To share or not to share? The contribution of self-disclosure to stress-related growth among suicide survivors

Military-bereaved siblings' growth and distress - Interplays between interpersonal factors and commemoration

Sibling bereavement due to military casualties can produce psychological distress but can also elicit personal growth. This research explored the association between psychological distress and post-traumatic growth (PTG) among military-bereaved siblings via a moderated mediation model. Israeli military-bereaved siblings were recruited through a nonprofit organization devoted to bereaved siblings of military casualties. Participants (N = 155) completed questionnaires of posttraumatic growth, distress, commemoration, social support. Results supported the moderated mediation study model. Specifically, higher psychological distress was associated with lower social support, which was subsequently associated with lower self-disclosure, for the entire sample. This association was strongest for bereaved siblings with high relief-related commemoration, which was then associated with lower PTG. Pursuant to our findings, mental health professionals need to guide bereaved siblings toward involvement in commemoration activities that bring them relief, thus further enabling social support that facilitates personal disclosure and, subsequently, PTG.

Posttraumatic growth experiences in suicide survivors: a qualitative inquiry in conflict zone

The present research explores the experience of positive psychological change i.e., posttraumatic growth (PTG) among the suicide survivors. Semi structured interview method was used to understand the process of PTG. Twelve young adults were recruited with the help of snowball sampling. Five themes emerged after data analysis i.e., social support, coping strategies, spiritual/religious change, changed priorities, and changed interpersonal relationships. Findings can provide new perspective to mental health professionals.

Shame, depression, and complicated grief among suicide loss-survivors: the moderating role of self-disclosure

Background: Suicide-loss survivors (SLSs) are recognised as an at-risk population for several psychiatric complications, including complicated grief (CG) and depression (SI). However, whereas shame is known as one of the characteristics of this population, knowledge about possible psychological processes which may moderate the contribution of shame levels to CG and depression in the aftermath of suicide loss is sparse. This study examines the role of self-disclosure - the inclination to share personal information with others - as a possible moderator of the associations of shame with CG and shame with depression over time.Method: Participants were 152 suicide-loss survivors, aged 18-70, who completed questionnaires tapping CG and depression at three time points (T1- index measurement, T2-two years after T1. and T3-four years after T1) and questionnaires tapping shame and SD at T3.Results: Hierarchical regression analyses showed that shame significantly and positively contributed to CG at T3 and to depression at T3, beyond the CG/depression trajectories. Notably, two significant interactions were found: Self-disclosure moderated the contribution of shame to CG at T3 and to depression at T3. At lower self-disclosure levels, shame's contribution to CG and depression was higher.Conclusion: The study's findings highlight shame as a significant facilitator of CG and depression in the aftermath of suicide loss. Moreover, the role of interpersonal interaction on SLSs' distress levels and grieving process was underscored, as this interaction may serve as a buffer against the deleterious sequelae of the suicide of a loved one.

The Detection of Resilience in Families Grieving Over a Suicide

The study, conducted in 2021, describes the relationship between resilience development factors and dimensions and the grief processes of persons affected by the suicide of a family member. The objective was to analyze whether the loved ones of suicide victims had developed resilient behaviors and how these were manifested during the mourning process. To achieve this, two instruments were used: the Brief Resilience Coping Scale (BRCS), and in-depth interviews, in both cases applied to a sample of 21 individuals from whom narratives of their experiences were obtained as elements for analysis. These narratives were operationalized, coded and analyzed according to the theoretical framework advanced by the authors Edith Grotberg and Cecily Knight. The behaviors detected took the form, among others, of artistic expression and/or the provisioning of support services to people affected by suicide, generally through participation in associations and self-help groups dedicated to the care and facilitation of emotional expression resulting from the traumatic event.

Predictors of Stigma, Guilt, and Shame among Adults Bereaved by Fatal Overdose

With the spectacular rise of US overdose deaths, bereavement for these affected families has become a matter of increasing concern. Qualitative research has highlighted the role of stigmatization as well as guilt and shame among this population. However, the magnitude and pre-death predictors of stigmatization, guilt, and shame have yet to be assessed quantitatively. In the current study, we assess the magnitude of stigmatization, guilt, and shame among 115 adults bereaved by overdose by drawing comparisons with 185 adults bereaved by suicide. Results revealed no significant differences regarding overall levels of stigmatization, guilt, and shame between the overdose and suicide bereaved. Among the overdose bereaved, regression models indicated a number of pre-death factors associated with stigmatization, guilt, and shame, such as the frequency of the decedent's drug use, family drug use severity, and interpersonal conflict between the bereaved and the decedent. Implications and future directions for research are discussed.

Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women

Coping with difficulty conceiving and the ensuing fertility treatments is a stressful experience that impacts many aspects of women's lives. On the basis of Lazarus and Folkman's model of stress and coping and Schaefer and Moos's model of personal growth, and in view of the sparse literature on cultural aspects of infertility and personal growth, this study examined the relationship between stress on the one hand and personal growth and life satisfaction on the other among Arab and Jewish Israeli women. Furthermore, it investigated the moderating role played by perceived stigma, coping flexibility, cultural orientation (individualism and collectivism), and ethnicity. Two hundred five Arab and Jewish Israeli women undergoing fertility treatment completed self-report questionnaires. The results show that Arab women reported higher levels of personal growth and individualism than Jewish women. In the whole sample, a linear negative relationship was found between stress and life satisfaction, and a curvilinear relationship was found between stress and personal growth. In addition, perceived stigma, collectivism, individualism, and coping flexibility were found to moderate the association between perceived stress and personal growth. The findings provide further understanding of personal growth in the context of infertility, showing that personal resources and perceptions are more important than cultural differences in this regard.

Prolonged Grief Symptoms among Suicide-Loss Survivors: The Contribution of Intrapersonal and Interpersonal Characteristics

BACKGROUND

Suicide-loss survivors (SLSs) are a population with unique characteristics that place them at increased risk for developing grief complications and painful feelings of guilt that may impact their supportive social environment. However, no studies to date have examined the role of intrapersonal and interpersonal variables that may contribute to prolonged grief symptoms (PGS) as outlined by the new DSM-5 criteria. The present study aimed to extend knowledge regarding the role of interpersonal variables, such as perceived burdensomeness, thwarted belongingness, and self-disclosure, in determining the impact of guilt on the development of PGS among SLSs.

METHOD

This study is part of a longitudinal study, though, in this study, we used a cross-sectional examination of the recently completed fourth measurement. Study participants included 152 SLSs aged 22 to 76 who completed questionnaires measuring guilt, depression, perceived burdensomeness, thwarted belongingness, self-disclosure, and PGS using the Prolonged Grief-Revised Inventory. Participants' demographics and loss-related characteristics, such as time since suicide and participant's age at the time of suicide, were examined.

RESULTS

Confirming the hypotheses, intrapersonal variables (i.e., guilt and depression), as well as interpersonal variables (i.e., perceived burdensomeness, thwarted belongingness, and self-disclosure), contributed significantly to PGS beyond sociodemographic and loss-related factors. Perceived burdensomeness significantly moderated the contribution of guilt to PGS: for participants with high burdensomeness levels, guilt contributed to PGS more strongly than for participants with low burdensomeness.

CONCLUSION

Guilt is an important contributor to PGS among SLSs, and perceived burdensomeness plays a critical role in moderating this contribution. In light of these findings, it can be suggested that SLSs with high levels of guilt should receive special attention and may benefit from therapeutic interventions focusing on reducing maladaptive cognitions that elicit intense guilt or perceived burden.

To share or not to share? Evaluation of a strategic disclosure program for suicide attempt survivors

While suicide attempt survivors often choose to conceal their suicidal thoughts and behaviors to avoid stigma, concealment might also limit the support they receive. This study evaluated a peer-led strategic disclosure intervention for suicide attempt survivors (N = 38) who were randomized to either a 6-hour group disclosure intervention or waitlist control. Results showed a significant group-by-time interaction from baseline to post-intervention on two measures of self-stigma, depression, and self-esteem, but not for other variables. Effect sizes were medium to large. Findings suggest that suicide attempt survivors may benefit from interventions that address self-stigma and disclosure.

Growing together: interpersonal predictors of posttraumatic growth trajectory among suicide-loss survivors

BACKGROUND

Recent studies have indicated that grieving after suicide loss can be particularly complex and traumatic. However, studies have recognized the opportunity for personal growth among suicide-loss survivors. This study signifies an effort to develop a comprehensive understanding of the underlying interpersonal facilitators of posttraumatic growth (PTG) among suicide-loss survivors in a longitudinal design.

METHOD

Participants included 189 suicide-loss survivors (155 females), aged 21-73, who completed questionnaires of thwarted belongingness (TB), perceived burdensomeness (PB), and self-disclosure at T1. Moreover, participants were assessed on PTG levels at T1, 18 months (T2), and 42 months (T3).

