Resilience and vulnerability: prolonged grief in the bereaved spouses of marital partners who died of AIDS

Spousal bereavement is closely linked to prolonged grief, that is, significant adjustment symptoms that last for more than six months after the loss. This article focused on potential risk and protective factors that may influence bereavement outcomes. Participants in this study were surviving spouses of individuals who died of acquired immune deficiency syndrome (AIDS). These participants were themselves living with human immunodeficiency syndrome. In this cross-sectional study, 120 bereaved participants completed measures of grief, quality of dying and death of the deceased, negative conceptions of death resulting from AIDS, death attitudes, and personal resilience. The results showed that one-third (35.0%) of the bereaved participants reported grief levels above the prolonged grief cut-off scores, and can be categorized as the "prolonged grief" group. Although quality of dying and death was not associated with the intensity of grief, negative conceptions of death from AIDS, fear of death and resilience independently predicted grief symptoms in the regression models. Our findings provide insight into the grief process for the surviving spouse of AIDS victims in rural China. Since resilience is malleable, developing resilience interventions to enhance adjustment to bereavement may be a promising direction in grief counselling and therapies.

Optimism in prolonged grief and depression following loss: A three-wave longitudinal study

There is considerable evidence that optimism, the predisposition to have generalized favorable expectancies for the future, is associated with numerous desirable outcomes. Few studies have examined the association of optimism with emotional distress following the death of a loved one. Doing so is important, because optimism may be an important target for interventions for post-loss psychopathology. In the current study, we examined the degree to which optimism, assessed in the first year post-loss (Time 1, T1), was associated with symptom levels of prolonged grief and depression six months (Time 2, T2) and fifteen months (Time 3, T3) later, controlling for baseline symptoms and also taking into account positive automatic cognitions at T1. Findings showed that higher optimism at T1 was associated with lower concurrent prolonged grief and depression severity. Higher optimism at T1 was also inversely related with depression symptom severity at T2 and T3, but not prolonged grief severity at T2 and T3. Implications of these findings are discussed.

Developing and Prioritizing Measures of Emotional Capital in Public Service Organizations

This research is to construct emotional capital of public service organizations (PSOs) through employees’ perspectives. The content analysis method and analytical hierarchy process were used to collect and analyze data. According to the results, the study divides organizational emotional capital of public service sectors into three dimensions: Personal Emotional Capital, Group Emotional Capital, and Organizational Emotional Capital. The research also develops 12 indicators for organizational emotional capital of PSOs assessment. Measuring organizational emotional capital can be used to help formulate public strategy, provide an evaluation method for governments and allocate resources for PSOs.

Cultural implications of death and loss from AIDS among women in South Africa

Over 1.8 million people have died of AIDS in South Africa, and it continues to be a death sentence for many women. The purpose of this study was to examine the broader context of death and loss from HIV/AIDS and to identify the cultural factors that influenced existing beliefs and attitudes. The participants included 110 women recruited from 3 communities in South Africa. Focus group methodology was used to explore their perceptions surrounding death and loss from HIV/AIDS. Using the PEN-3 cultural model, our findings revealed that there were positive perceptions related to how women cope and respond to death and loss from HIV/AIDS. Findings also revealed existential responses and negative perceptions that strongly influence how women make sense of increasing death and loss from HIV/AIDS. In the advent of rising death and loss from HIV/AIDS, particularly among women, interventions aimed at reducing negative perceptions while increasing positive and existential perceptions are needed. These interventions should be tailored to reflect the cultural factors associated with HIV/AIDS.

Coping versus grieving in a "death-accepting" society: AIDS-bereaved women living with HIV in Indonesia

The aim of this study was to understand how AIDS-bereaved women in Indonesia cope in a society where death is believed to be fated. Data analyses were conducted based on the women’s interview transcripts and journal entries. Each of the women experienced at least three traumatic life events. The most challenging experience was learning that they have contracted a disease they regarded as associated with prostitution. Given the short lapse of time between their husbands’ deaths and learning about their seropositivity, biographical disruption appeared to have acted as an ‘analgesic’, while concerns to protect their children seemed to have triggered biographical reinforcement. This phenomenon may have brought about a positive bereavement outcome. Specific counselling programmes for women affected by HIV/AIDS are needed, but emphasis should first be placed on improving their wellbeing and their perception of stigma.

Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa

The study examines the association between the presence of mental disorder and a range of independent variables. A sample of 900 HIV-positive individuals was administered the Composite International Diagnostic Interview to determine the presence of selected mental disorders. A structured interview assessed support received and factors that may contribute to mental disorder. Overall prevalence of mental disorder was 43.7%--though higher in Stage 3 (49.7%) and in Stage 4 (68%) of the disease. Eighteen percent of respondents were receiving antiretroviral treatment. Having had pre- and post-test counselling was not related to mental disorder; nor were the number of sessions, the professional status of the counsellor and perceived helpfulness of counselling. Being in an HIV support group was related to presence of a mental disorder, although the frequency of attendance was not. Although most of those who disclosed their HIV status found the experience helpful there was a significant positive association between presence of a mental disorder and having disclosed HIV-positive status. Although being a member of an association for people with HIV/AIDS and being religious was perceived as helpful, neither was statistically associated with the presence of mental disorder. Discrimination by community and family and isolation were related to mental disorder. Death of a significant other due to AIDS was related to mental disorder. The findings suggest a strong need for provision of psychiatric care as part of AIDS care as well as strengthening of support services.

Stress and quality of life in breast cancer recurrence: moderation or mediation of coping?

BACKGROUND/PURPOSE

Diagnosis with breast cancer recurrence often brings high levels of stress. Successful coping to alleviate stress could improve patients' quality of life (QoL). The intervening role coping plays between stress and QoL may depend on the types of stress encountered and the types of coping strategies used. The present study investigates the longitudinal relationships between stress, coping, and mental health QoL.

METHODS

Breast cancer patients recently diagnosed with recurrence (N = 65) were assessed shortly after the diagnosis and 4 months later. Four moderation and four mediation models were tested using hierarchical multiple regressions and path analyses. In the models, either traumatic stress or symptom-related stress at recurrence diagnosis was a predictor of mental health QoL at follow-up. Both engagement and disengagement coping strategies were tested as moderators or mediators between stress and QoL.

RESULTS

Engagement coping moderated the effect of symptom stress on mental health QoL, whereas disengagement coping mediated the effects of both traumatic stress and symptom stress on mental health QoL.

CONCLUSION

The findings imply that interventions teaching engagement coping strategies would be important for patients experiencing high symptom stress, while discouraging the use of disengagement coping strategies would be important for all patients.

Emotional Distress and Psychosocial Resources in Patients Recovering From Severe Burn Injury

Emotional distress as well as psychosocial resources in 55 patients with burn injuries was assessed during acute and follow-up treatment. Results showed significantly greater values of emotional distress among patients when compared with norms of the general population. As well as higher levels of general psychopathology, particularly prevalent were anxiety, depression, and posttraumatic symptoms. However, patients also reported high levels of resources such as general optimism, self-efficacy, and perceived social support. Within the sample, no significant correlation between severity of emotional distress and severity of burn injury was found. By psychological assessments a subgroup of highly distressed patients was identified. These patients were highly emotionally distressed while having objective injury severity comparable with the other patients in the sample. Reactions to burn accidents vary individually. The results demonstrate the importance of routine screenings of psychological symptoms. An early identification of patients at-risk allows for tailored psychotherapeutic interventions and can thus help to improve quality of life and general well-being of burn patients on a long-term basis.

Resiliency among individuals with childhood sexual abuse and HIV: perspectives on addressing sexual trauma

This study examined how resiliency (represented by optimism, social support, religiosity, and finding growth and meaning), within the context of perceived impact of sexual trauma and HIV-related stress, was linked to perspectives on addressing trauma among individuals (N=266) with HIV and childhood sexual abuse (CSA). Structural equation modeling analyses indicated that lower resiliency and greater HIV-related stress were related to negative feelings about addressing trauma, whereas greater resiliency and higher perceived impact of sexual trauma were associated with positive feelings about addressing trauma. Findings suggest that multiple factors influence perspectives on addressing trauma among individuals with HIV and CSA, and that resiliency might influence these attitudes.