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Attachment in Coping With Bereavement: A Theoretical Integration.
Abstract
Researchers have deplored shortcomings in theoretically based models of coping with bereavement. Integration of cognitive stress with attachment theory is proposed to predict adjustment to bereavement, describe different forms of effective coping, and resolve ongoing debates about continuing versus relinquishing bonds. These 2 generic approaches are integrated within a bereavement-specific perspective, the dual-process model of coping (Stroebe & Schut, 1999). Accordingly, (a) different coping styles are adopted by, and are differentially efficacious for, bereaved people according to their style of attachment; (b) bereaved people's ways of continuing bonds differ according to their attachment style; and (c) grief complications are associated with insecure attachment styles. The authors conclude that it is better for some bereaved individuals to work toward retaining ties and for others to work toward loosening ties.
... Importantly, grief is a process that evolves over time, with individuals often moving through various stages to eventually construct a meaning associated with such a loss (Hamilton, 2016;Neimeyer & Sands, 2011). The "dual-process" model of grief (Stroebe et al., 2005) provides a relevant framework for understanding how individuals navigate bereavement. This model posits that, to adapt healthily to bereavement, individuals oscillate between coping with loss-related stressors and restoration-oriented stressors. ...
... This model posits that, to adapt healthily to bereavement, individuals oscillate between coping with loss-related stressors and restoration-oriented stressors. In this sense, grieving involves oscillation between two coping orientations: a loss orientation, where individuals confront and process the emotional pain of the loss, and a restoration orientation, where individuals focus on adapting to life changes and fulfilling new roles and responsibilities (Stroebe et al., 2005). This model is particularly relevant to this study as it aligns with the varied adaptation modalities that may be observed. ...
... This aligns with previous research, as personal traits, resilience efforts, and constructively framing the loss can aid in resilience (Mancini & Bonano, 2009). Additionally, it seems that the personal effort made by these individuals consists of the restoration orientation laid out by Stroebe and Schut (1999), as they focused on adapting to life changes and pursuing professional progress (Stroebe et al., 2005). ...
On August 4, 2020, an explosion in the Beirut Port in Lebanon caused over 220 deaths and 76,000 injuries. The blast, which is considered a national tragedy, had profound impacts on Lebanese citizens, notably the traumatic loss for families who lost a loved one. This qualitative study explored the experiences of loss and adaptation among bereaved families following the Beirut Port explosion from a psychosocial perspective. Semi-structured interviews were conducted with 13 bereaved family members three years after the explosion. Participants reported an initial state of shock following the loss. They experienced emotional distress, including persistent sadness and anger, especially toward the political class, as well as existential concerns. Moreover, social support, religious coping, and the quest for justice were noteworthy adaptation modalities. The findings showcase the experiences and adaptation strategies of bereaved families and highlight their ongoing psychological struggles. These insights pave the way for interventions for similar events.
... Loss-oriented strategies focus on thoughts and feelings about the loss, while restoration-oriented coping describes the process of adaptation to the death, including stressors such as role and identity changes (Fiore 2021). Oscillation between loss-and restoration-oriented states is thought to facilitate a more adaptive grieving experience; by contrast, complicated grief symptoms (including prolonged grief disorder and post-traumatic stress disorder) arise when individuals do not oscillate between states, or when this oscillation is disturbed (Burton et al. 2012;Stroebe et al. 2005). The ability to oscillate between approaches can be understood in terms of psychological flexibility, which allows individuals to adjust their cognitions and behaviors to adapt to situational demands (Kashdan and Rottenberg 2010; Landstra et al. 2013). ...
... secure, avoidant, anxious) is proposed to shape individuals' response to bereavement, particularly regarding the loss of their attachment figure. For example, avoidant attachment is characterized by a lack of trust in others, compulsive independence, and tendency to avoid attachmentrelated emotions; following bereavement, these individuals are likely to suppress grief in favor of restoration-oriented actions (Stroebe et al. 2005). By contrast, anxiously attached individuals experience difficulty coping with attachment-related feelings, and tend to be loss-oriented, preoccupied and emotional in bereavement (Stroebe et al. 2005). ...
... For example, avoidant attachment is characterized by a lack of trust in others, compulsive independence, and tendency to avoid attachmentrelated emotions; following bereavement, these individuals are likely to suppress grief in favor of restoration-oriented actions (Stroebe et al. 2005). By contrast, anxiously attached individuals experience difficulty coping with attachment-related feelings, and tend to be loss-oriented, preoccupied and emotional in bereavement (Stroebe et al. 2005). Both avoidant and anxiously attached individuals thus show less psychological flexibility than securely attached individuals (Cohen and Katz 2015), impeding oscillation between grief processes. ...
Objectives
This paper focuses on the experiences of bereavement guilt among young adults bereaved by a caregiver’s cancer, examining associations with attachment style, experiential avoidance, and psychological flexibility with the aim of informing psychosocial interventions for this population.
Methods
Ninety-seven young adults (18–25 years) bereaved by a parent/guardian’s cancer completed an online survey, including measures of bereavement guilt, attachment style, experiential avoidance, and psychological flexibility. Mediation analyses explored the associations between attachment style (anxious, avoidant) and bereavement guilt, and if these associations were mediated by experiential avoidance or psychological flexibility.
ResultsBereavement guilt was significantly positively associated with anxious, but not avoidant, attachment to the deceased; the relationship between anxious attachment and bereavement guilt was partially mediated by experiential avoidance. Bereavement guilt was also negatively associated with psychological flexibility and engagement with bereavement counseling.
Significance of resultsGiven the limited literature on cancer-related bereavement in young adulthood, this study offers important theoretical and clinical insights into factors associated with more complex aspects of grief in this population. Specifically, this work identified that anxious attachment is associated with ongoing bereavement complications in the years following the death of a caregiver to cancer, with experiential avoidance partially mediating this relationship. While further research is needed to better understand the interaction between these factors and other related constructs, such as psychological flexibility, these findings may be helpful in selecting therapeutic approaches to use with this population.
... Since the seminal work of John Bowlby (1980), attachment, a biopsychosocial motivational system affecting how we relate to others, has been firmly on the map as a potential determinant of bereavement outcomes. It is a cornerstone to many prominent theories on coping with bereavement and prolonged grief (e.g., LeRoy et al., 2019;Maccallum & Bryant, 2013;Shear & Shair, 2005;Stroebe et al., 2005) and forms the basis for psychological treatments, e.g., attachment-informed grief therapy (Kosminsky & Jordan, 2016). In brief, attachment theory holds that an infant's relationship with their primary caregiver influences their attachment relationships later in life (Bowlby, 1973). ...
... In line with these theoretical notions, insecure attachment styles are proposed to be a risk factor of severe and persistent grief reactions across a wide range of prominent (prolonged) grief models (e.g., Shear & Shair, 2005;Stroebe et al., 2005;Maccallum & Bryant, 2013;Mikulincer & Shaver, 2022), which form the basis for bereavement care (e.g., Kosminsky & Jordan, 2016;Newsom et al., 2017;Shear et al., 2016). Across grief models, insecure attachment is presumed to contribute the persistence of severe grief reactions, via different proposed mechanisms. ...
... Taken together, the results from this systematic review confirm that attachment insecurity relates to prolonged grief, but contradict the central premise of theories of (prolonged) grief suggesting that attachment insecurity plays a causal role in the persistence of severe grief reactions (e.g., Maccallum & Bryant, 2013;Shaver & Tancredy, 2001;Shear & Shair, 2005;Stroebe et al., 2005). Nevertheless, attachment anxiety appears important to consider as a determinant of the effects of grief therapies (Schmidt et al., 2022). ...
Diagnoses characterized by severe, persistent and disabling grief have recently been added to the ICD-11 and DSM-5-TR as prolonged grief disorder. Adult attachment is widely assumed critical in the development, persistence, and treatment of prolonged grief, yet a meta-analysis on this topic is lacking. We conducted a systematic review (PROSPERO: CRD42021220511) searching PsycInfo, Web of Science, and PubMed (final search: August 2022) to identify and summarize quantitative research examining relationships between adult attachment (i.e., attachment anxiety, attachment avoidance, secure attachment, disorganized attachment) and prolonged grief symptoms. Thirty-one studies including 8347 bereaved adults were included. Attachment anxiety (r = 0.28, 95 % CI:0.23-0.32, k = 15) and attachment avoidance (r = 0.15, 95 % CI:0.05-0.26, k = 15) related positively to prolonged grief symptoms concurrently. We found no evidence of publication bias but did detect heterogeneity in effect sizes. Ten longitudinal analyses showed no evidence that insecure attachment styles increase prolonged grief symptoms. Attachment anxiety predicted better therapy outcomes. Insecure attachment styles are concurrently positively related to prolonged grief symptoms but do not increase grief severity. The role of adult attachment in contemporary grief theories may need reconsideration. Intensive longitudinal research should aim to clarify how dynamic changes in attachment to the deceased and others relate to changes in prolonged grief symptoms.
... Attachment theory has emerged as one of the primary paradigms for understanding adjustment to grief (Shaver & Fraley, 2008;Stroebe et al., 2005). The loss of a loved one through death is an event that triggers activation of the attachment system, giving rise to emotional and behavioural responses that serve to relieve distress through seeking proximity to others. ...
... The Dual Process Model suggests that being stuck in grief may be due to an individual focusing heavily on either loss-or restoration-oriented coping, with a lack of balanced oscillation (Stroebe & Schut, 1999). Stroebe et al. (2005) suggest that an individual's attachment orientation may underlie the 'stuckness' that characterises complicated grief. Stroebe et al. (2005) propose that individuals high in attachment anxiety may be focusing more on loss-oriented coping, and intervention may therefore be most beneficial if the bereaved person is supported to direct their attention towards restoration-focused tasks. ...
... Stroebe et al. (2005) suggest that an individual's attachment orientation may underlie the 'stuckness' that characterises complicated grief. Stroebe et al. (2005) propose that individuals high in attachment anxiety may be focusing more on loss-oriented coping, and intervention may therefore be most beneficial if the bereaved person is supported to direct their attention towards restoration-focused tasks. Bereaved individuals high in attachment avoidance on the other hand, may well be suppressing lossorientation needs, and thus therapy may specifically facilitate an individual to attend to the loss within the context of a supportive therapeutic relationship. ...
Attachment insecurity, including attachment anxiety and attachment avoidance, is proposed as a key factor disrupting adaptive recovery following bereavement, resulting in complicated grief. However, findings are inconsistent across studies. This review aimed to synthesise existing research on attachment patterns in adults experiencing complicated grief to better understand this relationship. 22 cross-sectional and lon- gitudinal studies (5149 participants), published between 2003 and 2020, met inclusion criteria. Higher levels of attachment anxiety were consistently associated with symptoms of complicated grief. Higher levels of attachment avoidance were associated with symptoms of complicated grief, although this relationship was less consistent. The review has implications for clinical practice as bereaved adults with insecure attach- ment histories may be particularly vulnerable to experiencing complicated grief. The research is limited by the reliance on mainly cross-sectional studies. Future research should focus on longitudinal studies, and studies that explore men’s experiences, and of individuals living in non-Western countries.
