1
|
Creegan M, O'Connell M, Griffin E, O'Connell S. Exploring posttraumatic growth in individuals bereaved by suicide: A secondary data analysis of a national survey. DEATH STUDIES 2024:1-9. [PMID: 38990548 DOI: 10.1080/07481187.2024.2376823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
This article explores the concept of posttraumatic growth (PTG) in individuals bereaved by suicide. The present study employs an exploratory approach to examine secondary data from a national survey. A sample of 2369 (n = 2369) responses were examined. Various instruments were utilized to assess grief experiences, social support, and personal growth. Descriptive statistics, correlational analysis and a hierarchical regression model were used to examine the relationship between the variables in this study. Hierarchical regression analysis revealed six independent predictors of PTG: social and formal support, time since loss, grief experiences, gender and multiple losses. The study highlighted the potential for growth in the aftermath of suicide bereavement, emphasizing the critical role of social support and the importance of time in promoting PTG. Despite some limitations, the present findings provide novel insight into the underlying mechanisms of PTG in suicide-bereaved individuals.
Collapse
Affiliation(s)
- Mark Creegan
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Selena O'Connell
- School of Public Health, College of Medicine and Health, University College Cork, Cork, Ireland
| |
Collapse
|
2
|
Zerach G, Levinstein Y, Levi-Belz Y. Longitudinal associations between exposure to potentially morally injurious events and suicidal ideation among recently discharged veterans - The mediating roles of depression and loneliness. J Affect Disord 2024; 350:689-697. [PMID: 38224741 DOI: 10.1016/j.jad.2024.01.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Exposure to potentially morally injurious events (PMIEs) during military service is associated with heightened suicidal ideation (SI). However, no longitudinal study has established temporal associations between these variables and examined the possible mediating roles of depression and loneliness in this effect. METHODS Participants were 374 active-duty Israeli combatants who participated in a five-year longitudinal study with four measurement points: T1- one year before enlistment, T2- one month before discharge from army service, and then again six months and twelve months following their discharge (T3 and T4, respectively). Data were assessed through semi-structured interviews and validated self-report questionnaires. RESULTS Above and beyond pre-enlistment personal characteristics (T1) and combat exposure (T2), PMIEs-'betrayal' (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of depression. Moreover, both PMIEs-'betrayal' and 'self' (T2) predicted more frequent SI over the past twelve months (T4) through the mediation of loneliness. LIMITATIONS We used self-report measures to assess PMIEs and SI, which may suffer from various biases. CONCLUSIONS Our findings are the first to provide evidence of longitudinal, temporal associations between exposure to PMIEs and SI. Notably, potential interventions might consider addressing the loneliness experienced following exposure to PMIEs during military service, among recently discharged traumatized veterans.
Collapse
Affiliation(s)
- Gadi Zerach
- Dept. of Psychology, Ariel University, Ariel, Israel.
| | - Yoav Levinstein
- Dept. of Health and Well-being, Medical Corps, IDF, School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
3
|
Shame, depression, and complicated grief among suicide loss-survivors: the moderating role of self-disclosure. Eur J Psychotraumatol 2023; 14:2182820. [PMID: 37052086 PMCID: PMC9987731 DOI: 10.1080/20008066.2023.2182820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
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.
Collapse
|
4
|
Gallardo-Flores A, Morán-Carrillo JM, García-Carmona M. The Detection of Resilience in Families Grieving Over a Suicide. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231219047. [PMID: 38018537 DOI: 10.1177/00302228231219047] [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: 11/30/2023]
Abstract
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.
Collapse
Affiliation(s)
- Ana Gallardo-Flores
- Department of Social Work and Social Services, Pablo de Olavide University, Seville, Spain
| | | | | |
Collapse
|
5
|
Pitman A, Logeswaran Y, McDonald K, Cerel J, Lewis G, Erlangsen A. Investigating risk of self-harm and suicide on anniversaries after bereavement by suicide and other causes: a Danish population-based self-controlled case series study. Epidemiol Psychiatr Sci 2023; 32:e53. [PMID: 37551142 PMCID: PMC10465319 DOI: 10.1017/s2045796023000653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/28/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023] Open
Abstract
AIMS To investigate mechanisms of suicide risk in people bereaved by suicide, prompted by observations that bereaved people experience higher levels of distress around dates of emotional significance. We hypothesised that suicide-bereaved first-degree relatives and partners experience an increased risk of self-harm and suicide around dates of (i) anniversaries of the death and (ii) the deceased's birthday, compared with intervening periods. METHODS We conducted a self-controlled case series study using national register data on all individuals living in Denmark from 1 January 1980 to 31 December 2016 and who were bereaved by the suicide of a first-degree relative or partner (spouse or cohabitee) during that period, and who had the outcome (any episode of self-harm or suicide) within 5 years and 6 weeks of the bereavement. We compared relative incidence of suicidal behaviour in (i) the first 30 days after bereavement and (ii) in the aggregated exposed periods (6 weeks either side of death anniversaries; 6 weeks either side of the deceased's birthdays) to the reference (aggregated unexposed intervening periods). As an indirect comparison, we repeated these models in people bereaved by other causes. RESULTS We found no evidence of an elevated risk of suicidal behaviour during periods around anniversaries of a death or the deceased's birthdays in people bereaved by suicide (adjusted incidence rate ratio [IRRadj] = 1.00; 95% confidence interval [CI] = 0.87-1.16) or other causes (IRRadj = 1.04; 95% CI = 1.00-1.08) compared with intervening periods. Rates were elevated in the 30 days immediately after bereavement by other causes (IRRadj: 1.95, 95% CI: 1.77-2.22). CONCLUSIONS Although people bereaved by suicide are at elevated risk of self-harm and suicide, our findings do not suggest that this risk is heightened around emotionally significant anniversaries. Bereavement care should be accessible at all points after a traumatic loss as needs will differ over the grief trajectory.