RESULTS

The integrated mediation model indicated that both TB and PB contributed to the PTG trajectory. PB and self-disclosure contributed to PTG at T3 beyond the PTG trajectory across time. We also found self-disclosure to mediate the association of TB and PTG at T2 and T3.

CONCLUSIONS

These findings suggest that interpersonal factors play critical roles in contributing to PTG over time among suicide-loss survivors. Basic psychoeducational interventions designed to foster interpersonal behaviors may facilitate achieving PTG among survivors in the aftermath of suicide loss.

Longitudinal Intercorrelations between Complicated Grief and Posttraumatic Growth among Suicide Survivors

BACKGROUND

Suicide survivors are prone to elevated risk for several psychiatric and somatic complications, including complicated grief (CG) and depression. Recent studies have highlighted the possibility of posttraumatic growth (PTG) among suicide survivors. However, to date, no longitudinal study has focused on the relationships between CG and PTG among suicide survivors.

AIMS

In this 18-month longitudinal design study, our goal was to investigate the longitudinal bidirectional associations between PTG and CG, as well as between PTG and depression among suicide survivors.

METHOD

Participants were156 suicide-loss survivors, aged 18-70, who completed questionnaires tapping the CG and PTG at T1 and again after 18 months (T2). Depression was measured only at T2.

RESULTS

The integrated model showed that CG-T1 predicts a reduction in PTG-T2 levels, beyond the trajectory of PTG. Whereas PTG-T1 was negatively correlated with CG-T2 and with depression at T2, this path was only marginally significant in the model.

LIMITATIONS

Voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment.

CONCLUSION

The study's findings suggest that CG levels play an important role in facilitating PTG among suicide survivors, with high CG levels impeding the possibility of growth. PTG did not act as a coping strategy to reduce CG. Clinical and research implications are discussed.

Self-disclosure, social support and postpartum depressive mood in online social networks: a social penetration theory perspective

Purpose

The purpose of this research is to investigate how postpartum mothers conduct self-disclosure on social media may obtain social support and therefore improve their depressive mood.

Design/methodology/approach

The authors extract variables of self-disclosure by manual coding postpartum mothers' 835 posts from a parenting social media in China. The ordinary least squares model and the binary logistic regression model are used to test the proposed hypotheses.

Findings

The study suggests that both mothers' superficial level disclosure and personal level disclosure positively affect online social support received, and the effect of personal level disclosure on social support is much greater than that of superficial level disclosure. Online social support received is related to the content of the post and reduces mothers' depressive mood. The authors further find that the association between personal level disclosure and depressive mood is fully mediated by social support.

Research limitations/implications

The data are collected from a parenting social network. Although it is the major parenting social media with the most users in China, the generalizability of this model and the findings to other social media need additional research.

Practical implications

This study offers implications for researchers and practitioners with regard to social media uses and impacts, which also has important implications for policy and interventions for the mental health of mothers.

Originality/value

This paper makes theoretical contributions to the literature of social penetration theory and social support by (1) dividing self-disclosure into superficial level disclosure and personal level disclosure according to the intimacy of self-disclosure; (2) empirically investigating the direct effect of online self-disclosure on social support and the mediating effect of social support between online self-disclosure and mothers' depressive mood.

Bereavement in the Aftermath of Suicide, Overdose, and Sudden-Natural Death: Evaluating a New Measure of Needs

Bereavement has been associated with a number of adverse outcomes, including mortality, particularly among those who experience the sudden loss of a close other. With rising rates of sudden death in the United States, fueled by an alarming increase in fatal overdose deaths, identifying bereavement-related needs among the sudden-death bereaved is essential. The present study investigated the factor structure, internal reliability, and validity of the Sudden Bereavement Needs Inventory (SBNI) in a sample of sudden loss survivors (i.e., fatal overdose, suicide, and sudden-natural loss; N = 403). Confirmatory factor analysis supported a six-factor structure, with items reflecting pragmatic, informational, spiritual, relational, meaning, and emotional needs. SBNI factors showed adequate internal consistency, with significant associations between SBNI scores, loss characteristics, and mental health outcomes (e.g., prolonged grief symptoms, meaning-making, posttraumatic stress disorder [PTSD] symptoms, and anxiety), supporting the scale's validity and highlighting the potential applicability of the instrument in both research and clinical contexts. Future research should examine test-retest reliability of the SBNI, particularly through the lens of understanding whether and how bereavement needs change over time.

