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Batista J, Alves D, Pires N, Silva JR, Mendes I, Magalhães C, Rosa C, Oliveira JT, Gonçalves MM, Neimeyer RA. The meaning in loss protocol: A clinical trial of online grief therapy. DEATH STUDIES 2024:1-13. [PMID: 38940635 DOI: 10.1080/07481187.2024.2370633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
For a minority of the bereaved, the loss of a significant other can trigger an overwhelming emotional reaction and impaired functioning across life domains, known as prolonged grief disorder (PGD). Hence, ongoing efforts have been made to refine existing treatments to increase their efficacy and to accommodate the idiosyncrasies of grief reactions. This study presents the results of an open clinical trial of the feasibility and effectiveness of the Meaning in Loss (MIL) protocol in an online format. The brief intervention of 12 to 16 sessions combines constructivist and narrative strategies to explore and work through impediments to meaning reconstruction in loss. The sample included 25 participants diagnosed with PGD who were treated by six therapists. Baseline and post-therapy comparisons showed a significant improvement in all clinical measures (grief symptomatology, depression and general distress) and an increase of meaning making regarding the loss. Meaning making was found to be a prospective mediator of symptomatic improvement in grief across the course of therapy. These findings suggest the effectiveness of the MIL protocol in decreasing grief specific and associated symptomatology and argue for the relevance of further controlled evaluations of its efficacy. Moreover, results confirm previous findings that meaning making is a relevant factor in the evolution of grief reactions, including in the context of psychotherapy.
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Affiliation(s)
- João Batista
- School of Psychology, University of Minho, Portugal
| | | | - Nuno Pires
- Higher Institute of Social Work of Porto, Porto, Portugal
- Lusíada Research Center on Social Work and Social Intervention (CLISSIS), Lisbon, Portugal
| | - Joana R Silva
- Portucalense Institute for Human Development (INPP), Department of Psychology and Education, Universidade Portucalense, Porto, Portugal
| | - Inês Mendes
- School of Psychology, University of Minho, Portugal
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Martins H, Romeiro J, Casaleiro T, Vieira M, Caldeira S. Insights on spirituality and bereavement: A systematic review of qualitative studies. J Clin Nurs 2024; 33:1593-1603. [PMID: 38345102 DOI: 10.1111/jocn.17052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 04/04/2024]
Abstract
AIM To describe a synthesis of the experience related to the spirituality of those living a bereavement journey in primary qualitative studies. DESIGN A systematic review of qualitative studies. DATA SOURCE A systematic review was carried out in March 2019 and was updated in January 2023. Searching was accomplished by an online database, such as CINAHL, MEDLINE, PsycINFO, MedicLatina, LILACS, SciELO and Academic Search Complete. The search strategy did not consider a timeline as an eligibility criterion. The quality of the studies was assessed, and a thematic synthesis was performed in this review. METHODS A systematic review of qualitative studies was conducted according to Saini and Shlonsky's methodology. REPORTING METHOD PRISMA checklist. RESULTS The review included 33 articles. Most of the studies were phenomenological and focused on parents' and family experiences of bereavement. Seven significant categories emerged, which match unmet spiritual needs during the grieving process. Two major categories were identified regarding the role of spirituality in bereavement: Spirituality as a process and spirituality as an outcome. CONCLUSION In clinical practice, attention to spirituality and providing spiritual care is critical to guarantee a holistic approach for those experiencing bereavement. IMPLICATIONS The findings of our study could foster awareness that healthcare professionals should include the spiritual dimension in their clinical practice to provide holistic care to individuals, enhancing the healing process in bereavement. NO PATIENT OR PUBLIC CONTRIBUTION This is a systematic review.
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Affiliation(s)
- Helga Martins
- Post Doctoral Program in Integral Human Development, CADOS, Universidade Católica Portuguesa, Lisbon, Portugal
- Polytechnic Institute of Beja, Beja, Portugal
- Centre for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Joana Romeiro
- Post Doctoral Program in Integral Human Development, CADOS, Universidade Católica Portuguesa, Lisbon, Portugal
- Centre for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Tiago Casaleiro
- Centre for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Margarida Vieira
- Centre for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Porto, Portugal
| | - Sílvia Caldeira
- Centre for Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
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3
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Barak A, Safyon M, Ben-Ezra L. Ideological meaning-making in the aftermath of traumatic loss: Radicalization as meaning. DEATH STUDIES 2024:1-10. [PMID: 38619431 DOI: 10.1080/07481187.2024.2339910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
In this qualitative study we explore the concept of ideological meaning-making, with a focus on political radicalization and its relation to the process of meaning-making. Through interviews with 33 individuals who experienced the loss of a close family member in the Israeli-Palestinian conflict and subsequently became politically radicalized, four key themes emerged: preliminary decision, zoom out, mission, and radicalized self. Participants initially stabilize their beliefs through a preliminary ideological decision, followed by adopting a broader perspective (zoom out) that encompasses the political context. As the process unfolds, a deep commitment to an ideological cause (mission) emerges, leading to the integration of ideology with self-identity (radicalized self). This study contributes to constructivist theory by providing a nuanced understanding of how ideological radicalization intertwines with the process of meaning-making, offering valuable insights into the complex interplay between individual beliefs, self-identity, and the construction of meaning.
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Affiliation(s)
- Adi Barak
- The Louis & Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Mor Safyon
- The Louis & Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Liron Ben-Ezra
- The Louis & Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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Milman EJ, Bottomley JS, Williams JL, Moreland AD, delMas S, Rheingold AA. Interventions for adult survivors of intrafamilial homicide: A review of the literature. DEATH STUDIES 2024; 48:164-175. [PMID: 37099444 PMCID: PMC10600326 DOI: 10.1080/07481187.2023.2201919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Individuals bereaved by intrafamilial homicide, in which the perpetrator and decedent were both members of the same family, experience an elevated risk for risk for mental health complications. Given the contextual complexity of intrafamilial homicide (IFH) and the negative sequalae this form of loss can engender, psychological interventions may assist survivors with adjustment on a number of fronts. This scoping review therefore addresses an important knowledge gap by summarizing the limited information on interventions specific to intrafamilial homicide survivors. Results failed to identify interventions specific to IFH bereavement, though interventions that may be deemed appropriate are highlighted and described. As such, this scoping review provides a practical synthesis of evidence-based and evidence-informed psychological interventions for traumatic loss that are applicable to and may hold promise for this vulnerable population. Recommendations for future research and best practices with intrafamilial homicide survivors are also discussed.
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Affiliation(s)
- Evgenia J. Milman
- Department of Psychology and Behavioral Neuroscience, St. Edwards University
- National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | - Jamison S. Bottomley
- National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | - Joah L. Williams
- School of Education, Social Work, and Psychological Sciences, University of Missouri, Kansas City
| | - Angela D. Moreland
- National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | - Sara delMas
- National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | - Alyssa A. Rheingold
- National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
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Modlin NL, Creed M, Sarang M, Maggio C, Rucker JJ, Williamson V. Trauma-Informed Care in Psychedelic Therapy Research: A Qualitative Literature Review of Evidence-Based Psychotherapy Interventions in PTSD and Psychedelic Therapy Across Conditions. Neuropsychiatr Dis Treat 2024; 20:109-135. [PMID: 38268571 PMCID: PMC10807282 DOI: 10.2147/ndt.s432537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/10/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Post-traumatic stress disorder (PTSD) is associated with significant patient burden. While pharmacotherapies and evidence-based psychotherapy interventions (EBPI) are effective, studies consistently highlight inadequate outcomes and high treatment dropout. Psychedelic therapy (PT) has shown preliminary promise across difficult-to-treat conditions, including MDMA-assisted therapy for PTSD, however trials of classical psychedelics in PTSD are lacking. Understanding patients' experiences of EBPI could help promote safety in PT. Aim To systematically review qualitative research on patients' subjective experience of EBPI for PTSD, and of PT, and examine areas of overlap and divergence between them. Methods Systematic literature searches for studies published between 2010 and 2023 were conducted on OVID, PubMed, Web of Science, and PsycInfo. Included were original studies in English that presented qualitative data of patient experiences of EBPI in PTSD, or PT for any indication. Extracted data from included studies were analysed using thematic synthesis. Syntheses were completed separately for EBPI and PT, before similarities and differences between the therapies were identified. Results 40 research articles were included for review: 26 studies on EBPI for PTSD, and 14 studies on PT. EBPI studied were CBT, EMDR, CPT and PE. Psychedelic compounds studied were psilocybin, ibogaine, LSD, MDMA and ketamine, for treatment of substance use disorders, anxiety relating to physical illness, depression, and PTSD. Core themes from patient experiences of EBPI: 1) patient burden in PTSD treatment; 2) readiness; 3) key mechanisms of change; 4) psychological safety and trust. Themes identified in the review of PT: 1) indirect trauma processing; 2) reorganisation of self-narratives via processes of relatedness and identification; 3) key treatment characteristics. Conclusion This study suggests overlap between patients' experience of EBPI and PT in terms of key mechanisms of change, the importance of psychological safety and readiness to engage in treatment. Trauma-informed care paradigms and practices may improve safety and acceptability of PT research.