... Attachment theory has emerged as one of the primary paradigms for understanding adjustment to grief (Shaver & Fraley, 2008;Stroebe et al., 2005). The loss of a loved one through death is an event that triggers activation of the attachment system, giving rise to emotional and behavioural responses that serve to relieve distress through seeking proximity to others. ...
... The Dual Process Model suggests that being stuck in grief may be due to an individual focusing heavily on either loss-or restoration-oriented coping, with a lack of balanced oscillation (Stroebe & Schut, 1999). Stroebe et al. (2005) suggest that an individual's attachment orientation may underlie the 'stuckness' that characterises complicated grief. Stroebe et al. (2005) propose that individuals high in attachment anxiety may be focusing more on loss-oriented coping, and intervention may therefore be most beneficial if the bereaved person is supported to direct their attention towards restoration-focused tasks. ...
... Stroebe et al. (2005) suggest that an individual's attachment orientation may underlie the 'stuckness' that characterises complicated grief. Stroebe et al. (2005) propose that individuals high in attachment anxiety may be focusing more on loss-oriented coping, and intervention may therefore be most beneficial if the bereaved person is supported to direct their attention towards restoration-focused tasks. Bereaved individuals high in attachment avoidance on the other hand, may well be suppressing lossorientation needs, and thus therapy may specifically facilitate an individual to attend to the loss within the context of a supportive therapeutic relationship. ...
Attachment insecurity, including attachment anxiety and attachment avoidance, is proposed as a key factor disrupting adaptive recovery following bereavement, resulting in complicated grief. However, findings are inconsistent across studies. This review aimed to synthesise existing research on attachment patterns in adults experiencing complicated grief to better understand this relationship. 22 cross-sectional and longitudinal studies (5149 participants), published between 2003 and 2020, met inclusion criteria. Higher levels of attachment anxiety were consistently associated with symptoms of complicated grief. Higher levels of attachment avoidance were associated with symptoms of complicated grief, although this relationship was less consistent. The review has implications for clinical practice as bereaved adults with insecure attachment histories may be particularly vulnerable to experiencing complicated grief. The research is limited by the reliance on mainly cross-sectional studies. Future research should focus on longitudinal studies, and studies that explore men’s experiences, and of individuals living in non-Western countries.
... Participants were asked to imagine the support seeker was a friend expressing bereavement over the loss of their best friend and a desire to talk with someone about it. Bereavement was chosen as the context for the study because it is an emotional stressor (Stroebe et al., 2005) for which individuals seek support via both SNSs (Meng et al., 2017;Rossetto et al., 2015) and OSGs (Sofka, 2009). Communication channel was varied in two ways: participants were exposed to a support-seeking message sent via either Facebook or an OSG. ...
... Further research is necessary to understand how contextual factors of online spaces influence noncollege-aged online users. Finally, this study focused specifically on bereavement as a stressor due to its use within previous work (Swartwood et al., 2011;Sofka, 2009;Stroebe et al., 2005). How this stressor may have influenced the results of the study should be tested in future research. ...
This study examined how contextual factors influence support providers’ motivations and message provision. Participants (N = 602) provided supportive messages in response to support-seeking posts sent either publicly or privately through either Facebook or an online support group. Findings revealed that providers’ motivations and message provision varied as a function of the channel and privacy of communication. Moderated mediation analyses showed that privacy moderated the indirect effect of channel on verbal person-centered message provision through approach motivation. This project advances extant understanding regarding direct and indirect effects of contextual factors and motivations on the quality of supportive messages people produce.
... This is in line with what Cupit et al. (2022) said that individuals who feel close to the person who died will be greatly affected by the death in various aspects of their lives. Widow(er)s must cope with practical challenges such as living alone or managing the household tasks previously carried out by their spouse (restoration-oriented), and the emotional distress associated with the death (loss-oriented) (Stroebe et al., 2005). ...
... According to the research conducted by Sari & Wardhana (2015), there are challenges or problems that arise in individuals or women after the death of a partner, namely a decrease in physical condition, an unfavorable societal stigma about a widow, the need for a partner figure, financial problems, and their responsibility in taking care of children alone. They must cope with practical challenges such as living alone or managing the household tasks previously carried out by their spouse (restoration-oriented), and the emotional distress associated with the death (loss-oriented) (Stroebe et al., 2005). Given the number of stressors surrounding widowhood, the coping strategies used may be highly consequential for widow's mental health. ...
This study aimed to describe the grieving process in women mourning for their husbands. This research uses a qualitative design with a phenomenological approach. The subjects consisted of three people, taken through purposive sampling technique with certain criteria. Data collection was carried out using in-depth interviews through interview guidelines made (semi-structured). At the initial stage, data reduction was carried out, then analyzing and presenting data and coding the interview transcripts. This study showed that the three respondents in this study had a positive view of their deceased husbands even though the loss was caused by different things. Their initial response after hearing the sad news was almost the same, namely shock and crying. After that, they tried to adjust and move on with their lives. Although they still feel a sense of longing, they are getting used to their new lives. Regarding the culture of remarriage, they are aware of it, but the subjects prefer to focus on the happiness of the children and let life go on over time.
... According to the Children Act 1989, it is anticipated that care in foster homes is internationally accepted and is preferable than group care (Homes, 1993). Bereavement referred to psychiatric complications in parenting styles and attachment patterns in childhood are related to the attachment patterns later in adulthood (Stroebe, Schut, & Stroebe, 2005). Apparently, it is acceptable that the theory underpinning most impactful research on bereavement is Bowlby's attachment theory. ...
... Avoidant of attachment and experiencing persistent difficulties may result in the expression of grief. During bereavement, the lack of trust coupled with a disorganized attachment, may resulted in high scores of depression, panic/anxiety, and substance used (Stroebe et al., 2005) when assessed. Bowlby had relied and explained on the experiences of childhood bereavement and the reactions following it during adulthood. ...
The loss of a caregiver or loved one is a tragic moment, which can have psychosocial impact on a child. Children inside institutions either in foster or residential care are prevalence to the experience of neglect and parental loss bereavement. Bereavement endures a variety of factors that influence negatively on child mental health. The purpose of this concept paper is to explain noteworthy contributions with regards to information on bereavement among children and their psychosocial problems in institutions and residential cares. The attachment theory is significant to explain the association of bereavement and institutions, which supported the evidence that bereavement among vulnerable population inside institution, are at high risk of social deterioration. The theory implies a cause-effect relationship between early attachments. Children are potentially psychologically affected by any traumatic events, which caused them to experience prolong mental developmental delay that are associated with different psychological disorders. Institutionalized children can easily become victim of their psychosocial inability to defend themselves from ruthless violence. Research had examined the differentiating factors of certain symptoms in normal grief and bereavement within the context of depressive disorders, including self-guiltiness, death thoughts, maltreatment, and worthlessness. Experiences of bereavement may occur over the loss, which then shifted to transient withdrawal. Parental loss is one of the most extreme social deprivations that a child can experience Therefore responses to parental loss may be age-specific, related to temperament and to culture. The literature indicated that bereavement in institutional settings has the potential to cause significant risks of mental health with the most prevalent impact related to psychological issues. To cope with the consequences of child maltreatment, prolonged effective interventions should be encouraged. Noteworthy, studies related to bereavement and stress to explain the psychological health issues of children due to parental loss in institutional care are limited, especially within the context of developing countries.
... According to the Children Act 1989, it is anticipated that care in foster homes is internationally accepted and is preferable than group care (Homes, 1993). Bereavement referred to psychiatric complications in parenting styles and attachment patterns in childhood are related to the attachment patterns later in adulthood (Stroebe, Schut, & Stroebe, 2005). Apparently, it is acceptable that the theory underpinning most impactful research on bereavement is Bowlby's attachment theory. ...
... Avoidant of attachment and experiencing persistent difficulties may result in the expression of grief. During bereavement, the lack of trust coupled with a disorganized attachment, may resulted in high scores of depression, panic/anxiety, and substance used (Stroebe et al., 2005) when assessed. Bowlby had relied and explained on the experiences of childhood bereavement and the reactions following it during adulthood. ...
The loss of a caregiver or loved one is a tragic moment, which can have psychosocial impact on a child. Children inside institutions either in foster or residential care are prevalence to the experience of neglect and parental loss bereavement. Bereavement endures a variety of factors that influence negatively on child mental health. The purpose of this concept paper is to explain noteworthy contributions with regards to information on bereavement among children and their psychosocial problems in institutions and residential cares. The attachment theory is significant to explain the association of bereavement and institutions, which supported the evidence that bereavement among vulnerable population inside institution, are at high risk of social deterioration. The theory implies a cause-effect relationship between early attachments. Children are potentially psychologically affected by any traumatic events, which caused them to experience prolong mental developmental delay that are associated with different psychological disorders. Institutionalized children can easily become victim of their psychosocial inability to defend themselves from ruthless violence. Research had examined the differentiating factors of certain symptoms in normal grief and bereavement within the context of depressive disorders, including self-guiltiness, death thoughts, maltreatment, and worthlessness. Experiences of bereavement may occur over the loss, which then shifted to transient withdrawal. Parental loss is one of the most extreme social deprivations that a child can experience Therefore responses to parental loss may be age-specific, related to temperament and to culture. The literature indicated that bereavement in institutional settings has the potential to cause significant risks of mental health with the most prevalent impact related to psychological issues. To cope with the consequences of child maltreatment, prolonged effective interventions should be encouraged. Noteworthy, studies related to bereavement and stress to explain the psychological health issues of children due to parental loss in institutional care are limited, especially within the context of developing countries.
... Furthermore, the women in this study were more vulnerable to trauma situations. This is supported by research that women are more sensitive to traumatic experiences (Stroebe et al., 2005;Rzeszutek et al., 2017). Dell'Osso et al. (2012) also reported that women significantly higher PTSD prevalence rates and post-traumatic spectrum symptoms than men. ...
... The sensitivity of women causes the emergence of self-brooding rumination) and a lack of thinking about self-reflective rumination (Lund et al., 2010). Furthermore, Stroebe et al. (2005) allude to the tendency of men to be oriented toward cognitive activity, so that this allows men to be more adaptive in dealing with trauma and lead to growth. ...