The longitudinal contribution of attachment models and interpersonal factors to posttraumatic growth among suicide-loss survivors

OBJECTIVE

This study aimed to deepen our understanding of the interpersonal facilitators of posttraumatic growth (PTG) among suicide-loss survivors (SLSs) by focusing on the effects of attachment models on PTG in a 4-year longitudinal design.

METHOD

One-hundred and fity-two SLSs completed a series of questionnaires tapping attachment models, self-disclosure, social support and PTG in a three-wave study design.

RESULTS

Attachment models, self-disclosure, and perceived social support at T1 were found to predict PTG levels at T2. Self-disclosure alone predicted PTG at T3. Structural equation modeling analysis revealed that interpersonal factors served as mediators of the relationship between attachment models and PTG beyond the PTG trajectory.

CONCLUSIONS

Attachment models play an important role in facilitating PTG among SLSs. Thus, therapeutic interventions based on attachment models of self and other specifically designed to promote a sense of self-worth and confidence in others may be valuable in facilitating growth among SLSs.

Using Multiple Regression Analyses to Uncover Patterns of Correlates of Grief Problems, Depression and Suicidal Ideation Among Suicide Bereaved Individuals

This analysis of a convenience sample survey of 195 suicide bereaved adults focuses on predictors of three important highly interrelated experiences among the suicide bereaved: grief problems, depression and suicidal thinking. Although each of these three experiences can be explained by a unique set of predictors, they share many commonalities. Several predictors stood out especially in either aggravating or alleviating these experiences: personal (or post-traumatic) growth, perceived social support, feelings of blameworthiness, perceived suicide stigma, years since loss and a respondent's mental health difficulties experienced prior to their suicide loss. We also review the clinical implications of these results.

Pulling Together - The Protective Role of Belongingness for Depression, Suicidal Ideation and Behavior Among Suicide-Bereaved Individuals

Background: While belongingness has frequently been investigated in the general population as an antidote to experiencing depression, suicidal thoughts, and suicidal behavior, it has rarely been evaluated as a protective factor among individuals bereaved by suicide. Aims: We examined whether perceived belongingness could moderate the differences between suicide-bereaved, suicide-exposed, and nonexposed respondents regarding depression, suicide ideation, and suicide attempts. Method: We conducted an online survey of the adult Israeli population (N = 806), with 203 suicide-bereaved, 266 suicide-exposed, and 377 nonexposed respondents. Participants completed several questionnaires tapping depression and suicidality as well as perceived belongingness levels. Results: Individuals bereaved by suicide reported the highest levels of depression, suicide ideation, and suicide attempts in comparison with suicide-exposed and nonexposed individuals. However, belongingness was found to moderate these distinctions concerning suicide ideation and suicide attempts. Limitations: Belongingness was assessed by only a single question, and the online survey suffered from a relatively high nonresponse rate. Conclusion: Our results suggest that belongingness may act as a potent antidote to the adverse mental health consequences among individuals bereaved by suicide. Clinicians should accord adequate attention to fostering social connectedness among their clients bereaved by suicide.

Interpersonal predictors of suicide ideation and complicated-grief trajectories among suicide bereaved individuals: A four-year longitudinal study

BACKGROUND

Survivors of suicide loss (suicide survivors) are recognized as an at-risk population for several psychiatric complications, including complicated grief (CG) and suicide ideation (SI). Recent studies have emphasized the contribution of interpersonal factors, such as thwarted belongingness and perceived burdensomeness, on distress and suicidality. However, no longitudinal study has examined the predictive values of these interpersonal factors on CG and SI trajectories among suicide survivors to date. In this 42-month prospective design study, we examined interpersonal variables as predictors of CG and SI over time.

METHOD

Participants were 152 suicide survivors, aged 18-70, who completed questionnaires tapping thwarted belongingness, perceived burdensomeness, CG, and SI at index measurement (T1) and again after 18 months (T2) and 40 months (T3).

RESULTS

The integrated model showed that thwarted belongingness and perceived burdensomeness predicted SI and CG levels over time, both directly and indirectly. Thwarted belongingness was found to have a high predictive value on SI levels, whereas perceived burdensomeness was predictive of CG levels.

LIMITATIONS

The voluntary nature of the participants; self-report measures; lack of pre-suicide-loss assessment.

CONCLUSION

The study's findings highlight the critical role of interpersonal factors in facilitating CG and SI among suicide survivors. Those with higher levels of thwarted belongingness and perceived burdensomeness presented increased prospects of both SI and CG. Theoretical implications relating to healing processes are discussed, as well as focused clinical recommendations, including psychoeducational interventions for addressing PB and TB among suicide survivors.