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Affiliation(s)
- Nadav Liam Modlin
- The Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Michael Creed
- The Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
| | - Maria Sarang
- The Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Carolina Maggio
- The Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - James J Rucker
- The Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK
| | - Victoria Williamson
- King’s Centre for Military Health Research, King’s College London, London, SE5 9RJ, UK
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, OX2 6 GG, UK
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Carter C, Giosa J, Rizzi K, Oikonen K, Stephenson B, Holyoke P. The Reflection Room ®: Moving from Death-Avoiding to Death-Discussing. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231192163. [PMID: 37515417 DOI: 10.1177/00302228231192163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
We developed, implemented, and evaluated a participatory arts-based storytelling initiative called the Reflection Room project. Our aim was to investigate if visiting a Reflection Room, (1) creates opportunities for disclosing emotions and processing thoughts, (2) increases comfort discussing dying and death, and (3) supports advance care planning (ACP), conversations. In the pilot phase of the Reflection Room project, a Reflection Room was installed in 25 sites across Canada from 2016-2017. Data collection included reflection cards (n = 463), and surveys completed by visitors upon exiting a room (n = 271) and 3 months later (n = 50). Analysis involved theoretically driven coding, inductive content analysis, and descriptive statistics. We found reflections contained both emotional disclosures and reflective processing. Survey data indicated visiting a Reflection Room increased comfort in thinking and talking about dying and death as well as the likelihood of engaging in ACP. In the future, we will explore the extent to which the project fosters social connections and well-being.
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Affiliation(s)
| | - Justine Giosa
- SE Research Centre, Markham, ON, Canada
- School of Public Health Sciences, The University of Waterloo, Waterloo, ON, Canada
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7
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Castiglioni M, Caldiroli CL, Procaccia R, Conte F, Neimeyer RA, Zamin C, Paladino A, Negri A. The Up-Side of the COVID-19 Pandemic: Are Core Belief Violation and Meaning Making Associated with Post-Traumatic Growth? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5991. [PMID: 37297595 PMCID: PMC10252371 DOI: 10.3390/ijerph20115991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/23/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
The negative impact of the COVID-19 pandemic on mental health has been extensively documented, while its possible positive impact on the individual, defined as Post-Traumatic Growth (PTG), has been much less investigated. The present study examines the association between PTG and socio-demographic aspects, pre-pandemic psychological adjustment, stressors directly linked to COVID-19 and four psychological factors theoretically implicated in the change processes (core belief violation, meaning-making, vulnerability and mortality perception). During the second wave of the pandemic 680 medical patients completed an online survey on direct and indirect COVID-19 stressors, health and demographic information, post-traumatic growth, core belief violation, meaning-making capacity, feelings of vulnerability and perceptions of personal mortality. Violation of core beliefs, feelings of vulnerability and mortality, and pre-pandemic mental illness positively correlated with post-traumatic growth. Moreover, the diagnosis of COVID-19, stronger violation of core beliefs, greater meaning-making ability, and lower pre-existing mental illness predicted greater PTG. Finally, a moderating effect of meaning-making ability was found. The clinical implications were discussed.
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Affiliation(s)
- Marco Castiglioni
- Department of Human Sciences “R. Massa”, University of Milano Bicocca, 20126 Milano, Italy;
| | | | | | - Federica Conte
- Department of Psychology, University of Milano Bicocca, 20126 Milano, Italy;
| | | | - Claudia Zamin
- Italian Society of Relationship Psychoanalysis, 20135 Milano, Italy
| | - Anna Paladino
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy (A.N.)
| | - Attà Negri
- Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy (A.N.)
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8
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McLean E, Livingston TN, Mitchell SM, Singer J. Perceptions of grief reactions in family members of incarcerated individuals: A vignette-based experiment. DEATH STUDIES 2023; 47:1167-1179. [PMID: 36772949 PMCID: PMC10363178 DOI: 10.1080/07481187.2023.2175391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
We examined perceptions of individuals grieving the loss of a family member to incarceration. Participants (N = 1095) were randomized to a vignette that varied by race-ethnicity, crime type, and grief trajectory to assess their perceptions. Results indicated: (1) participants perceived prolonged grief as less appropriate than resilience; (2) Black family members grieving someone who committed a violent crime as more appropriate compared to White family members; and (3) women endorsed both grief trajectories as more appropriate and indicated greater comfort supporting the family member. Lastly, participants indicated prolonged, White and Latinx grievers should seek therapy more than resilient or Black individuals.
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Affiliation(s)
- Elisabeth McLean
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | | | - Sean M. Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Jonathan Singer
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
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9
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Den Elzen K, Breen LJ, Neimeyer RA. Rewriting grief following bereavement and non-death loss: a pilot writing-for-wellbeing study. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2023. [DOI: 10.1080/03069885.2022.2160967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Katrin Den Elzen
- School of Media, Creative Arts and Social Inquiry (MCSI), Curtin University, Perth, Australia
| | - Lauren J. Breen
- Curtin School of Population Health and Curtin enAble Institute, Curtin University, Perth, Australia
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10
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Hunt C, Josselin D. "What's Inside of You Now is Just Bones and Skin": The Tension between Restorative Meaning-Making and Deliberate Detachment in Maternal Experiences of Stillbirth. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221112255. [PMID: 36029020 DOI: 10.1177/00302228221112255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article explores the ways in which bereaved mothers framed experiences of continuing bonds with their stillborn child and aims to enrich an understanding of maternal sense-making. Four interviews were carried out with bereaved mothers and approached using Interpretative Phenomenological Analysis, so as to offer deeper insight into their individual experiences. Themes which arose from the analysis include: "Continuing bonds and the female body;" "Conflicted bonding with the shape-shifting baby;" and "Experiencing connection in the life beyond loss." These findings point to a tension between restorative meaning-making and detachment in maternal sense-making following stillbirth and have implications for clinicians working with bereaved mothers.
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Affiliation(s)
- Catharine Hunt
- Department of Psychology, City University of London, London, UK
| | - Daphne Josselin
- Department of Psychology, City University of London, London, UK
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11
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Keser E, Ar-Karci Y, Danışman IG. Examining the Basic Assumption of Psychoanalytic Theory Regarding Normal and Abnormal Grief: Roles of Unfinished Businesses and Bereavement Related Guilt. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221111946. [PMID: 35776860 DOI: 10.1177/00302228221111946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To date, several theoretical models have been proposed to explain how the expected and natural grief processes turns into psychiatric disorders. Nevertheless, there is a paucity of empirical research examining the basic assumption of psychoanalytic theory regarding pre-death conflict and bereavement related guilt. Accordingly, the current study aimed to investigate the mediator role of bereavement related guilt in the relationship between the pre-death conflict and maladaptive grief process. The sample consisted of 447 bereaved adults who lost a loved one due to death in the last 5 years. The Unfinished Business in Bereavement (UBBS), Bereavement Guilt Scale (BGS), Beck Depression Inventory (BDI), and Prolonged Grief Disorder Scale (PG-13) scales were administered. The results indicated that the UBBS scores were positively correlated with both BDI and PG-13 scores, and BGS scores mediated these relationships. Obtained findings were discussed in relation to psychoanalytic theory and existing studies in the grief literature.