COVID-19 has brought a massive psychological impact on individuals' life. The current study sets a significant purpose to test the model whether post-traumatic stress and coping strategies affect stress-related growth regarding the COVID-19 event. One hundred and ninety-nine participants have participated in an online survey in the period of lockdown. The proposed hypotheses model is further tested using PLS-SEM. The first model explains a significant moderate, 46% amount of variance for stress-related growth. With gender as moderator, the second model explains a significant 29% amount of variance for stress-related growth, which is also moderate. This study shows that active coping strategies and positive affirmation significantly influence individual stress-related growth. The trauma event (COVID-19) does not significantly affect growth. Women experience trauma compared to men, besides active coping with the COVID-19 situation is higher in men than women. Using the Bio-centric perspective, having a positive connection through acceptance and awareness of the situation, self-care, and affective interaction with others would develop growth regarding traumatic situations. Further, interventions about coping skills and positive affirmations are essential to give, especially to vulnerable groups such as women.
... 64 By contrast, good quality relationships can ease the bereavement. 16 Stroebe et al. 16 argue that former research on attachment [65][66][67] shows that good relational quality between a dying patient and a bereaved importantly influences the outcome for the bereaved. The hypothesis that different coping styles intensify relational challenges between persons with ALS and their family carers 48 strengthens our argument that healthcare professionals have a responsibility to provide early support to persons with ALS and their family carers, if necessary, providing separate and individual support. ...
Background
Amyotrophic lateral sclerosis (ALS) can lead to emotional and psychological distress between persons with ALS and their family carers. Many persons with ALS develop cognitive impairment, which limits their ability to process complex information, interact, and communicate. This cognitive decline adds to caregiver burden. Few studies have explored interpersonal relations between persons with ALS and their family carers.
Aim
To better understand how ALS-associated cognitive impairment influences close relations.
Methods
Individual semi-structured in-depth, interviews were conducted once, with four persons with ALS and four family carers. Reflexive thematic analysis was used.
Results
Increased distance of close relations was identified as the overarching theme. Differences and similarities within the data were identified according to the two main themes. The first main theme, Everyday life together but apart: a demanding role to play, was structured according to three subthemes: Keeping the façade of civility, Demanding daily interaction and communication, and Taken for granted changes in everyday roles. The second main theme, Coping with a lost future, was structured according to the two subthemes, Striving to live in the normal present, and Holding on to self.
Conclusions and significance
Cognitive impairment following ALS can lead to increased relational distance between persons with ALS and their family carers. To ease their burden, professionals should recognize person with ALS’ and family carers’ relational issues and grief at an early stage. Focusing on their occupational identity and valued occupations that are still-accessible may help persons with ALS and family carers regain meaning in everyday life.
... These studies have reported innovative digital behaviors such as continuing bonds online or the expression of emotions and feelings through online platforms. Continuing bonds has been defined as ''the presence of an ongoing inner relationship with the deceased person by the bereaved individual'' [9] and has been showed to be associated with positive experiences in most people bereaved by suicide. In a recent systematic review [10], women bereaved by suicide were reported to create more online memorials than males and, conversely, men appeared to engage more in avoidant coping strategies and would express their grief less openly. ...
Background
According to recent research, the Internet and social media are shaping and changing how we die and mourn. However, the use of social media after bereavement by suicide remains poorly understood. Thus, emerging research is needed to better assess the role that social media can play after bereavement by suicide. The objective of our study was to evaluate the use of social media in French people bereaved by suicide and to assess their expectations toward social media.
Method
We conducted a national cross-sectional online survey including French people bereaved by suicide assessing their use of social media after the death of their relative. All adults bereaved by suicide were eligible to participate in the study. An online 26-item questionnaire collected sociodemographic and loss-related characteristics and evaluated four dimensions: (1) the use of social media in daily life, (2) the perceived needs regarding suicide bereavement, (3) the use of social media associated with the suicide loss, and (4) the expectations regarding the development of an online resource for people bereaved by suicide and proposals regarding the development of such a resource.
Results
Among 401 participants, 61.6% reported using social media after the death of their relative by suicide, especially those recently bereaved, those receiving counseling and bereaved parents. The participants mainly used social media to reach peers bereaved by suicide and to memorialize, while they expected social media to help them finding information on suicide and accessing bereaved peers. Younger participants were more prone to use social media to memorialize, while bereaved partners and those bereaved by the suicide of a parent were less prone to use them with such aim.
Discussion
A large part of people bereaved by suicide use social media for their grief process, mainly to contact peers bereaved by suicide and to memorialize their loved one. According to or results, social media contributes to contemporary grief processes after suicide bereavement and can be seen as putative means to improve the well-being of people bereaved by suicide.
... On one hand, the death of a child entails the profound loss of a beloved family member, often resulting in a rupture in intimacy and attachment. This experience is frequently accompanied by intense emotions, such as profound sadness and enduring suffering, which may not significantly diminish over time (Harper et al., 2014;Rogers et al., 2008;Stroebe et al., 2005). On the other hand, the loss of the child also signifies the relinquishment of the parental role, which can inflict substantial harm on the parent's sense of self-identity, leading to a significant psychological burden (Jetten et al., 2002;Zheng & Lawson, 2015). ...
Child loss is recognized as a risk factor for Chinese older adults' mental health, yet the differential impact and protective factors related to this association are not fully understood. This study examines potential differences in the effects of the deceased child's gender and only-child status, as well as the moderating role of community care service. Data is collected from a sample of 9686 Chinese older adults through the 2018 China Longitudinal Aging Social Survey. The results indicate that the loss of a son has a more significant impact on depressive symptoms among Chinese older adults than the loss of a daughter. The effect of child loss on depressive symptoms is not related to being an only child. Furthermore, community care service can buffer the negative impact of child loss on depressive symptoms. This study holds significant practical implications for enhancing the mental health of bereaved older adults.
... People with avoidant attachment suppress 2 -PELEG ET AL. their feelings of pain and delay asking for support (Mikulincer & Shaver, 2007). Attachment theory has emerged as one of the primary paradigms for understanding adjustment to grief (Shaver & Fraley, 2008;Stroebe et al., 2005). The death of a primary caregiver in youth is almost always a traumatic event for children because their sense of self is inseparable from the attachment figures they rely upon for a sense of security. ...
This study aimed to examine attachment and adult separation anxiety (ASA) among women who lost a parent in their youth. We hypothesized that insecure attachment and increased ASA from a romantic partner would be found among women who have lost a parent in youth, compared to women whose parents were both alive. Sixty women who lost one or both parents in their youth and 60 who had living parents participated in the study (mean age: 32.3, range: 18–62 years). Participants filled out the ASA and Short Attachment questionnaires. Women who lost a parent reported higher levels of anxious attachment and ASA from partner; the two groups did not differ, however, in terms of avoidant attachment. Additionally, similar effects on ASA and attachment were found among adult women who lost a father or a mother in their youth. In conclusion, the loss of a parent early in life may be associated with an insecure attachment style and increased ASA.
... Regarding hypothesis 2, it has been confirmed that the Fand M-REC, and empathetic communication at the time of loss predict a secure attachment. Although scientific literature had shown that insecure attachment plays a pivotal role in the development of CG (Lobb et al., 2010;Stroebe et al., 2005;Vanderwerker et al., 2006), our findings show that the experience of parents' support in the time of grief may become a milestone for the development of a secure attachment with them. Childhood experiences of maternal sensitive care are internalised in the Internal Working Models (MOI) of the attachment figures, constituting a crucial bridge between a child's experience and later relationships (Bowlby, 1980). ...
The perception of the caregiver as a haven of safety in painful times is crucial for the development of a secure attachment style. The goal of this study is to retrospectively investigate the association of recalled emotional closeness to parents at the time of loss (REC) and how the news of loss was broken (HOW) with adult Complicated Grief and attachment style in 273 adults who lost a beloved person in childhood, using inventories of Complicated Grief and Parent and Peer Attachment, REC scale and an open-ended questionnaire on the circumstances of death. Data evidenced that REC and HOW scores in the experience of loss in childhood predicted less complicated grief and more secure attachment in the present.
... 16 Our findings suggest that healthcare teams should focus on helping patients and their carers maintain a close relationship as the disease progresses. Stroebe et al. 16 argue that former research on attachment [54][55][56] shows that good relational quality between a dying patient and a bereaved importantly influences the outcome for the bereaved. Since good relations, high quality of life, effective coping, and resilience in severe illness 20 are important, healthcare professionals need to provide helpful preventive and supportive procedures to address relational issues at an early stage. ...
Background: Amyotrophic lateral sclerosis (ALS) can lead to emotional and psychological distress between patients and their family carers. Many people with ALS develop cognitive impairment, which limits their ability to process complex information, interact, and communicate. This cognitive decline adds to caregiver burden. Few studies have explored interpersonal relations between people with ALS and their carers.
Aim: To better understand how ALS-associated cognitive impairment influences close relations.
Methods: Individual semi-structured in-depth, interviews were conducted once, with four patients and four family carers. Thematic analysis was used.
Results: Increased distance of close relations was identified as the core theme. Differences and similarities within the data were identified according to the subthemes, (1) Everyday life together but apart: a demanding role to play, and (2) Coping with a lost future: living in the ‘normal’ present and searching for hope through a well-lived life.
Conclusions and significance: Cognitive impairment following ALS can lead to increased relational distance between patients and their family carers. To ease their burden, professionals should recognize patients’ and carers’ relational issues and grief at an early stage. Focusing on their occupational identity and highly valued occupations that are still-accessible may help patients and carers regain meaning in everyday life.
... This research into the significance of art therapy in bereavement counselling acts as a valuable contribution as a protocol because bereavement memorial protocols are available but limited in the current literature (Garti & Bat Or, 2019). Schut and Stroebe (2005) discuss the lack of qualitative research, as bereavement is considered a 'natural' phenomenon. Both argue that natural grief processes should be allowed to unfold with no intervention except for persistent complex grief interventions (Hall, 2014;Garti & Bat Or, 2019). ...
Art therapy in South Africa has focused on counselling and grief work but not on modelling a persistent complex bereavement memorial protocol as a viable alternative to traditional bereavement counselling. This article addresses this gap in practice and literature in the following ways: Investigating an organically modelled and observed bereavement process reflected in the form of interviews. Analysing the literature that will support this hypothesis, consider how this art-based therapeutic bereavement memorial protocol can provide a viable alternative to traditional bereavement counselling. Investigating how the use of art materials in the form of clay-work in this research can support healing and a safe place to process persistent complex grief processing. The methodology of this article is a qualitative arts-based inquiry extracting the information of an organically modelled process observing two bereavement case studies of two mothers processing persistent complex grief through the action of using the clay processing to the attachment onto a surface, creating bereavement artworks as memory capsules to support their unique mourning processes. The time frame of two years of observing, recording and creating a thematic analysis and synthesis is likened to the mourning process of persistent complex grief. Using a supporting psychodynamic investigation from an extensive literature review enables a unique art therapy bereavement protocol that could be used as an alternative to traditional grief and bereavement counselling. Furthermore, through the action of clay-work with an extension to paper collage to ‘piece together’ memories integrating the loss of a loved one into a life without them.
