Ambiguous Loss Research Articles

“Forever family is like a manufactured Hallmark idea”: Adoption discontinuity experiences of intercountry adoptees

BackgroundMedia stories over the past decade have sensationalized cases of intercountry adoption discontinuity, a phenomenon largely missing from the research literature. ObjectiveThis study sought to understand how intercountry adoptees with adoption discontinuity histories experience legal, relational, and residential permanency losses through the framework of ambiguous loss and trauma. Participants and settingTwenty intercountry adoptees in the United States who experienced adoption discontinuity as minor children. MethodsParticipants were recruited through social media sites and professional and informal organizations serving intercountry adoptees. ResultsParticipants described multiple experiences with legal, residential, and relational permanency losses often in multiple combinations, multiple times, and in multiple settings. Participants also experienced racial, ethnic and cultural identity losses in addition to their permanency ruptures. ConclusionMore research on the lived experiences of intercountry adoptees with adoption discontinuity histories is needed. Adoptees experience trauma in their pre-adoptive histories as well as in the adoption process itself and need adoptive parents skilled in trauma-informed parenting. In addition, there is a need for robust trauma-informed support for adoptees throughout their lifetime.

Y el luto sigue (and the grief continues): Latinx Immigrant's Experiences of Ambiguous Loss in the Age of Restrictive Immigration Policy

ObjectiveInformed by Boss's ambiguous loss theory and an ecological perspective, this study examined Latinx immigrant mothers' experiences of loss associated with their immigration status and the restrictive immigration policy climate.BackgroundUndocumented participants strive to maintain international familial ties and experience loss in their inability to see or share a space with loved ones in their country of origin due to restrictive immigration policy and enforcement that inhibits their international mobility.MethodsIn‐depth semistructured interviews were completed with 25 Latinx immigrant mothers who were mostly undocumented or members of mixed‐status families.ResultsFindings support a model of transnational loss. Loss is experienced at premigration, upon arrival, and long after settlement. Participants' quotes illustrate their experiences of ambiguous, anticipatory, and complicated loss. In addition, transnational loss was described as a shared experience, one that impacted many undocumented immigrants in the United States and participants' family members. A subtheme, intergenerational loss, emerged in which children vicariously experienced their parents' loss.ConclusionTransnational loss is disenfranchised because it is not socially recognized, leaving immigrants to mourn in silence.ImplicationsPractitioners serving immigrant communities should integrate grief and loss support through psychoeducation, assessments, and therapy. At a policy level, immigrants need to have the opportunity to adjust their status so that they can reclaim these lost social interactions.

A Literature Review: Pet Bereavement and Coping Mechanisms

ABSTRACT The loss of a companion animal results in millions of pet owners grieving annually. To date, little information has been synthesized on the grief response and coping mechanisms of bereaved pet owners. The aim of this review was to examine the relationship between pet loss and owner grief response. Major themes included: factors that influence the grief response, the disenfranchised nature surrounding pet loss, ambiguous pet loss and coping mechanisms used. Across the 48 studies included in this review, bereaved pet owners frequently reported feelings of embarrassment and loneliness following the loss of their pet. Types of coping mechanisms used by bereaved pet owners were identified and included: isolation, social support, continuing bonds, memorialization, religion, and relationships with other animals. Overall, this review was able to identify a consensus among the literature that bereaved pet owners are likely to experience disenfranchisement surrounding their loss. Based on the present findings, suggestions for future research include a focus on the effectiveness of coping mechanisms used by bereaved pet owners.

Quantitative Metrics for Performance Monitoring of Software Code Analysis Accredited Testing Laboratories.

Modern sensors deployed in most Industry 4.0 applications are intelligent, meaning that they present sophisticated behavior, usually due to embedded software, and network connectivity capabilities. For that reason, the task of calibrating an intelligent sensor currently involves more than measuring physical quantities. As the behavior of modern sensors depends on embedded software, comprehensive assessments of such sensors necessarily demands the analysis of their embedded software. On the other hand, interlaboratory comparisons are comparative analyses of a body of labs involved in such assessments. While interlaboratory comparison is a well-established practice in fields related to physical, chemical and biological sciences, it is a recent challenge for software assessment. Establishing quantitative metrics to compare the performance of software analysis and testing accredited labs is no trivial task. Software is intangible and its requirements accommodate some ambiguity, inconsistency or information loss. Besides, software testing and analysis are highly human-dependent activities. In the present work, we investigate whether performing interlaboratory comparisons for software assessment by using quantitative performance measurement is feasible. The proposal was to evaluate the competence in software code analysis activities of each lab by using two quantitative metrics (code coverage and mutation score). Our results demonstrate the feasibility of establishing quantitative comparisons among software analysis and testing accredited laboratories. One of these rounds was registered as formal proficiency testing in the database—the first registered proficiency testing focused on code analysis.