The Experiences of Grief and Personal Growth in University Students: A Qualitative Study

BACKGROUND

Experiencing the death of a close person, especially in emerging adults and students, can have profound effects on the bereaved individual's life. As most research in this field has focused on negative effects of a loss, little is known about potential positive effects experienced by bereaved university students. This study investigated the experience of grief and personal growth in a sample of students from The University of Melbourne, Australia.

METHODS

Semi-structured interviews via Zoom/telephone with bereaved students (n = 14), who were invited to reflect on their loss and any personal growth potentially experienced. Thematic analysis of the data was based on a deductive and inductive approach.

RESULTS

The analysis identified four themes: (i) sharing of grief as a coping mechanism, (ii) balance between grief reactions and moving forward in life, (iii) lessons learned and personal growth, and (iv) adopting values from the deceased person and continuing bonds.

CONCLUSIONS

Participants emphasized personal growth regarding self-perception and philosophical views on life. Following the loss, they preferred peer support, and used formal services only when they had a specific need. The findings indicate the importance of social support for bereaved students, and the complimentary role of peer and professional support. Hence, academic institutions should offer supportive services tailored to both students and professionals to help bereaved students.

Forgive but not forget: From self-forgiveness to posttraumatic growth among suicide-loss survivors

Suicide-loss survivors often experience personal growth in the aftermath of a loss, depending on their personal and interpersonal characteristics. The current study focuses on the role of self-forgiveness (SF) as a contributing factor, both directly and indirectly, to posttraumatic growth (PTG) among suicide-loss survivors. Israeli suicide-loss survivors (N = 124) completed questionnaires measuring SF and PTG as well as adaptive coping strategies, social support, and self-disclosure. SF positively contributed to PTG, both directly and indirectly, through interpersonal and cognitive processes. These findings highlight the value of actions promoting self-forgiveness, compassion, and acceptance in psychological interventions with suicide-loss survivors.

"It Changes Your Orbit": The Impact of Suicide and Traumatic Death on Adolescents as Experienced by Adolescents and Parents

BACKGROUND

Having someone close die through suicide or another form of traumatic death is a distressing event in the lives of adolescents, putting them at risk of grief and mental health ramifications. As most research in this field has been focused on intrapersonal grief reactions, this study aimed to broaden the perspective by exploring the impact of the death through an interpersonal lens.

METHODS

The study involved individual and group interviews with bereaved adolescents (n = 20) and parents of bereaved adolescents (n = 18), and thematic analysis of the data.

RESULTS

The analysis yielded three themes: (i) the death is a life-changing experience, (ii) the death differentiates you from your peers, and (iii) the death impacts on the family system.

CONCLUSIONS

The study revealed the devastating impact of the deaths on adolescents, their relationships with peers and the family system. Adolescents' grief must be understood within the context of their agency and their immediate social environment. The findings clearly indicate that support for bereaved adolescents should incorporate the familial context.

Factors of Seeking Professional Psychological Help by the Bereaved by Suicide

Background

Studies show that people bereaved by suicide often feel a strong need for professional help. It is hypothesized that aspects related to suicide bereavement, such as stigmatization, shame or guilt, hinder help-seeking process of the bereaved. However, little is known about help-seeking behaviors of people who has lost someone due to suicide.

Aims

This study was conducted to attain a better understanding of the contributing factors, including the specific features of grief following suicide, to help-seeking behaviors of the bereaved by suicide.

Methods

The sample consisted of 82 adults bereaved by suicide (64 female; average age 37.79, SD = 14.33). Instruments assessing stigmatization, shame, guilt levels, well-being, tendency to disclose emotional distress and attitudes toward seeking professional psychological help were used. The participants were also asked an open-ended question what professional help-seeking barriers they had encountered. Comparisons between the groups, logistic regression analysis and thematic analysis of the qualitative data were performed.

Results

The findings revealed that bereaved participants who sought professional psychological help reported experiencing stigmatization and feeling guilty after the loss significantly more often. Also the results showed that attitudes toward mental health specialists had the highest prognostic value in predicting help-seeking behaviors of the bereaved. The participants themselves identified the gaps in the health care system as main barriers to seeking help.

Conclusion

The results challenge previously spread notion that stigmatization, guilt and shame after suicide can act only as help-seeking barriers.

