups and suggestions for working with grieving…
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The Acceptance of Exceptionality: A Three Dimensional Model.
ERIC Educational Resources Information Center
Martin, Larry L.; Nivens, Maryruth K.
A model extrapolates from E. Kubler-Ross' conception of the stages of grief to apply to parent and family reactions when an exceptionality is identified. A chart lists possible parent feelings and reactions, possible school reactions to the parent in grief, and the child's reactions during each of five stages: denial, rage and anger, bargaining,…
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Do Incarcerated Offenders Experience the Five Stages of Grief as Do Terminally Ill Patients?
ERIC Educational Resources Information Center
Pledger, Carolyn Brastow
1985-01-01
Examines Kubler-Ross' five stages of grief (denial, anger, bargaining, depression, acceptance) as they are experienced not by terminally ill persons, but by 20 criminal offenders and their families during incarceration. Concludes that shock of arrest and incarceration stimulates reactions similar to those of persons coping with terminal diagnosis.…
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Living with Grief: Children, Adolescents, and Loss.
ERIC Educational Resources Information Center
Doka, Kenneth J., Ed.
Noting that the best way to help and prepare children to cope with death and trauma is through education and understanding of the day-to-day ramifications that loss and grief have on them, this book is designed to help adults involved with children and adolescents to provide that education and understanding. Chapters in the first section of the…
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Couples at Risk Following the Death of Their Child: Predictors of Grief versus Depression
ERIC Educational Resources Information Center
Wijngaards-de Meij, Leoniek; Stroebe, Margaret; Schut, Henk; Stroebe, Wolfgang; van den Bout, Jan; van der Heijden, Peter; Dijkstra, Iris
2005-01-01
This longitudinal study examined the relative impact of major variables for predicting adjustment (in terms of both grief and depression) among bereaved parents following the death of their child. Couples (N = 219) participated 6, 13, and 20 months postloss. Use of multilevel regression analyses enabled assessment of the impact of several…
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The Complexity of Couple Communication in Bereavement: An Illustrative Case Study
ERIC Educational Resources Information Center
Hooghe, An; Neimeyer, Robert A.; Rober, Peter
2011-01-01
Sharing grief experiences, or "storying" grief, can be a key resource in adapting to loss, one that can contribute to stronger bonds and relational intimacy within the family. In this article, the authors conceptualize communication between grieving family members in terms of 3 "D" processes, emphasizing the extent to which such communication is…
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Elevated Rates of Prolonged Grief Disorder in African Americans
ERIC Educational Resources Information Center
Goldsmith, B.; Morrison, R. S.; Vanderwerker, L. C.; Prigerson, H. G.
2008-01-01
The prevalence of Prolonged Grief Disorder (PGD) in non-Whites is currently unknown. This study was performed to explore the prevalence of PGD in African Americans (AAs). Multivariable analysis of two studies of recently bereaved individuals found AAs to have significantly higher rates of PGD than Whites (21% [14 of 66] vs. 12% [55 of 471],…
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Mourning Child Grief Support Group Curriculum: Preschool Edition. Denny the Duck Stories.
ERIC Educational Resources Information Center
Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann
The Mourning Child Preschool grief support curriculum is intended for use with preschool children who have experienced the death of someone special to them. It is designed for use by professionals who work in schools, hospitals, hospices, mental health agencies, or any setting that serves bereaved children. The curriculum contains lesson plans for…
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ERIC Educational Resources Information Center
Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas
2012-01-01
A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed…
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Suicide Survivors' Mental Health and Grief Reactions: A Systematic Review of Controlled Studies
ERIC Educational Resources Information Center
Sveen, Carl-Aksel; Walby, Fredrik A.
2008-01-01
There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified…
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The Stigmatized Deaths in Jonestown: Finding a Locus for Grief
ERIC Educational Resources Information Center
Moore, Rebecca
2011-01-01
This article considers the stigmatized deaths in Jonestown, Guyana, in 1978, in which more than 900 Americans died of mass murder and suicide, and how this led to the disenfranchisement of grief. It examines the rituals of exclusion by which bodies were handled and describes the experiences of Jonestown survivors. It then looks at the ways in…
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Treatment of complicated grief using virtual reality: a case report.
Botella, C; Osma, J; Palacios, A García; Guillén, V; Baños, R
2008-01-01
This is the first work exploring the application of new technologies, concretely virtual reality, to facilitate emotional processing in the treatment of Complicated Grief. Our research team has designed a virtual reality environment (EMMA's World) to foster the expression and processing of emotions. In this study the authors present a description of EMMA's World, the clinical protocol, and a case report. The treatment program was applied in eight sessions. We present a brief description of the session agendas including the techniques used. We offer short-term (from pre-test to post-test) and long-term (2-, 6- and 12-month follow-ups) efficacy data. Our results offer preliminary support of the use of EMMA's World for the treatment of Complicated Grief.
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Rachamim, Lilach
2017-09-01
This article highlights the feasibility of a dyadic prolonged exposure (DPE) intervention (L. Rachamim, I. Mirochnik, L. Helpman, N. Nacasch, & E. Yadin, ) in a 3-year-old preschooler and in a 6-year-old kindergartener immediately following the traumatic death of their younger sibling. It presents a detailed case description of the DPE treatment addressing traumatic grief and includes transcribed treatment dialogue. At the time of treatment termination, both children and caregivers resumed normal functioning. The results suggest that DPE intervention may ameliorate posttraumatic grief symptoms in young children. Controlled studies of preventive interventions for this population are clearly warranted. © 2017 Michigan Association for Infant Mental Health.
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Mothers Coping With Bereavement in the 2008 China Earthquake: A Dual Process Model Analysis.
Chen, Lin; Fu, Fang; Sha, Wei; Chan, Cecilia L W; Chow, Amy Y M
2017-01-01
The purpose of this study is to explore the grief experiences of mothers after they lost their children in the 2008 China earthquake. Informed by the dual process model, this study conducted in-depth interviews to explore how six bereaved mothers coped with such grief over a 2-year period. Right after the earthquake, these mothers suffered from intensive grief. They primarily coped with loss-oriented stressors. As time passed, these mothers began to focus on restoration-oriented stressors to face changes in life. This coping trajectory was a dynamic and integral process, which bereaved mothers oscillated between loss- and restoration-oriented stressors. This study offers insight in extending the existing empirical evidence of the dual process model.
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Mothers Coping With Bereavement in the 2008 China Earthquake: A Dual Process Model Analysis.