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Affiliation(s)
- Emrah Keser
- Department of Psychology, TED University, Ankara, Turkey
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12
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Heo SJ, Kim YA, Lee DH, Shin JY. How Bereaved Parents Experience Public, Self Stigma Years After a Child's Death. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221100902. [PMID: 35532351 DOI: 10.1177/00302228221100902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
This study identifies the stigma experienced by 12 bereaved parents 2 and 5 years after losing a child in the Sewol ferry disaster in South Korea. Using thematic analysis, we categorized the experience of stigma into two components based on Corrigan and Kosyluk's social cognitive model of stigma: public stigma and self-stigma, and each was analyzed into three types of stigma: stereotype, prejudice, and discrimination. We identified four additional factors related to stigma mitigation. The potential implications for characterizing the experiences of bereaved parents, particularly those facing stigma, are discussed in light of these findings in the longitudinal perspective.
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Affiliation(s)
- So Jung Heo
- Department of Education, Traumatic Stress Center, 35017Sungkyunkwan University, Seoul, South Korea
| | - Young Ae Kim
- Department of Education, Traumatic Stress Center, 35017Sungkyunkwan University, Seoul, South Korea
| | - Dong Hun Lee
- Department of Education, Traumatic Stress Center, 35017Sungkyunkwan University, Seoul, South Korea
| | - Ji Young Shin
- Department of Education, Traumatic Stress Center, 35017Sungkyunkwan University, Seoul, South Korea
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13
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Steinberg MH, Bellet BW, McNally RJ, Boals A. Resolving the paradox of posttraumatic growth and event centrality in trauma survivors. J Trauma Stress 2022; 35:434-445. [PMID: 34750893 DOI: 10.1002/jts.22754] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/25/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022]
Abstract
When a traumatic experience is central to an individual's identity and worldview, it can result in either severe posttraumatic stress disorder (PTSD) symptoms, perceived posttraumatic growth (PTG), or, paradoxically, both. To resolve this apparent paradox, we used network analytic methods to estimate the relations among components of event centrality (EC), PTSD symptoms, and PTG in 1,136 undergraduates who had experienced trauma. Participants completed surveys on their experiences with traumatic events as well as the degree to which they experienced PTSD symptoms, components of EC, and components of PTG. We performed network analysis to examine EC, PTSD, and PTG and identify which components of EC were most conducive to its associations with PTSD versus those with PTG. We found that the components of EC most associated with PTSD, the extent to which trauma serves as a script for the future, were markedly distinct from the components associated with PTG, the extent to which trauma is seen as a turning point in one's life. The combined findings suggest that EC may be a catalyst for subsequent positive or negative effects contingent upon how an individual interprets the centrality of their traumatic experience.
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Affiliation(s)
- Margot H Steinberg
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Benjamin W Bellet
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Richard J McNally
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Adriel Boals
- Department of Psychology, University of Northern Texas, Denton, Texas, USA
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14
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Barak A, Garber M. Bereavement in political conflict: Ideological meaning-making and dialogue. DEATH STUDIES 2022; 46:1455-1464. [PMID: 35172709 DOI: 10.1080/07481187.2022.2038309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In this research article we explored the dialogical mechanisms of ideological meaning making in the aftermath of traumatic loss, via descriptive phenomenological qualitative research. Thirty-three individuals who lost a close family member in the Israeli-Palestinian conflict were interviewed regarding the dialogues they had about their ideology in the aftermath of their loss. Analysis identified four types of dialogues that assisted in ideological meaning making: dialogue with political figures, dialogue with and through the media, dialogue with the deceased, and dialogue with radicalized bereaved individuals. Applications of our findings to the constructivist theory of bereavement are discussed.
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Affiliation(s)
- Adi Barak
- The Louis & Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Maayan Garber
- The Louis & Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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15
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Keegan O, Murphy I, Benkel I, Limonero JT, Relf M, Guldin MB. Using the Delphi technique to achieve consensus on bereavement care in palliative care in Europe: An EAPC White Paper. Palliat Med 2021; 35:1908-1922. [PMID: 34488504 DOI: 10.1177/02692163211043000] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The WHO definition of palliative care includes bereavement support as integral to palliative care, yet a previous survey of bereavement support in palliative care in Europe has shown a range of service responses to loss. A rigorous approach to agreeing and implementing a palliative care bereavement framework was required. AIM The aim of this study was to develop consensus on best-practice recommendations for bereavement care principles, structures, processes and delivery based on current practice and evidence. DESIGN In accordance with Guidance on Conducting and Reporting Delphi Studies, a consensus-building five-round Delphi technique was performed. A scoping review of research literature informed drafting of 54 statements by the EAPC Bereavement Task Force. Evaluation of the statements was performed by an expert panel using a 5-point Likert scale. ⩾80% agreement were defined as essential items and 75%-79% agreement were defined as desirable items. Items with a consensus rating <75% were revised during the process. SETTING/PARTICIPANTS The Delphi study was carried out by an expert panel among membership organisations of the European Association for Palliative Care. RESULTS In total, 376 email requests to complete Delphi questionnaire were distributed with a response rate of 23% (n = 87) and a follow-up response-rate of 79% (n = 69). Of the initial 54 statements in six dimensions, 52 statements were endorsed with 26 essential statements and 26 desirable statements. CONCLUSIONS The six dimensions and 52 statements agreed through this Delphi study clarify a coherent direction for development of bereavement services in palliative care in Europe.
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Affiliation(s)
- Orla Keegan
- Head of Education & Bereavement, Irish Hospice Foundation, Dublin, Ireland
| | - Irene Murphy
- Maymount University Hospital and Hospice, Cork, Ireland
| | | | - Joaquim T Limonero
- Facultat de Psicologia, Universitat Autonoma de Barcelona, Barcelona, Spain
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Moules NJ, Laing CM, Pelletier W, Guilcher GMT, Chan JA. Enduring Cell Lines: Parents' Experiences of Postmortem Tumor Banking in Childhood Cancer. JOURNAL OF FAMILY NURSING 2021; 27:285-294. [PMID: 33855892 PMCID: PMC8642166 DOI: 10.1177/10748407211001431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While cure rates in pediatric oncology have improved over the past 30 years, childhood cancer remains the second leading cause of death in children aged 1 to 14. Developing therapies often require using cancerous tissues, which may come from deceased donors. Tumor banks collect, store, and distribute these donated samples. While tumor banking is more common, factors that contribute to parents' decision and the impact of it on the family are not well understood. The purpose of this hermeneutic study was to understand the meaning and impact of tumor banking for parents of children who have died from cancer. Findings suggest that parents donating their child's tumors unexpectedly found a sense of meaning in their loss. They also found a legacy of their child's life; the living cells in some ways assisted the parents with grief. Aspects of this sensitive conversation and decision are discussed from the perspective of the parents' experiences.
