H.A.W. Schut

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• Associate professor
• Professor (Associate) at Utrecht University

The Dual Process Model of Coping with Bereavement (DPM) was put forward as a framework to help understand reactions to the death of a loved person. Since its inception, there have been various developments and further specifications regarding the model’s parameters. A number of researchers have assessed the model’s contribution and put some of its...

Background and objectives: Repetitive thought is a trans-diagnostic risk factor for development of psychopathology. Research on repetitive thought in bereaved individuals has focused primarily on clarifying the role of rumination, repetitive thinking about past negative events and/or negative emotions. While detrimental effects of rumination have...

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 tim...

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...

In recent decades, there have been diverse reviews published on intervention program value for bereaved people. The variation and multiplicity of such reviews makes it difficult to obtain an overview of what is known about treatment effectiveness. In this systematic umbrella review, we explore the current knowledge base on psychotherapeutic bereave...

The vital role social relationships play in mental health and well-being has been well-documented. Disruption of an intimate bond through bereavement can be enduringly stressful, with loneliness featuring prominently, possibly compromising mental and physical health. We systematically reviewed studies examining loneliness across marital status grou...

Although child loss impairs well-being, its impact on behavioral exchanges between bereaved parents remains understudied. We compared bereaved and non-bereaved couples regarding affectionate touch levels, the role of affectionate touch in intimacy, and the association between partners' affectionate touch similarity and intimacy. Bereaved (228 coupl...

Manual for use of the Utrecht Homesickness Scale

Insecure attachment is proposed to be a risk factor in the development and persistence of severe grief. Although prior research demonstrates positive cross-sectional and longitudinal correlations between attachment styles and prolonged grief symptoms, controlled longitudinal analyses yield fewer convincing results. Therefore, we sought to further c...

Learning Objectives: After participating in this CME activity, the psychiatrist should be better able to • Explain the steps required for diagnosis of mental disorders in diagnostic handbooks. • Identify current procedures for classifying and reporting prolonged grief disorder. Abstract Prolonged grief disorder (PGD) was added to the 11th edition...

Loneliness can be prominent in bereavement, possibly leading to compromised mental and physical health. We systematically reviewed the extent of loneliness across marital status groups, examining the prevalence, intensity, risk factors, and correlates of loneliness in widowhood, compared to other marital statuses. Studies that met predefined criter...

Purpose: The death of a child can elicit enduring and intense parental grief. Additionally, as parents are both confronted with the loss of their child, interpersonal processes come into play. This study aimed to examine the change in reported levels of grief among bereaved parents individually and at a couple-level. We examined the differences in...

Kübler-Ross’s stage model of grief, while still extremely popular and frequently accepted, has also elicited significant criticisms against its adoption as a guideline for grieving. Inaccurate portrayal of the model may lead to bereaved individuals feeling that they are grieving incorrectly. This may also result in ineffectual support from loved on...

The role of loneliness in the bereavement experience has been reported as substantial, with the death of a close person leaving a considerable void in the life of the bereaved. Yet, there is lack of agreement about its precise role and, notably, whether loneliness should be included as a core symptom for diagnosis of grief complications. The ongoin...

Funerals have long been of interest to social scientists. Previous sociological work has examined the relationship between individuality, belief and tradition within funeral services, founded on the assumption that public rituals have psycho-social benefit for organisers and attendees. With the introduction of direct cremation to the UK, and the im...

It has generally been understood that the majority of bereaved people suffer from loneliness to at least a moderate degree, and more so than their non-bereaved counterparts. Even before the COVID-19 pandemic impacted social isolation, loneliness had been closely associated with poor mental health outcomes. In this study we systematically review the...

Counterfactual thoughts, mental simulations about how a situation may have turned out differently (i.e., “if only …, then …”), can reduce mental health after stressful life-events. However, how specific counterfactual thought types relate to post-loss mental health problems is unclear. We hypothesized that self-referenced upward counterfactuals (i....