Chen, Lin; Fu, Fang; Sha, Wei; Chan, Cecilia L W; Chow, Amy Y M
2017-01-01
The purpose of this study is to explore the grief experiences of mothers after they lost their children in the 2008 China earthquake. Informed by the Dual Process Model, this study conducted in-depth interviews to explore how six bereaved mothers coped with such grief over a 2-year period. Right after the earthquake, these mothers suffered from intensive grief. They primarily coped with loss-oriented stressors. As time passed, these mothers began to focus on restoration-oriented stressors to face changes in life. This coping trajectory was a dynamic and integral process, which bereaved mothers oscillated between loss- and restoration-oriented stressors. This study offers insight in extending the existing empirical evidence of the Dual Process Model.
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Childhood traumatic grief: a multi-site empirical examination of the construct and its correlates.
Brown, Elissa J; Amaya-Jackson, Lisa; Cohen, Judith; Handel, Stephanie; Thiel De Bocanegra, Heike; Zatta, Eileen; Goodman, Robin F; Mannarino, Anthony
2008-01-01
This study evaluated the construct of childhood traumatic grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, posttraumatic stress disorder (PTSD), depression, and anger. CTG was distinct from but highly correlated with PTSD, depression, and, to a lesser degree, anger. In contrast to a recent study of complicated grief, CTG severity was significantly associated with the degree to which the death was viewed as traumatic. CTG was also associated with caregivers' emotional reaction at the time of the death and caregivers' current sadness. Clinical implications and recommendations for future research are discussed.
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Interpersonal ambivalence, perceived relationship adjustment, and conjugal loss.
Bonanno, G A; Notarius, C I; Gunzerath, L; Keltner, D; Horowitz, M J
1998-12-01
Ambivalence is widely assumed to prolong grief. To examine this hypothesis, the authors developed a measure of ambivalence based on an algorithmic combination of separate positive and negative evaluations of one's spouse. Preliminary construct validity was evidenced in relation to emotional difficulties and to facial expressions of emotion. Bereaved participants, relative to a nonbereaved comparison sample, recollected their relationships as better adjusted but were more ambivalent. Ambivalence about spouses was generally associated with increased distress and poorer perceived health but did not predict long-term grief outcome once initial outcome was controlled. In contrast, initial grief and distress predicted increased ambivalence and decreased Dyadic Adjustment Scale scores at 14 months postloss, regardless of initial scores on these measures. Limitations and implications of the findings are discussed.
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Psychiatric investigation of 18 bereaved pet owners.
Kimura, Yuya; Kawabata, Hidenobu; Maezawa, Masaji
2011-08-01
This survey explores the grief associated with the loss of a pet, and was carried out using a self-administered questionnaire. The questionnaires were handed out to 50 bereaved pet owners attending a public animal cremation service, and we received 18 responses. Participants responded within 0 to 44 (median 4) days of the death of their pet. Although most mental health problems immediately following mourning are presumed to be normal grief reactions, on the basis of several psychiatric scales, 8 of the 16 valid responses indicated depression and/or neurosis. Statistical analyses showed that the following factors were significantly associated with grief reactions: age of owner, other stressful life events, family size, age of deceased animal, rearing place, and preliminary veterinary consultation.
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Heaton, Kenneth W
2012-10-01
To find out if Shakespeare, famed for his insights into human nature, is exceptional in how much his characters express grief through somatic symptoms and signs, and by physical illness. The texts of all large-scale works currently attributed to Shakespeare (39 plays, 3 long narrative poems) were systematically searched for bodily changes and for evidence of grief as dominating the character's emotional state at the time. The findings were compared with those from a search of 46 works, similar in genre, by 15 prominent playwrights active at the same time as Shakespeare. In Shakespeare 31 different grief-associated symptoms or signs were found, in 140 instances. They are present in all but two of his plays and long poems and involve most systems of the body. With non-Shakespearean writers there were 26 kinds, 132 instances. Twenty-two changes are common to both groups, including fainting, death (sudden or after a decline), and wrinkled face, and symptoms such as malaise, fatigue, awareness of the heart-beat, and anorexia. Ten somatic expressions of grief were found only in Shakespeare, including hyperventilation, hair turning white and premature childbirth. Four were found only in his contemporaries but were trivial or unconvincing. Deaths and non-fatal illnesses are prevalent in Shakespeare. Grieving Shakespearean characters exhibit many somatic symptoms and signs and a wide range of psychosomatic illnesses. This panoply of psychosomatic phenomena may be an artistic artefact but it also confirms that Shakespeare's empathy with grieving humanity was unrivalled. Copyright © 2012 Elsevier Inc. All rights reserved.
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Robalo Nunes, Inês; José, Helena; Capelas, Manuel Luís
The aim of this study was to explore the relationship between humor and professional grief. Findings confirm that these are not independent phenomena. Using humor as a coping mechanism emerged as a response to death-related work. Likewise, positive attitudes toward humor seem to alleviate the distress associated with end-of-life care.
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ERIC Educational Resources Information Center
Wood, Jane E.
2016-01-01
Counseling can promote positive outcomes for grieving clients by addressing personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as psychological stress, poor health, or an increased risk of depression. Education and…
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DoDLive | Department of Defense Blog
her surgical career and her marriage to a Navy chief. Surgeon and Spouse: How One Navy Wife Balances Memorial Day Deal Legacy Mentors Play Key Role In TAPS Good Grief Camps Legacy mentors at the Memorial Day themselves. Legacy Mentors Play Key Role In TAPS Good Grief Camps Legacy Mentors Play Key Role In TAPS Good
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Navy chief. Read More Posted in DoD News, Family Focus Friday, Inside the DoD, Military Families Challenge: It's Kind of a Big Memorial Day Deal Legacy Mentors Play Key Role In TAPS Good Grief Camps Posted Play Key Role In TAPS Good Grief Camps NBA's Rip Hamilton Learns What's Real Vs. Myth on USO Tour
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ERIC Educational Resources Information Center
Pfefferbaum, Betty; Tucker, Phebe; Jeon-Slaughter, Haekyung; Allen, James R.; Hammond, Donna R.; Whittlesey, Suzanne W.; Vinekar, Shreekumar S.; Feng, Yan
2013-01-01
Trauma is thought to interfere with normal grief by superimposing symptoms of posttraumatic stress disorder. This exploratory pilot study examined the association between traumatic grief and objectively measured physiological reactivity to a trauma interview in 13 children who lost relatives in the Oklahoma City bombing as well as a potential link…
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Losing Jay: A Meditation on Teaching while Grieving
ERIC Educational Resources Information Center
Parker, Blaise Astra
2009-01-01
The author's partner Jay died on May 23, 2006. It was sudden and unexpected--he was 31, the author was 30. Her grief was prolonged and agonizing, and she has since learned that doctors refer to her condition as "complicated grief." Truly, she is not sure how she survived the first year after Jay's death. She certainly was not convinced she wanted…
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Authority from Grief, Presence and Place in the Making of Roadside Memorials
ERIC Educational Resources Information Center
Clark, Jennifer; Franzmann, Majella
2006-01-01
Those who make memorials for the victims of motor vehicle crashes assume an authority to do so that stems from three main elements of experience: the overwhelming empowerment of grief; the belief that the presence of the deceased can be felt and recognized; and the understanding that the place where life was lost is a special place for…
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Personal Reflections of Funeral Rituals and Spirituality in a Kentucky African American Family
ERIC Educational Resources Information Center
Collins, Wanda Lott; Doolittle, Amy
2006-01-01
This article introduces the authors' experiences and observations as grief/bereavement counselors participating in urban and rural funerals. A vignette illustrates the use of rituals and spirituality of one African American family, living in a rural area of Kentucky, and their efforts to cope with their own grief and loss of a loved one. The…
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ERIC Educational Resources Information Center
Schnider, Kimberly R.; Elhai, Jon D.; Gray, Matt J.