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Pinheiro P, Gonçalves MM, Nogueira D, Pereira R, Basto I, Alves D, Salgado J. Emotional processing during the therapy for complicated grief. Psychother Res 2021; 32:678-693. [PMID: 34663184 DOI: 10.1080/10503307.2021.1985183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Prior research, mainly conducted on depression, observed that clients' improved capability to process their emotions predicted better therapeutic outcomes. The current comparative study aimed to investigate whether emotional processing was related to therapeutic change in complicated grief. METHOD We analyzed two contrasting cases (good or poor outcome) treated with grief constructivist therapy. In both cases we investigated the association of emotional processing (Experiencing Scale) to (1) therapeutic outcome (Inventory of Complicated Grief), and (2) change in the type of grief-related emotions (Emotions Episodes). RESULTS The session-by-session growth of clients' emotional processing and the change of grief-related emotions were qualitatively explored throughout both cases. Compared with the poor outcome case, the good outcome case achieved more improvement in the ability to process emotions. Such improvement occurred alongside a deeper change in the type of grief-related emotions aroused, from maladaptive to more adaptive responses. CONCLUSION Our findings suggest that a higher emotional processing capability may be associated with the transformation of grief-related maladaptive emotions and with the improvement of complicated grief condition.
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Affiliation(s)
- Patrícia Pinheiro
- School of Psychology, University of Minho, Braga, Portugal.,Department of Social and Behavior Sciences, University of Maia, Maia, Portugal
| | | | - Daniela Nogueira
- Department of Social and Behavior Sciences, University of Maia, Maia, Portugal
| | - Rui Pereira
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Isabel Basto
- Department of Social and Behavior Sciences, University of Maia, Maia, Portugal.,Center for Psychology at the University of Porto, University of Porto, Porto, Portugal
| | - Daniela Alves
- School of Psychology, University of Minho, Braga, Portugal
| | - João Salgado
- Department of Social and Behavior Sciences, University of Maia, Maia, Portugal.,Center for Psychology at the University of Porto, University of Porto, Porto, Portugal
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McLean E, Singer J, Laurita E, Kahler J, Levin C, Papa A. Perception of grief responses: Are maladaptive grief responses and the stages of grief considered normal? DEATH STUDIES 2021; 46:1414-1423. [PMID: 34632956 DOI: 10.1080/07481187.2021.1983890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Literature indicates laypeople hold strong opinions about how persons should grieve. This study examined how individuals perceive normal grief. Participants across two distinct samples (Study 1: N = 510 via MTurk; Study 2: N = 210 via Qualtrics panels) completed the Perception of Grief Scale and Grief Expectations Questionnaire. Findings indicated participants endorsed maladaptive grief responses as normal relative to other responses to loss. Endorsement of maladaptive grief responses as normal predicted endorsement of grief work beliefs. If social expectations deem maladaptive grief to be normal, as this study suggests, bereaved individuals might implicitly push themselves to grieve maladaptively.
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Affiliation(s)
| | - Jonathan Singer
- Department of Psychology, Texas Tech University, Lubbock, TX, USA
| | - Emily Laurita
- Department of Psychology, University of Nevada, Reno, NV, USA
| | - Julie Kahler
- Health Services Research and Development, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
| | - Crissa Levin
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Anthony Papa
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
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19
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Testoni I, Antonellini M, Ronconi L, Biancalani G, Neimeyer RA. Spirituality and Meaning-Making in Bereavement: The Role of Social Validation. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.1983304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Padua, Italy
- Emil Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Marco Antonellini
- Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Padua, Italy
| | - Lucia Ronconi
- Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Padua, Italy
| | - Gianmarco Biancalani
- Department of Philosophy, Sociology, Education and Applied Psychology (FISSPA), University of Padua, Padua, Italy
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20
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Vig PS, Lim JY, Lee RWL, Huang H, Tan XH, Lim WQ, Lim MBXY, Lee ASI, Chiam M, Lim C, Baral VR, Krishna LKR. Parental bereavement - impact of death of neonates and children under 12 years on personhood of parents: a systematic scoping review. BMC Palliat Care 2021; 20:136. [PMID: 34481491 PMCID: PMC8418708 DOI: 10.1186/s12904-021-00831-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Losing a child tragically impacts the well-being and functioning of parents. With these effects extending beyond emotional, physical morbidity and compromising self-perceptions, appropriate, longitudinal, timely and personalised support is key to effective care of bereaved parents. However, in the absence of a comprehensive understanding of parental bereavement, effective support of bereaved parents remains suboptimal. To address this gap, we scrutinise prevailing data on the effects of a child's death, aged 0-12 years, through the lens of the Ring Theory of Personhood (RToP). METHODS To study prevailing accounts of bereaved parents following the death of a child, we adopt Krishna's Systematic Evidence Based Approach (SEBA) to structure our Systematic Scoping Review (SSR in SEBA). RESULTS Three thousand seventy-four abstracts were reviewed, 160 full text articles were evaluated, and 111 articles were included and analysed using thematic and content analysis. Four themes/categories were identified relating to the four rings of the RToP. Findings reveal that static concepts of protective and risk factors for grief are misplaced and that the support of healthcare professionals is key to assisting bereaved parents. CONCLUSION In the absence of consistent support of bereaved parents, this study highlights the need for effective training of healthcare professionals, beginning with an appreciation that every aspect of an individual parent's personhood is impacted by the loss of their child. Acknowledging grief as a complex, evolving and personalised process subjected to parental characteristics, settings, context and available support, this SSR in SEBA calls attention to effective nurturing of the relationship between parents and healthcare professionals, and suggests use of the RToP to assess and direct personalised, timely, specific support of parents in evolving conditions. We believe the findings of this review also call for further studies to support healthcare professionals as they journey with bereaved parents.
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Affiliation(s)
- Prachi Simran Vig
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Jia Yin Lim
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Randal Wei Liang Lee
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Huixin Huang
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Xiu Hui Tan
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Wei Qiang Lim
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Marie Bernadette Xin Yi Lim
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
| | - Crystal Lim
- Medical Social Services, Singapore General Hospital, Outram Road, Block 3 Level 1, Singapore, 169608 Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
| | - Vijayendra Ranjan Baral
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
- Division of Neonatal and Developmental Medicine, Singapore General Hospital, Outram Road, Block 5 Level 4, Singapore, 169608 Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road NUHS Tower Block, Level 11, Singapore, 119228 Singapore
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610 Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597 Singapore
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436 Singapore
- Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA UK
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21
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Kelley MM. Teaching Meaning: A Pedagogical Strategy to Help Ministry Students Understand Meaning Making in Narrative Perspective. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2021; 75:207-213. [PMID: 34384033 DOI: 10.1177/15423050211038905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This article describes a pedagogical classroom exercise that encourages ministry students to understand the jarring experience some people may confront when their life stories are disrupted and their ways of making meaning are challenged. Contemporary work in narrative and meaning making that grounds the exercise is presented. This exercise may be helpful to professionals who teach or mentor ministry students in their care of those enduring loss.
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Affiliation(s)
- Melissa M Kelley
- Boston College School of Theology and Ministry, Chestnut Hill, MA, USA
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22
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Keser E, Işıklı S. Investigation of the relationship between continuing bonds and adjustment after the death of a first-degree family member by using the Multidimensional Continuing Bonds Scale. J Clin Psychol 2021; 78:218-232. [PMID: 34240416 DOI: 10.1002/jclp.23210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 05/02/2021] [Accepted: 06/17/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The study aims to develop a continuing bonds scale, investigate the relationship between continuing bonds and adjustment after loss, and test the moderating role of meaning reconstruction in this relationship. METHODS Data were collected from two different samples of 306 (Study 1) and 271 (Study 2) bereaved adults. RESULTS The four factors structure of the Multidimensional Continuing Bonds Scale (MCBS) was explored and confirmed. Hierarchical regression analysis revealed that continuing bonds showed a significant relationship with prolonged grief symptoms after controlling the risk factors such as gender, age of the deceased, time since loss, and cause of death. Meaning reconstruction moderated the relationship between continuing bonds and prolonged grief symptoms. CONCLUSION The results revealed that the MCBS can be used as a valid and reliable scale to assess the continuing bonds construct. The relationship between continuing bonds and prolonged grief symptoms varies according to the levels of meaning reconstruction.