Narrating ambiguous loss: Deficiencies in narrative processing and negative appraisal of consequences.

To compare narrative coping with physical and psychological ambiguous loss (AL) and definite loss in terms of distancing (vs. narrative immersion), meaning-making, and subjective biographical consequences. Thirty adults who had lost a parent to death, to going missing, or to Alzheimer disease (N = 90, 67 females; mean age 36.73 years, SD = 7.27; mean time since loss 9.0 years) narrated two loss-related and three control memories. Individuals with AL were not more immersed in the loss experience, but less successful in finding meaning and in evaluating the loss and its consequences positively compared to those with a definite loss. These group differences were not due to differences in depression, posttraumatic stress disorder, and protracted grief. Ambiguity of loss renders meaning-making and coherently narrating loss more difficult, leading to more negative affect, suggesting interventions that help narrating loss coherently in a self-accepting way.

Diamond Island bridge is falling down: Cultural deathscapes of grief, funeral ceremonies, and continuing bonds after a disaster in Cambodia I – The first days

Funerals play a key role in grief and mourning, but little is known about the culturally scripted processes after a disaster. Cambodia has faced multiple disasters, from the Khmer Rouge killing fields to COVID-19. Drawing upon a case study of the 2010 Diamond Island stampede, which killed 347 people, this article focuses on the period leading up to the funeral ceremony, while a companion article discusses events that unfold in the months that follow.An ethnographic study was carried out in Phnom Penh and nine provinces with members of the families of those who were killed, villagers, and monks and Buddhist lay officiants.Buddhist ceremonies conducted at the cremation and at seven- and hundred-days, helped families accept the irreversibility of loss and allow the dead to be reborn. Complications comprised the misidentification of bodies, managing the dangerous ghosts of ‘bad death’, getting the souls safely from the mortuary to the cremation site and dealing with disruptions along the way, convincing the souls that they are really dead, and ambiguous losses in the case of ‘counterfeit funerals’ conducted without the corpse.The mourning hinges on the maintenance of continuing bonds as evidenced by the ‘dream work’ by the bereft families, enabled by the ‘emergency Buddhist disaster relief’ provided by the monks. It is proposed that understanding the cultural deathscapes can provide insights into developing culturally-responsive interventions after a disaster.

The COVID-19 Disappeared: From Traumatic to Ambiguous Loss and the Role of the Internet for the Bereaved in Italy.

In Italy, in the very first phase of the COVID-19 pandemic there was a dramatic rise in mortality. However, families were forbidden because of lockdown regulations to be with their loved ones at their deathbeds or to hold funerals. This qualitative study examined bereavement experiences among family members, how they processed their grief, and how they used social networks in particular by uploading photographs during the working-through of bereavement. The sample was composed of 40 individuals aged 23–63 (80% women) from different Italian cities severely impacted by the virus, including a subgroup from the province of Bergamo, which was the city with the highest mortality rate during that time. All interviews were conducted by phone, Skype, or Zoom. Then, the transcriptions underwent a thematic analysis using Atlas.ti. The main themes that emerged were: abandonment anger and guilt, dehumanized disappeared, derealization and constant rumination, and social support and the importance of sharing photos on Facebook. Importantly, the use of social networks proved to be a valuable source of support and photographs were a powerful tool in facilitating the process of mourning by encouraging narration and sharing. Grief had a complex profile: on the one hand, it was traumatic and characterized by all the risk factors causing mourners to experience prolonged grief, but on the other, some features were similar to ambiguous loss (that occurs without closure and clear understanding) because of the impossibility to be with their relatives in their final moments. The possible relationships between ambiguous loss, the use of internet, and the risk of prolonged grief are discussed.

Traumatized Syrian Refugees with Ambiguous Loss: Predictors of Mental Distress.