2007-01-01
Problem-focused coping, and active and avoidant emotional coping were examined as correlates of grief and posttraumatic stress disorder (PTSD) severity among 123 college students reporting the unexpected death of an immediate family member, romantic partner, or very close friend. The authors administered to participants, via the Internet, 5…
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Disciplinary Wounds: Has Grief become the Identified Patient for a Field Gone Awry?
ERIC Educational Resources Information Center
Granek, Leeat
2013-01-01
In the last few decades, grief and loss research in the psychological domain has focused almost exclusively on its dysfunctional nature. I examine what is underneath these questions about pathology and suggest that our discipline is suffering from an attachment wound where we have dissociated from our historical roots when it comes to the study of…
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ERIC Educational Resources Information Center
Sanders, Sara; Ott, Carol H.; Kelber, Sheryl T.; Noonan, Patricia
2008-01-01
An abundance of literature on caregivers of individuals with dementia has been written since the mid-1980s. However, most of this literature focused on the experience of stress, burden, and depression in caregivers, thus excluding the grief experience that also accompanies the caregiving experience. The purpose of this multimethod study is to…
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Spuij, Mariken; Dekovic, Maja; Boelen, Paul A
2015-01-01
In the past years, there is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). Although mostly studied in adults, clinically significant PGD symptoms have also been observed in children and adolescents. To date, no effective treatment for childhood PGD yet exists. We recently developed a nine-session cognitive-behavioural treatment for childhood PGD combined with five sessions of parental counselling. In the current article, we present outcomes of treatment of 10 consecutive children and adolescents turning to our university clinic with elevated PGD symptoms as their primary problem and main reason to seek therapy. Patients were significantly improved at post-treatment, with large improvements in self-rated PGD and post-traumatic stress (effect sizes > 0.8) and small to moderate improvement in depression and parent-rated internalizing and externalizing problems (0.2 < effect sizes < 0.8). Additional predictor analysis of outcomes suggested that, among other things, this treatment approach is less efficacious for children and adolescents further removed from loss and those confronted with suicidal loss. That said, the treatment appears promising, and controlled evaluation is clearly indicated. Copyright © 2013 John Wiley & Sons, Ltd.
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Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline
2017-09-01
Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA's negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study's objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG. An online, retrospective survey was conducted with 161 women. Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses. Moderate levels of PTG were observed for "relating to others," "personal strengths" and "appreciation of life." "Positive reframing" was a significant predictor of PTG. Despite using mainly "adaptive" coping strategies, women's grief levels were high. "Adaptive" coping strategies such as, "positive reframing" are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women's experience, may be beneficial.
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Couples' grief and experience of support in the aftermath of miscarriage.
Conway, K; Russell, G
2000-12-01
The aim of this prospective study involving 39 women and 32 partners was to investigate the grief response of both the woman and her partner to miscarriage and to ascertain if support received was adequate and appropriate to their needs. Previous research shows that partners' grief can often be delayed and chronic. Special emphasis is placed on this area in this study. The miscarriage was found to be a significant event and the majority of women and partners still experienced feelings of loss up to 4 months afterwards, describing their reactions as sad or very sad. Scores on the first administration of the Perinatal Grief Scale showed that, in contrast with previous findings, partners scored significantly higher than the women on the three subscales and overall. Partners' scores on the second administration were also higher than those for the women but the difference was not significant. The women tended to receive and welcome social support more than the partners. Support received from health professionals was not always optimal, particularly for partners. Pregnancy subsequent to miscarriage was often viewed with some anxiety. It is argued that the results of the study have important implications for health practice.
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Bui, Eric; Nadal-Vicens, Mireya; M. Simon, Naomi
2012-01-01
Complicated grief (CG) is a common and often under-acknowledged cause of profound impairment experienced after the loss of a loved one. Although both clinical and basic research suggests that pharmacological agents might be of use in the treatment of CG, research on pharmacological approaches to this condition is still scarce. Three open-label trials and one randomized trial on bereavement-related depression suggest that tricyclic antidepressants may be effective, although they may be more efficacious for depressive symptoms than for grief-specific symptoms. Four open-label trials (total number of participants, 50) of selective serotonin reuptake inhibitors (SSRIs) have yielded results, providing very preliminary support that they might be effective in the treatment of CG, both as a standalone treatment and in conjunction with psychotherapeutic interventions. These more recent studies have shown an effect on both depression and grief-specific scales. Furthermore, therapeutic interventions for CG may be more effective in conjunction with SSRI administration. Given the small number of pharmacological studies to date, there is a need for randomized trials to test the potential efficacy of pharmacological agents in the treatment of CG. PMID:22754287
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Grief Interrupted: The Experience of Loss Among Incarcerated Women
Harner, Holly M.; Hentz, Patricia M.; Evangelista, Maria Carmela
2011-01-01
Incarcerated women face a number of stressors apart from the actual incarceration. Nearly half of all women in prison experience the death of a loved one during their incarceration. Our purpose for this study was to explore the experience of grief and loss among incarcerated women using a phenomenological method. Our study approach followed van Manen's method of phenomenology and Munhall's description of existential lifeworlds. Our analysis revealed four existential lifeworlds: temporality: frozen in time; spatiality: no place, no space to grieve; corporeality: buried emotions; and relationality: never alone, yet feeling so lonely. The findings generated from this study can help mental health providers as well as correctional professionals develop policies and programs that facilitate the grief process of incarcerated women within the confines of imprisonment. PMID:20581074
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The prevalence of childhood traumatic grief--a comparison of violent/sudden and expected loss.
