Complication of Grief and PTSD among bereaved siblings in Israel

This study explores the experiences of bereaved siblings in Israel, examining how different causes of death affect their psychological well-being. We recruited three groups of siblings who lost loved ones as a result of military service, terrorism, or civilian circumstances. A total of 159 bereaved siblings completed questionnaires measuring complications of grief (CG), posttraumatic stress disorder (PTSD), and world assumptions. Results indicated that siblings who experienced civilian loss exhibited the highest prevalence of CG, while no significant differences in PTSD levels were observed across the groups. Both CG and PTSD were associated with the world assumptions regarding the benevolence of the world and sense of self-worth. The study also examined how demographic variables influence siblings' well-being and coping with loss. Overall, the findings emphasize the importance of recognizing the unique experiences of bereaved siblings and underscore the necessity of tailored support to address their individualized needs.

How does social complexity facilitate coping flexibility? The mediating role of dialectical thinking

BACKGROUND AND OBJECTIVE

Past research has shown that worldviews can influence coping strategies but coping is often regarded as a stable person-based behavioral characteristic. The present research aims to examine how one component of worldviews - social complexity - influences the flexibility of coping strategies across situations.

DESIGN

In two cross-sectional studies and one prospective study, we tested a mediation model in which the perceived complexity of the social world (i.e., social complexity) predicted coping flexibility through dialectical thinking.

RESULTS

Across three studies, social complexity consistently facilitated dialectical thinking, which in turn fostered the cross-situational flexibility of coping strategies at a single time point and over 12 months.

CONCLUSIONS

Believing in complex causes of phenomena and multiple solutions to problems facilitates a cognitive style of viewing issues from multiple perspectives and tolerating contradictions, which are conducive to the flexible evaluation and implementation of effective strategies to cope with problems. Theoretical and practical implications of the present research are discussed.

Distinct Psychological Characteristics Predict Resilience and Recovery Throughout Widowhood

The dual-process model proposes that early and later bereavement involves different types of stressors and adaptation processes (Stroebe & Schut, 1999, 2010). It is thus possible that different factors facilitate adaptation during the early months versus subsequent years following widowhood. Elevated depressive symptoms, though prevalent after widowhood, may indicate problematic adaptation, as they are associated with poor long-term physical and mental health outcomes. We predicted that neutral death acceptance would be associated with less increase in depression during early widowhood (when confronted with loss-oriented stressors), whereas perceived control would predict depressive symptom decline during later widowhood (when adapting to controllable restoration-oriented stressors). Older adults (N = 265) reported on neutral death acceptance, perceived control, and depression before widowhood and on depression 0.5, 1.5, and 4.0 years after the death of their spouse. Bilinear spline growth modeling revealed that, on average, depressive symptoms increased from before to 0.5 years after spouse death and fell from 0.5 to 4.0 years after spouse death. Neutral death acceptance predicted a smaller increase in depression from before to 0.5 years after spouse death, as well as a smaller subsequent decrease in depression from 0.5 to 4.0 years after spouse death. Perceived control predicted a larger decrease in depression from 0.5 to 4.0 years after spouse death. Neutral death acceptance and perceived control had unique associations with resilience and recovery throughout early and later widowhood. These variables may be fruitful targets in interventions for depression throughout the full course of widowhood.

Prolonged grief and posttraumatic stress disorder following the loss of a significant other: An investigation of cognitive and behavioural differences

BACKGROUND

Cognitive behavioural correlates to bereavement-related mental health problems such a Prolonged Grief Disorder (PGD) and Posttraumatic Stress Disorder (PTSD) are of theoretical and clinical importance.

METHODS

Individuals bereaved at least six months (N = 647) completed measures of loss-related cognitions and behaviours (i.e., loss-related memory characteristics, negative appraisals, coping strategies, grief resilience, and perceived social disconnection) and measures of PGD and PTSD symptoms. Individuals were assigned to one of four groups depending on probable clinical diagnoses (No-PGD/PTSD, PTSD, PGD, PGD+PTSD).

RESULTS

Results indicated that higher loss-related memory characteristics and lower grief resilience increased the likelihood of a clinical problem. The PGD and PGD+PTSD groups reported significantly higher loss-related memory characteristics and appraisals compared to the PTSD group. Social disconnection increased the likelihood of comorbid PGD+PTSD in comparison to any other group.

CONCLUSIONS

Results indicate cognitive differences between loss-related cognitions, memory characteristics and coping strategies between PGD and PTSD, and points to distinct cognitive correlates to psychopathology following loss.