... For example, it is unclear whether the ICD-11 (World Health Organization, 2012) category for PGD conceptualises complicated grief as a homogenous diagnosis, or whether there are sub-categories relating to traumatic grief or traumatic loss. Stroebe et al. (2005) have made a case for complicated grief to be considered separately from traumatic grief. They contend that the distinction between the two relates to the theoretical underpinnings unique to each condition. ...
... The death of a child is often considered to be the most devastating type of bereavement (Engelkemeyer & Marwit, 2008). Theories about bereavement underscoring grief (Arnold & Gemma, 2008;Harper et al., 2014), attachment (Klass, 1997;Stroebe et al., 2005), life transitions (Kachoyeanos & Selder, 1993), ongoing bonds (Foster, 2009), and constructed meanings (Lichtenthal et al., 2010) help to enhance the understanding of the bereavement experience which is complex, individualized and potentially lifelong. ...
Objectives: This study aims to examine the relationship between child loss and depression among middle-aged and older adults in China and whether this relationship changes over time.
Methods:Data were derived from the four waves of the China Health and Retirement Longitudinal Study (2011-2018). Depressive symptoms were measured repeatedly using the 10-item Centre for Epidemiologic Studies Depression Scale (CES-D-10). Child loss included the bereavement experience, number, sex, and duration. Multilevel linear regression modelling was used.
Results:CES-D-10 scores were 1.04 higher among parents who lost their children. In contrast to parents with only deceased daughters, parents with only deceased sons or both deceased sons and daughters scored 0.67 or 1.28 higher, respectively. However, the number of deceased children was not associated with depression. the depression level gradually decreased with time and significantly higher among those who lost their children within one year to four years but this association was not significant after four years.
Discussion:Child loss was associated with long-term depression among parents. However, these associations were heterogeneous for specific bereavement types. Efforts should be made to strengthen the psychological care to bereaved middle-aged and older adults.
... Bowlby was also the first to maintain that there is a relationship between a person's attachment history and how he or she will react to the loss of a loved one. For example, children who endured frequent separations from their parents may form anxious and highly dependent attachments as adults and may react with intense and prolonged grief when a spouse or partner dies (see Shaver and Tancredy (2001), or Stroebe et al. (2005), for a more detailed discussion). Because it provides a framework for understanding individual differences in response to loss, Bowlby's attachment model has continued to be influential in the study of grief and loss (Shear et al. 2007). ...
... Puisque ses tentatives de retrouver le défunt sont infructueuses, l'endeuillé devrait peu à peu désinvestir le lien et les symptômes de deuil devraient diminuer, et ce jusqu'à ce que l'endeuillé retrouve finalement son fonctionnement habituel . Surtout, différents types d'attachement peuvent influencer la facilité et les méthodes employées pour composer avec la perte du lien Stroebe et al., 2005a;, Yu et al., 2016Zech et Arnold, 2011). ...
La mort assistée ou aide médicale à mourir étant débattue et légalisée dans de plus en plus de pays et régions, notamment au Québec, le contexte du mourir en Occident semble en mouvance. Puisque la légalisation de cette pratique introduit un nouveau soin de fin de vie, de nombreuses personnes doivent désormais faire le choix entre mourir « naturellement » ou par aide médicale à mourir; un choix important susceptible de teinter le deuil des proches du défunt. La présente thèse porte un regard sur ces expériences de deuil en contexte d’aide médicale à mourir ou de mort naturelle accompagnée de soins palliatifs, et ce afin de déterminer les similitudes et différences dans le vécu des endeuillés, ainsi que le rôle des influences interpersonnelles (des relations avec autrui) dans ce même vécu.
Dans le premier article de la thèse, les expériences de deuil sont directement comparées par l’entremise d’une recherche à devis mixte. L’échantillon se compose de 60 endeuillés ayant rempli des questionnaires mesurant des symptômes de deuil (25 endeuillés en contexte d’aide médicale à mourir et 35 en contexte de mort naturelle), desquels 16 ont pris part à des entrevues de recherche individuelles. Les résultats quantitatifs mettent en lumière l’absence de différences statistiquement significatives entre les deux populations. Les conséquences des deux contextes de fin de vie sur l’intensité du deuil s’avèreraient donc similaires. De plus, les scores ne suggèrent pas de complications du deuil, ce qui peut sous-entendre que l’aide médicale à mourir et la mort naturelle ne contribuent pas de prime abord à rendre l’expérience du deuil davantage éprouvante. Les résultats qualitatifs sont nuancés : des « empreintes » négatives et positives (concernant la distance temporelle et le symbole du héros) peuvent colorer l’expérience dans les deux contextes. Bien que les morts naturelles et médicalement assistées semblent généralement toutes deux ne pas avoir un impact foncièrement négatif sur le processus de deuil, il demeure qu’elles peuvent produire des vécus plus difficiles lorsqu’en interaction avec d’autres facteurs de risques.
Dans le deuxième article, le concept du paysage relationnel est utilisé afin d’informer des conclusions à l’égard des facteurs interpersonnels à l’oeuvre dans le deuil. Les résultats présentés sont basés sur les 16 entrevues individuelles conduites auprès d’endeuillés et prennent la forme d’un modèle interprétatif permettant de décrire cinq types d’acteurs dans l’environnement de l’endeuillé (le défunt, les co-endeuillés, les aidants, les antagonistes et les personnages secondaires) et leurs manières « d’être avec » et de « laisser seul ». Le modèle comprend également quatre paysages vécus décrivant la manière dont le deuil se vit en lien avec l’environnement social (se sentir entouré, se sentir seul et loin, se sentir assiégé et se sentir investi d’un message). Le modèle interprétatif du paysage relationnel permet de s’attarder aux similitudes entre les défis relationnels du deuil par aide médicale à mourir et du deuil par mort naturelle, ainsi qu’au rôle d’autrui.
L’intégration des différents résultats nourrit des réflexions sur la création de sens, la compréhension de la souffrance en fin de vie, la temporalité, la culture, de même qu’à l’égard du poids relatif des circonstances d’une mort anticipée dans l’expérience du deuil des proches. L’accompagnement de la mort et du deuil en Occident à l’ère de la mort assistée est abordé sur la base des différents constats issus de la thèse. Ces réflexions permettent de songer à de futures avenues de recherche et de penser la clinique du deuil. /
With assisted dying being debated and legalized in more countries and regions, including Quebec, the context of death in the Western world seems to be in flux. Since the legalization of this practice introduces a new type of end-of-life care, many individuals must now choose between dying “naturally” or with medical assistance in dying, an important choice that may affect the grief of the deceased’s loved ones. This thesis examines grief experiences in the context of medical assistance in dying or natural death with palliative care to determine the similarities and differences in the experiences of the bereaved persons and the role of interpersonal influences (relationships with others) on bereavement.
In the thesis’ first article, grief experiences are directly compared through a mixed design research study. The sample consists of 60 bereaved persons who completed questionnaires measuring grief symptoms (25 bereaved individuals in the context of medical assistance in dying and 35 in the context of natural death), of whom 16 participated in individual research interviews. The quantitative results show no statistically significant differences between the two populations. The consequences of the two end-of-life contexts on grief intensity would therefore appear to be similar. Furthermore, the scores do not suggest grief complications, which may imply that medical assistance in dying and natural death do not prima facie contribute to a more distressing grief experience. Qualitative findings are nuanced: negative and positive “imprints” (regarding temporal distance and the hero symbol) may colour the grief experience in both contexts. Although both natural and medically assisted deaths generally appear not to have an inherently negative impact on the grieving process, they can still produce more difficult experiences when interacting with other risk factors.
In the second article, the relational landscape concept is used to inform conclusions regarding the influence of interpersonal factors at work during bereavement. The results presented are based on the 16 individual interviews conducted with bereaved persons and take the form of an interpretive model describing five types of actors in the bereaved individuals’ environment (the deceased, co-bereaved, caregivers, antagonists, and secondary characters) and their ways of “being with” and “leaving alone”. The model also includes four lived landscapes describing how grief is experienced relative to the social environment (to feel open and visited, to feel alone and far away, to feel besieged, and to feel invested with a message). The relational landscape interpretive model allows us to focus on the similarities between the relational challenges of bereavement after a medical assistance in dying and after a natural death. It also sheds light on the role of others on one’s grief experience.
The different results are integrated to provide insights into meaning-making, the understanding of suffering at the end of life, temporality, culture, and the relative weight of an anticipated death’s circumstances on the grief experience. End-of-life and grief support within Western societies in the era of assisted dying is also discussed based on the thesis’ various findings. These reflections allow us to consider future research avenues and to elaborate on grief intervention.
... Ölen kişiyle ilişkinin kesilmesi talebinin ölülerin ruhuyla iletişim kurmakla ilgili kültür temelli inanç sistemlerini anormalize ettiği hâller özellikle rahatsızlık vericidir. Buradaki sorun, yas tutan herkesin kaybettiği nesnelerle olan bağı kesmesi gerektiği ve herkesin deneyiminin biricikliğine saygı duyup bu kişi için en uygun bağ kurma biçiminin ne olabileceğini düşünmekten ziyade ayrılık/kopmayla ilgili radikal yorumlarda diretmektedir (Stroebe, Schut & Stroebe, 2005). Bağın kopmasını talep etmek yerine geliştirilecek daha yardımcı ve insancıl bir yaklaşım, kalıcı bir ilişkiye, süregiden bağlara fırsat tanımak üzere kaybedilen kişi ya da nesnelerle olan ilişkiyi gözden geçirme, yeniden tanımlama veya değiştirme hususunda yaslı bireylere destek olmayı kapsar (Klass ve diğ., 1996). ...
Kayıp ve Yas İçin Danışmanlık Becerileri öncelikle farklı psikoterapi ortamında çalışan klinik süpervizörlerine ve danışma uzmanlarına ulaşmayı hedeflemiştir. Aynı zamanda, kayıp ve yas konularının yetersiz bir düzeyde ele alan (Humphrey, 1993) danışmanlık ve ilgili alanlardaki lisansüstü öğrencilerine değerli ve kullanışlı bir kaynak olacaktır. Burada ana hatları belirlenen stratejiler yetişkinler ve ergenler için daha uygundur ve temel olarak bireysel terapi seanslarını hedeflemektedir. Ancak bu stratejileri grup ve aile terapisi ortamlarında kullanmaya yönelik öneriler de verilmiştir. Belli konular ile ilgili çeşitli ek kaynak önerileri de metin boyunca verilmiştir.
... Il n'en demeure pas moins que le travail des empreintes peut être une stratégie à considérer pour revisiter la relation. Le lien d'attachement influençant le cours d'un deuil [27,28], un tel travail peut s'avérer indiqué (p. ex. ...