Collapse
Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, University College London (UCL), London, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK
| | | | - Keltie McDonald
- UCL Division of Psychiatry, University College London (UCL), London, UK
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Gemma Lewis
- UCL Division of Psychiatry, University College London (UCL), London, UK
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Psychiatric Centre Copenhagen, Hellerup, Copenhagen, Denmark
- Copenhagen Research Centre for Mental Health, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Hellerup, Copenhagen, Denmark
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
| |
Collapse
|
6
|
Fire NT, Alkalay S, Gvion Y, Zalsman G. The association between school staff's coping strategies following a student's suicide, school climate, and previous experience with suicide. PSYCHOLOGY IN THE SCHOOLS 2023. [DOI: 10.1002/pits.22898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Affiliation(s)
| | - Sarit Alkalay
- Department of Psychology Yezreel Valley Academic College Emek Yezreel Israel
| | - Yari Gvion
- Department of Psychology Bar Ilan University Ramat Gan Israel
| | - Gil Zalsman
- Geha Mental Health Center Petach Tikwa Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Psychiatry, Division of Molecular Imaging and Neuropathology Columbia University and New York State Psychiatric Institute New York New York USA
| |
Collapse
|
7
|
Abu-Sharkia S, Taubman - Ben-Ari O, Mofareh A. Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2187. [PMID: 36767553 PMCID: PMC9915886 DOI: 10.3390/ijerph20032187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
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.
Collapse
Affiliation(s)
- Salam Abu-Sharkia
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Orit Taubman - Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Ali Mofareh
- Clalit Health Services (Kupat Holim Clalit), Jerusalem 9112102, Israel
| |
Collapse
|
8
|
Ning J, Tang X, Shi H, Yao D, Zhao Z, Li J. Social support and posttraumatic growth: A meta-analysis. J Affect Disord 2023; 320:117-132. [PMID: 36181914 DOI: 10.1016/j.jad.2022.09.114] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The beneficial role of social support on posttraumatic growth (PTG) has been assumed by theoretical models and established in some studies. However, there are inconsistent findings and little knowledge on moderators. The present study aims to investigate the overall effect size of the relationship and identify factors affecting the association. METHODS Six electronic databases were searched. Newcastle-Ottawa Quality Assessment Scale (NOS) were used to evaluate the quality of studies. Study quality, study design, trauma type, PTG measure, social support measure, continent, publishing language, sample size, gender, religion, and age were analyzed as moderators. Meta-regression was conducted with the significant differential predictors in moderator analysis. RESULTS The meta-analysis included 217 samples and a total of 47,940 participants from both longitudinal and cross-sectional studies. There was a medium positive effect size between social support and PTG in random effect model, r = 0.418, p < .001. The meta-regression analysis indicated that the association between social support and PTG was stronger among caregivers (vs. other traumatized samples), Chinese, older individuals and studies with smaller sample size. LIMITATIONS Only survey results were included in the analysis. The retrospective self-report may limit a more objective assessment of the relations. In addition, 87 % of the studies were cross-sectional, which may influence the estimation of a valid effect size. CONCLUSIONS Regarding the medium positive association between social support and PTG, it is important to enhance social support for trauma survivors. It will be especially effective for caregivers, Chinese, and older people.
Collapse
Affiliation(s)
- Jing Ning
- Department of Psychology, Renmin University of China, Beijing, China
| | - Xinfeng Tang
- Department of Psychology, Renmin University of China, Beijing, China
| | - Hanlu Shi
- Department of Psychology, Renmin University of China, Beijing, China
| | - Dongpeng Yao
- Department of Psychology, Renmin University of China, Beijing, China
| | - Ziqing Zhao
- Department of Psychology, Renmin University of China, Beijing, China
| | - Jie Li
- Department of Psychology, Renmin University of China, Beijing, China.
| |
Collapse
|
9
|
Tiech Fire N, Gvion Y, Alkalay S, Zalsman G. The "Forgotten Grievers": The Impact of Pupil Suicide on Post-Trauma and Grief Symptoms in School Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912160. [PMID: 36231464 PMCID: PMC9564756 DOI: 10.3390/ijerph191912160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND The suicide of a pupil impacts survivors greatly, but most studies on the subject do not consider school staff, and do not differentiate between the various professional domains. Our aim was to investigate the existence of differences in symptoms of complicated grief as well as post-trauma symptoms after a pupil's suicide, among school staff in four domains: counsellors, psychologists, principals and home-room teachers. METHOD Eighty-four staff members from schools that lost pupils to suicide within the past five years were assessed for symptoms of complicated grief and trauma. All reported their symptoms using self-report scales. RESULTS Principals and home-room teachers had significantly higher complicated grief and post-trauma symptoms. The main limitations of this study are that the data were collected via self-report questionnaires, which can introduce bias. Additionally, the sample is relatively small and comprises mainly women. CONCLUSIONS School professionals in domains receiving less coping and crisis training, and those with supervisory responsibilities (principals and home-room teachers) show more symptoms of trauma and complicated grief after a pupil's suicide, and require special attention. More preparatory training would surely benefit them and assist them in coping with such crises.