Testing If Primal World Beliefs Reflect Experiences-Or at Least Some Experiences Identified ad hoc

Do negative primal world beliefs reflect experiences such as trauma, crime, or low socio-economic status? Clifton and colleagues recently suggested that primals-defined as beliefs about the general character of the world as a whole, such as the belief that the world is safe (vs. dangerous) and abundant (vs. barren)-may shape many of the most-studied variables in psychology. Yet researchers do not yet know why individuals adopt their primals nor the role of experience in shaping primals. Many theories can be called retrospective theories; these theories suggest that past experiences lead to the adoption of primals that reflect those experiences. For example, trauma increases the belief that the world is dangerous and growing up poor increases the belief that the world is barren. Alternatively, interpretive theories hold that primals function primarily as lenses on experiences while being themselves largely unaffected by them. This article identifies twelve empirical tests where each theory makes different predictions and hypothesizes that retrospective theories are typically less accurate than interpretive theories. I end noting that, even if retrospective theories are typically inaccurate, that does not imply experiences do not shape primals. I end by offering a conceptual architecture-the Cube Framework-for exploring the full range of human experience and suggest that, though psychologists have historically focused on negative, externally imposed experiences of short-duration (e.g., trauma), positive, internally driven, and longer-term experiences are also worth considering.

The Development of the Widowhood Resilience Scale

Widowhood researchers have been increasingly interested in the construct of resilience and identifying factors which contribute to adaptive responses to conjugal loss. Available measures of general resilience were validated on nonwidowed samples and broadly lack face validity for use with widowed people. This article reports the development and validation of a resilience scale specific to widowhood, the Widowhood Resilience Scale. Initially, qualitative responses from 744 widowed people were analyzed and cross-referenced with existing literature on resilience to develop 49 items. The 49 items were tested on a sample of 1,188 widowed people, resulting in a 6-factor, 25-item scale.

Testing the indirect effects of somatic and parental effort on stress: the roles of worldviews and coping strategies

Life history theory (LHT) is a mid-level theory from evolutionary biology. LHT, adapted to humans, assumes that individuals can be placed along a single continuum of LH strategies referred to as the slow-to-fast LH continuum: faster life history strategists score higher on mating effort and lower on somatic and parental effort. In the present study we examine the hypothesis that worldview and coping strategies are mediators between somatic and parental effort (SPE) and current perceived stress. 226 participants completed a set of instruments: Mini-K, the World Assumptions Scale, Brief COPE, and the Perceived Stress Scale. In order to test the hypotheses about mediators, Structural Equation Modeling (SEM) was used. The results from the current study showed that individuals allocating their own resources to SPE experienced lower current stress, and felt positive about the benevolence and meaningfulness of the world as well as the worthiness of the self. A more complex linkage was also revealed: individuals displaying SPE endorsed stronger beliefs about self-worth, which in turn was associated with a lower tendency to use disengagement coping and which again translated into a lower level of perceived stress. Furthermore, females investing in SPE maintained a higher level of belief in the meaningfulness of the world, which translated into a higher tendency to use external support for coping.

Adaptation of the Scrambled-Sentences Task to Assess "Shattered Assumptions:" Construction of the Test and Investigation of Neural Substrates in an fMRI Study

BACKGROUND

Increasing recognition is being given to the importance of cognitions observed in posttraumatic conditions. These cognitions may reflect the activation of negative schemas. The aim of this work was to evaluate the feasibility of the scrambled-sentences task (SST) to assess individual differences in attributions commonly observed after traumas. Originally developed to assess the tendency to activate negative cognitions in individuals predisposed to depression, the SST is a laboratory task the outcome of which has been shown to predict depression relapse and is associated with depressiveness.

SAMPLING AND METHODS

We used content from self-rating scales for assessment of the activation of trauma-related schemas to develop a trauma-related SST and evaluated its performance in a behavioral study (n = 43) and a functional neuroimaging study (n = 20).

RESULTS

In the healthy sample in which we tested it, the trauma-related SST was strongly associated with individual differences in negative affect (scores in depressiveness and neuroticism scales) as well as with the scores on trauma-related cognition scales. However, we failed to detect a clear specificity of trauma-related cognitions in correlations with scores on the trauma-related scales in the healthy participants. The neuroimaging data demonstrated activation of a ventral network of areas that included the perisylvian/temporal cortex and the peri-cingular cortex in handling trauma-related relative to neutral material, replicating previous neuroimaging studies of the SST.

CONCLUSION

The shattered-assumptions SST demonstrated strong associations with individual differences in all of the rating scales used in the study, suggesting its usefulness in capturing aspects of affective psychopathology. The neuroimaging study confirmed the capacity of this task to elicit specific activations. In future studies, evaluation of the conditions in which these neural substrates are active may shed light on the mechanism of schema selection.