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Affiliation(s)
- Emrah Keser
- Department of Psychology, TED University, Ankara, Turkey
| | - Sedat Işıklı
- Department of Psychology, Hacettepe University, Ankara, Turkey
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23
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Yehene E, Manevich A, Rubin SS. Caregivers' Grief in Acquired Non-death Interpersonal Loss (NoDIL): A Process Based Model With Implications for Theory, Research, and Intervention. Front Psychol 2021; 12:676536. [PMID: 33995234 PMCID: PMC8119762 DOI: 10.3389/fpsyg.2021.676536] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/07/2021] [Indexed: 12/31/2022] Open
Abstract
The number of family members caring and caregiving for a loved one undergoing physical and mental changes continues to increase dramatically. For many, this ongoing experience not only involves the “burden of caregiving” but also the “burden of grief” as their loved-one’s newfound medical condition can result in the loss of the person they previously knew. Dramatic cognitive, behavioral, and personality changes, often leave caregivers bereft of the significant relationship they shared with the affected person prior to the illness or injury. This results in what we term conditions of acquired “non-death interpersonal loss” (NoDIL). Current approaches to these losses use an amalgam of models drawn from both death and non-death loss. Despite their utility, these frameworks have not adequately addressed the unique processes occurring in the interpersonal sphere where the grieving caregiver needs to reach some modus vivendi regarding the triad of “who the person was,” “who they are now,” and “who they will yet become.” In this paper we propose a process-based model which addresses cognitive-emotional-behavioral challenges caregivers meet in the face of their new reality. These require a revision of the interpersonal schemas and the relationships that takes into account the ongoing interactions with the affected family member. The model and its utility to identify adaptive and maladaptive responses to NoDIL is elaborated upon with clinical material obtained from caregivers of people diagnosed with major neuro-cognitive disorder and pediatric traumatic brain injury. The article concludes with implications for theory, research and clinical intervention.
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Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Alexander Manevich
- The School of Psychological Sciences and the International Laboratory for the Study of Loss, Bereavement and Human Resilience, University of Haifa, Haifa, Israel
| | - Simon Shimshon Rubin
- The School of Psychological Sciences and the International Laboratory for the Study of Loss, Bereavement and Human Resilience, University of Haifa, Haifa, Israel.,Department of Psychology, Max Stern Academic College of Emek Yezreel, Jezreel Valley, Israel
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24
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How Does Grief Lead to Change? Understanding the Process of Change in Three Contemporary Psychotherapies. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2021. [DOI: 10.1007/s10879-020-09482-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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25
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Kawashima D, Kawano K. Meanings of Loss Among Japanese Suicide Bereaved: Content Analysis of Open‐Ended Responses
1. JAPANESE PSYCHOLOGICAL RESEARCH 2020. [DOI: 10.1111/jpr.12311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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26
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Aizenkot D. Meaning-Making to Child Loss: The Coexistence of Natural and Supernatural Explanations of Death. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2020. [DOI: 10.1080/10720537.2020.1819491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Dana Aizenkot
- Department of Multidisciplinary Studies, Ashkelon Academic College, Ashkelon, Israel
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27
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Schiff M, Elkins Y, Aharoni E, Weisler-Mamou I, Parnas Goldberger S, Simhon Y. Bereavement among Israeli parents who lost children in military service: Protective factors for coping with loss. DEATH STUDIES 2020; 46:1266-1275. [PMID: 32903171 DOI: 10.1080/07481187.2020.1815102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examined parental coping with grief and identified protective factors for better coping among parents who suffered the loss of a child during military service in Israel. Coping indicators included complicated grief, functioning in life tasks, succeeding in living meaningful lives, and personal growth. Participants were 164 parents who had lost children 5-16 years previously. We found strong associations between parents' decision to continue life despite traumatic loss and several indicators of coping. Meaning-making was associated with better functioning and greater personal growth. Practitioners should explore with parents the internal struggles about deciding whether to continue in life.
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Affiliation(s)
- Miriam Schiff
- Paul Berwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yoni Elkins
- Paul Berwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eti Aharoni
- Jerusalem District Department of Families and Commemoration, the Israel Defense Ministry, Jerusalem, Israel
| | - Idit Weisler-Mamou
- Jerusalem District Department of Families and Commemoration, the Israel Defense Ministry, Jerusalem, Israel
| | - Sarit Parnas Goldberger
- Jerusalem District Department of Families and Commemoration, the Israel Defense Ministry, Jerusalem, Israel
| | - Yardena Simhon
- Jerusalem District Department of Families and Commemoration, the Israel Defense Ministry, Jerusalem, Israel
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28
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Huang M, Schmiedek F, Habermas T. Only some attempts at meaning making are successful: The role of change‐relatedness and positive implications for the self. J Pers 2020. [DOI: 10.1111/jopy.12573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Manxia Huang
- Department of Psychology Goethe University Frankfurt Frankfurt am Main Germany
| | - Florian Schmiedek
- DIPF Leibniz Institute for Research and Information in Education Frankfurt am Main Germany
| | - Tilmann Habermas
- Department of Psychology Goethe University Frankfurt Frankfurt am Main Germany
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29
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Boelen PA, Lenferink LIM. Associations of depressive rumination and positive affect regulation with emotional distress after the death of a loved one. Clin Psychol Psychother 2020; 27:955-964. [PMID: 32474986 PMCID: PMC7754322 DOI: 10.1002/cpp.2482] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 11/24/2022]
Abstract
The death of a loved one may precipitate symptoms of prolonged grief disorder (PGD), post‐traumatic stress disorder (PTSD) and depression. Brooding about the causes and consequences of one's negative affect (NA), also termed depressive rumination, has been linked to distress after loss. The role of dysregulation of positive affect (PA) has received less attention. We examined (1) the factor structure of depressive rumination and PA dysregulation and (2) to what extent these factors were related to PGD, PTSD and depression symptom levels. Self‐report data were included from 235 Dutch bereaved people who completed measures tapping symptoms of PGD, PTSD and depression. Depressive rumination and PA regulation strategies were assessed with the Ruminative Response Scale (RRS) Brooding Scale and the Response to Positive Affect (RPA) Questionnaire (including three subscales: emotion‐focused and self‐focused rumination and dampening), respectively. Confirmatory factor analyses and structural equation modelling were used for data analyses. The four‐factor model (i.e., depressive rumination and the three RPA subscales) showed the best fit. An increase in depressive rumination was related to higher distress levels (across all outcomes in univariate and multivariate analyses). An increase in emotion‐focused rumination about PA was associated with less depression. More dampening of PA was related to higher PTSD levels. Findings suggest that, alongside the regulation of NA, the regulation of PA plays a role in how people respond to the death of a loved one. This points to the need for more research on NA and PA regulation in grief.
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Affiliation(s)
- Paul A Boelen
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.,ARQ Nationaal Psychotrauma Centre, Diemen, The Netherlands
| | - Lonneke I M Lenferink
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.,Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
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30
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Hope, Loneliness and Sense of Coherence among Bereaved Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082797. [PMID: 32325645 PMCID: PMC7216278 DOI: 10.3390/ijerph17082797] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/09/2020] [Accepted: 04/16/2020] [Indexed: 12/28/2022]
Abstract
Coping with the loss of a child is a challenging and difficult experience that disrupts the lives of the surviving parents and the fabric of the family. Our goal is to identify the factors that help bereaved parents cope with this loss and introduce hope and future perspectives into their lives. Our sample consisted of 81 parents (30 fathers and 51 mothers), who completed questionnaires on the following topics: family climate, loneliness, sense of coherence and hope. In addition, interviews were conducted with six parents to further clarify the quantitative results. A moderated mediation model revealed that increased levels of loneliness among the parents predicted lower levels of hope. However, their emotional resources in terms of their sense of coherence mediated this relationship. In addition, the number of years since the loss moderated the negative relationship between loneliness and the parents’ emotional resources. It can be concluded that the negative impact of loneliness on parents’ sense of coherence declined over time. The interviews conducted extend the understanding of these results, as parents described their ability to continue with their lives and identified their goals in terms of the hope theory, alongside their ongoing pain. Finally, the therapeutic implications of the results we obtained are discussed.