Collapse
Affiliation(s)
| | - Yari Gvion
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel
- Correspondence:
| | - Sarit Alkalay
- Department of Psychology, Yezreel Valley Academic College, Yezreel Valley 1930600, Israel
| | - Gil Zalsman
- Geha Mental Health Center, Petah Tikwa 49100, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Division of Molecular Imaging and Neuropathology, Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
| |
Collapse
|
10
|
Hybholt L, Higgins A, Buus N, Berring LL, Connolly T, Erlangsen A, Morrissey J. The Spaces of Peer-Led Support Groups for Suicide Bereaved in Denmark and the Republic of Ireland: A Focus Group Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169898. [PMID: 36011534 PMCID: PMC9407788 DOI: 10.3390/ijerph19169898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 05/13/2023]
Abstract
Research has shown that people bereaved by suicide have an increased risk of mental health problems, suicidality and associated stigma, as well as higher rates of sick leave and increased rates of receiving disability pensions. Peer-led suicide bereavement support groups are perceived to enhance people's recovery by enabling shared experiences with others who are bereaved in similar circumstances. The aim of the research was to explore the viewpoints of participants living in Denmark and the Republic of Ireland on these peer-led support groups. This study focused on how the participants experienced being part of the peer-led support and how the participation affected them. We conducted four focus groups, two in Denmark and two in the Republic of Ireland, and two individual interviews, involving a total of 27 people bereaved by suicide. Data were analyzed thematically. The participants' experiences in the peer-led support groups were in contrast to what they had experienced in their daily lives. They felt alienated in daily living, as they believed that people could not comprehend their situation, which in turn led participants to search for people with similar experiences and join the peer-led support groups. While peer-led support groups may not be helpful for everyone, they created 'supportive spaces' that potentially affected the participants' recovery processes, from which we generated three key themes: (i) 'A transformative space', describing how the peer-led support group created a place to embrace change, learning and knowledge about suicide and suicide bereavement and the making of new connections; (ii) 'An alternative space for belonging and grieving', describing how the participants felt allowed to and could give themselves permission to grieve; and (iii) 'A conflicted space' describing how it was troublesome to belong to and participate in the peer-led support groups. In conclusion, despite the two cultural settings and different organizational approaches, the experiences were comparable. Peer-led support groups can, despite being a conflicted space for some, provide supportive spaces aiding the participants' recovery process.
Collapse
Affiliation(s)
- Lisbeth Hybholt
- Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark
- Mental Health Services East, Psychiatry Region Zealand, 4000 Roskilde, Denmark
- Correspondence:
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Niels Buus
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Lene Lauge Berring
- Psychiatric Research Unit, Psychiatry Region Zealand, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Terry Connolly
- Friends of Suicide Loss (FOSL), D06 T685 Dublin, Ireland
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, 2900 Hellerup, Denmark
- Copenhagen Research Centre for Mental Health, 2900 Hellerup, Denmark
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Center of Mental Health Research, Australian National University, Canberra, ACT 0200, Australia
| | - Jean Morrissey
- School of Nursing and Midwifery, Trinity College Dublin, D02 PN40 Dublin, Ireland
| |
Collapse
|
11
|
Zhen B, Yao B, Zhou X. How does parent-child communication affects posttraumatic stress disorder and growth in adolescents during the COVID-19 pandemic? The mediating roles of self-compassion and disclosure. J Affect Disord 2022; 306:1-8. [PMID: 35301037 PMCID: PMC8920085 DOI: 10.1016/j.jad.2022.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/14/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Research suggests that family factors play an important role in adolescent posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). Parent-child communication has attracted particular attention. However, it remains unclear whether parent-child communication affects PTSD and PTG via unique or shared underlying mechanisms. The study aim was to examine the effect of parent-child communication on PTSD and PTG via self-compassion and self-disclosure. METHODS Self-report questionnaires were administered to 683 adolescents during the COVID-19 pandemic. RESULTS Open parent-child communication was positively associated with PTG and negatively associated with PTSD via two 1-step indirect paths of self-compassion and self-disclosure, and by one 2-step indirect path of self-compassion to self-disclosure. Problematic parent-child communication was negatively associated with PTG and positively associated with PTSD via two 1-step indirect paths of self-compassion and self-disclosure. LIMITATIONS First, pandemics differ from other disasters, generalizing these findings to other traumatized populations must be cautious. Then, this was a cross-sectional study, so longitudinal effects could not be examined and causal relationships cannot be confirmed. CONCLUSIONS Different types of parent-child communication have different influencing mechanisms on PTSD and PTG. Therefore, distinct intervention strategies are needed targeted to these two psychological reactions.
Collapse
Affiliation(s)
- Baohua Zhen
- College of Educational Science, Anhui Normal University, Wuhu 241000, China
| | - Benxian Yao
- College of Educational Science, Anhui Normal University, Wuhu 241000, China; Department of Psychology, Hefei Normal University, Hefei 238076, China.