Les soignants en oncologie et en soins palliatifs gagnent à considérer les effets de l’euthanasie sur leur pratique. Choisir les circonstances de sa mort est dans l’ère du temps, ce qui influence les trajectoires de soins. Ainsi, il devient pertinent de s’intéresser à l’impact du décès anticipé (euthanasique ou naturel) à la fois sur l’accompagnement du patient et sur celui des proches endeuillés. À cet égard, nous proposons une approche relationnelle et des pistes d’intervention fondées sur les empreintes laissées par la mort et le paysage relationnel du deuil. / Oncology and palliative care professionals benefit from considering the effect of euthanasia on their practice. Choosing the circumstances of one’s death is the zeitgeist, which impacts care trajectories. It becomes relevant to examine the influence of anticipated death (euthanasia or natural death) both on the patient and bereaved loved ones’ experience. We propose a relational approach and grief interventions based on the imprints left by death and the relational landscape of bereavement.
... Relatedly, the experience of multiple, concurrent losses may be particularly difficult to cope with (e.g., Mercer & Evans, 2006). Reporting a difficult relationship history with the subject or object of loss has also been noted to make one's ability to work through grief potentially more difficult (e.g., Schulz et al., 2006;Schwarzer & Leppin, 1989;Stroebe et al., 2005). In this regard, the degree of relational closeness and role salience can complicate grief; not unexpectedly, when people lose relationships or roles that are important to them, the loss is often more difficult to overcome (Stroebe et al., 2006). ...
Grief – a physical, emotional, and psychological reaction to loss – reflects a fundamental human experience with significant implications for organizations. Although there is a voluminous research literature reflecting the complexity of grief, I argue more could be done to integrate existing work into organizational theory and practice. Grief is not a unidimensional construct and yet research suggests the ways in which organizations support grieving employees often fail to recognize the varieties of their experiences. Effective grief support therefore requires a better understanding of the complex interplay between the individual, interpersonal, organizational, and societal factors that shape the experience of loss. This paper embeds the multi-level forces that influence grief into a social-ecological framework and subsequently applies it to advance the idea that flexibility within social systems is needed to optimize support for grieving employees.
... Examples include holding on to the memory of the deceased, sensing the deceased's presence, keeping photographs of the deceased or his/her possessions, visiting the deceased's grave, and talking to and about the deceased (see Klass & Steffen, 2017;Root & Exline, 2014). Nonetheless, research stresses that continuing bonds are subjected to social and cultural influences (Khatib et al., 2020;Klass, 2006), as well as other factors such as attachment style (Stroebe et al., 2005), the quality of the relationship with the deceased prior to death and type of loss (Currier et al., 2015;Field et al., 2003). ...
The current study sheds light on the continuing bonds experience of adult Israeli daughters whose mothers were murdered by their fathers. Through 11 semi structured interviews, common externalized and internalized continuing bonds with the deceased mothers were closely examined. The interpreted results supported the existence of bonds, yet revealed a unique manifestation; the bonds were purposefully and defensively restricted, which seemed to be an adjustive compromise in light of the strong traumatic component of the loss. Our results contribute to the theoretical and clinical understanding of the restrictive effect that trauma components have on loss components in cases of traumatic bereavement.
... The current study findings, that grief symptoms were associated with IL-6 over and above depressive symptoms, add evidence to recent neuroscience developments suggesting that a unique neurobiological profile may exist for individuals experiencing extreme grief (Kakarala et al., 2020). In particular, the breaking of an attachment bond (i.e., the death of one's spouse; Stroebe et al., 2005) may partially explain the importance of grief symptoms over and above depressive symptoms after the death of a spouse. In adulthood, spouses play a critical role in maintaining physiological homeostasis (i.e., "coregulation"; Sbarra & Hazan, 2008, p. 143). ...
The death of a spouse is associated with maladaptive immune alterations; grief severity may exacerbate this link. We investigated whether high grief symptoms were associated with an amplified inflammatory response to subsequent stress among 111 recently bereaved older adults. Participants completed a standardized psychological stressor and underwent a blood draw before, 45 min after, and 2 hr after the stressor. Those experiencing high grief symptoms (i.e., scoring > 25 on the Inventory of Complicated Grief) experienced a 45% increase in interleukin-6 (IL-6; a proinflammatory cytokine) per hour, whereas those experiencing low grief symptoms demonstrated a 26% increase. In other words, high grief was related to a 19% increase in IL-6 per hour relative to low grief. The grief levels of recently bereaved people were associated with the rate of change in IL-6 following a subsequent stressor, above and beyond depressive symptoms. This is the first study to demonstrate that high grief symptoms promote inflammation following acute stress.
... Parental bereavement has traditionally been studied through the lens of grief (Arnold & Gemma, 2008;Harper et al., 2014), attachment (Klass, 1997;Stroebe et al., 2005), life transitions (Kachoyeanos & Selder, 1993), continuing bonds (Foster, 2009;Klass, 1993), and constructed meaning (Lichtenthal et al., 2010). These theories have helped us understand that the grief experienced by bereaved parents is complex, intense, individualized, and lifelong. ...
Outcomes
1. Learners will be able to value a need for interventions for bereaved parents
2. Learners will learn to appraise research articles using the GRADE method
Importance
The core function of pediatric palliative care (PPC) is to offer medical and psychosocial support for patients with serious conditions and their family during life and after. Despite increasing availability of PPC, bereaved parents have expressed a sense of abandonment from the healthcare system after their child has died. Bereaved parents have a higher risk of dying and a higher incidence of physical and mental conditions than the general population.
Objective(s)
To conduct a systematic literature review of studies involving bereaved parents’ health outcomes after the loss of a child from a chronic condition.
Method(s)
The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to rate the effectiveness of selected articles describing bereaved parents’ physical, social, and psychological health outcomes. We searched Medline via PubMed, CINAHL, and PsycINFO using search words related to our study purpose. A blinded screening of title and abstract was performed, with final inclusion decisions resolved through group discussions. Matrices for remaining articles were created. The levels of evidence of the final 36 articles or records were rated from very low to high based on the GRADE guidelines.
Findings
The initial search identified a total of 4,373 records after deduplication. During the initial title and abstract screening process, 4,266 records were excluded based on inclusion/exclusion criteria. A full-text review of 107 records eliminated 71 additional records that did not meet the inclusion criteria. Of the final 36 records, the GRADE values were 3, very low; 14, low; 16, moderate; and 3, strong evidence.
Conclusion(s)
The state of the science on bereaved parents’ health outcomes highlights the need for resources and interventions to address bereaved parents’ poor health.
Impact
This review provides evidence of the need for US population-based studies with an emphasis on evaluating minority bereaved parents’ health conditions.
... Also, it can facilitate the adaptation of mourning mothers by validating their maternal identity and promoting personal growth from this painful experience (Bellet et al., 2019;Casellato, 2018). Support from the social environment is an essential factor for coping with grief, as when it allows the mourner to receive support from the community in effective ways, it dismisses any complementary intervention (Parkes, 1988;Santos, 2017;Stroebe et al., 2005). These data also corroborate those found in our study, as they consider that, even though facing a traumatic situation such as losing a baby, it is possible to build a context of posttraumatic growth for these bereaved women (Lafarge et al., 2017(Lafarge et al., , 2020. ...
This study sought to identify the factors associated with the development and prevention of complicated grief in women who have lost a baby. This is a systematic review of scientific articles in the main mental health databases: MEDLINE (PubMed), EMBASE, Latin American and Caribbean Health Sciences Literature (LILACS), and APA Databases (PsycINFO). The selection and data extraction processes occurred independently and blindly by two authors, considering the eligibility criteria. The analysis included publications from 2013 to 2021 of observational studies with adult women who had experienced losing a baby (during pregnancy up to 2 years of life) and that employed standardized instruments to evaluate grief. From the 8,200 records found, 23 articles were selected for analysis. As risk factors, we identified the presence of mother’s psychopathology, history of gestational loss, and social pressure for a new pregnancy, while as protective factors, we identified the presence of another child other than the deceased one, the quality of specialized healthcare, and the social support provided by either a partner, community, or spiritual activities. Furthermore, the studies pointed to the event of losing a baby as an opportunity for posttraumatic growth. Although complicated grief is often associated with other mental health conditions, such as anxiety, depression, or posttraumatic stress, it is necessary to differentiate it for a clearer understanding of the complicated grief as a singular condition, to enable access to appropriate care for bereaved mothers and families, as well as to promote public policies which provide support to them.
... Parental bereavement has traditionally been studied through the lens of grief (Arnold & Gemma, 2008;Harper et al., 2014), attachment (Klass, 1997;Stroebe et al., 2005), life transitions (Kachoyeanos & Selder, 1993), continuing bonds (Foster, 2009;Klass, 1993), and constructed meaning (Lichtenthal et al., 2010). These theories have helped us understand that the grief experienced by bereaved parents is complex, intense, individualized, and lifelong. ...
Objective: The death of one’s child may negatively affect parental health. Existing models exploring parental bereavement do not provide sufficient frameworks to understand the complexities of health outcomes. The purpose of this study was to examine the health status of bereaved parents. Method: Cross-sectional retrospective study of bereaved parents whose children died at this hospital between 2002 and 2019. A study-specific demographic questionnaire, the National Institutes of Health Roadmap Patient-Reported Outcomes Measurement Information System (PROMIS) initiative. Depressive symptoms were assessed using the PROMIS v1.0 Emotional Distress–Depression—Short Form 8a ( Pilkonis et al., 2011 ). PROMIS measures (depressive symptoms, anxiety, applied cognitive functioning, physical functioning, sleep disturbance), and a measure of posttraumatic growth were mailed and included a link to self-enter data via Research Electronic Data Capture (REDCap, n.d. ) or return paper copies. Results: One hundred fifty surveys were returned (22% response rate). Mean participant age was 41.6 years ( SD = 10.3 years; 83% female). Participants’ health history responses show greater prevalence of depressive symptoms, anxiety, and sleep disorders after their child’s death. The largest difference on PROMIS measures was poorer physical function in the bereaved cohort than in the general population. There were no differences in PROMIS scores based on participant gender or on the presence of surviving siblings. Among those reporting smoking or alcohol consumption, qualitative data suggest that although some might increase use, such use might decrease over time. Conclusions: Bereaved parents manifest poorer psychological and cognitive functioning, and their physical functioning was substantially poorer than the general population mean. Bereaved parents may benefit from proactive guidance normalizing potential challenges to health status and behavior, including appropriate psychoeducational resources.
Implications for Impact Statement
Bereaved parents have poorer physical and mental health when compared with the general population. Clinicians that care for these parents must offer health promotion and disease prevention measures early to improve their long-term health outcomes.