Emotional Distress Among Suicide Survivors: The Moderating Role of Self-Forgiveness

Grief after suicide entails unique challenges and difficulties, such as intense feelings of anger and guilt, as well as various psychological risks. The current study examined the contribution of self-forgiveness (SF) to emotional distress (e.g., depressed mood and suicidal ideation) among suicide-loss survivors, compared with bereavement following sudden and expected death types. Bereaved individuals (N = 309; aged 18-84) completed questionnaires measuring SF, depressed mood, suicidal ideation, demographics, and personal characteristics concerning the bereavement. A significant interaction between SF and type of loss was found, in which suicide-loss survivors with low levels of SF manifested the highest levels of depression and suicidal ideation compared with other subgroups. The findings reflect the importance of SF as a protective factor against depression and suicidality among suicide-loss survivors as well as the possible efficacy of forgiveness-based interventions in this population.

Public Response to Suicide News Reports as Reflected in Computerized Text Analysis of Online Reader Comments

Previous research has documented the rise in rates of suicidal behaviors following media reports of celebrity suicide. Whereas most research has focused on documenting and analyzing suicide rates, little is known about more subtle psychological effects of celebrity suicide on the public, such as despair and feelings of abandonment. The Internet has revolutionized the responses to news reports, enabling immediate and anonymous responses potentially reflecting these psychological processes. Thus, the current study explored the unique psychological impact of a celebrity suicide on the public by analyzing the big data of readers' comments to suicide news reports, using computational linguistics methods. Readers' comments (N = 14,506) to suicide news reports were retrieved from 4 leading online news sites. The comments were posted in response to 1 of 1 types of reports: a celebrity suicide (Robin Williams), a non-celebrity suicide, and general reports of suicide as a social phenomenon. LIWC software for computerized linguistic analysis was used to calculate the frequency of the various types of words used. Comparison of the responses to the 3 types of suicide reports revealed higher frequency of first-person pronouns and for emotionally charged words on comments to a celebrity suicide, compared with comments to the other types of suicide reports. The findings suggest that celebrity suicide news reports evoke the expression of positive emotions, possibly related to the venerated celebrity, alongside negative, internalized emotions, and feelings of social isolation. Theoretical, practical, and methodological implications are discussed.

"Let's Talk About It": The Moderating Role of Self-Disclosure on Complicated Grief over Time among Suicide Survivors

Suicide often imparts highly stressful ramifications to those left behind. Previous research on suicide survivors (SUSs) has demonstrated their being at high risk for developing anxiety and depression, including pathological complicated grief (CG). Self-disclosure (S-D)--the tendency to share one's personal feelings--has been found to be an important component of dealing with grief. In this study, we examined the effect of S-D on CG in an 18-month longitudinal design following one hundred fifty-six SUSs. We found that SUSs suffering from pathological CG at Time 1 (T1) were lower in S-D at T1 and T2 and higher in depression at T2. We also found that SUSs with lower S-D at T1 had higher CG at T2. Using a structural equation model, we found that S-D at T1 contributed significantly (and negatively) to CG at T1, above and beyond the natural fading of CG over time. Our findings emphasize that while CG is highly prevalent among SUSs, S-D has a beneficial effect which can serve as a protective factor against CG for this group. Implications regarding possible interventions with SUSs were discussed.

Attachment Styles and Posttraumatic Growth Among Suicide-Loss Survivors

Abstract. Background and aims: The world loses approximately one million people to suicide every year, leaving behind many suicide-loss survivors, family members and friends, who are significantly affected by the traumatic loss. Yet some suicide-loss survivors not only manage to cope with the loss, but actually experience posttraumatic growth (PTG). To date, no studies have fully examined the psychological processes that underlie this personal positive change. We hypothesized that attachment style would predict PTG and this association would be mediated by self-disclosure and social support. Method: A community sample of 131 suicide-loss survivors (108 women), aged 18–70, self-reported on attachment style, self-disclosure, social support, and PTG. Results: Securely attached individuals scored highest on PTG compared with other attachment styles. A structural equation model confirmed that self-disclosure and social support mediated the association between attachment and PTG. Suicide-loss survivors with secure attachment tended to self-disclose more and to perceive greater support from others than did suicide-loss survivors with insecure attachment, thus enhancing their chances of PTG. Limitations: The sample comprised mostly female participants, and the findings may not be directly generalizable to male suicide-loss survivors. Conclusion: Our results suggest that different psychological interventions should be utilized for suicide-loss survivors with particular attachment styles. Psychotherapies aiming to modify internal working models may be useful for enhancing PTG among survivors characterized by insecure attachment styles.