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310028, China.
| |
Collapse
|
12
|
Levi-Belz Y. Growing together: interpersonal predictors of posttraumatic growth trajectory among suicide-loss survivors. ANXIETY, STRESS, AND COPING 2022; 35:284-297. [PMID: 34314267 DOI: 10.1080/10615806.2021.1958791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.,Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
13
|
Levi-Belz Y. Longitudinal Intercorrelations between Complicated Grief and Posttraumatic Growth among Suicide Survivors. Arch Suicide Res 2022; 26:677-691. [PMID: 32956611 DOI: 10.1080/13811118.2020.1820412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
Collapse
|
14
|
Levi-Belz Y, Rotem N. The longitudinal contribution of attachment models and interpersonal factors to posttraumatic growth among suicide-loss survivors. J Clin Psychol 2021; 78:184-200. [PMID: 34191278 DOI: 10.1002/jclp.23204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/13/2021] [Accepted: 06/04/2021] [Indexed: 01/09/2023]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.,Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - Noa Rotem
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
15
|
Levi-Belz Y, Feigelman W. Pulling Together - The Protective Role of Belongingness for Depression, Suicidal Ideation and Behavior Among Suicide-Bereaved Individuals. CRISIS 2021; 43:278-288. [PMID: 34130482 DOI: 10.1027/0227-5910/a000784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.,Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - William Feigelman
- Sociology Department, Nassau Community College, Garden City, NY, USA
| |
Collapse
|
16
|
Abstract
Suicide is a preventable health problem. Multiple definitions and inconsistent use of the term suicidality can result in failure to properly recognize suicide risk and behavior and confuses suicide research. Clarification of the suicidality concept is needed to facilitate the care for individuals at risk for suicide. Using Rodgers' evolutionary concept analysis method, this analysis describes the breadth and scope of the suicidality concept. Findings indicate suicidality covers a spectrum of suicidal risk and levels of emotional suffering and intent. The analysis does not draw definite conclusions, but outlines a direction for further research.
Collapse
Affiliation(s)
- Tamara Pike Keefner
- Nursing, South Dakota State University - College of Nursing, Rapid City, South Dakota, USA
| | - Thomas Stenvig
- Graduate Nursing, South Dakota State University - College of Nursing, Brookings, Rapid City, South Dakota, USA
| |
Collapse
|
17
|
Levi-Belz Y, Aisenberg D. Interpersonal predictors of suicide ideation and complicated-grief trajectories among suicide bereaved individuals: A four-year longitudinal study. J Affect Disord 2021; 282:1030-1035. [PMID: 33601675 DOI: 10.1016/j.jad.2021.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/03/2020] [Accepted: 01/01/2021] [Indexed: 12/15/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel.
| | - Daniela Aisenberg
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
18
|
Tan J, Andriessen K. The Experiences of Grief and Personal Growth in University Students: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1899. [PMID: 33669340 PMCID: PMC7920249 DOI: 10.3390/ijerph18041899] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/19/2022]
Abstract
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.
Collapse
Affiliation(s)
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia;
| |
Collapse
|
19
|
Li J, Sun Y, Maccallum F, Chow AYM. Depression, Anxiety and Post-traumatic Growth Among Bereaved Adults: A Latent Class Analysis. Front Psychol 2021; 11:575311. [PMID: 33519589 PMCID: PMC7844091 DOI: 10.3389/fpsyg.2020.575311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/17/2020] [Indexed: 01/29/2023] Open
Abstract
Background The death of a loved one can trigger a range of responses, including painful thoughts and emotions, as well as positive changes, such as post-traumatic growth (PTG). To understand more about the relationship between these outcomes this study explored the co-occurrence of depression, anxiety and PTG among a group of bereaved Chinese adults. Methods Data were collected from 194 participants, who had lost a first-degree relative. Latent class analysis was used to analyze the data to identify subgroups of participants with shared symptom profiles. Results Three classes were identified: a Growth class, a Depression/Anxiety/Growth class and a Depression/Anxiety class. Marital status, social support, close relationship with the deceased and witnessing the suffering of the deceased were identified as differential predictors of class membership. Conclusion The findings contribute to our understanding of the potentially wide ranging impacts of bereavement and highlight the important role of stressor characteristics and support and in influencing impairment and positive outcomes.
Collapse
Affiliation(s)
- Jie Li
- Department of Psychology, Renmin University of China, Beijing, China
| | - Yihua Sun
- Department of Psychology, Renmin University of China, Beijing, China
| | - Fiona Maccallum
- School of Psychology, University of New South Wales, Sydney, NSW, Australia.,School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, China
| |
Collapse
|
20
|
Gilo T, Feigelman W, Levi-Belz Y. Forgive but not forget: From self-forgiveness to posttraumatic growth among suicide-loss survivors. DEATH STUDIES 2020; 46:1870-1879. [PMID: 33345718 DOI: 10.1080/07481187.2020.1864064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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.