McClatchy, Irene Searles; Vonk, M Elizabeth; Palardy, Gregory
2009-01-01
The purpose of this study was to examine the prevalence of childhood traumatic grief (CTG) and posttraumatic stress disorder (PTSD) symptoms in parentally bereaved children and compare scores between those who had lost a parent to a sudden/violent death and those who had lost a parent to an expected death. A sample of 158 parentally bereaved children ages 7-16 completed the Extended Grief Inventory (EGI); 127 of those also completed the UCLA PTSD Index. A large number of children were experiencing CTG symptoms at moderate and severe levels. There was no significant difference in EGI or UCLA PTSD Index scores between the two types of losses. Findings are discussed in relation to trauma theory, research on parentally bereaved children and implications for practice.
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Let me hear of your mercy in the mourning: forgiveness, grief, and continuing bonds.
Gassin, Elizabeth A; Lengel, Gregory J
2014-01-01
Clarity about the utility of continuing bonds (CB) continues to be evasive in the research. In 2 different correlational studies, the authors explored the relationship between CB and 2 other variables: 1 representing mental health (forgiveness of the deceased) and the other representing psychological distress (prolonged grief). Although researchers have addressed the latter relationship in the literature, assessing the relationship between CB and forgiveness has not been undertaken. Results suggest that forgiveness in general, and affective aspects of forgiveness in particular, predict psychological forms of CB. Results related to grief depended on how CB was assessed. These findings provide evidence of the relative health of certain types of relationship with deceased persons and also suggest that forgiveness interventions may be a way of promoting such healthy bonds.
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Soul mate: exploring the concept of soul.
Fenske, Joan M
2011-09-01
This article describes an "advanced practice" registered nurse's skill in using multiple theoretical frameworks to make meaning of her severely developmentally disabled son's untimely death. Aspects of religion, spirituality, and philosophy are presented plus how related practices, such as used within Alcoholics Anonymous, are incorporated into everyday life are referenced. Creating unique rituals and ceremonies demonstrates the power of the mind as a partner in the healing process when grief seems insurmountable. This article, titled "Soul Mate" discusses how individuals create their own healing narratives when confronted with grief and tragedy. Nursing interventions, sensitive to this process, support and promote the grief process. Eliciting, recognizing, and accepting a patient's unique self-made rituals and ceremonies as they cope with a beloved's death and dying enhances their nursing interventions. © 2011 The Author(s)
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ERIC Educational Resources Information Center
Hinton, Devon E.; Field, Nigel P.; Nickerson, Angela; Bryant, Richard A.; Simon, Naomi
2013-01-01
The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol…
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Parents' Grief in the Context of Adult Child Mental Illness: A Qualitative Review
ERIC Educational Resources Information Center
Richardson, Meg; Cobham, Vanessa; Murray, Judith; McDermott, Brett
2011-01-01
Research indicates that parents and other family members often grieve their child or relative's mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in "Am J Psychiatry" 151(8):1137-1139, 1994; Davis and Schultz in "Soc Sci Med" 46(3):369-379, 1998; Jones…
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ERIC Educational Resources Information Center
Kelley, Melissa M.; Chan, Keith T.
2012-01-01
Research has examined the relationship of styles of attachment to others and meaning with grief and the stress-related growth process. Less has been written on styles of attachment to God and patterns of religious coping and how these constructs may impact adjustment in persons dealing with loss. This study examines the roles of attachment to God,…
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The Winding Valley of Grief: When a Dog Guide Retires or Dies
ERIC Educational Resources Information Center
Schneider, Katherine Standish
2005-01-01
Schools that train dog guides work hard to help their clients bond with their new partners, but during the initial training, little is said about the other end of the process, for example, when it is time to say good-bye. When people return for subsequent dogs, a grief group or individual counseling may be offered, but the focus remains on moving…
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NASA Astrophysics Data System (ADS)
Monteiro, L. H. A.
2014-12-01
Grieving is a natural human reaction to a significant loss. According to a psychiatric model, this process is characterized by a typical sequence of psychological changes. Here, I propose a discrete-time dynamical system, called the grief map, in order to represent the grieving process. The corresponding bifurcation diagram, which exhibits stationary, periodic, and chaotic behavior, is related to the stages of this sorrowful journey occurring during about 12 months post-loss.
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Dionne-Odom, J Nicholas; Azuero, Andres; Lyons, Kathleen D; Hull, Jay G; Prescott, Anna T; Tosteson, Tor; Frost, Jennifer; Dragnev, Konstantin H; Bakitas, Marie A
2016-09-01
Little is known about whether early palliative care (EPC) support for family caregivers (CGs) impacts depressive symptoms and grief after care recipients die. To assess after-death CG depressive symptom and grief scores for early compared to delayed group CGs. We conducted a randomized controlled trial (10/2010-9/2013) of an EPC telehealth intervention for CGs (n = 123) initiated at the time of care recipients' advanced cancer diagnosis (early group) or 12 weeks later (delayed group) in a rural comprehensive cancer center, affiliated clinics, and a Veterans Administration medical center. The ENABLE [Educate, Nurture, Advise, Before Life Ends] CG intervention consisted of three weekly sessions, monthly follow-up, and a bereavement call. CGs completed the Center for Epidemiological Study-Depression (CES-D) scale and the Prigerson Inventory of Complicated Grief-Short Form (PG13) 8-12 weeks after care recipients' deaths. Crude and covariate-adjusted between-group differences were estimated and tested using general linear models. For care recipients who died (n = 70), 44 CGs (early: n = 19; delayed: n = 25) completed after-death questionnaires. Mean depressive symptom scores (CES-D) for the early group was 14.6 (SD = 10.7) and for the delayed group was 17.6 (SD = 11.8). Mean complicated grief scores (PG13) for the early group was 22.7 (SD = 4.9) and for the delayed group was 24.9 (SD = 6.9). Adjusted between-group differences were not statistically significant (CES-D: d = 0.07, P = 0.88; PG13: d = -0.21, P = 0.51). CGs' depressive symptom and complicated grief scores 8-12 weeks after care recipients' deaths were not statistically different based on the timing of EPC support. The impact of timing of CG EPC interventions on CGs bereavement outcomes requires further investigation. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Heeke, Carina; Stammel, Nadine; Knaevelsrud, Christine
2015-03-01
Forced disappearance is a frequent phenomenon in violent conflicts and regimes, yet little is known about unresolved grief processes as a possible outcome of the disappearance of a loved one. This study investigates prolonged grief disorder (PGD) and its risk factors in a sample of persons who lost a significant other to disappearance as compared with a sample of bereaved individuals, both groups having experienced displacement due to the armed conflict in Colombia. In a cross-sectional study conducted in four Colombian provinces, 73 persons who lost a significant other to disappearance and 222 bereaved individuals completed measures of PGD (PG-13), depression (HSCL-25), and PTSD (PCL-C) via face-to-face interviews. Trauma- and loss-related variables, including the extent to which significant others of disappeared persons hoped that their loved one was still alive, were assessed. Results indicated that 23% of participants who lost a significant other to disappearance met criteria for PGD as compared to 31.5% in bereaved participants. No differences were found between the two groups in terms of symptom severity of PGD, depression, posttraumatic stress disorder, or traumatic exposure. Regression analysis indicated that, among relatives and friends of disappeared persons, the extent of hope predicted PGD above and beyond depression severity whereas among bereaved persons, PGD was predicted by time since the loss, the number of traumatic events and symptom severity of PTSD and depression. The instruments were not validated for use in Colombia; generalizability of findings is limited. Forced disappearance is related to prolonged grief reactions, particularly when those left behind maintain hope that the disappeared person is still alive. Copyright © 2014 Elsevier B.V. All rights reserved.