A review of the literature on adaptation to bereavement during the COVID-19 pandemic was conducted to assess the current state of knowledge. Scopus, Web of Science and Google Scholar databases were searched for studies published during the first 6 months of the COVID-19 outbreak. 44 articles were included in the review. Narrative synthesis showed t...

Does restricting the ceremonial/ritual arrangements around a cremation to a minimum have a negative association with grief over time? This question has increasingly concerned professionals in the funeral industry as well as those in healthcare capacities working with bereaved persons. We examined the relationship between cremation arrangements and...

Our knowledge about the effects of perceived emotional support on PTSD, anxiety and depressive symptoms after serious threat and violence is primarily based on post-event studies. Very little is known about the extent to which (1) victims lacking pre-event emotional support are more at risk of post-event symptoms and lack of post-event support than...

Objectives Little is known about the 12-month prevalence of potentially traumatic events (PTEs) and to what extent the type of PTE is a risk factor for post-event lack of social support. In addition, it is largely unknown if pre-event mental health problems and loneliness, and demographics are risk factors for a lack of support. Aim of the present...

Funeral services are known to serve multiple functions for bereaved persons. There is also a common, intuitively reasonable assumption of positive associations between engaging in funeral activities and adjustment to bereavement. We examined whether restricting ceremonial cremation arrangements to a minimum has a negative association with grief ove...

Background: Prior network analyses demonstrated that the death of a loved one potentially precedes specific depression symptoms, primarily loneliness, which in turn links to other depressive symptoms. In this study, we extend prior research by comparing depression symptom network structures following two types of marital disruption: bereavement ver...

Homesickness is common among university students and associated with mental health problems. Most previous studies assessed homesickness as a summary of the past weeks. However, there may be significant fluctuations across situations. At the current residence, homesickness may especially be triggered during (phone) interactions with attachment figu...

Background Prior network analyses demonstrated that the death of a loved one potentially precedes specific depression symptoms, primarily loneliness, which in turn links to other depressive symptoms. In this study, we extend prior research by comparing depression symptom network structures following two types of marital disruption: bereavement vers...

Background and objectives: Major negative life-events including bereavement can precipitate perceived positive life-changes, termed posttraumatic growth (PTG). While traditionally considered an adaptive phenomenon, it has been suggested that PTG represents a maladaptive coping response similar to cognitive avoidance. To clarify the function of PTG,...

Het fasedenken over rouw, zoals dat door Elisabeth Kübler-Ross in 1969 in een model is vastgelegd, is helaas uitgegroeid tot een wetmatigheid. Dat heeft schadelijke gevolgen. We moeten het fasedenken dus laten vallen.

A new theory of eating regulation is presented to account for the over-responsiveness of restrained eaters to external food-relevant cues. According to this theory, the food intake of restrained eaters is characterized by a conflict between two chronically accessible incentives or goals: eating enjoyment and weight control. Their difficulty in weig...

Objective: Poverty is related to increased grief-related mental health problems, leading some to suggest bereavement counseling should be tailored to income. However, information about accessibility and effectiveness of such counseling programs serving low-income households is scarce. This longitudinal study therefore investigated the association b...

This controlled, longitudinal investigation tested the effectiveness of a bereavement counselling model for adults on reducing complicated grief (CG) symptoms. Participants (N = 344; 79% female; mean age: 49.3 years) were adult residents of Scotland who were bereaved of a close relation or partner, experiencing elevated levels of CG, and/or risks o...

Bereavement research is reaching the hundred-year landmark of the publication of Freud’s classic 1917 ‘Mourning and Melancholia’, an essay of great significance for subsequent theoretical developments, particularly — in the current context — with regard to the centrality placed on ‘grief work’ in coming to terms with bereavement. Where do we stand...