Collapse
Affiliation(s)
- Tal Gilo
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Department of Clinical Psychology, Ruppin Academic Center, Emek Hefer, Israel
| | | | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Department of Clinical Psychology, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
21
|
Peterson A, Bozzay M, Bender A, Monahan M, Chen J. Those left behind: A scoping review of the effects of suicide exposure on veterans, service members, and military families. DEATH STUDIES 2020; 46:1176-1185. [PMID: 32762420 PMCID: PMC8162890 DOI: 10.1080/07481187.2020.1802628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Veteran and service member suicide remains a significant public health concern. One factor that may impact suicide risk is suicide exposure-knowing someone who has died by suicide or attempted suicide. However, the majority of the extant literature has focused on nonmilitary samples, which may not generalize to military veterans and service members. The current review synthesizes findings regarding suicide exposure in military veterans, service members, their families, and military systems. Our review suggests that the relationship between suicide exposure, suicide risk, and mental health outcomes remains inconsistent. Future research should further explore this important area.
Collapse
Affiliation(s)
- Amanda Peterson
- Department of Psychology, College of Arts and Science, University of South Florida, Tampa, Florida, USA
| | - Melanie Bozzay
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, Rhode Island, USA
| | - Ansley Bender
- Department of Psychology, College of Arts and Science, University of South Florida, Tampa, Florida, USA
| | - Maureen Monahan
- Department of Psychology, College of Arts and Science, University of South Florida, Tampa, Florida, USA
| | - Jason Chen
- HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA
- Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| |
Collapse
|
22
|
Tosini D, Fraccaro D. "Like climbing a glass wall": Suicide survivors in an Italian province. DEATH STUDIES 2020; 46:987-995. [PMID: 32716258 DOI: 10.1080/07481187.2020.1795746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The study contributed to understanding suicide grief by focusing on suicide survivors' subjective experience combined with attention to social settings that influenced their interpretations. We interviewed 25 survivors and analyzed field notes from 47 meetings of a suicide support group. We documented the unfolding of typical forms of meaning reconstructions that helped survivors redefine their situation. These forms included searching for reconciliation with the deceased individuals; attempting to tame the tendency to self-blame; and making an effort to reframe social relationships. The support group functioned as a defining agency that assisted the survivors' interpretations and contributed to overcoming conflicting feelings.
Collapse
Affiliation(s)
- Domenico Tosini
- Department of Sociology and Social Research, University of Trento, Trento, Italy
| | | |
Collapse
|
23
|
Scott HR, Pitman A, Kozhuharova P, Lloyd-Evans B. A systematic review of studies describing the influence of informal social support on psychological wellbeing in people bereaved by sudden or violent causes of death. BMC Psychiatry 2020; 20:265. [PMID: 32471407 PMCID: PMC7257446 DOI: 10.1186/s12888-020-02639-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/30/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Whilst any type of bereavement can be traumatic, bereavement through violent or sudden causes is associated with more severe negative health and wellbeing outcomes compared to other types of loss. Social support has been found to have a positive impact on wellbeing after traumatic events in general. However, this association appears to be less consistently demonstrated in studies that focus on bereavement, and the literature in this area has not yet been systematically reviewed. This study aimed to review the international literature to examine systematically whether there is an association between informal social support from family and friends after bereavement through sudden and/or violent causes and post-bereavement wellbeing. METHODS We conducted a systematic search for quantitative studies that tested for an association between social support and any outcome related to wellbeing after a sudden and/or violent loss. Included studies were assessed for quality, and findings were reported using the approach of narrative synthesis. The review was pre-registered on Prospero (registration number CRD42018093704). RESULTS We identified 16 papers that met inclusion criteria, 11 of which we assessed as being of good or fair quality and 5 as poor quality. Fifteen different wellbeing outcomes were measured across all studies. We found consistent evidence for an inverse association between social support and symptoms/presence of depression, predominantly consistent evidence for an inverse association between social support and symptoms/presence of post-traumatic stress disorder (PTSD), and conflicting evidence for an inverse association between social support and symptoms/presence of complicated grief. CONCLUSIONS Our systematic review identified evidence to suggest that social support after sudden or violent bereavement is associated with a reduced severity of depressive and PTSD symptoms. Further longitudinal research is needed to explore potential causality in this relationship, widening the focus from common mental disorders to include other mental illnesses, wellbeing outcomes, and suicide-related outcomes after bereavement. There is also a need for consensus on the conceptualisation and measurement of social support. Our findings imply that interventions to improve access to and quality of social support may reduce the burden of mental illness after bereavement, and may therefore be worth investing in.