Self-Disclosure Here and Now: Combining Retrospective Perceived Assessment With Dynamic Behavioral Measures

Most previous research on self-disclosure (SD) focused on its perceived retrospective aspects using self-report questionnaires. Few studies investigated actual SD as reflected in interpersonal interaction. We propose a comprehensive approach that combines new objective and dynamic measures of SD that evaluate situated SD with the traditional measures that evaluate stable SD properties. As SD is essentially verbal, we build on linguistic parameters for assessing actual SD, including acoustic features such as intonation and fluency, and verbal features such as the particular choice of words. Critically, the new measures highlight SD here and now and may reveal transient situational factors that affect it, such as the dynamics of interpersonal interaction. Based on these measures, we propose a three-dimensional evaluation that can portray different profiles of SD and offer a better prediction of SD behavior in different situations. The theoretical and clinical implications of the proposed approach are discussed.

Korean Teachers' Bereavement Experience Following Student Suicide

Background: Suicide is the leading cause of death in Korean adolescents and it exposes school teachers to the impact of student suicide. Aims: This study aimed to explore the bereavement experience of teachers following student suicide. Method: Using semistructured questions, five female teachers working at secondary schools in Korea were interviewed on their bereavement experiences. Data were analyzed using a phenomenological approach. Results: Participants described their experiences in dimensions of individuals and professions, yielding four major themes and 11 subthemes. They made efforts to learn about the suicide as a first step toward understanding. Participants suspended their grief in public owing to the atmosphere in their workplace. They aimed to tolerate the suicide and recognized their role anew in preventing student suicide. Conclusion: Following student suicide, bereaved teachers experience a variety of effects, dysfunctions, and adjustments as individuals and professionals. Their experience should be understood in both individual and collective ways in school settings and in the cultural context. The findings encourage school health providers to develop programs and policies to help teachers bereaved by student suicide.

Is There Anybody Out There? Attachment Style and Interpersonal Facilitators as Protective Factors Against Complicated Grief Among Suicide-Loss Survivors

Losing a loved one to suicide may have detrimental effects, one of them being suffering from complicated grief (CG). To date, no studies have fully examined the psychological processes that delineate the risk and resilience factors that contribute to CG among suicide-loss survivors (SLSs). We hypothesized that social support and self-disclosure would moderate the relationship between attachment styles and CG for SLS. Questionnaires assessing attachment style, self-disclosure, social support, and CG were completed by 156 SLS participants. A regression model revealed that secure attachment negatively predicted CG, but self-disclosure moderated this association. Secure attachment seems to be a resilient factor for CG. However, SLS with low secure attachment but high in self-disclosure ability use this behavior as a way to impede CG. The capacity to seek out other people, to share experiences with them, and to accept comfort from them may offer a means for SLS to better deal with their tragedy.

Perceived suicide stigma, secrecy about suicide loss and mental health outcomes

Perceived suicide stigma and consequent secrecy about suicide loss could contribute to impaired mental health among suicide loss survivors. Using online survey data from 195 suicide loss survivors, higher perceived suicide stigma was associated with more grief difficulties, higher suicidality, and less personal growth. Secrecy partly mediated the association between perceived suicide stigma and grief difficulties as well as suicidality and completely mediated the association between perceived suicide stigma and personal growth. Our findings suggest that supporting suicide loss survivors in coping with perceived suicide stigma could reduce secrecy about suicide loss and by this improve their mental health outcomes.

The adolescent grief inventory: Development of a novel grief measurement

BACKGROUND

To develop an empirically derived, reliable and valid measure of grief in adolescents, aged 12-18 years old.

METHODS

An online survey comprising 59 items derived from a qualitative study of 39 bereaved adolescents, the Hogan Inventory of Bereavement Children and Adolescents (HIB), the Depression, Anxiety and Stress Scales (DASS-21), the Multidimensional Scale of Perceived Social Support (MSPSS), and a series of death- and mental health-related questions, targeted adolescents bereaved when aged 12-18 years, with 176 adolescents (80.6% girls) completing the survey.

RESULTS

Factor Analysis of the 59-items resulted in a final solution, the Adolescent Grief Inventory (AGI) comprised of 40 items and 6 factors: Sadness, Self-blame, Anxiety and Self-harm, Shock, Anger and Betrayal, and Sense of Peace, with indices of good fit (RMSEA = 0.057, CFI = 0.952, TLI = 0.948). There was strong evidence of convergent (HIB) and divergent (MSPSS) validity. Adolescents bereaved by suicide scored higher on Self-blame, Anger and Betrayal while those with a history of suicidal behaviour or having a mental health diagnosis scored higher overall than those who had not.