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Otani, Hiroyuki; Yoshida, Saran; Morita, Tatsuya; Aoyama, Maho; Kizawa, Yoshiyuki; Shima, Yasuo; Tsuneto, Satoru; Miyashita, Mitsunori
2017-09-01
Few studies have explored the clinical significance of the family's presence or absence at the moment of a patient's death and meaningful communication (saying "goodbye") in terms of post-bereavement outcomes. To explore the potential association between the family's depression/complicated grief and their presence at the moment of a patient's death and the patient's communication with the family. A nationwide questionnaire survey was conducted on 965 family members of cancer patients who had died at palliative care units. More than 90% of family members wished to have been present at the moment of death (agree: 40%, n = 217; strongly agree: 51%, n = 280); 79% (n = 393) thereof were present. Families' presence at death was not significantly associated with the occurrence of depression and complicated grief, but the dying patient's ability to say "goodbye" to the family beforehand was (depression: adjusted odds rate, 0.42; 95% CI, 0.26-0.69 adjusted P = 0.001; complicated grief: adjusted odds rate, 0.53; 95% CI, 0.29-0.94 adjusted P = 0.009). Many families wished to be present at the moment of the patient's death; however, meaningful communication (saying "goodbye") between the patient and family members, and not their presence or absence itself, was associated with better outcomes on measures of depression or complicated grief. Health care professionals could consider promoting both mutual communication (relating to preparation for death) between family members and patients before imminent death, as well as the family's presence at the moment of death. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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Schut, Henk; Stroebe, Margaret S.; Wilson, Stewart; Birrell, John
2016-01-01
Objective This study assessed the validity of the Indicator of Bereavement Adaptation Cruse Scotland (IBACS). Designed for use in clinical and non-clinical settings, the IBACS measures severity of grief symptoms and risk of developing complications. Method N = 196 (44 male, 152 female) help-seeking, bereaved Scottish adults participated at two timepoints: T1 (baseline) and T2 (after 18 months). Four validated assessment instruments were administered: CORE-R, ICG-R, IES-R, SCL-90-R. Discriminative ability was assessed using ROC curve analysis. Concurrent validity was tested through correlation analysis at T1. Predictive validity was assessed using correlation analyses and ROC curve analysis. Optimal IBACS cutoff values were obtained by calculating a maximal Youden index J in ROC curve analysis. Clinical implications were compared across instruments. Results ROC curve analysis results (AUC = .84, p < .01, 95% CI between .77 and .90) indicated the IBACS is a good diagnostic instrument for assessing complicated grief. Positive correlations (p < .01, 2-tailed) with all four instruments at T1 demonstrated the IBACS' concurrent validity, strongest with complicated grief measures (r = .82). Predictive validity was shown to be fair in T2 ROC curve analysis results (n = 67, AUC = .78, 95% CI between .65 and .92; p < .01). Predictive validity was also supported by stable positive correlations between IBACS and other instruments at T2. Clinical indications were found not to differ across instruments. Conclusions The IBACS offers effective grief symptom and risk assessment for use by non-clinicians. Indications are sufficient to support intake assessment for a stepped model of bereavement intervention. PMID:27741246
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[A Clinical Case of Grief Hallucination through the Mourning Work Normal Grief and Spiritual Care].
Kurotori, Isaku; Kato, Satoshi
2015-01-01
Auditory or visual hallucinations of a deceased person are well known in the normal course of the bereavement process. According to DSM-5, this symptom is included in the associated features supporting diagnosis of persistent complex bereavement disorder. In Japan, however, little is known about these hallucinatory experiences during grieving, and few reports on their prevalence are available. Here, we have reported a clinical case of such experiences following the loss of a spouse. A 66-year-old patient presented to the outpatient department with insomnia after her husband's death. She was preoccupied with a sense of loss and absolute loneliness. One day, she confessed to regularly encountering her husband's ghost at night; the ghost was distinguishable from a dream and provided the bereaved wife with some degree of comfort. The appearances lasted for 15 months and occurred several times a week without disturbing her social functioning. She gradually became aware that her husband was returning from the spirit world to give her solace. Her treatment was focused on resolving her conflicting feelings concerning her grief at his death and her relief at his no longer suffering from disease. While accepting her experiences, she started to review the days they spent together and appreciated his attachment. Therefore she completed the work of mourning and the ghost no longer appeared. One year after the departure of the ghost, she still attends the hospital regularly and there has been no recurrence. A reconstruction of her internal world leads us to conclude that the support of normal grief with such hallucinations prevents the intense experience of loss from generating pathological grief. Furthermore, we suggest reconsidering the importance of the mourning work and the inclusion of both the bereaved and deceased person in the medical context.
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Complicated grief and manic comorbidity in the aftermath of the loss of a son.