Collapse
Affiliation(s)
- H. R. Scott
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, 6th floor, Maple House, 149 Tottenham Court Road, London, W1T 7BN UK
| | - A. Pitman
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, 6th floor, Maple House, 149 Tottenham Court Road, London, W1T 7BN UK
| | - P. Kozhuharova
- grid.35349.380000 0001 0468 7274Department of Psychology, University of Roehampton, London, UK
| | - B. Lloyd-Evans
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, 6th floor, Maple House, 149 Tottenham Court Road, London, W1T 7BN UK
| |
Collapse
|
24
|
Levi-Belz Y, Gilo T. Emotional Distress Among Suicide Survivors: The Moderating Role of Self-Forgiveness. Front Psychiatry 2020; 11:341. [PMID: 32390889 PMCID: PMC7190787 DOI: 10.3389/fpsyt.2020.00341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/06/2020] [Indexed: 12/15/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Tal Gilo
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
- Department of Clinical Psychology, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
25
|
Zerach G. Posttraumatic growth among combat veterans and their siblings: A dyadic approach. J Clin Psychol 2020; 76:1719-1735. [PMID: 32173865 DOI: 10.1002/jclp.22949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES We aimed to use a dyadic approach to assess the effects of veterans' posttraumatic stress disorder symptoms (PTSS) and siblings' secondary PTSS, as well as veterans' and siblings' relationship quality, on primary and secondary posttraumatic growth (PTG). METHOD A volunteers' sample of 106 dyads of Israeli combat veterans and their close-in-age siblings responded to self-report questionnaires in a cross-sectional, dyadic design study. RESULTS Veterans' primary PTG was positively associated with siblings' secondary PTG. Veterans' PTSS and siblings' secondary PTSS were associated with higher levels of primary and secondary PTG, respectively. Furthermore, among veterans, warmth in siblings' relationships was associated with higher levels of primary PTG. However, among siblings, rivalry in sibling relationships was associated with lower levels of secondary PTG. CONCLUSIONS Both veterans' and siblings' PTSS are only related to their own PTG. Moreover, perception of siblings' relationship quality might have a differential effect on PTG among veterans and their siblings.
Collapse
Affiliation(s)
- Gadi Zerach
- Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel
| |
Collapse
|
26
|
Link KA, Garrett-Wright D, Jones MS. The Burden of Farmer Suicide on Surviving Family Members: A Qualitative Study. Issues Ment Health Nurs 2020; 41:66-72. [PMID: 31770042 DOI: 10.1080/01612840.2019.1661048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this descriptive qualitative study was to better understand the burden of farmer suicide on surviving family members. Themes included: (1) family members expressed guilt; (2) family members experienced symptoms of psychological distress; (3) family members felt attached to the land and chose to remain on the farm; (4) short-term coping mechanisms included family, friends and faith; (5) long-term coping mechanisms included acts of honoring their loved one; (6) there was a lack of awareness of community support resources following the suicide.
Collapse
Affiliation(s)
- Kimberly A Link
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Dawn Garrett-Wright
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, Kentucky, USA
| | - M Susan Jones
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, Kentucky, USA
| |
Collapse
|
27
|
Oexle N, Sheehan L. Perceived Social Support and Mental Health After Suicide Loss. CRISIS 2020; 41:65-69. [DOI: 10.1027/0227-5910/a000594] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract. Background: Despite great need, social support is limited after suicide loss, which could contribute to worse mental health outcomes including increased suicidality among suicide loss survivors. Aims: To examine the associations between perceived social support, grief difficulties, depressive symptoms, suicidality, and personal growth among 195 suicide loss survivors. Method: The associations between perceived social support, grief difficulties, depressive symptoms, suicidality, and personal growth were tested using linear regression modeling. Results: In controlled models, more perceived social support was significantly associated with decreased grief difficulties, depressive symptoms, and suicidality, as well as with increased personal growth. Limitations: Participants were mostly Caucasian women who participated in a cross-sectional online survey. Conclusion: Our findings suggest that programs to increase social support after suicide loss may be an important aspect of suicide postvention.
Collapse
Affiliation(s)
- Nathalie Oexle
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | - Lindsay Sheehan
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| |
Collapse
|
28
|
Recipients of Suicide-Related Disclosure: The Link between Disclosure and Posttraumatic Growth for Suicide Attempt Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203815. [PMID: 31658681 PMCID: PMC6843227 DOI: 10.3390/ijerph16203815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/01/2019] [Accepted: 10/04/2019] [Indexed: 02/06/2023]
Abstract
It is important to explore factors that could help or hinder one’s wellbeing following a suicide attempt, which could yield not only negative consequences but also posttraumatic growth (PTG; positive changes following a traumatic event). The present study used a multivariate analysis of covariance (MANCOVA) to test the relationship between disclosure, PTG, and posttraumatic depreciation among suicide attempt survivors when controlling for time since attempt and to test whether these effects remained after controlling for quality of support from family and friends. Suicide attempt survivors (n = 159) completed an online survey about their experiences. Increases in disclosure to family and friends but not to healthcare providers predicted changes in PTG. The effects of family disclosure remained even after controlling for quality of support. Disclosure to healthcare providers demonstrated some statistical effects on PTG, yet in the opposite direction and only after controlling for quality of support. The control variables—time since attempt and quality of support—were the only variables that predicted a change in posttraumatic depreciation. These findings suggest there is value in disclosing one’s personal story to family regardless of whether one receives supportive responses and that social support can impact one’s PTG.
Collapse
|
29
|
Levi-Belz Y, Lev-Ari L. "Let's Talk About It": The Moderating Role of Self-Disclosure on Complicated Grief over Time among Suicide Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3740. [PMID: 31590225 PMCID: PMC6801618 DOI: 10.3390/ijerph16193740] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 12/04/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer 40250, Israel.
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 40250, Israel.
| | - Lilac Lev-Ari
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer 40250, Israel.