LIMITATIONS

Study limitations include the self-selected, mostly female, sample, a high proportion of participants with a mental health and self-harm history, and reliance on self-reported data.

CONCLUSIONS

The AGI is a novel, comprehensive and valid measure of grief in adolescents. It can be used broadly, including with bereaved adolescents at-risk of mental health ramifications.

Predictors of Posttraumatic Growth in Adults Bereaved by Suicide

Background: Although suicide loss has been associated with several negative outcomes, numerous studies have shown that loss survivors can experience posttraumatic growth (PTG) following the suicide loss of a significant other. However, few studies have explored the mechanisms of such growth. Aims: The aim of this study was to identify predictors of PTG among a sample of adult suicide loss survivors and to explore whether the amount of time since the suicide loss moderated the relation between self-reported coping and PTG. Method: Suicide-bereaved adults (n = 307) completed online questionnaires measuring personality, coping, help-seeking attitudes, social support, and PTG. Results: Hierarchical regression analyses showed five independent associations with PTG: time since loss, perceived closeness, help-seeking attitudes, social support, and problem-focused coping. Time since loss did not moderate the relation between any of the self-reported coping styles and PTG. Limitations: The limitations of this study include a cross-sectional design, potential selection bias, no comparison or control group, and unrepresentative sample demographics of suicide loss survivors. Conclusion: Problem-focused coping showed the strongest association with PTG, independent of time since loss, suggesting that this coping style may facilitate growth throughout the grief trajectory.

Interpersonal theory dimensions facilitate posttraumatic growth among suicide-loss survivors: An attachment perspective

Many studies have highlighted the deleterious psychological impact of suicide on bereaved individuals. We examined the psychological processes facilitating posttraumatic growth (PTG) among 124 suicide-loss survivors, focusing on attachment styles, perceived burdensomeness, and thwarted belongingness. Securely attached individuals achieved higher PTG than insecurely attached individuals. Perceived burdensomeness and thwarted belongingness both mediated and moderated the associations between attachment and PTG. Anxiously or avoidantly attached individuals who also had a high level of perceived burdensomeness were the least likely to achieve PTG. Thus, these individuals may derive particular benefit from attachment-based therapeutic interventions focusing on interpersonal relationships.

Effect of Relative Versus Absolute Quantitative Messages Regarding Suicide on the Perceived Severity of the Phenomenon

Presentation of epidemiological information about the absolute number of suicides has been used occasionally to increase awareness of the suicide phenomenon. This study investigated the effectiveness of absolute quantitative messages versus relative messages. An example of relative messages would be comparing the number of suicide deaths with the number of deaths by car accidents. Participants were randomly presented with absolute or relative messages regarding suicide. They were then requested to indicate the degree of severity they attributed to the suicide phenomenon, being the level to which they view the phenomenon as sufficiently important to mandate national intervention and resource allocation. Relative messages proved more effective than absolute ones in yielding greater perceived severity of suicide. Increasing public and policymakers’ awareness of the suicide phenomenon could be aided by presenting information in relative terms.

Disclosure in traumatic deaths as correlates of differential mental health outcomes

This analysis addresses the controversial question of whether disclosure of a significant other's traumatic death cause is associated with mental health outcomes. Consistent with the limited previous research, this data, collected from 131 suicide bereaved, 10 exclusively drug death bereaved, and six other bereaved respondents, showed fewer grief difficulties and better self-rated mental health among those inclined to openly disclose a significant other's death cause, compared to those who feared incurring shame and embarrassment from doing so. Regression analyses suggested that the tendency to openly discuss the death was the single most powerful correlate to explaining variations in grief difficulties.

Relationship with the deceased as facilitator of posttraumatic growth among suicide-loss survivors

This study aimed to investigate the role of ongoing relationships with the deceased in facilitating posttraumatic growth among suicide-loss survivors. The sample comprised 58 suicide-loss survivors, 48 sudden-death, and 53 natural-death bereaved individuals, who completed questionnaires assessing the two-track model of bereavement, grief, and growth-related characteristics. Suicide-loss survivors reported lower levels of positive relationships with the deceased than did the other groups. An interaction was found between relational-active grieving and type of death in predicting posttraumatic growth. The study concluded that intense grief along with preoccupation with the deceased lessened positive personal transformation, especially among those struggling with a loved one's suicide.