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31
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Maccallum F, Bryant RA. A Network Approach to Understanding Quality of Life Impairments in Prolonged Grief Disorder. J Trauma Stress 2020; 33:106-115. [PMID: 30958609 DOI: 10.1002/jts.22383] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 12/12/2022]
Abstract
Prolonged grief (PGD) is a potentially debilitating consequence of bereavement that is experienced by 7%-10% of bereaved individuals. In recent years, PGD has been the focus of increasing interest as it is associated with a range of significant negative physical and mental health outcomes. To date, however, there is little understanding of how impairment is associated with individual PGD symptom interactions. Network analysis is an innovative statistical approach that has been productively applied to examine how symptoms of psychopathology influence and reinforce each other. In this study, we examined the association between PGD symptoms and quality of life (QoL) impairments. Data from 215 bereaved individuals were used to construct networks comprising PGD symptoms and different facets of QoL. The results showed that PGD symptoms of meaninglessness and role confusion were linked with reduced psychological QoL, trust difficulties were linked with reduced social QoL, and bitterness was linked with reduced environmental QoL. These results are consistent with models that highlight the importance of self-identity and loss of meaning in PGD. By elucidating pathways of dysfunction, these findings offer clinical implications that may help to improve outcomes for persons with PGD.
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Affiliation(s)
- Fiona Maccallum
- School of Psychology, University of Queensland, St. Lucia, Australia.,School of Psychology, University of New South Wales, Sydney, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
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32
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Djelantik AAAMJ, Robinaugh DJ, Kleber RJ, Smid GE, Boelen PA. Symptomatology following loss and trauma: Latent class and network analyses of prolonged grief disorder, posttraumatic stress disorder, and depression in a treatment-seeking trauma-exposed sample. Depress Anxiety 2020; 37:26-34. [PMID: 30724427 PMCID: PMC7004006 DOI: 10.1002/da.22880] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/14/2018] [Accepted: 01/02/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Although bereavement is likely a common stressor among patients referred to a psychotrauma clinic, no study has yet examined the co-occurrence and relationships between symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder symptoms in this population. METHOD In a sample of patients seeking treatment following psychological trauma (n = 458), we used latent class analysis to identify classes of patients sharing the same profile of PGD, PTSD, and depression symptoms. We then used network analysis to investigate the relationships among these symptoms and with loss-related variables. RESULTS Most participants (65%) were members of a class that exhibited elevated endorsement of PGD symptoms. PGD, PTSD, and depression symptoms hung together as highly overlapping but distinguishable communities of symptoms. Symptoms related to social isolation and diminished sense of self bridged these communities. Violent loss was associated with more difficulty accepting the loss. The loss of close kin was most strongly associated with difficulty moving on in life. CONCLUSIONS PGD symptoms are common in trauma-exposed bereaved adults and closely associated with symptoms of PTSD and depression, illustrating the importance of assessing bereavement and PGD symptoms in those seeking treatment following trauma.
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Affiliation(s)
- A. A. A. Manik J. Djelantik
- Department of Clinical PsychologyUtrecht UniversityUtrechtThe Netherlands
- Arq Psychotrauma Expert GroupDiemenThe Netherlands
- Foundation Centrum ’45DiemenThe Netherlands
| | | | - Rolf J. Kleber
- Department of Clinical PsychologyUtrecht UniversityUtrechtThe Netherlands
- Arq Psychotrauma Expert GroupDiemenThe Netherlands
| | - Geert E. Smid
- Arq Psychotrauma Expert GroupDiemenThe Netherlands
- Foundation Centrum ’45DiemenThe Netherlands
| | - Paul A. Boelen
- Department of Clinical PsychologyUtrecht UniversityUtrechtThe Netherlands
- Arq Psychotrauma Expert GroupDiemenThe Netherlands
- Foundation Centrum ’45DiemenThe Netherlands
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Wojtkowiak J, Lind J, Smid GE. Ritual in Therapy for Prolonged Grief: A Scoping Review of Ritual Elements in Evidence-Informed Grief Interventions. Front Psychiatry 2020; 11:623835. [PMID: 33613334 PMCID: PMC7887294 DOI: 10.3389/fpsyt.2020.623835] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/28/2020] [Indexed: 11/13/2022] Open
Abstract
The aim of this article of to analyze ritual in evidence-informed treatments for prolonged and traumatic grief. A scoping review is conducted in order to give an overview of existing literature on ritual and symbolic interventions in grief therapies for prolonged grief and the type of evidence supporting these interventions. The 22 studies reported in this review reveal a variety of ritual elements ranging from symbolic expression and interaction, writing assignments, dialogue with the deceased or an imaginary person, to farewell ceremonies at the end of the treatment. The interventions are studied within different populations (e.g., bereaved spouses, perinatal loss, grief after violent death, and genocide). Almost all studies show significant effects of the grief treatment, trauma and related symptoms. However, the effects are mostly measured for the entire treatment and not separately for the ritual intervention. In the discussion we focus on the role of ritual and culture in prolonged grief treatment.
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Affiliation(s)
- Joanna Wojtkowiak
- Department of Humanist Chaplaincy Studies, University of Humanistic Studies, Utrecht, Netherlands
| | - Jonna Lind
- ARQ National Psychotrauma Center, Diemen, Netherlands
| | - Geert E Smid
- Department of Humanist Chaplaincy Studies, University of Humanistic Studies, Utrecht, Netherlands.,ARQ National Psychotrauma Center, Diemen, Netherlands
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Kim J, Jasper A, Kim J, Park SH. Understanding the Dynamics of Intergroup Relations from the Perspectives of Western Immigrants Living in Korea. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2019. [DOI: 10.1080/10720537.2019.1697975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Junhyoung Kim
- School of Public Health, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Andrea Jasper
- Department of Counseling and Special Education, Central Michigan University, Mount Pleasant, Michigan, USA
| | - Jaehyun Kim
- Department of Health and Human Performance, Texas State University, San Marcos, Texas, USA
| | - Se-Hyuk Park
- Department of Sports Sciences, Seoul National University of Science and Technology, Seoul, South Korea
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Rubin SS, Manevich A, Doron II. The Two-Track Model of Dementia Grief (TTM-DG): The theoretical and clinical significance of the continuing bond in sickness and in death. DEATH STUDIES 2019; 45:755-771. [PMID: 31713463 DOI: 10.1080/07481187.2019.1688014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Grief and mourning for family members caring for a dementia patient begin with the initial changes in the person's cognitive abilities, and intensify with the worsening of his or her condition. The aim of this article is to propose a Two-Track Model of Dementia Grief (TTM-DG). This model enlarges the theoretical, research and clinical lenses for dementia, and explores how the illness process as well as the bereavement responses after death stimulate the reworking of grief and mourning over the beloved family member. Based on the insights derived from the Two-Track Model of Loss and Bereavement and the Continuing Bonds paradigm, we propose that the clinical and research examination of dementia grief begin in life and continue after the death. The TTM - DG's Track I focuses on bio-psycho-social functioning and Track II focuses on the internalized psychological representation of the patient, the ongoing relational bond and the illness and death story. A case study illustrates how this combined perspective provides a comprehensive picture of the experience of grief for persons afflicted with dementia over the course of the disease trajectory. Future clinical and empirical research has an important role to play in the further development of this model.