Carmassi, Claudia; Shear, M Katherine; Socci, Chiara; Corsi, Martina; Dell'osso, Liliana; First, Michael B
2013-09-01
Based on the recommendations of the sub-workgroup on trauma and dissociative disorders, the American Psychiatric Association (APA) removed the "bereavement exclusion" from the criteria for major depression in DSM-5. In addition, proposed DSM-5 research criteria for persistent complex bereavement disorder (PCBD) were included in the new manual in a section for conditions and criteria needing further research. We describe a case that warranted such a diagnosis. The patient was a 52- year-old woman who was admitted to the inpatient unit of our clinic on the birthday of her son who had died 18 months earlier. She was diagnosed with a manic episode with psychotic symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and was treated accordingly. Three months after discharge, she made a suicide attempt and was admitted and re-assessed. During this admission, she completed the Inventory of Complicated Grief (ICG), the Mood-Spectrum Rating Scale (MOODS-SR), and the Trauma and Loss Spectrum questionnaire (TALS-SR). She endorsed symptoms of intense yearning for her son, feelings of shock and disbelief, anger and bitterness related to his death, estrangement from others, auditory, tactile and visual hallucinations of the deceased, and intense emotional reactivity to memories of her son. These symptoms were sufficiently prolonged and severe to meet criteria for complicated grief. While complicated grief appeared to be the primary diagnosis for this patient, when she was diagnosed using only DSMIV-TR criteria, her treatment failed to address herprimary problem. This case draws attention to the occurrence of manic-like symptoms as well as depression-like manifestations following bereavement and highlights the importance of including the syndrome of complicated grief in the diagnostic nomenclature.
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DSM-5: proposed changes to depressive disorders.
Wakefield, Jerome C
2012-03-01
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is currently undergoing a revision that will lead to a fifth edition in 2013. Proposed changes for DSM-5 include the creation of several new categories of depressive disorder. Some nosologists have expressed concern that the proposed changes could yield many 'false-positive diagnoses' in which normal distress is mislabeled as a mental disorder. Such confusion of normal distress and mental disorder undermines the interpretability of clinical trials and etiological research, causes inefficient allocation of resources, and incurs risks of unnecessary treatment. To evaluate these concerns, I critically examine five proposed DSM-5 expansions in the scope of depressive and grief disorders: (1) a new mixed anxiety/depression category; (2) a new premenstrual dysphoric disorder category; (3) elimination of the major depression bereavement exclusion; (4) elimination of the adjustment disorder bereavement exclusion, thus allowing the diagnosis of subsyndromal depressive symptoms during bereavement as adjustment disorders; and (5) a new category of adjustment disorder related to bereavement for diagnosing pathological non-depressive grief. I examine each proposal's face validity and conceptual coherence as well as empirical support where relevant, with special attention to potential implications for false-positive diagnoses. I conclude that mixed anxiety/depression and premenstrual dysphoric disorder are needed categories, but are too broadly drawn and will yield substantial false positives; that the elimination of the bereavement exclusion is not supported by the evidence; and that the proposed elimination of the adjustment-disorder bereavement exclusion, as well as the new category of grief-related adjustment disorder, are inconsistent with recent grief research, which suggests that these proposals would massively pathologize normal grief responses.
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Neria, Yuval; Gross, Raz; Litz, Brett; Maguen, Shira; Insel, Beverly; Seirmarco, Gretchen; Rosenfeld, Helena; Suh, Eun Jung; Kishon, Ronit; Cook, Joan; Marshall, Randall D
2007-06-01
A Web-based survey of adults who experienced loss during the September 11, 2001, terrorist attacks was conducted to examine the prevalence and correlates of complicated grief (CG) 2.5-3.5 years after the attacks. Forty-three percent of a study group of 704 bereaved adults across the United States screened positive for CG. In multivariate analyses, CG was associated with female gender, loss of a child, death of deceased at the World Trade Center, and live exposure to coverage of the attacks on television. Posttraumatic stress disorder, major depression, anxiety, suicidal ideation, and increase in post-9/11 smoking were common among participants with CG. A majority of the participants with CG reported receiving grief counseling and psychiatric medication after 9/11. Clinical and policy implications are discussed.
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Constructions of Mexican American family grief after the death of a child: an exploratory study.
Doran, Gerry; Downing Hansen, Nancy
2006-04-01
Using a collective case study ethnographic approach, nine individuals comprising three Mexican American families were interviewed about their family bereavement experiences after the death of a child. All families were Catholic, had surviving siblings, and had had three or more years to grieve their loss when interviewed. The deceased children ranged in age from 3 to 14, and all experienced sudden, traumatic, nonsuicide deaths. To provide a broader, contextual picture of their grief experiences, four individuals who supported these family members after the loss were also interviewed. Unique grief experiences were identified, and eight common themes emerged, reflecting the ways in which family members maintained their bond to the deceased: dreams, storytelling, keepsakes, sense of presence, faith-based connections, proximity connections, ongoing rituals, and pictorial remembrances. The cultural implications of family bereavement are highlighted.
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1990-01-01
1974). Loss and Change. Pantheon Books, Random House: New York. McDonnell, K. (1986). Not an easy choice, a feminist reexamines abortion. Whole Earth...Boston: Little, Brown and Company. Worden, J. W. (1982). Grief Counseling and Grief Therapy . New York: Springer Publishing Company. APPENDIX A--Meaning of
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ERIC Educational Resources Information Center
Creighton, Genevieve; Oliffe, John; Matthews, Jennifer; Saewyc, Elizabeth
2016-01-01
Background: The death of a male friend can be challenging for men because expressions of grief can be governed and restrained by dominant ideals of masculinity. It is common for young men to engage in health risk practices, such as alcohol overuse, to deal with feelings of sadness. Objective: This qualitative study investigated the ways that young…
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Alexandre, M; Votino, C; De Noose, L; Cos Sanchez, T; Gaugue, J; Jani, J
2016-01-01
There is insufficient research on the mother's early relationship with a child born subsequent to a previous medical termination of pregnancy (TOP). This study explores mother-infant interactions following prior TOP and the impact on the infant's development. Being an exploratory research comprising 12 mother-infant (6-7 months old) couples, following prior TOP, and five controls, this study uses a descriptive methodology and a qualitative approach. The Greenspan and Lieberman Observation Scale (GLOS) and the Stern's "R"-Interview were employed to investigate the mother-infant relationship. We used the Brunet-Lézine's Revised Scales (BL-R) and the Projective Kit for Early Childhood (PKEC) to assess the infant's development. Grief resolution was taken into account (Perinatal Grief Scale, semi-structured interview). The later the perinatal loss, the less likely children are to express their emotions and respond contingently (GLOS). Their psychomotor (BL-R) and emotional (PKEC) development remains adequate. Unresolved grief is associated with more pronounced disturbances: no dyadic exchange (GLOS), language disruptions (BL-R), and withdrawal from the environment (PKEC). This study suggests that mother-infant interactions following a prior late TOP could undergo disturbances, which do not lead systematically to pathogenic effect on the subsequent child. Nevertheless, unresolved grief could lead to adverse effects.