The present study aimed to examine whether bereaved parents “meaning-made”–defined as results of attempts to reduce discrepancies between the meaning assigned to the death of the child and self and world-views—was influenced by their own and their partner’s coping orientations. Coping orientations were conceptualized within the Dual Process Model,...

Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to ''prescribe'' stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively,...

Eye Movement Desensitisation and Reprocessing (EMDR) is an evidence-based treatment for posttraumatic stress disorder (PTSD). However, the literature concerning the efficacy of EMDR for complexed PTSS is ambiguous. Documentation of efficacy of EMDR among war veterans traumatized during combat mission is scarce. In this study, changes in the severit...

The article outlines and reflects on the current state of scientific knowledge of bereavement. Bereavement reactions and associated health consequences are described, and the factors influencing vulnerability and resilience are summarized. We explore ways of coping and links to (mal)adjustment. We outline the current understanding of complicated gr...

Standardized, evidence-based risk assessment is an important component in providing effective bereavement care. E-health intake assessments have been offered alongside or instead of in-person assessments, although evidence concerning the equivalence of assessment results is lacking. This article examines differences between a semi-structured intake...

The death of a loved one can be heartbreaking for those left behind, and indeed, bereavement is associated not only with adverse health effects but also a higher risk of dying oneself. Not surprisingly, its consequences have been the subject of much psychological enquiry, with a major interest in shedding light on how one adapts, who is most at ris...

Homesickness (HS) is associated with mental and physical health problems and is thus of clinical concern. In some highly influential theoretical models and widely used questionnaires, HS spans home-related losses and new-locality adjustments. A differentiated approach is needed: Evidence suggests that distinct manifestations are associated with the...

Large-scale migration in contemporary society underscores the need to learn about the complex experience of leaving home and relocating within or beyond one's own country. Separate consideration of various types of stressors associated with geographic moves is called for, because these are likely to be associated with different (but mutually exacer...

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 wai...

A previous prospective study on psychotrauma revealed that the experienced burden of this research is strongly predicted by the experienced burden of participating in previous research on politics and values, and research on personality and health, and not by PTSD symptoms, coping self-effi cacy and personality. Two subsequent surveys enabled us to...

Symptoms of psychopathology are associated with overgeneral memory retrieval. Overgeneral memory is hypothesized to be the result of an emotion regulatory process, dampening emotional reactions associated with retrieval of distressing specific memories. However, higher post-loss symptom severity has been related to higher specificity of loss-relate...

Rumination, a risk factor in adjustment to bereavement, has often been considered a confrontation process. However, building on research on worry in generalized anxiety disorder (GAD) and rumination in post-traumatic stress disorder (PTSD), researchers recently developed the Rumination as Avoidance Hypothesis (RAH), which states that rumination aft...

Aspects of the socio-economic costs of bereavement in Scotland were estimated using three sets of data. Spousal bereavement was associated with increased mortality and longer hospital stays, with additional annual cost of around £20 million. Cost of bereavement coded consultations in primary care was estimated at around £2.0 million annually. Addit...

Objectives Rumination is a risk factor after bereavement, predicting higher concurrent and prospective symptom levels of complicated grief and depression in mourners. Research has shown that rumination may consist of adaptive and maladaptive subtypes, but there has been a paucity of research in this topic in the bereavement area. Therefore, we aime...

Rumination is a risk factor in adjustment to bereavement. It is associated with and predicts psychopathology after loss. Yet, the function of rumination in bereavement remains unclear. In the past, researchers often assumed rumination to be a maladaptive confrontation process. However, based on cognitive avoidance theories of worry in generalised a...

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...

Two different types of ruminative coping, depressive rumination and grief rumination, negatively influence bereavement outcome. Although grief-specific rumination is likely to be relevant in the bereavement context no internationally validated scale to measure grief rumination exists. Therefore, the current contribution aims to validate the Utrecht...