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer 40250, Israel.
| |
Collapse
|
30
|
Levi-Belz Y, Lev-Ari L. Attachment Styles and Posttraumatic Growth Among Suicide-Loss Survivors. CRISIS 2019; 40:186-195. [DOI: 10.1027/0227-5910/a000550] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Israel
| | - Lilac Lev-Ari
- Department of Behavioral Sciences, Ruppin Academic Center, Israel
| |
Collapse
|
31
|
Pak K, Ferreira KE, Ghahramanlou-Holloway M. Suicide Postvention for the United States Military: Literature Review, Conceptual Model, and Recommendations. Arch Suicide Res 2019; 23:179-202. [PMID: 29393834 DOI: 10.1080/13811118.2018.1428704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Suicide continues to be a significant public health problem in the United States and the Department of Defense (DoD). Timely and systematic postvention efforts can play an instrumental role in helping family members, peers, and military command to best manage the aftermath of a suicide. To date, several postvention efforts have been implemented in the military. However, there continues to be an overall lack of understanding of the specific short- and long-term effects of exposure to military suicide. In addition, more emphasis needs to be placed on empirically driven approaches to postvention and program evaluation. The purpose of this article is threefold: (1) to provide a summary of the postvention literature with special emphasis placed on the military organization; (2) to propose a conceptual model as a framework for understanding Military-Unit Suicide Survivorship; and (3) to briefly highlight postvention strategies within the DoD in the context of a number of research, clinical, and policy recommendations.
Collapse
|
32
|
Kreiner H, Levi-Belz Y. Self-Disclosure Here and Now: Combining Retrospective Perceived Assessment With Dynamic Behavioral Measures. Front Psychol 2019; 10:558. [PMID: 30984058 PMCID: PMC6447712 DOI: 10.3389/fpsyg.2019.00558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/27/2019] [Indexed: 11/26/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Hamutal Kreiner
- Department of Behavioral Sciences, Linguistic Cognition Lab, Ruppin Academic Center, Hadera, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin, Academic Center, Emek Hefer, Israel
| |
Collapse
|
33
|
Is There Anybody Out There? Attachment Style and Interpersonal Facilitators as Protective Factors Against Complicated Grief Among Suicide-Loss Survivors. J Nerv Ment Dis 2019; 207:131-136. [PMID: 30720603 DOI: 10.1097/nmd.0000000000000940] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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.
Collapse
|
34
|
Oexle N, Feigelman W, Sheehan L. Perceived suicide stigma, secrecy about suicide loss and mental health outcomes. DEATH STUDIES 2018; 44:248-255. [PMID: 30451645 DOI: 10.1080/07481187.2018.1539052] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 05/27/2023]
Abstract
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.
Collapse
Affiliation(s)
- Nathalie Oexle
- Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
| | | | - Lindsay Sheehan
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| |
Collapse
|
35
|
Drapeau CW, Lockman JD, Moore MM, Cerel J. Predictors of Posttraumatic Growth in Adults Bereaved by Suicide. CRISIS 2018; 40:196-202. [PMID: 30375239 DOI: 10.1027/0227-5910/a000556] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
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.
Collapse
Affiliation(s)
| | - Jennifer D Lockman
- 2 The VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA
| | - Melinda M Moore
- 3 Department of Psychology, Eastern Kentucky University, Richmond, KY, USA
| | - Julie Cerel
- 4 College of Social Work, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
36
|
Lev-Ari L, Levi-Belz Y. Interpersonal theory dimensions facilitate posttraumatic growth among suicide-loss survivors: An attachment perspective. DEATH STUDIES 2018; 43:582-590. [PMID: 30285584 DOI: 10.1080/07481187.2018.1504351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 05/09/2018] [Accepted: 06/04/2018] [Indexed: 06/08/2023]
Abstract
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.
Collapse
Affiliation(s)
- Lilac Lev-Ari
- Behavioral Sciences Department, Ruppin Academic Center , Emek Hefer , Israel
| | - Yossi Levi-Belz
- Behavioral Sciences Department, Ruppin Academic Center , Emek Hefer , Israel
- The Suicide and Mental Pain Study Center, Ruppin Academic Center , Emek Hefer , Israel
| |
Collapse
|
37
|
Levi-Belz Y, Gamliel E. Effect of Relative Versus Absolute Quantitative Messages Regarding Suicide on the Perceived Severity of the Phenomenon. OMEGA-JOURNAL OF DEATH AND DYING 2018; 81:592-606. [DOI: 10.1177/0030222818791715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
- The Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| | - Eyal Gamliel
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
- The Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
38
|
Feigelman W, Cerel J, Sanford R. Disclosure in traumatic deaths as correlates of differential mental health outcomes. DEATH STUDIES 2018; 42:456-462. [PMID: 28985141 DOI: 10.1080/07481187.2017.1372533] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
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.
Collapse
Affiliation(s)
- William Feigelman
- a Sociology , Nassau Community College , Garden City , New York , USA
| | - Julie Cerel
- b Social Work , University of Kentucky , Lexington , Kentucky , USA
| | - Rebecca Sanford
- c Social Work , Thompson Rivers University Kamloops , BC , Canada
| |
Collapse
|
39
|
Cerel J, Sanford RL. It’s Not Who You Know, It’s How You Think You Know Them: Suicide Exposure and Suicide Bereavement. PSYCHOANALYTIC STUDY OF THE CHILD 2018. [DOI: 10.1080/00797308.2017.1415066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Julie Cerel
- College of Social Work, University of Kentucky
| | | |
Collapse
|
40
|
Levi-Belz Y. Relationship with the deceased as facilitator of posttraumatic growth among suicide-loss survivors. DEATH STUDIES 2017; 41:376-384. [PMID: 28129044 DOI: 10.1080/07481187.2017.1285372] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
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.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- a Department of Behavioral Sciences , Ruppin Academic Center , Emek Hefer , Israel
| |
Collapse
|
41
|
Castelli Dransart DA. Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One. QUALITATIVE HEALTH RESEARCH 2017; 27:994-1005. [PMID: 27055497 DOI: 10.1177/1049732316637590] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.