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Rahiminia, Elaheh
2013-01-01
Background: The birth of a child is an event to be remembered. However, a premature birth may shock the parents and cause their grief. Understanding differences between mothers and fathers can help nurses in providing nursing supports. Objectives: This study was performed with the aim of comparing nursing behaviors which facilitate grief work for parents of premature infants hospitalized in the NICU from perspectives of mothers and fathers. Patients and Methods: This comparative descriptive design was conducted among 40 pairs of mothers and fathers selected by convenience sampling method. The study was performed in 2011 using the Fordham Scale (1989). Data were analyzed with "wilcoxon ranks test" by using SPSS software version 13. Results: The mean scores of nursing behaviors which facilitate grief work were 2.81 ± 0.16 and 2.82 ± 0.29 in the perspectives of mothers and fathers, respectively. The Wilcoxon test did not show any statistically significant difference between mothers and fathers (P = 0.55). Conclusions: Despite expectations, provided nursing behaviors in mothers and fathers showed no difference in this study. Therefore, nursing policymakers and directors should take measures in order to provide appropriate services to the parents. PMID:25414860
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The persistence of attachment: complicated grief, threat, and reaction times to the deceased's name.
Mancini, Anthony D; Bonanno, George A
2012-08-01
Complicated grief is increasingly recognized as a debilitating disorder with significant mental and health consequences. The underlying mechanisms of complicated grief remain unclear, however. In the present study, we investigated a specific mechanism of complicated grief (CG) derived from attachment theory: the accessibility of the deceased's mental representation under threat. In a matched comparison of complicated (n=26) and asymptomatic grievers (n=30), we used an emotional Stroop task following subliminal threat or neutral primes to examine the accessibility of mental representations of the deceased, current attachment figures, and close others. Complicated grievers did not evidence differential accessibility to the deceased's mental representation across priming conditions, whereas asymptomatic grievers showed reduced accessibility (deactivation) of the deceased's mental representation specifically in the threat prime condition. These effects were independent of depressive symptoms. Across grievers, attachment anxiety and avoidance uniquely predicted accessibility of the deceased's name in the threat condition. The limitations of this study are its small sample size and reliance on analog attachment threats. These data support that accessibility of the deceased's mental representation in threatening contexts is an important component of complicated and asymptomatic grieving and that attachment insecurity contributes to a maladaptive reliance on the deceased as an attachment figure. Copyright © 2012 Elsevier B.V. All rights reserved.
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Lee, So Hee; Nam, Hee Sun; Kim, Hak Beom; Kim, Eun Ji; Noh, Jin-Won; Chae, Jeong-Ho
2018-03-01
The Sewol ferry disaster caused shock and grief in South Korea. The aim of this study was to identify the factors associated with symptoms of complicated grief (CG) among the surviving students 20 months after that disaster. This study was conducted using a cross-sectional design and a sample of 57 students who survived the Sewol ferry disaster. Data were collected using the following instruments: Inventory of Complicated Grief (ICG), the Lifetime Incidence of Traumatic Events-Child, the Child Report of Post-Traumatic Symptoms (CROPS), KIDSCREEN-27, Family Adaptability and Cohesion Evaluation Scales-III, the Peri-traumatic Dissociation-Post-traumatic Negative Beliefs-Post-traumatic Social Support scale, and the Strengths and Difficulties Questionnaire. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with symptoms of CG. The mean score on the ICG was 15.57 (standard deviation: 12.72). Being born in 1999, a higher score on the CROPS and a lower score in autonomy and relationship with parents on the KIDSCREEN-27 were related to higher levels of CG. Twenty months after the Sewol ferry disaster, 24.5% of surviving students were suffering from CG. This study uncovered a vulnerable population of bereaved children at high risk for CG.
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Lee, So Hee; Nam, Hee Sun; Kim, Hak Beom; Kim, Eun Ji; Noh, Jin-Won; Chae, Jeong-Ho
2018-01-01
Objective The Sewol ferry disaster caused shock and grief in South Korea. The aim of this study was to identify the factors associated with symptoms of complicated grief (CG) among the surviving students 20 months after that disaster. Methods This study was conducted using a cross-sectional design and a sample of 57 students who survived the Sewol ferry disaster. Data were collected using the following instruments: Inventory of Complicated Grief (ICG), the Lifetime Incidence of Traumatic Events-Child, the Child Report of Post-Traumatic Symptoms (CROPS), KIDSCREEN-27, Family Adaptability and Cohesion Evaluation Scales-III, the Peri-traumatic Dissociation–Post-traumatic Negative Beliefs–Post-traumatic Social Support scale, and the Strengths and Difficulties Questionnaire. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with symptoms of CG. Results The mean score on the ICG was 15.57 (standard deviation: 12.72). Being born in 1999, a higher score on the CROPS and a lower score in autonomy and relationship with parents on the KIDSCREEN-27 were related to higher levels of CG. Conclusion Twenty months after the Sewol ferry disaster, 24.5% of surviving students were suffering from CG. This study uncovered a vulnerable population of bereaved children at high risk for CG. PMID:29475240
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Management of death and grief in obituary and in memoriam pages of Nigerian newspapers.
Alali, A O
1993-12-01
This analysis of obituaries and in memoriam advertisements in Nigerian newspapers provides the identification of dimensions of content used to manage death and grief. Ten dimensions of content were abstracted: pictorial representation is a widespread practice, immediacy of announcement following death is an appropriate etiquette in the management of death, funeral arrangements are included as open invitation to a community of mourners, advertisements indicate direct contact and communication with the deceased, contents suggest the belief in personal immortality of the soul, religion is a pervasive and dominating force in advertisements, there are similarities in choice of words used in death advertisements, there is recognition of the temporal nature of life, mourning seems to be an ongoing process, and often the deceased is perceived as resting in peace. Never do obituaries and in memoriam statements include the flaws of the deceased. Clearly, the dimensions of content in the obituaries and in memoriam advertisements of Nigerian newspapers are a specific cultural behavior of people who exhibit similarity in the management of death and grief. These advertisements serve as an unbroken link between the deceased and the bereaved. This study also suggests that openness to death is the appropriate etiquette in the management of death and grief in Nigeria.