The role of grief symptoms and a sense of injustice in the pathways to post-traumatic stress symptoms in post-conflict Timor-Leste

AIMS

Grief symptoms and a sense of injustice may be interrelated responses amongst persons exposed to mass conflict and both reactions may contribute to post-traumatic stress disorder (PTSD) symptoms. As yet, however, there is a dearth of data examining these relationships. Our study examined the contributions of grief and a sense of injustice to a model of PTSD symptoms that included the established determinants of trauma events, ongoing adversity and severe psychological distress. The study involved a large population sample (n = 2964, response rate: 82.4%) surveyed in post-conflict Timor-Leste.

METHODS

The survey sites included an urban administrative area (suco) in Dili, the capital of Timor-Leste and a rural village located an hour's drive away. Culturally adapted measures were applied to assess conflict related traumatic events (TEs), ongoing adversity, persisting preoccupations with injustice, symptoms of grief, psychological distress (including depressive symptoms) and PTSD symptoms.

RESULTS

We tested a series of structural equation models, the final comprehensive model, which included indices of grief symptoms and injustice, producing a good fit. Locating grief symptoms as the endpoint of the model produced a non-converging model. In the final model, strong associations were evident between grief and injustice (β = 0.34, s.e. = 0.02, p < 0.01) and grief and PTSD symptoms (β = 0.14, s.e. = 0.02, p < 0.01). The sense of injustice exerted a considerable effect on PTSD symptoms (β = 0.13, s.e. = 0.03, p < 0.01). In addition, multiple indirect paths were evident, most involving grief and a sense of injustice, attesting to the complex inter-relationship of these factors in contributing to PTSD symptoms.

CONCLUSIONS

Our findings support an expanded model of PTSD symptoms relevant to post-conflict populations, in which grief symptoms and a sense of injustice play pivotal roles. The model supports the importance of a focus on loss, grief and a sense of injustice in conducting trauma-focused psychotherapies for PTSD amongst populations exposed to mass conflict and violence. Further research is needed to identify the precise mechanisms whereby grief symptoms and the sense of injustice impact on PTSD symptoms.

Complicated grief and bereavement in young adults following close friend and sibling loss

BACKGROUND

This study examined the association between types of loss (i.e., sibling or close friend) and relationship quality (i.e., depth and conflict) with complicated grief, depression, somatic symptoms, and world assumptions in bereaved young adults.

METHODS

Participants were 107 young adults aged 17-29 years who were either bereaved or had never experienced a loss. Among bereaved participants, 66 lost a close friend and seven lost a sibling within the past 3 years (M = 1.63 years).

RESULTS

Nineteen percent of the young adults met criteria for complicated grief and 31% had mild to severe depression. Participants with a deceased sibling reported greater depth in the relationship as compared to those who lost a friend. They were also more likely to have complicated grief (57% versus 15%) and report significantly higher levels of grief, depression, and somatic symptoms. Those who lost a sibling reported a lower sense of meaningfulness and benevolence of the world and self-worth as compared with those who lost a close friend or had not experienced a loss.

CONCLUSIONS

Complicated grief and depression are common among bereaved young adults. Sibling loss is particularly distressing to young adults, due in part to the high level of relationship depth, and is associated with increased psychological and physical symptoms postloss.

A Cognitive Attachment Model of prolonged grief: integrating attachments, memory, and identity

Prolonged grief (PG), otherwise known as complicated grief, has attracted much attention in recent years as a potentially debilitating condition that affects approximately 10% of bereaved people. We propose a model of PG that integrates processes of attachment, self-identity, and autobiographical memory. The paper commences with a discussion of the PG construct and reviews current evidence regarding the distinctiveness of PG from other bereavement related-outcomes. We then review the evidence regarding the dysfunctional attachments, appraisals, and coping styles that people with PG display. Recent evidence pertaining to the patterns of autobiographical memory in PG is described in the context of the self-memory system. This system provides a unifying framework to understand the roles of personal memories, identity, attachments, and coping responses in PG. The proposed model places emphasis on how one's sense of identity influences yearning, memories of the deceased, appraisals, and coping strategies, to maintain a focus on the loss. The model is discussed in relation to existing models of PG. The potential for shaping treatment strategies to shift perceptions of the self is then outlined. Finally, we outline future directions to test propositions stemming from the model and enhance our understanding of the mechanisms underlying PG.

The Narrative Dynamics of Grief after Homicide

The homicidal death of a loved one is horrific. Dying from homicide can be more sudden, frightening, and stigmatizing than natural dying and may be followed by a sub-type of prolonged grief complicated by vivid narrative reenactment of the dying, intense feelings of remorse, and nihilistic despair. After a literature review of grief after homicide, the author clarifies the salient narrative themes of homicidal dying and their specific effects on trauma and separation distress. A preliminary model is then developed and illustrated in a therapy case outlining a technique (imaginative exposure) to diminish the disabling fixation of reenactment imagery, remorse, and despair.