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Affiliation(s)
- Simon Shimshon Rubin
- International Center for the Study of Loss, Bereavement and Human Resilience and the School of Psychological Sciences, University of Haifa, Haifa, Israel
- Department of Psychology, Max Stern Yezreel Valley College, Israel
| | - Alexander Manevich
- International Center for the Study of Loss, Bereavement and Human Resilience and the School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Israel Issi Doron
- Department of Gerontology and the Center for Research and Study of Ageing, University of Haifa, Haifa, Israel
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Crunk AE, Burke LA, Neimeyer RA, Robinson EHM, Bai H. The Coping Assessment for Bereavement and Loss Experiences (CABLE): Development and initial validation. DEATH STUDIES 2019; 45:677-691. [PMID: 31608784 DOI: 10.1080/07481187.2019.1676323] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The authors present the development and validation of the Coping Assessment for Bereavement and Loss Experiences (CABLE), the first instrument designed to assess a range of potentially constructive strategies for coping with grief following the death of a loved one. Exploratory and confirmatory factor analysis with an international sample of bereaved adults (N = 844) yielded a six-factor, 28-item structure. Use of this validated, clinically useful, self-report tool can inform clinicians and researchers in evaluating bereavement coping, and in developing interventions designed to increase the number and broaden the types of coping strategies used to facilitate healing following loss.
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Affiliation(s)
- Anne Elizabeth Crunk
- Graduate School of Education and Human Development, Department of Counseling and Human Development, The George Washington University, Washington, District of Columbia, USA
| | - Laurie A Burke
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Robert A Neimeyer
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Edward H Mike Robinson
- Department of Child, Family, and Community Sciences, University of Central Florida, Orlando, Florida, USA
| | - Haiyan Bai
- Department of Learning Sciences & Educational Research, College of Community Innovation and Education, University of Central Florida, Orlando, Florida, USA
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37
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Wheat LS, Thacker NE. LGBTQ+ Loss Experiences and the Use of Meaning Reconstruction with Clients. JOURNAL OF LGBT ISSUES IN COUNSELING 2019. [DOI: 10.1080/15538605.2019.1627973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Laura S. Wheat
- Department of Educational Psychology and Counseling, The University of Tennessee, Knoxville, TN, USA
| | - Nancy E. Thacker
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
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Hay A, Hall CW, Sealey M, Lobb EA, Breen LJ. Developing a practice-based research agenda for grief and bereavement care. DEATH STUDIES 2019; 45:331-341. [PMID: 31293223 DOI: 10.1080/07481187.2019.1636897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We aimed to identify practitioners' perspectives on current research priorities in grief and bereavement care. Grief and bereavement care providers were invited to participate in a three-phase Delphi study to create expert consensus on the top priorities for grief and bereavement research. A total of 140 participants completed Phase 1, 84 completed Phase 2, and 70 completed Phase 3. These top 10 research priorities form the basis of a practice-based research agenda for grief and bereavement care to enable researchers to respond to key issues in grief and bereavement care that will ultimately improve the lives of bereaved people.
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Affiliation(s)
- Ashton Hay
- School of Psychology, Curtin University, Perth, Australia
| | | | - Margaret Sealey
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
| | - Elizabeth A Lobb
- Calvary Health Care Kogarah, Kogarah, Australia
- Cunningham Centre for Palliative Care, Darlinghurst, Australia
- School of Medicine, University of Notre Dame Sydney, Darlinghurst, Australia
| | - Lauren J Breen
- School of Psychology, Curtin University, Perth, Australia
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Zakarian RJ, McDevitt-Murphy ME, Bellet BW, Neimeyer RA, Burke LA. Relations Among Meaning Making, PTSD, and Complicated Grief Following Homicide Loss. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1565111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Rebecca J. Zakarian
- aDepartment of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | | | - Benjamin W. Bellet
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Robert A. Neimeyer
- aDepartment of Psychology, The University of Memphis, Memphis, Tennessee, USA
- Portland Institute for Loss and Transition, Portland, Oregon, USA
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40
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Milman E, Neimeyer RA, Fitzpatrick M, MacKinnon CJ, Muis KR, Cohen SR. Rumination moderates the role of meaning in the development of prolonged grief symptomatology. J Clin Psychol 2019; 75:1047-1065. [DOI: 10.1002/jclp.22751] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/19/2018] [Accepted: 12/27/2018] [Indexed: 02/04/2023]
Affiliation(s)
- Evgenia Milman
- Department of Educational and Counselling PsychologyMcGill UniversityMontreal Quebec
| | | | - Marilyn Fitzpatrick
- Department of Educational and Counselling PsychologyMcGill UniversityMontreal Quebec
| | | | - Krista R. Muis
- Department of Educational and Counselling PsychologyMcGill UniversityMontreal Quebec
| | - S. Robin Cohen
- Departments of Oncology and MedicineMcGill UniversityMontreal Quebec
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41
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Mahat-Shamir M, Pitcho-Prelorentzos S. Grieving From the Womb: Meaning Construction in Response to Father Loss Before Birth. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2019. [DOI: 10.1080/10720537.2019.1568939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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42
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Broden EG, Uveges MK. Applications of Grief and Bereavement Theory for Critical Care Nurses. AACN Adv Crit Care 2019; 29:354-359. [PMID: 30185503 DOI: 10.4037/aacnacc2018595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Elizabeth G Broden
- Elizabeth G. Broden is a Registered Nurse, Pediatric Intensive Care Unit, Children's Hospital of Philadelphia, and a doctoral student, University of Pennsylvania School of Nursing, 418 Curie Blvd #425, Philadelphia, PA 19104 . Melissa Kurtz Uveges is a Post-Doctoral Fellow, Center for Bioethics, Harvard Medical School, Boston, Massachusetts
| | - Melissa Kurtz Uveges
- Elizabeth G. Broden is a Registered Nurse, Pediatric Intensive Care Unit, Children's Hospital of Philadelphia, and a doctoral student, University of Pennsylvania School of Nursing, 418 Curie Blvd #425, Philadelphia, PA 19104 . Melissa Kurtz Uveges is a Post-Doctoral Fellow, Center for Bioethics, Harvard Medical School, Boston, Massachusetts
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Abstract
The death of a significant person, especially when it comes tragically or prematurely, can shake the foundations of our assumptive and relational world and lead to anguished attempts to find meaning in the loss and in our lives in its aftermath. In this article, I review one program of research focused on this attempt at meaning reconstruction, describe recently developed measures of meaning in mourning, and discuss several therapeutic techniques for helping clients make sense of the death and rework their attachment relationship to the deceased. I conclude by illustrating some of this work in my therapy with a couple grieving the loss of not one but two children to tragic accidents, as they try to adapt to a compound traumatic bereavement.
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Affiliation(s)
- Robert A Neimeyer
- a Department of Psychology , University of Memphis , Memphis , TN , USA
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44
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Romero MM. Meaning Reconstruction in Bereaved Family Caregivers of Person's With Alzheimer's Disease: A Mixed-Methods Study. OMEGA-JOURNAL OF DEATH AND DYING 2018; 82:548-569. [PMID: 30590989 DOI: 10.1177/0030222818821024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this descriptive study was to identify whether meaning reconstruction was associated with indicators of bereavement adaptation in 66 spouses and adult child caregivers of person's with Alzheimer's disease. A cross-sectional mixed-methods design was used. Hierarchical regression models were used to examine whether meaning making predicted grief, depression, and positive and states of mind in the sample. Qualitative interviews were conducted to gain further knowledge about ways in which Alzheimer's disease caregivers construct meaning during bereavement. The majority of participants reported experiencing positive aspects of meaning reconstruction. Benefit-finding and identity change contributed to reductions in grief, and benefit-finding contributed to positive states of mind. Being a spouse and female gender contributed to increased grief and depression. Bereaved caregivers who are at risk for high levels of grief should be targeted for grief therapy interventions that foster meaning making.