... In relation to this, at least half of the study participants reported that fellow congregants and attending church had helped them come to terms with their loss. Other than support provision, Stroebe et al. (2005) posit that distraction from the loss is an important coping mechanism, as exclusive focus on the loss would be psychologically exhausting. Therefore, bereaved persons engage in adaptive grieving by oscillating between confronting and avoiding the loss through either focusing on the loss or "get[ting] on with other things" (Stroebe et al., 2005, p. 52) at different points of the grieving period. ...
Bereavement is a deeply personal experience that is also shaped by one’s socio-cultural context. This qualitative study explored the social support experiences and needs of spousally bereaved individuals in a South African township. The botho/ubuntu philosophical framework was used to interpret participants’ experiences in this regard. Six ethnically diverse, bereaved spouses aged 55–67years, residing in a predominantly Setswana-speaking township in the North West Province of South Africa, were interviewed. Thematic analysis was used to analyze the data. An indigenous knowledge consultant was interviewed to situate participant experiences pertaining to mourning rites and traditions within the indigenous socio-historical and contemporary cultural context. The following themes were identified: (i) Sources of social support during bereavement; (ii) Inadequate social support after spousal death; (iii) The need for grief counseling; and (iv) Social restrictions and systematic isolation during the traditional mourning period: “It is as if you smell.” Broadly, bereaved spouses drew on their support networks at various stages of their bereavement, which included family members, in-laws, friends, burial societies, their surrounding communities, and religious communities and figures. However, some experienced ostracization and stigmatization during the mourning period, which was invariably longer for the widows in this study, in line with conventions across Black South African cultures. Some participants reported withdrawal of support by their in-laws and harmful attitudes and assumptions rooted in patriarchal ideology by family members and in-laws. As pertaining to botho/ubuntu, the study also showed that communality or relationality entailed both positive and negative aspects, including support, co-operation, care, lack of support, stigmatization, and ostracization. Unlike conventional conceptualizations of botho/ubuntu, the study findings illustrate the human experience as comprising varying dimensions of relationality, ranging from harmony to disharmony. Findings regarding the negative aspects of communality are compatible with those relating to relational interdependence in African and East Asian settings. The findings also expand our understanding of the nature of disharmony alongside harmony in interdependent socio-cultural contexts.
... Reward is inherently a process by which learning develops, as one's predictions about the world are either rewarded or not, leading to accommodation and consolidation of information and future predictions. Those who develop PGD may have 1) a pre-existing reward system that strongly supports the anxiety and attention to the "everlasting" aspect of attachment as a diathesis (dependency [25], attachment style [26], and separation anxiety as predictors [27]). Attachment style may also be a diathesis for brain function [28], and may predict complications when layered with bereavement. ...
Recent grief research suggests that the influential cognitive stress theory should be updated with evidence from cognitive neuroscience. Combining human and animal neuroscience with attachment theory, we propose that semantic knowledge of the everlasting nature of the attachment figure, and episodic, autobiographical memories of the death are in conflict, perhaps explaining the duration of grieving and generating predictions about complications in prolonged grief disorder (PGD). Our Gone-But-Also-Everlasting model emphasizes that grieving may be a form of learning, requiring time and experiential feedback. Difficulties pre-loss, such as spousal dependency or pre-existing hippocampal volume, can prolong learning and predict PGD. Complications such as avoidance, rumination, and stress-induced hippocampal atrophy may also develop post-loss, and create functional or structural mechanisms predicting PGD.
This qualitative study examines the experiences of young bereaved siblings of Israeli security personnel. Through 26 semi-structured interviews with 12- to 21-year-olds who lost a sibling before age 21, the research reveals complex cognitive and emotional challenges within Israel’s unique context. Participants struggle with understanding death’s finality, managing intense emotions, and navigating altered family dynamics. Coping strategies vary, from maintaining routines to avoiding grief-related interactions. The study highlights a significant contrast between young bereaved siblings’ perspectives and those of adults, with siblings describing an ongoing struggle while maintaining hope for the future. They actively manage their identities, often rejecting societal labels and preferring informal support over formal interventions. These findings underscore the importance of recognizing young bereaved siblings’ distinct voices and can inform more effective support strategies within a national service context.
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 clarify the concurrent and longitudinal associations between these constructs. A sample of 225 bereaved Dutch adults (87% women; Mean age: 48.86 years) participated in a three-wave longitudinal survey including measures of attachment anxiety and attachment avoidance at baseline and prolonged grief symptoms at baseline and 6- and 12-month follow-up. Attachment anxiety and attachment avoidance were significantly positively correlated with prolonged grief symptoms at all time-points. However, multiple regressions, controlling for baseline symptoms, showed that attachment anxiety, attachment avoidance, and their interaction did not predict residual change in prolonged grief symptoms. These findings cast doubt on the proposed role of insecure attachment styles in prolonged grief.
Is it possible to interact with the dead? Belief in such encounters is more widespread than we might think. Yet sociologists, unlike other disciplines, have not fully engaged the question. Here, I review both long-standing theoretical objections to such research and recent theories that encourage attention to the issue. Leaning on the latter, I use closed- and open-ended survey data collected from 535 Americans to explore what I call “living-deceased perceived interaction.” My data show that nearly half of my study participants report meaningful and regular interactions with deceased relatives and friends who were important in their lives. I examine the characteristics of such interactions—how and when they are performed and what these experiences mean to respondents. I also investigate the role of one’s social location in initiating interactions with the dead. Finally, I explore the social benefits, if any, these interactions provide for individuals who engage in them.
This comprehensive, evidence-informed text provides clinicians, researchers, policy-makers and academicians, with content to inform and enrich the guidelines recommended by the National Consensus Project and the National Quality Forum Preferred Practices. It is designed to meet the needs of health social work professionals who seek to provide culturally sensitive biopsychosocial-spiritual care for patients and families living with life-threatening illness. Edited by two of the leading social work clinician-researchers in the US, this text serves as the definitive resource for practicing clinicians and fulfils the need for social work faculty who wish to complement general health care texts with information specific to palliative and end-of-life care.
Purpose: Previous research supports the idea that attachment style is closely associated to experience of bereavement, but the research investigating current attachment style and childhood experience of bereavement is lacking. This study aims to explore how experience of bereavement in childhood relates to current attachment style in adulthood and to utilize attachment theory in understanding the experience of bereavement during childhood. Methodology: Mixed method design was used to address the research objectives. This study was based on qualitative interview and a quantitative questionnaire. Twenty-four students from University of Bedfordshire were employed through purposive sampling to conduct semi-structured interviews. Experience in Close Relationships (ECR) questionnaire was used for quantitative assessment. Findings: The results of thematic analysis showed people with various attachment styles offered various accounts of their bereavement experience as children. This study offered proof that this was the case. Recommendations: It is suggested that this research can help us understand how children experience bereavement by illustrating how attachment theory might be used. This study may aid mental health practitioners in identifying some practical methods for assisting grieving individuals. The parent-child attachment bond approach among bereaved families may involve the appropriate bereavement counsellors and professionals. Bereavement experience during childhood links to adulthood attachment style. This study will contribute in developing the understanding of bereavement in children with attachment theory perspective.
Many bereaved individuals turn online to seek support. The present study employed a 4 (coping display: none, poor, good, balanced) x 2 (platform type: social network site, online support group) x 2 (channel publicness: private, public) between-subjects online experiment with 602 college students. Participants reported on their impressions of the bereaved after viewing a screenshot of either a private message or public post from either Facebook or SupportGroups.com that varied according to the content of the bereaved individual's support-seeking attempt. Results indicated that the most positive impressions of the bereaved were formed when they demonstrated good coping compared to other coping displays, sought support through an online support group as opposed to Facebook, and communicated privately rather than publicly. Further, the perceived appropriateness of support-seeking messages was shaped by a three-way interaction of coping display, platform type, and channel publicness, such that a private Facebook message was viewed as more appropriate than a public Facebook post when the message included any negative content but less appropriate when the message was wholly positive. All effect sizes were very small. Findings are discussed in relation to theory and research on seeking support and coping with distress, in general and in online spaces.
Palliative social workers will be attending to grief and bereavement in their respective settings. Palliative social workers combine humility and skill to provide impeccable assessment, which includes a working knowledge of widely held assumptions about grief that are not supported by empirical research. Awareness of other variables that influence grief include the quality of care proved over the continuum of illness, racism, culture, spirituality, disenfranchised and/or ancestral grief, gender/sexual identity, and COVID-19 pandemic issues helps inform assessment that seeks to understand each person’s unique experience. Appropriate and effective intervention also requires knowledge of current bereavement research and theory. The field of grief and bereavement is continuously evolving, and palliative social workers need to stay current and adjust their practice accordingly. Self-awareness and self-care are additional responsibilities that enable social workers to sustain effective practice over time.
El objetivo de este estudio es explorar los mecanismos de afrontamiento de la soledad generada por rupturas amorosas a la luz de la psicología del consumidor, con un enfoque centrado en las motivaciones de resolución de la situación de ruptura de manera no clínica y mediada por la dinámica de consumo de bienes o servicios reparadores. El estudio es de tipo cualitativo, para ello se efectuaron diez entrevistas en profundidad a siete mujeres y tres hombres que experimentaron, en el último año, los efectos y las consecuencias de una ruptura amorosa. Entre los hallazgos se encuentra que los afectados recurren a variadas formas de consumo como la música, libros de apoyo, actividades deportivas y de ocio (ir a cine, viajar), lo que les proporcionó maneras de pasar el tiempo, mantener la mente activa, tener interacción social para divertirse y reconectarse con amigos y familia, de tal forma que pudieron mejorar la relación consigo mismos en esa fase situacional de sus vidas. Se concluye que la mediación de actividades de consumo y el redescubrimiento de nexos sociales son fuentes importantes para reponerse de la ruptura amorosa. El estudio presenta limitaciones en cuanto al número de participantes, pero se logró punto de saturación en la información obtenida.
It is nearly inevitable that an early adolescent (ages 10–14) will experience a death-related loss of an individual significant to them. Given the significant amount of time early adolescents spend within the school system, a multi-tiered system of care (MTSC) is a systematic school counseling program focus that reflects the needs of early adolescents grieving a death-related loss. The Dual Process Model (DPM) provides school counselors with a contemporary, holistic lens that considers cultural, environmental, and familial perspectives, appropriate for recognizing and addressing early adolescents’ grief in an effective manner. The authors provide a practical, developmentally appropriate MTSC model that addresses early adolescents’ experiences of loss- and restoration-orientations of stress and coping with grief.
