Psychological distress and bereavement

Patterns of Parental Bereavement following the Loss of a Child and Related Factors

This study investigated the patterns of parental bereavement in 20 parents who have lost a child to cancer, congenital heart disease, meningitis, or drowning in the last 19 months, using semi-structured interviews and standardized questionnaires of depression and grief. Qualitative content analysis of interviews identified three bereavement patterns: The majority of parents (65%) presented uncomplicated, Integrated Grief, five mothers were Consumed by Grief, and one mother and one father expressed Minimal Grief. Quotes from parents exemplified these patterns. Parental gender, symptoms of depression, and pre-death relationship between parents and their deceased child differentially related to these patterns. Having surviving children, social support, and being active appeared to help to integrate grief into daily life. These findings illustrate differential patterns of parental bereavement and related factors, information that has important implications for identifying at-risk parents for complicated bereavement.

An Integrative Model of Personality, Coping and Appraisal for the Prediction of Grief Involvement in Adults

This Study Contrasts Two Opposing Conceptualizations Of Personality's Effect Upon Grief: A Traditional Ego Psychology (Risk Factor) View And Lazarus And Folkman's Contextual Coping Model. The Eysenck Personality Questionnaire, the Coping Inventory for Stressful Situations, and the Revised Grief Experience Inventory were administered to 101 bereaved adults. Predictor variables included neuroticism, extraversion, threat appraisal, emotion-oriented coping, task/problem-oriented coping, and avoidance coping. Significant predictive effects for emotion oriented coping, task/problem oriented coping, and grief-related variables were found. Results support contextual coping theory, indicating that immediate coping processes may be better predictors of grief involvement than longstanding personality traits. Clinical implications are discussed.

[Reactive (psychogenic) depressions]

In this literature review, authors analyzed the history of studies on psychogenic (stress-included) depressions and the current state of the problem. The status of these diseases in classification systems, main directions of current research, proposed conceptions and perspectives of future studies in the filed are considered.

[The systematics of psychogenic depressions (reactions of complicated grief)]

OBJECTIVE

Reactive depression provoked by the loss of loved ones is a controversial problem of modern psychiatry based on the diametrically opposite conceptions. The author suggests a clinical typology of these depressions based on a psychopathological analysis of trigger mechanisms and constitutional predisposition.

MATERIAL AND METHODS

Fifty-five patients, aged from 31 to 65 years (mean age 46.9±13.9 years), were examined. The course of depression, including previous psychogenia, was followed up for 5-15 years (mean 11.5±3.6 years).

RESULTS AND CONCLUSION

Three types of catathymic complexes (affective dissonance, affective resonance and affective imbalance) can be considered as a significant parameter responsible for trigger mechanisms of these psychogenias and their further dynamics. Each type determines not only the psychopathological structure of psychogenic depression but has a predictive validity thus allowing to predict the dynamics of depression and its nosological attribution.

Can Money Symbolize Acknowledgment? How Victims' Relatives Perceive Monetary Awards for Their Emotional Harm

Legal systems differ markedly on how they treat the emotional harm suffered by close family members of crime or accident victims. This paper reports the results of two empirical studies examining how citizens whose child, partner, or parent was killed or seriously injured as a result of violent crime or tort (secondary victims) perceive a monetary award for their own non-economic harm relating to the death or injury of their loved one. The objective of our research was to test the Dutch legislator's assumption that a (modest) monetary award for secondary victims' emotional harm can have a meaningful symbolic value by providing recognition and satisfaction. Until then, no compensation was available for such harm under Dutch law. In addition, we examined whether victims' relatives preferred standardization or individuation in determining the amount of the award, how they evaluated the amount, and the manner in which such awards might be offered. In a first quantitative survey study conducted in the Netherlands, 726 secondary victims were asked for their evaluations of such awards for the emotional harm they suffered as a result of the death or injury of their family member. We also asked our representative sample about their actual experience of the legal process in order to put their evaluations of such awards into context. In a second qualitative study, conducted in Belgium, interviews were held with 14 secondary victims who had actually received an award for their own emotional harm under Belgian law (study 2). Results suggest that secondary victims regard an award for emotional harm as a positive gesture and may interpret it as helping to satisfy relatives' psychological concerns by seeing it, for example, as an acknowledgment of loss and responsibility. Overall findings suggest that victims' relatives may be seeking acknowledgement of their emotional losses and the norm violation.

Subjective well-being and adaptation to life events: a meta-analysis

Previous research has shown that major life events can have short- and long-term effects on subjective well-being (SWB). The present meta-analysis examines (a) whether life events have different effects on affective and cognitive well-being and (b) how the rate of adaptation varies across different life events. Longitudinal data from 188 publications (313 samples, N = 65,911) were integrated to describe the reaction and adaptation to 4 family events (marriage, divorce, bereavement, childbirth) and 4 work events (unemployment, reemployment, retirement, relocation/migration). The findings show that life events have very different effects on affective and cognitive well-being and that for most events the effects of life events on cognitive well-being are stronger and more consistent across samples. Different life events differ in their effects on SWB, but these effects are not a function of the alleged desirability of events. The results are discussed with respect to their theoretical implications, and recommendations for future studies on adaptation are given.