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45
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Masterson MP, Slivjak E, Jankauskaite G, Breitbart W, Pessin H, Schofield E, Holland J, Lichtenthal WG. Beyond the bucket list: Unfinished and business among advanced cancer patients. Psychooncology 2018; 27:2573-2580. [PMID: 29947443 PMCID: PMC6219918 DOI: 10.1002/pon.4821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/13/2018] [Accepted: 06/07/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The study aims to examine the prevalence and common themes of unfinished business (UB) and its associations with distress among advanced cancer patients. METHODS A total of 223 patients from a larger randomized controlled trial of Individual Meaning-Centered Psychotherapy (IMCP) completed self-report questionnaires that assessed UB and UB-related distress, hopelessness, desire for hastened death, anxiety and depression, quality of life, spiritual well-being, and purpose/meaning. Unfinished business themes were identified by qualitative analysis of open-ended data. RESULTS A total of 161 (72%) patients reported the presence of UB. The mean UB-related distress score was 7.01 (SD = 2.1) out of 10. Results of independent t tests showed that patients with UB reported significantly higher levels of anxiety and lower levels of existential transcendence than patients without UB. Linear regression equations indicated that UB-related distress significantly predicted hopelessness (F1,154 = 9.54, P < 0.05, R2 = 0.058), anxiety (F1,154 = 4.31, P < 0.05, R2 = 0.027), personal meaning (F1,136 = 6.18, P < 0.05, R2 = 0.043), and existential transcendence (F1,119 = 6.7, P < 0.05, R2 = 0.053). Ten UB themes emerged from open-ended responses; UB themes were not associated with UB-related distress or psychological adjustment. CONCLUSIONS Unfinished business was both prevalent and distressing in our sample. Findings underscore the need to develop and implement interventions designed to help patients resolve or find solace with UB.
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Affiliation(s)
- Melissa P Masterson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Psychology, Fordham University, Bronx, New York
| | - Elizabeth Slivjak
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Greta Jankauskaite
- Department of Psychology, University of Maryland, College Park, Maryland
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hayley Pessin
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Wendy G Lichtenthal
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
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46
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Schaefer LM, Howell KH, Schwartz LE, Bottomley JS, Crossnine CB. A concurrent examination of protective factors associated with resilience and posttraumatic growth following childhood victimization. CHILD ABUSE & NEGLECT 2018; 85:17-27. [PMID: 30205895 DOI: 10.1016/j.chiabu.2018.08.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/17/2018] [Accepted: 08/29/2018] [Indexed: 06/08/2023]
Abstract
The present study concurrently examined protective factors associated with the adaptive outcomes of resilience and posttraumatic growth (PTG; defined as positive psychological change resulting from a life crisis or trauma), after accounting for relevant demographic factors and the impact of circumstances surrounding childhood victimization (i.e., age of first trauma, frequency of victimization, and perception of trauma severity). The protective factors examined in the present study included social support from friends and family, optimism, positive religious coping (i.e., looking to God for support and guidance; forgiveness), and negative religious coping (i.e., feeling abandoned by God; anger towards God). Participants included 161 college students from the US MidSouth, aged 18-24 (Mage = 19.97, SD = 1.86). All participants reported experiencing physical violence and/or sexual abuse during their childhood. Hierarchical multiple regression analyses indicated that after accounting for demographics and circumstances surrounding the childhood victimization, higher resilience was associated with greater family support, optimism, and positive religious coping, while higher posttraumatic growth was associated with greater optimism and positive religious coping. These findings underscore the protective role of optimism with respect to both resilience and posttraumatic growth. Additionally, results highlight the importance of examining cognitions related to religious coping rather than simply assessing broadband religiosity, as only positive religious coping was associated with adaptive outcomes. Findings suggest the importance of early intervention to bolster protective factors (i.e., family support, positive thinking, gratitude, and positive religious coping skills) among youth exposed to childhood physical and sexual victimization.
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47
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Malgaroli M, Maccallum F, Bonanno GA. Symptoms of persistent complex bereavement disorder, depression, and PTSD in a conjugally bereaved sample: a network analysis. Psychol Med 2018; 48:2439-2448. [PMID: 30017007 DOI: 10.1017/s0033291718001769] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Complicated and persistent grief reactions afflict approximately 10% of bereaved individuals and are associated with severe disruptions of functioning. These maladaptive patterns were defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent complex bereavement disorder (PCBD), but its criteria remain debated. The condition has been studied using network analysis, showing potential for an improved understanding of PCBD. However, previous studies were limited to self-report and primarily originated from a single archival dataset. To overcome these limitations, we collected structured clinical interview data from a community sample of newly conjugally bereaved individuals (N = 305). METHODS Gaussian graphical models (GGM) were estimated from PCBD symptoms diagnosed at 3, 14, and 25 months after the loss. A directed acyclic graph (DAG) was generated from initial PCBD symptoms, and comorbidity networks with DSM-5 symptoms of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) were analyzed 1 year post-loss. RESULTS In the GGM, symptoms from the social/identity PCBD symptoms cluster (i.e. role confusion, meaninglessness, and loneliness) tended to be central in the network at all assessments. In the DAG, yearning activated a cascade of PCBD symptoms, suggesting how symptoms lead into psychopathological configurations. In the comorbidity networks, PCBD and depressive symptoms formed separate communities, while PTSD symptoms divided in heterogeneous clusters. CONCLUSIONS The network approach offered insights regarding the core symptoms of PCBD and the role of persistent yearnings. Findings are discussed regarding both clinical and theoretical implications that will serve as a step toward a more integrated understanding of PCBD.
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48
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Florczak KL, Lockie N. Losing a partner: Do continuing bonds bring solace or sorrow? DEATH STUDIES 2018; 43:281-291. [PMID: 29757109 DOI: 10.1080/07481187.2018.1458761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 01/08/2018] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this qualitative descriptive study, underpinned by the humanbecoming paradigm, was to bring forth a deeper understanding about continuing bonds with a deceased spouse and describe the transformative process of losing a partner. Each of six participants dialogued with researchers on three to four occasions about the life and death of their loved one, continuing bonds with the deceased, struggles they have encountered, and dreams of the future. It was discovered that participants told a story that changed over time, struggled with continuing bonds, suffered with loneliness and desired new intimate relationships.
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Affiliation(s)
| | - Nancy Lockie
- b Saint Xavier University , Chicago , Illinois , USA
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49
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Silvén Hagström A. "Why did he choose to die?": A meaning-searching approach to parental suicide bereavement in youth. DEATH STUDIES 2018; 43:113-121. [PMID: 30252619 DOI: 10.1080/07481187.2018.1457604] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article analyzes from a narrative perspective how young people talk about their experience of parental suicide in different social contexts. The results show how these young grievers are preoccupied with the question of Why the parent committed suicide. Moreover, they tend primarily to interpret the suicide in line with stigmatizing discourses regarding Who is to blame, which has negative impacts on their identities. In contrast, a "meaning-searching approach" seeks to answer the question of What caused the suicide and to identify a combination of internal vulnerabilities and external stressors. Professional interventions are recommended to foster the latter health promoting coping strategy.
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Affiliation(s)
- Anneli Silvén Hagström
- a Department of Social Work and Psychology, Faculty of Health and Occupational Studies , Gävle University , Gävle , Sweden
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50
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Bottomley JS, Smigelsky MA, Bellet BW, Flynn L, Price J, Neimeyer RA. Distinguishing the meaning making processes of survivors of suicide loss: An expansion of the meaning of loss codebook. DEATH STUDIES 2018; 43:92-102. [PMID: 30247994 DOI: 10.1080/07481187.2018.1456011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Suicide loss represents particularly a difficult form of bereavement due to the challenges that volitional death poses to survivors. Understanding these challenges requires recognition of the idiosyncratic processes of meaning reconstruction for this specific group of grievers. The current study investigates such processes in survivors of suicide loss (SOSL) by utilizing the Meaning of Loss Codebook (MLC) to analyze the narratives of eight SOSL. The findings contribute to a broader understanding of meaning making following suicide, strengthen the validity of the MLC by demonstrating its appropriateness for SOSL, and illuminate unique challenges faced by SOSL, resulting in the proposal of supplemental MLC codes. Research and clinical implications are discussed.
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Affiliation(s)
- Jamison S Bottomley
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Melissa A Smigelsky
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Benjamin W Bellet
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Lauren Flynn
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Justin Price
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
| | - Robert A Neimeyer
- a Department of Psychology , University of Memphis , Memphis , Tennessee , USA
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