Collapse
|
42
|
Talseth AG, Gilje FL. Liberating burdensomeness of suicide survivorship loss: A Critical Interpretive Synthesis. J Clin Nurs 2017; 26:3843-3858. [PMID: 28252831 DOI: 10.1111/jocn.13797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2017] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES What is an interpreted and synthesised understanding of responses of survivors to a suicide death of a close person? BACKGROUND It is well known that survivors of suicide loss who are in a close relationship with the deceased are at high risk for suicidality and health conditions. Nurses in various settings need evidenced-informed approaches to encounter these vulnerable persons and support their healing journey from postvention to prevention. DESIGN The design is reflexive and iterative. METHOD A Critical Interpretive Synthesis comprised of six phases: formulating the review question; searching literature; sampling; determining quality; extracting data; interpretive synthesis. Qualitative content analysis was also. RESULTS Based on a sample of 15 published full-text qualitative and quantitative nursing research studies published between 1990 and 2016, an aggregated, interpreted and synthesised understanding of responses of survivors of suicide loss to the suicide death of a close person emerged. Four synthesised concepts were: dreading burden of suicide risk and stigma; facing burdensomeness in the aftermath of suicide death; enduring being burdened-unburdened, striving to invest in living; and liberating burdensomeness, journeying toward healing. CONCLUSIONS Contextually, geo-cultural gaps exist in published nursing studies. Most studies were from North American and a few from Asia. The reported suicide deaths occurred over a wide range of time. Conceptually, four synthesised concepts can be viewed as a process of moving from burdensomeness to liberating burdensomeness. Methodologically, a small body of knowledge that met quality appraisal was interpreted and synthesised into an understanding of an evidenced-informed approach to guide nurses' encounters with survivors of suicide loss. RELEVANCE TO CLINICAL PRACTICE The results contribute to an evidenced-informed approach for nurses in practice to support survivors of suicide loss journeying from burdensomeness to liberating burdensomeness. Results also serve as a foundation for further research.
Collapse
Affiliation(s)
- Anne-Grethe Talseth
- Department of Health and Care Sciences, Faculty of Health Sciences, University in Tromsø, Tromsø, Norway
| | | |
Collapse
|
43
|
Feigelman W, Rosen Z, Joiner T, Silva C, Mueller AS. Examining longer-term effects of parental death in adolescents and young adults: Evidence from the national longitudinal survey of adolescent to adult health. DEATH STUDIES 2017; 41:133-143. [PMID: 27813715 PMCID: PMC7219956 DOI: 10.1080/07481187.2016.1226990] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Using longitudinal data spanning a 7-year period, we investigated the behavioral and psycho-social effects resulting from a parent's death during early childhood or teenage years on adolescent and early adulthood functioning. Findings confirmed previous work demonstrating various behavioral problems and social-psychological adjustment deficits during adolescence. Results suggested that most detrimental adjustment behaviors among parentally bereaved youth fade as they entered into young adulthood. Yet, premature school withdrawals and diminished interests in college attendance at Wave 1 left many of these young adults with diminished academic accomplishments, lingering economic disadvantages and for females a hesitancy to marry as their lives progressed into adulthood.
Collapse
Affiliation(s)
- William Feigelman
- a Department of Sociology , Nassau Community College , Garden City , New Jersey , USA
| | - Zohn Rosen
- b Mailman School of Public Health , Columbia University , New York , New York , USA
| | - Thomas Joiner
- c Department of Psychology , Florida State University , Tallahassee , Florida , USA
| | - Caroline Silva
- c Department of Psychology , Florida State University , Tallahassee , Florida , USA
| | - Anna S Mueller
- d Comparative Human Development , University of Chicago , Chicago , Illinois , USA
| |
Collapse
|
44
|
Levi-Belz Y. To share or not to share? The contribution of self-disclosure to stress-related growth among suicide survivors. DEATH STUDIES 2016; 40:405-413. [PMID: 26963136 DOI: 10.1080/07481187.2016.1160164] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study examined to what extent suicide survivors can experience growth in the aftermath of suicide loss, as well as the role of self-disclosure and coping strategies in stress-related growth (SRG) among suicide survivors, compared to bereavement following sudden and expected death types. One hundred forty-five bereaved individuals (aged 18-73) completed questionnaires measuring SRG, self-disclosure, and coping strategies. Significant interaction between self-disclosure and types of death was found, in which suicide survivors with low levels of self-disclosure manifested the lowest level of SRG compared to other subgroups. This finding suggests that sharing intimate information can be beneficial in struggling with a situation of suicide in the family.
Collapse
Affiliation(s)
- Yossi Levi-Belz
- a Department of Behavioral Sciences , Ruppin Academic Center , Emek Hefer , Israel
| |
Collapse
|