Two longitudinal studies assessed whether disclosure of emotions facilitates recovery from bereavement. Study 1 tested prospectively over a 2-year period whether the extent to which bereaved persons talked about their loss to others and disclosed their emotions was associated with better adjustment to the loss of a marital partner. There was no evidence that disclosure facilitated adjustment. Study 2 randomly assigned recently bereaved individuals either to the Pennebaker writing task (J. W. Pennebaker & S. K. Beall, 1986) or to no-essay control conditions. The writing task did not result in a reduction of distress or of doctors visits either immediately after the bereavement or at a 6-month follow-up. Beneficial effects were not demonstrated for bereaved persons who had suffered an unexpected loss or who at the time of the study still expressed a high need for emotional disclosure.
This study explored the relationships between mental models of attachment and adjustment to abortion in 408 women undergoing a 1st-trimester abortion at a large free-standing abortion clinic. As expected, mental models of attachment were related to postabortion distress and positive well-being. These relationships were mediated by feelings of self-efficacy for coping with abortion, perceived support from a woman's male partner, and perceived conflict from this same source. Model of self and model of others interacted only in predicting perceived conflict and positive well-being. Model of self was more strongly related to the mediator and outcome variables than was model of others. The effects of model of self, however, were largely a reflection of the overlap between model of self and self-esteem.
Psychological theories and practices frequently neglect the extent to which their subject matter is historically and culturally defined. This issue is explored in the context of theories and therapies related to bereavement. Contemporary orientations emphasize the importance of breaking bonds with the deceased and the return of survivors to autonomous lifestyles. Placing this orientation in cultural and historical context reveals that it is largely a product of a modernist worldview. Within the romanticist ethos of the preceding century, such breaking of bonds would destroy one's identity and the meaning of life. In light of contemporary variations in subcultural meanings and values, a postmodern view is suggested in which reflexive responsibility is focal.
In 3 studies, 352 undergraduate Israeli students were classified into secure, avoidant, and ambivalent attachment groups, and their differences in traitlike measures of self-disclosure willingness and flexibility and in disclosure reciprocity and liking of hypothetical or real partners were assessed. Findings indicated that both secure and ambivalent people showed more self-disclosure than avoidant people. Findings also yielded that secure and ambivalent people disclosed more information to, felt better interacting with, and were more attracted to a high discloser partner than a low discloser partner. In contrast, avoidant people's self-disclosure and liking were not affected by the partner's disclosure. Secure people showed more disclosure flexibility and topical reciprocity than ambivalent and avoidant people. Findings are discussed in terms of the interaction goals of attachment groups.
A new 4-group model of attachment styles in adulthood is proposed. Four prototypic attachment patterns are defined using combinations of a person's self-image (positive or negative) and image of others (positive or negative). In Study 1, an interview was developed to yield continuous and categorical ratings of the 4 attachment styles. Intercorrelations of the attachment ratings were consistent with the proposed model. Attachment ratings were validated by self-report measures of self-concept and interpersonal functioning. Each style was associated with a distinct profile of interpersonal problems, according to both self- and friend-reports. In Study 2, attachment styles within the family of origin and with peers were assessed independently. Results of Study 1 were replicated. The proposed model was shown to be applicable to representations of family relations; Ss' attachment styles with peers were correlated with family attachment ratings.
Our model outlines the cognitive operations, response strategies, and dynamics of the attachment system in adulthood. It also describes the goals of each attachment strategy and their psychological manifestations and consequences. Whereas the goals of security-based strategies are to form intimate relationships, to build a person's psychological resources, and to broaden his or her perspectives and capacities, the goal of secondary attachment strategies is to manage attachment-system activation and reduce or eliminate the pain caused by frustrated proximity-seeking attempts. Hyperactivating strategies keep the person focused on the search for love and security, and constantly on the alert for threats, separations, and betrayals. Deactivating strategies keep the attachment system in check, with serious consequences for cognitive and emotional openness. This framework serves as our "working model" for understanding the activation and functioning of the attachment system in adulthood. It also provides a framework for reviewing our research findings, which is the mission of the next section.
This article explores the possibility that romantic love is an attachment process--a biosocial process by which affectional bonds are formed between adult lovers, just as affectional bonds are formed earlier in life between human infants and their parents. Key components of attachment theory, developed by Bowlby, Ainsworth, and others to explain the development of affectional bonds in infancy, were translated into terms appropriate to adult romantic love. The translation centered on the three major styles of attachment in infancy--secure, avoidant, and anxious/ambivalent--and on the notion that continuity of relationship style is due in part to mental models (Bowlby's "inner working models") of self and social life. These models, and hence a person's attachment style, are seen as determined in part by childhood relationships with parents. Two questionnaire studies indicated that relative prevalence of the three attachment styles is roughly the same in adulthood as in infancy, the three kinds of adults differ predictably in the way they experience romantic love, and attachment style is related in theoretically meaningful ways to mental models of self and social relationships and to relationship experiences with parents. Implications for theories of romantic love are discussed, as are measurement problems and other issues related to future tests of the attachment perspective.
A Dual Process Model of Bereavement, which considers the impact of loss- and restoration-oriented variables on widowers' levels of well-being, is tested on 200 widowed men during the second year of bereavement. Those who were widowed less than 500 days exhibited significantly more negative affect, less positive affect, and lower well-being that those widowed more than 500 days. Multiple regression analyses revealed that both loss and restoration variables were important throughout bereavement. Loss variables influenced negative affect and were especially critical during the early stages. Restoration variables significantly affected positive affect and had greater impact on the later bereaved. The results support a dual process model of bereavement, but also suggest that certain events, such as circumstances of death, are more important during early bereavement while reinvestment activities, such as dating, become relevant later. Some circumstances, such as a wife's suffering, have prolonged effects.
This study explored specific associations between global attachment styles (e.g., secure, anxiousambivalent, avoidant),attachment to the deceased, suddenness of death, and three specific reactions to bereavement (grief, depression, and somatization) in a sample of 91 adults (21 men, 70 women) who had lost a loved one in the past 18 months. A path model on cross-sectional data (obtained after the bereavement) examined several specific predictions, controlling for background variables such as gender, age, and education of the respondents, age of the deceased, time since the death, and social desirability responding. As predicted, individuals who reported having a closer attachment to the deceased and had a more sudden loss reported greater levels of grief. Individuals with an anxious-ambivalent attachment style reported greater levels of grief and depression. Somatization was more likely to be reported by those with an avoidant attachment style. Although not predicted, we also found that individuals with a secure attachment style reported less depression. Social desirability responding was associated with reports of more grief. A greater time since the death and less education were associated with less depression, and older respondents reported less somatization. Discussion focuses on the importance of distinguishing grief, depression, and somatization following bereavement in order to better predict and identify individuals at risk for adverse bereavement reactions. In the context of the study 'slimitations (cross-sectional design and issues of generalizability), the potential utility attachment style may provide in identifying maladaptive reactions following the loss of a loved one is also discussed.
In 3 studies, 352 undergraduate Israeli students were classified into secure, avoidant, and ambivalent attachment groups, and their differences in traitlike measures of self-disclosure willingness and flexibility and in disclosure reciprocity and liking of hypothetical or real partners were assessed. Findings indicated that both secure and ambivalent people disclosed more information to, felt better interacting with, and were more attracted to a high discloser partner than a low discloser partner. In contrast, avoidant people's self-disclosure and liking were not affected by the partner's disclosure. Secure people showed more disclosure flexibility and topical reciprocity than ambivalent and avoidant people. Findings are discussed in terms of the interaction goals of attachment groups. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A basic principle of attachment theory is that early attachment relationships with caregivers provide the prototype for later social relations. Working within an attachment framework, a new 4-group model of characteristic attachment styles in adulthood is proposed. In particular, two forms of adult avoidance of intimacy are differentiated: a fearful style that is characterized by a conscious desire for social contact which is inhibited by fears of its consequences, and a dismissing style that is characterized by a defensive denial of the need or desire for greater social contact. This distinction corresponds to two differing models of the self: people who fearfully avoid intimacy view themselves as undeserving of the love and support of others, and people who dismiss intimacy possess a positive model of the self that minimizes the subjective awareness of distress or social needs. The emotional and interpersonal ramifications of the two proposed styles of adult avoidance are discussed.
This study examined the role of attachment style in adjustment to bereavement. Midlife bereaved individuals whose spouse had died in the previous year completed the Reciprocal Attachment Questionnaire (RAQ; West & Sheldon-Keller, 1994) and a measure assessing aspects of appraising and coping with the loss. They also were administered repeated symptom measures at 6, 14, 25, and 60 months post-bereavement. Complete symptom measures data over the course of the 5-year period were available for 32 participants. The RAQ compulsive care-seeking measure of anxious attachment was predictive of appraised inability to cope with the loss and of more severe symptomatology over the course of 5 years. Furthermore, appraised inability to cope with the loss was shown to mediate the relationship between compulsive care-seeking and symptoms. The RAQ compulsive self-reliance measure of avoidant attachment was not related to symptomatology, however. Finally, the RAQ angry withdrawal measure of ambivalent attachment was predictive of 6 and 14 months post-loss symptoms, but not of 25-or 60-month symptoms. The differences in the pattern of findings for compulsive care-seeking and angry withdrawal are discussed in the context of previous findings in the bereavement literature on the role of dependency and ambivalence in bereavement-related adjustment.
This study examines the association between adult attachment style and the way people react to the crisis of divorce. A research group of 120 participants undergoing legal procedures related to divorce and a control group of 108 married participants were classified according to their attachment style (secure, avoidant, anxious-ambivalent) and completed the Mental Health Inventory. In addition, the divorced participants answered scales tapping appraisal of divorce and ways of coping with it. As expected, divorced participants reported more distress than married ones. This effect was found among avoidant and anxious-ambivalent participants, but not among secure participants. Significant differences were also found among attachment groups in appraisal and coping variables. Structural analyses supported the hypothesis that appraisal and coping mediate the association between attachment style and mental health during the crisis of divorce. Results are discussed in terms of attachment theory.
This chapter begins with an evaluation of recent research that has accumulated about traumatic grief (TG) symptomatology. More specifically, the available evidence is reviewed to determine whether it satisfies requirements for the establishment of TG as a distinct clinical entity. Following this review, the authors discuss some advantages and disadvantages of developing standardized criteria for TG. Given their belief that the advantages outweigh the disadvantages, they then describe the logic behind the consensus criteria for TG proposed by a panel of experts. Results of a preliminary test of the proposed criteria set for TG are reported, directions for their further refinement are discussed, and assessment tools for TG are presented. The authors conclude by proposing ways to distinguish between normal and TG reactions and by suggesting directions for future research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This chapter begins with a review of the defining characteristics of behavioral systems and an examination of variations in patterns of care from a functionalist or evolutionary perspective. We then describe a behavioral-systems-based model outlining major influences on the etiology of the caregiving system. We follow with a summary of our own research and describe the ways in which our studies of mothers' mental representations of caregiving have informed us about the caregiving system. We end with a discussion of what the behavioral-systems approach to caregiving adds to our understanding of parent–child interaction, and of how this perspective may be used to enhance relationship-based intervention. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Despite tremendous progress in understanding the human body as a biological mechanism, researchers are finding that many aspects of physical health are strongly linked to a person ‘s thoughts, emotions, and behaviors, and to features of the sociocultural environment. This interdisciplinary volume, the newest in the Rutgers Series on Self and Social Identity, provides a survey of this research, emphasizing the connections between health and an individual ‘s sense of self. Drawing on psychology, sociology and anthropology, the collection examines the health-related effects both of broad social forces and of individual experiences. Part I examines the diverse systems involved, moving from the biological and psychological systems in the individual to such societal systems as language, politics, economics, and health care. Part II focuses on stress and emotion and includes an extensive discussion of race related stress and of the beneficial effects of disclosing and talking about individual traumatic events. Part III addresses health in the context of personality and development, proposing a multilevel view of personality and describing the emergence of sexual identities during adolescence. The final part then looks at the other side of the self-health relationship by examining the effects of illness on one ‘s sense of self. As a whole, the collection provides a wide ranging survey of existing work on how self and health are linked and is a valuable source of ideas for future research.