Over the course of a lifespan, most people will be confronted with the loss of a close relationship: if attachments have been formed, one is likely to have to suffer the consequences of separation. The term ‘bereavement’ refers to the situation of a person who has recently experienced the loss of someone significant in their lives through that pers...

Ruminative coping has been associated with negative outcomes in bereavement. Rather than assuming it to be a problematic confrontation process, researchers have recently suggested rumination to be maladaptive through its links with avoidance processes. The main aim of this study was to examine, for the first time, whether the relationship between r...

Scientific research on the impact of the death of a child on parents is reviewed. A major aim is to extend coverage from individual to social – in particular interactive – perspectives. We not only illustrate how such approaches complement each other, but also how different conclusions can be reached when interactive phenomena are examined. Intrape...

Bereavement research has focused on individual rather than interdependent processes in coping with loss. Yet bereavement takes place in a social context, and relationship partners are likely to influence each other's grieving process. We examined the impact of a dynamic, interpersonal phenomenon, partner-oriented self-regulation (POSR): the avoidan...

Research has shown that rumination after the death of a loved one may influence the grieving process negatively. For instance, ruminative thought has been related to symptoms of depression and complicated grief. Although most research into rumination after bereavement has been done with the Ruminative Response Scale, or RRS (Nolen-Hoeksema & Morrow...

There is debate whether continuing bonds with a deceased person help or hinder adaptation to bereavement. This longitudinal study examined causal relationships between continuing bonds and symptoms over time. Following attachment theory predictions, suddenness of separation was examined as a moderator. Data were obtained from 60 bereaved spouses at...

Evaluating the effectiveness of bereavement interventions presents major theoretical, ethical and practical challenges. Based on the extensive research experience of the authors, this article outlines some of the key considerations that must be addressed when seeking to demonstrate the effectiveness of an intervention. These include what methods to...

All too often it is assumed that the differing priorities, values and ethics of practitioners and researchers are irreconcilable. This article describes the long, sometimes difficult and ultimately fruitful process of setting up an evaluation of the efficacy of the bereavement support service offered by Cruse Bereavement Care Scotland (CBCS). CBCS...

Helsemessige følger av sorg Sorg er ikke en sykdom, og de fleste mennesker tilpasser seg utenprofesjonellpsykologisk behandling. Men noen opplever ekstrem, vedvarendementalogfysisk uhelse. Derfor er sorg et viktig tema, iforebyggendearbeidog i klinisk praksis. Forskning på belastende livshendelser har gjennomgått en betydelig utvikling i de siste t...

Can other persons, personally or professionally, help bereaved individuals deal with the loss of a loved one? An increasing number of empirical studies, as well as qualitative and quantitative reviews, have addressed this question. Here, the main findings are summarised and implications for researchers and practitioners considered. First, provision...

The Dual Process Model of Coping with Bereavement (DPM; Stroebe & Schut, 1999) is described in this article. The rationale is given as to why this model was deemed necessary and how it was designed to overcome limitations of earlier models of adaptive coping with loss. Although building on earlier theoretical formulations, it contrasts with other m...

Psycho-education for patients diagnosed with atrial fibrillation: a controlled study In outpatient care settings, there is often a lack of possibilities to inform patients sufficiently about their diagnosed disease. This is partially due to inefficient time management and a shortage of financial means. The patient is left with many unanswered quest...

Research so far has shown little evidence that written disclosure facilitates recovery from bereavement. There are good reasons to assume that written disclosure may only benefit those bereaved who are at risk for developing problems or who are experiencing significant psychological problems as a result of their loss, and only when appropriate writ...

Henk Schut responds to Larson and Hoyt's challenge (see Bereavement Care 28 (3), winter 2009) to the prevailing pessimism about the effectiveness of grief counselling. Studies indeed show that the more formalised professional therapeutic interventions with those experiencing complicated grief reactions can be effective, but for those who have simpl...

