Psychopathology Symptoms, Rumination and Autobiographical Memory Specificity: Do Associations Hold After Bereavement?

A Psychometric Analysis of the Spanish Version of the Grief Impairment Scale: A Screening Tool of Biopsychosocial Grief-Related Functional Impairment in a Salvadoran Sample

The objective of this study was to translate and psychometrically evaluate a Spanish version of the Grief Impairment Scale (GIS) using a sample of bereaved adults from El Salvador (N = 579). The results confirm the unidimensional structure of the GIS, and solid reliability, item characteristics, and criterion-related validity, where the GIS scale significantly and positively predicts depression. However, this instrument only showed evidence of configural and metric invariance between different sex groups. Overall, these results support the Spanish version of the GIS as a psychometrically sound screening tool for health professionals and researchers to use in their clinical work.

Grief Impairment Scale: A biopsychosocial measure of grief-related functional impairment

Though most mourners are resilient, a minority of the bereaved experience disabling grief accompanied by clinically significant impairment in important areas of functioning. Although impairment measures exist, they have notable limitations in the context of bereavement. Therefore, the objective of this study was to develop and evaluate the Grief Impairment Scale (GIS), which was designed to identify the impact of grief on biopsychosocial functioning. The resulting 5-item scale, which was based on 363 adults who are struggling with grief, demonstrated solid reliability, factorial validity, and convergent and divergent validity with correlations with measures of impairment, prolonged grief, and psychological distress. The GIS also measures grief-related functioning equivalently across demographic groups and satisfactorily discriminates between persons with and without impairment using an optimized cut score of ≥ 9 (79% sensitivity and 74% specificity). These results provide preliminary support for the GIS as a flexible tool for clinical research and practice.

Grieving as a form of learning: Insights from neuroscience applied to grief and loss

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 before 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 after loss and create functional or structural mechanisms predicting PGD.

Preparedness for the death of an elderly family member: A possible protective factor for pre-loss grief in informal caregivers

BACKGROUND

Pre-loss grief (PLG) has been identified as a robust risk factor for Prolonged Grief Disorder, which will be added to the DSM 5-TR. Therefore, identifying treatment targets to reduce PLG is warranted. "Preparedness" has been found to strongly predict PLG. The work is nascent and a consensus has not been reached about how best to assess for preparedness, and no reliable measure of this construct exists. Before examining the relationship between preparedness and PLG, an in depth understanding of how family members define preparedness is warranted.

OBJECTIVES

The purpose of this study was to develop a preliminary theoretical framework of preparedness for the loss.

METHODS

This was achieved through prospective semi-structured interviews with family members of Stage 4 Cancer (N = 16) and Advanced Dementia (N = 24) patients.

RESULTS

The overarching theme related to preparedness for the loss was the need to reduce uncertainty, both before the person passes away (i.e., present certainty) and after the person passes away (i.e., future certainty). Factors associated with the need to establish certainty in the present included, religiosity and spirituality, good relationship quality with the person with the life limiting illness, having access to support, good communication with person with life limiting illness, and acceptance of the impending death. Certainty for the future included, knowing what to expect due to past experience of loss, having plans for life without the person, and social support.

CONCLUSION

This study provides a preliminary framework of preparedness for family members of individuals with life limiting illness.

How do family members experience drug death bereavement? A systematic review of the literature

Despite high rates of drug-related deaths (DRDs), drug-related bereavement has been sparsely investigated. A systematic literature search for qualitative and quantitative studies was conducted. Studies on bereaved DRD family members and systems influencing bereavement were eligible for inclusion. Eight studies were included. Three themes emerged from the thematic analysis (Emotional Roller Coaster, Lack of Understanding by the Social World, and Meaning Making) describing an emotional and existential overload, stigmatization and lack of understanding and help from support systems. The results also shed light on life after the loss. Directions for further research were subsequently outlined.

The Poetry of Grief: Beyond Scientific Portrayal

To comprehend grief, we need knowledge about the range of diverse reactions incorporated within it. While scientists have documented the phenomena and manifestations following the loss of a loved one in quite some detail, poets can add to our understanding by portraying these vividly, bringing the feelings to life. In this article, I map the array of grief reactions identified in scientific investigations. I then go on to give short, selective illustrations from poetry, ones that have enhanced my own understanding of grief. These choices are naturally influenced by my own preferences; I include those that I find personally appealing and evocative of the multifaceted manifestations of grief. My aim is to demonstrate the value of artistic representation for scientific comprehension.

Rethinking a Negative Event: The Affective Impact of Ruminative versus Imagery-Based Processing of Aversive Autobiographical Memories

INTRODUCTION

Ruminative (abstract verbal) processing during recall of aversive autobiographical memories may serve to dampen their short-term affective impact. Experimental studies indeed demonstrate that verbal processing of non-autobiographical material and positive autobiographical memories evokes weaker affective responses than imagery-based processing. In the current study, we hypothesized that abstract verbal or concrete verbal processing of an aversive autobiographical memory would result in weaker affective responses than imagery-based processing.

METHODS

The affective impact of abstract verbal versus concrete verbal versus imagery-based processing during recall of an aversive autobiographical memory was investigated in a non-clinical sample (n = 99) using both an observational and an experimental design. Observationally, it was examined whether spontaneous use of processing modes (both state and trait measures) was associated with impact of aversive autobiographical memory recall on negative and positive affect. Experimentally, the causal relation between processing modes and affective impact was investigated by manipulating the processing mode during retrieval of the same aversive autobiographical memory.

RESULTS

Main findings were that higher levels of trait (but not state) measures of both ruminative and imagery-based processing and depressive symptomatology were positively correlated with higher levels of negative affective impact in the observational part of the study. In the experimental part, no main effect of processing modes on affective impact of autobiographical memories was found. However, a significant moderating effect of depressive symptomatology was found. Only for individuals with low levels of depressive symptomatology, concrete verbal (but not abstract verbal) processing of the aversive autobiographical memory did result in weaker affective responses, compared to imagery-based processing.

DISCUSSION

These results cast doubt on the hypothesis that ruminative processing of aversive autobiographical memories serves to avoid the negative emotions evoked by such memories. Furthermore, findings suggest that depressive symptomatology is associated with the spontaneous use and the affective impact of processing modes during recall of aversive autobiographical memories. Clinical studies are needed that examine the role of processing modes during aversive autobiographical memory recall in depression, including the potential effectiveness of targeting processing modes in therapy.