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Kerns, Jennifer L; Mengesha, Biftu; McNamara, Blair C; Cassidy, Arianna; Pearlson, Geffan; Kuppermann, Miriam
2018-06-01
We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, p<.0001), as were posttraumatic stress and grief scores (r=0.7, p<.0001). In the adjusted analysis, higher decision satisfaction was associated with lower grief and posttraumatic stress scores (p=.02 and p=.01, respectively) and higher shared decision making was associated with lower posttraumatic stress scores (p=.01). Decision satisfaction and shared decision making have a positive effect on psychological outcomes after second-trimester abortion for pregnancy complications. Counseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. These results highlight the importance of patient-centered counseling for women seeking pregnancy termination. Copyright © 2018. Published by Elsevier Inc.
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Hogan, Nancy; Schmidt, Lee; Coolican, Maggie
2014-09-01
Donated tissues can save lives of critically burned patients and those needing a heart valve replacement. Tissues enhance the lives of a million recipients annually through transplants of corneas, bones, tendons, and vein grafts. Unfortunately, the need for some tissues exceeds their availability. The goal of the quantitative component of this mixed methods study was to identify the grief, posttraumatic stress, personal growth, and ongoing attachment response of tissue donors' family members during a 2-year period. Simultaneous mixed methods design. The sample for this study consisted of 52 tissue donors' family members, mostly widows (83%). Data were collected for 2 years to test changes in grief, posttraumatic stress, panic behavior, personal growth, and ongoing attachment. The bereaved participants experienced significantly fewer grief reactions, less posttraumatic stress, and greater personal growth. There was no significant difference in the ongoing attachment to their deceased loved ones. The results of this study may reinforce the positive meaning that tissue donors' family members can find in tissue donation. Findings also demonstrate that the bereavement process corroborates contemporary bereavement and attachment theories. Health professionals are encouraged to seek donations with less worry that tissue donors' family members will experience adverse outcomes during bereavement.
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ERIC Educational Resources Information Center
Chur-Hansen, Anna
2010-01-01
Companion animals play various roles in people's lives and these roles can impact on loss, grief, bereavement and mourning when the animal has been lost, whether that is through death, when missing, or when relinquished. This paper considers not only companion animal owners, but also those who own farm animals and those who work in animal service…
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Living, loving and losing: implications for health and well-being.
Downey, A M
1983-01-01
Living, loving and losing - we live, we love and we lose - this is an integral part of life's unending circle. Throughout the lifecycle, we are confronted continually with experiences of loss and separation. The loss of a loved one through separation, divorce, or death is one of the most difficult experiences to be dealt with in a lifetime. How do we cope with the "crisis of loss" in our lives? If education is supposed to prepare one for life, then Death Education is crucial in assisting individuals to cope with "myriad loss issues." This paper will explore the implications of loss for health and well-being, and briefly review some of the research findings regarding the negative impact of grief and bereavement upon health. The stages of the grief process will be cited, mentioning some of the barriers to grief resolution. Most importantly, the positive aspects of loss upon life and health will be elaborated.
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Patterns of attachment and parents' adjustment to the death of their child.
Wijngaards-de Meij, Leoniek; Stroebe, Margaret; Schut, Henk; Stroebe, Wolfgang; van den Bout, Jan; van der Heijden, Peter G M; Dijkstra, Iris
2007-04-01
The impact of adult attachment on psychological adjustment among bereaved parents and the mediating effect of relationship satisfaction were examined among a sample of 219 couples of parents. Data collection took place 6, 13, and 20 months after loss. Use of the actor partner interdependence model in multilevel regression analysis enabled exploration of both individual as well as partner attachment as predictors of grief and depression. Results indicated that the more insecurely attached parents were (on both avoidance and anxiety attachment), the higher the symptoms of grief and depression. Neither the attachment pattern of the partner nor similarity of attachment within the couple had any influence on psychological adjustment of the parent. Marital satisfaction partially mediated the association of anxious attachment with symptomatology. Contrary to previous research findings, avoidant attachment was associated with high grief intensity. These findings challenge the notion that the avoidantly attached are resilient.
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Vanderwerker, Lauren C; Jacobs, Selby C; Parkes, Colin Murray; Prigerson, Holly G
2006-02-01
Recent studies have suggested that the vulnerability to complicated grief (CG) may be rooted in insecure attachment styles developed in childhood. The aim of this study was to examine the etiologic relevance of childhood separation anxiety (CSA) to the onset of CG relative to major depressive disorder, posttraumatic stress disorder, and generalized anxiety disorder in bereaved individuals. The Structured Clinical Interview for the DSM-IV, Inventory of Complicated Grief-Revised, and CSA items from the Panic Agoraphobic Spectrum Questionnaire were administered to 283 recently bereaved community-dwelling residents at an average of 10.6 months postloss. CSA was significantly associated with CG (OR = 3.2; 95% CI, 1.2-8.9), adjusting for sex, level of education, kinship relationship to the deceased, prior history of psychiatric disorder, and history of childhood abuse. CSA was not significantly associated with major depressive disorder, posttraumatic stress disorder, or generalized anxiety disorder.
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Rheingold, Alyssa A; Williams, Joah L
2018-03-01
Significant strides have been made in the trauma and grief fields to address the unique needs of those who have lost a loved one to violent death. Several treatment techniques have been found to be effective for symptoms of trauma and grief that are prevalent among violent loss survivors including restorative retelling and cognitive behavioral strategies. Current interventions either are tailored for a specific mental health problem or are more universal in nature for grief related to violent loss. This paper presents an evidence-based and guided modular approach for responding to the myriad potential mental health needs of violent loss survivors. A comprehensive module-based structured intervention for violent loss survivors, which specifically targets several common mental health difficulties following traumatic loss, may offer clinicians a thorough and flexible approach guided by clinical assessment to address the distinctive and common issues violent loss survivors often face.
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Storyboarding used as an aid to explore grief.
2016-07-06
Yvonne Dexter, writing in Nursing Children and Young People, discusses the use of storyboarding and its use as a reflective practice aid. As children's nurses are among the child health professionals most directly affected by childhood death, storyboarding can provide nursing students with a safe environment to reflect on their feelings about the death of a child. Ms Dexter considers the potential for its use in practice, for example in clinical supervision and classroom settings, to manage grief.