Bereavement increases the risk of ill health, but only a minority of bereaved suffers lasting health impairment. Because only this group is likely to profit from bereavement intervention, early identification is important. Previous research is limited, because of cross sectional designs, small numbers of risk factors, and use of a single measure of...

There is lack of clarity in the scientific literature concerning the adaptive functions of continuing versus relinquishing bonds to deceased persons. It remains unclear what type of bonds or underlying processes are related to (mal)adaptive bereavement outcomes. Furthermore, empirical research has rarely been theoretically-driven. Thus, the purpose...

Twee dingen vielen me meteen op toen ik de eerste keer door het Handbook of Thanatology bladerde. Ten eerste, de consistente structuur van het boek als geheel: het is opgebouwd uit zes secties rondom bepaalde onderwerpen: sterven; beslissingen rond het levenseinde; rouw: assessment en interventies; traumatische omstandigheden rondom de dood; en tra...

A longitudinal study was conducted among bereaved parents, to examine the relationship between parents' own and their partners' ways of coping in terms of the constructs loss-orientation and restoration-orientation (coping strategies based on the bereavement-specific Dual Process Model (Stroebe & Schut, 1999)), and psychological adjustment followin...

A longitudinal study was conducted among bereaved parents to examine the relationship between the circumstances surrounding the death of their child and psychological adjustment. Two hundred nineteen couples participated at 6, 13, and 20 months post-loss. Examination was made of two categories of factors: those that were determined by the particula...

A new theory of eating regulation is presented to account for the over-responsiveness of restrained eaters to external food-relevant cues. According to this theory, the food intake of restrained eaters is characterized by a conflict between two chronically accessible incentives or goals: eating enjoyment and weight control. Their difficulty in weig...

In this Review, we look at the relation between bereavement and physical and mental health. Although grief is not a disease and most people adjust without professional psychological intervention, bereavement is associated with excess risk of mortality, particularly in the early weeks and months after loss. It is related to decrements in physical he...

Bereavement is generally regarded as one of the most stressful events one can encounter. Yet, bereavement research and the study of post-traumatic stress seem to be mainly developing along separate lines. Strictly speaking, post-traumatic stress disorder can only occur after encountering events outside the range of normal human experience. Thus, by...

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 explorati...

Adult attachment dimensions as well as the personality trait neuroticism have been shown to be related to psychological adjustment after bereavement. No investigations so far have studied the relative contribution of these constructs to grief and depression. In our study of 219 bereaved parents, the two adult attachment dimensions, attachment anxie...

Using data of 56 bereaved individuals, this study examined associations of various manifestations of continuing bonds, assessed at 7-12 months post-loss, with concurrent and prospective (9 months later) symptoms of grief and depression. Among other things it was found that, independent of initial symptom levels, manifestations of continuing bonds d...

Some studies of the relationship between continuing bonds and grief intensity have claimed that continuing bonds lead to poor adaptation to bereavement. However, operationalizations of continuing bonds and grief intensity appear to overlap conceptually. Thus, it is still unclear what character the connection between continuing bonds and grief bears...

We propose an integrative risk factor framework to enhance understanding of individual differences in adjustment to bereavement and to encourage more systematic analysis of factors contributing to bereavement outcome (e.g., examination of interactions between variables and establishing pathways in the adaptation process). The examination of individ...

The death of a newborn infant is an extremely emotional event for relatives. Many hospitals provide the parents with support, and in some cases a mourning protocol is available. Some hospitals offer parents photographs of infants which have died around birth. The photographs are often taken by a nurse or doctor on the maternity or paediatric ward....

A great deal of research, notably by Prigerson and colleagues (e.g., Prigerson & Jacobs, 2001; see Prigerson & Maciejewski, this issue) and Horowitz and colleagues (e.g., Horowitz, this issue; Horowitz, Bonanno, & Holen, 1993), has recently been conducted with the purpose of establishing criteria for the designation of Complicated Grief (CG) as a m...