Relationship between behavioral lifestyle and mental health status evaluated using the GHQ-28 and SDS questionnaires in Japanese factory workers

In order to clarify the relationships between lifestyle behaviors and mental health status in Japanese workers, the 28-item General Health Questionnaire (GHQ-28) and Zung's Self-rating Depression Scale (SDS) were administered to 254 male factory workers; further, eight of their personal health practices were surveyed using the Health Practice Index (HPI). Few studies have used the GHQ-28 and SDS simultaneously; moreover, to date, no study has included the lifestyle factors in these scales. We used these tools for the concurrent assessment of mental health status and classified the subjects into high-risk and low-risk groups. The GHQ-28 and SDS scores correlated negatively with the HPI scores. In the older age group, these scores decreased significantly corresponding to an increase in the total number of favorable lifestyle practices followed. Significant relationships were observed between the GHQ-28 subscales and the HPI. Multiple logistic regression analysis revealed that four of the eight health practices surveyed were significantly related to the mental health status in all subjects. Thus, good health practices appear to be closely associated with good mental health status. However, to establish our results, larger study populations are required for further studies in various occupational fields.

Pre-bereavement meaning and post-bereavement distress in mothers of children who underwent haematopoietic stem cell transplantation

OBJECTIVES

The purpose of this study was to explore the association of meaning-making with psychological adjustment to bereavement among mothers of children who had undergone haematopoietic stem cell transplantation (HSCT).

DESIGN

A prospective research design was used. Regression analyses were conducted to determine the relations between pre-bereavement variables (distress, searching for meaning, and finding meaning) and distress post-bereavement.

METHODS

Thirty-five mothers of children who had undergone HSCT were interviewed at the time of their child's HSCT and 3 months post-bereavement.

RESULTS

Mothers who reported searching for meaning at HSCT reported greater post-bereavement distress, and mothers who reported finding meaning at HSCT reported less post-bereavement distress. Distress at HSCT and the number of days between the time of death and the post-bereavement time point were also found to be significant predictors of post-bereavement distress.

CONCLUSIONS

This study provides partial support for the role of meaning in adjustment to loss.

Bereavement in cognitively impaired older adults: case series and clinical considerations

The intersection of bereavement and cognitive impairment presents unique clinical challenges that have been overlooked in the literature. Cognitive impairment can interfere with normal ways of coping in the aftermath of loss. Elderly persons with cognitive impairment may have difficulty processing their loss and may even forget that their loved one has died, repeatedly asking other family members when the deceased is coming to visit. This can prove devastating for such individuals and their families, who are forced to keep reexperiencing their grief. This article examines the phenomenology of bereavement-related distress in older adults with cognitive impairment and dementia through a case series gathered from a large geriatric facility. The dilemmas in caring for bereaved elderly with cognitive difficulties and their families are highlighted, drawing attention to a vulnerable population. The purpose of this undertaking is to present a novel classification of a clinically relevant but overlooked issue as well as provide strategies for management and suggestions for future research.

An investigation of the relationship of personality, coping, and grief intensity among bereaved mothers

A mediational model of grief intensity (Meuser & Marwit, 2000) was examined in a population at risk for complicated grief. Coping strategies (emotion-oriented, task-oriented, and avoidance-oriented coping) were hypothesized to mediate the influence of personality factors (neuroticism and extraversion) on grief. Bereaved mothers (N = 138) completed the Eysenck Personality Questionnaire, Coping Inventory for Stressful Situations, and Revised Grief Experiences Inventory. Coping strategies partially mediated the influence of personality factors on grief. However, compared to prior findings among bereaved spouses, coping played a weaker mediating role, and neuroticism had a stronger direct influence on grief among bereaved mothers. Results suggest that personality and coping factors may function differently across different loss circumstances.

Evaluation of the Bereavement Risk Index (BRI): a community hospice care protocol

AIM

to test the validity, reliability and feasibility of using a modified version of Parkes' (1993) Bereavement Risk Index (BRI) and bereavement support protocol in an Australian home hospice care setting. In addition, the study aimed to explore what types of family members are most likely to experience a more difficult grief reaction.

DESIGN

a prospective, descriptive study was used. One hundred and fifty bereaved family members participated. Bereaved family members were classified as high, medium or low risk and received a structured bereavement support protocol based on their level of risk as measured by the BRI.

FINDINGS

results indicated that a shorter 4-item version of the BRI was more internally consistent than the longer version and demonstrated good predictive validity when correlated with outcome measures at 3 months following the patient's death.

CONCLUSION

the modified 4-item BRI demonstrated acceptable reliability and validity and was brief and simple to use. Nurses were able to use the instrument with minimal training and were able to adhere to a matched bereavement support protocol.

Complicated grief in Bosnian refugees: associations with posttraumatic stress disorder and depression

Complicated grief is likely to be common among refugee populations exposed to war trauma. However, there have been few studies investigating the traumatic antecedents and correlates of complicated grief in refugees, and the relationship of that symptom pattern with other common disorders such as posttraumatic stress disorder (PTSD) and depression. We studied Bosnian refugees recruited from a community center in Sydney, Australia, with the sample being supplemented by a snowball method (N = 126; response rate, 86%). Measures included a trauma inventory, the Clinician Administered PTSD Scale (CAPS), the depression module of the Structured Clinical Interview (SCID), and the Core Bereavement Items (CBI). A dimension of traumatic loss derived from the trauma inventory was a specific predictor of complicated grief, with exposure to human rights violations being associated with images of the traumatic events surrounding the lost person. There was no link between PTSD and grief other than for a low-order association with the PTSD intrusion dimension. In contrast, depression was strongly associated with grief and its subscales. Only the subgroup with comorbid grief and depression reported higher levels of traumatic loss. The results suggest that complicated grief in refugees can become persistent and associated with depression. While PTSD and grief share common symptoms of intrusion, the two symptom domains are sufficiently distinct to warrant independent assessment of grief in refugee populations.