The Nature of Grief is a provocative new study on the evolution of grief. Most literature on the topic regards grief either as a psychiatric disorder or illness to be cured. In contrast to this, John Archer shows that grief is a natural reaction to losses of many sorts, even to the death of a pet, and he proves this by bringing together material from evolutionary psychology, ethology and experimental psychology. This innovative new work will be required reading for developmental and clinical psychologists and all those in the caring professions.
Drawing from theory and clinical lore, we consider how individuals are assumed to cope following irrevocable loss. Several assumptions are reviewed reflecting beliefs concerning the grieving process. Specifically, we examine the expectation that depression is inevitable following loss; that distress is necessary, and failure to experience it is indicative of pathology; that it is necessary to "work through" or process a loss; and that recovery and resolution are to be expected following loss. Although limited research has examined these assumptions systematically, available empirical work fails to support and in some cases contradicts them. Implications of our analysis for theoretical development and research are explored. Finally, w e maintain that mistaken assumptions held about the process of coping with loss fail to acknowledge the variability that exists in response to loss, and may lead others to respond to those who have endured loss in ways that are unhelpful. In this article, we focus on how people cope with loss events that involve permanent change and cannot be altered or undone. It is our belief that such experiences provide an excellent arena in which to study basic processes of stress and coping. In the health and medical areas, many specific losses might be considered irrevocable: the permanent loss of bodily function, the loss of particular body parts, the loss of cognitive capacity, the death of a loved one, or one's own terminal illness. In an attempt to advance theoretical development in this rich and complex area, this article updates an earlier review we completed on reactions to undesirable life events (Silver & Wortman, 1980). Because the most rigorous empirical studies have been in the areas of physical disability and bereavement, we shall focus on these two areas in this article. When a person experiences an irrevocable loss, such as the death of a loved one or permanent paralysis, how will he or she react? We maintain that people hold strong assumptions about how others should respond to such losses. As we have discussed in more detail elsewhere (Silver & Wortman, 1980; Wortman & Silver, 1987), such assumptions are derived in part from the theories of loss offered by prominent writers in the area, and in part from clinical lore about coping with loss and our cultural understanding of the experience. As detailed below, individuals who encounter a loss are expected to go through a period of intense distress; failure to experience such distress is thought to
The article challenges the longstanding belief in the importance of “grief work” for adjustment to bereavement (the grief work hypothesis). It examines claims made in theoretical formulations and principles of grief counseling and therapy concerning the necessity of working through loss. Empirical evidence is reviewed, and cross-cultural findings are described to document alternative patterns of coping with grief. It is argued that there are grounds for questioning the hypothesis: 1) existing definitions and operationalizations are problematic; 2) the few empirical studies that have examined the impact of grief work have yielded equivocal results; 3) grief work is not a universal concept. Limitations of the grief work hypothesis as an explanation of coping with bereavement are identified and a differential approach is suggested. Implications for counseling and therapy are discussed.
Background: Although the association between childhood parental loss and later development of mood disorder has received much research interest in the past, the results obtained and conclusions drawn have been various, and inconsistent with each other. The present study aims to examine this old, yet unresolved, question among the Japanese. Methods: Patients with bipolar disorder (n=73) and unipolar depression (n=570) and community healthy controls (n=122) were examined as to their psychopathology and childhood parental loss experiences with semi-structured interviews. Results: Stratified for sex and age, no statistically significant difference was observed in the incidence of paternal or maternal death or separation before age 16 between bipolar patients and healthy controls. Female patients with unipolar depression under the age of 54 experienced significantly more maternal loss than the corresponding controls. This excess in loss appeared to be largely due to the patients experiencing separation from their mothers. Conclusion: Our findings concerning bipolar disorder have replicated the previous two studies reported in the literature. Those concerning unipolar depression appear to be in line with several recent studies on the subject but, as stated, many discrepant findings can also be found in the literature.
Ethological attachment theory is a landmark of 20th century social and behavioral sciences theory and research. This new paradigm for understanding primary relationships across the lifespan evolved from John Bowlby's critique of psychoanalytic drive theory and his own clinical observations, supplemented by his knowledge of fields as diverse as primate ethology, control systems theory, and cognitive psychology. By the time he had written the first volume of his classic Attachment and Loss trilogy, Mary D. Salter Ainsworth's naturalistic observations in Uganda and Baltimore, and her theoretical and descriptive insights about maternal care and the secure base phenomenon had become integral to attachment theory. Patterns of Attachment reports the methods and key results of Ainsworth's landmark Baltimore Longitudinal Study. Following upon her naturalistic home observations in Uganda, the Baltimore project yielded a wealth of enduring, benchmark results on the nature of the child's tie to its primary caregiver and the importance of early experience. It also addressed a wide range of conceptual and methodological issues common to many developmental and longitudinal projects, especially issues of age appropriate assessment, quantifying behavior, and comprehending individual differences. In addition, Ainsworth and her students broke new ground, clarifying and defining new concepts, demonstrating the value of the ethological methods and insights about behavior. Today, as we enter the fourth generation of attachment study, we have a rich and growing catalogue of behavioral and narrative approaches to measuring attachment from infancy to adulthood. Each of them has roots in the Strange Situation and the secure base concept presented in Patterns of Attachment. It inclusion in the Psychology Press Classic Editions series reflects Patterns of Attachment's continuing significance and insures its availability to new generations of students, researchers, and clinicians.
This study examined the association of attachment organization and recalled grief responses following the dissolution of an important romantic relationship. College students (N = 118) completed questions about demographics, attachment organization, and grief. Factor analysis resulted in 4 interpretable grief themes. Multiple regression analyses indicated that the adult attachment style predicted 3 grief-related cognitive themes: Preoccupied attachment predicted self-reproach, fearful attachment predicted partner blame, and both fearful and secure attachment predicted a friendly resolution. Implications of the findings are discussed.
“Expression is the link between internal experience and the outside world. It is intimately connected to who we are, how we feel, and how we relate to others,” write psychologists Eileen Kennedy-Moore and Jeanne C. Watson. With clinical sensitivity and empirical rigor, the authors describe the many forms of emotional expression and nonexpression and their implications for personal well-being and social relationships. Vivid clinical examples translate theory into practice. This comprehensive and clearly written book guides mental health professionals and students in understanding and treating problems in emotional behavior.
The first section, "Overview of Attachment Theory," provides an updated primer on the theory. The second section of the volume, "Biological Perspectives," stems from J. Bowlby's reliance on ethology and primate research in the creation of attachment theory. The third section of the volume, "Attachment in Infancy and Childhood," contains 3 chapters that provide an overview of empirical research on patterns of attachment in infancy and childhood. The fourth section, "Attachment in Adolescence and Adulthood," contains chapters growing out of Bowlby's early contention that attachment characterizes humans "from the cradle to the grave." The fifth section of the volume, "Clinical Applications of Attachment Theory and Research," contains chapters that reflect the strong roots of attachment theory in clinical psychology and psychiatry, and the contributions that the theory and associated research can now make to clinical work. The final section of the volume,"Emerging Topics and Perspectives," provides a sampling of the wide array of areas into which attachment theory and research are being extended. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Examined differences in trust and self-disclosure associated with secure, anxious/ambivalent, and avoidant attachment in 98 undergraduates (aged 17–52 yrs). Ss completed an attachment questionnaire and measures of trust and self-disclosure. Ss who reported themselves as securely attached also reported, in comparison with avoidant attachment, higher levels of trust in partner, amount of self-disclosure, and comfort with self-disclosure. Significant sex and ethnic differences and interaction effects were also reported. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This book was designed to advance our collective knowledge about the methods and procedures by which we gain insight and information about psychological trauma and its effects on human behavior. Since the publication of the first edition in 1997, the field of traumatic stress studies has seen rapid advances in all domains of scientific inquiry about posttraumatic stress disorder (PTSD) and the understanding of acute and chronic forms of traumatic stress. This volume reflects many of these advances, which range from neuroscience studies of brain functions to cross-cultural differences in trauma response. Part I focuses on conceptual and diagnostic approaches to understanding trauma and PTSD. Part II focuses attention on standardized psychometric measures, clinical protocols, epidemiological methods, and projective techniques of assessing trauma and PTSD. Part III is devoted to the assessment of the psychobiology of PSTD. Part IV focuses on assessing trauma, loss, and PTSD in medical settings. Part V assesses trauma and PTSD in gender, cultural, and psychosocial development. Part VI is concerned solely with the forensic/clinical assessment of psychological trauma and PTSD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
the aim of this chapter is to present our recent discovery of a new, insecure-disorganized/disoriented category of infant-parent attachment / our discovery of this attachment category is based upon our study of infant response to the Ainsworth strange situation procedure, a brief, structured observation of the infant's response to separation from and reunion with the parent in the laboratory setting
individual differences in infant response to this situation presently permit placement of infants in one of three major "attachment classifications," that is, as secure (group B), insecure-avoidant (group A), or insecure-ambivalent (group C) with respect to the parent with whom the infant is observed
our chapter begins with a review of previous studies reporting difficulties in "forcing" each infant in a given sample into one of the three major categories (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This chapter explores the evidence that traumas—and especially those not disclosed to others—are linked to higher rates of illness. It discusses the authors' research paradigm in which they have repeatedly found that health problem disclosure in the laboratory can have beneficial effects on physical health. This chapter also tackles the question of how disclosure through writing and talking can help people cope with stressful and traumatic experiences. Specifically, how traumas may be linked to physical illness through their negative impact on a person's self-definition, and how disclosure may help to assimilate the traumatic experience into a person's self-definition are examined.
Other areas of discussion included procedural differences, educational, linguistic, or cultural effects that can affect disclosure. (PsycINFO Database Record (c) 2012 APA, all rights reserved)