Refugees from war zones often have missing significant others. A loss without confirmation is described as an ambiguous loss. This physical absence with simultaneous mental persistence can be accompanied by economic, social or legal problems, boundary ambiguity (i.e., uncertainty about who belongs to the family system), and can have a negative impact on mental health. The aim of this study was to identify sociodemographic and loss-related predictors for prolonged grief, anxiety, depression, post-traumatic stress disorder (PTSD) and somatization in treatment-seeking Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. For the present study, data were based on the treatment-seeking baseline sample of the “Sanadak” randomized-controlled trial, analyzing a subsample of 47 Syrian refugees with post-traumatic stress symptoms in Germany experiencing ambiguous loss. Sociodemographic and loss-related questions were applied, along with standardized instruments for symptoms of prolonged grief (ICG), anxiety (GAD-7), depression (PHQ-9), PTSD (PDS-5) and somatization (PHQ-15). Linear regression models were used to predict mental health outcomes. Having lost a close family member and higher boundary ambiguity showed a statistically significant association with higher severity in prolonged grief. The overall model for somatization reached statistical significance, while no predictor independently did. Boundary ambiguity showed a statistically significant positive association with depression, while the overall model showed no statistically significant associations. Boundary ambiguity and missing family members seemed to be important predictors for prolonged grief. These findings support the importance of reunification programs and suggest an inclusion of the topic into psychosocial support structures, e.g., including psychoeducational elements on boundary ambiguity in support groups for traumatized individuals and families experiencing ambiguous loss. Further research is needed for a more detailed understanding of the impact of ambiguous loss on refugee populations.

Development of the Conceptual Future Parent Grief (CFPG) Scale for LGBTQ+ people.

Parenthood is highly valued around the world. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people, however, have faced a history of discrimination and challenges related to becoming parents (e.g., legal and/or practical barriers to adoption or biological parenthood). As such, LGBTQ+ youth may believe that certain pathways to parenthood (or parenthood itself) are unavailable to them. These feelings could prompt experiences of ambiguous loss related to a future idealized self. No quantitative research, however, has been conducted to capture these possible experiences; scale development is an important step to attempt to quantify them. Here, we report results from two studies using exploratory and confirmatory factor analysis to investigate the factor structure of a new scale reflecting conceptual future parent grief (CFPG) among LGBTQ+ individuals. Participants also responded to several measures to explore validity with the CFPG scale. Following model respecification, a 9-item one-factor solution resulted, reflecting ambiguous loss, complex grief, and sexual stigma-all of which could contribute to difficulties in reconciling one's LGBTQ+ and future parenthood identities. Significant associations with greater authenticity of LGBTQ+ identity, depressive symptoms, and sexual stigma provided evidence of convergent and divergent validity with the CFPG scale. Thus, ambiguous loss among LGBTQ+ people may connect to aspects of identity, mental health, and parenthood goals. Developing this scale represents a first step toward an assessment for LGBTQ+ individuals regarding future parenthood. Understanding more about CFPG among LGBTQ+ individuals could inform prevention efforts to reduce negative mental health symptoms and enhance positive LGBTQ+ identity development. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Protecting the Global Mental Health of Forcibly Displaced Children From the COVID-19 Pandemic.

* Abbreviation: COVID-19 — : coronavirus disease 2019 Forcibly displaced children and families are among the most vulnerable groups in the world, now with an unprecedented 30 million children displaced by conflict and a peak of 19 million children internally displaced.1 Public health crises, such as the coronavirus disease 2019 (COVID-19) pandemic, highlight the preexisting refugee crisis, placing them at greater mental health risk. Although children are not the highest risk cohort to suffer serious illness from COVID-19,2 pandemic-related policies, health precautions, and psychosocial stressors are potentially damaging for vulnerable children and families such as forcibly displaced youth. Basic public health measures, such as social distancing, hand hygiene, and self-isolation, are difficult to implement in camps, settlements, and homes because of overcrowded living situations, poor access to basic sanitation, and lack of access to health services, leaving displaced children at risk for contracting disease. Many forcibly displaced families are understandably distrusting of government requests for public health measures because they are fleeing governments that are the cause of violence and armed conflict.3 These psychosocial stressors can lead to a worsening of mental health, especially when combined with a history of potentially traumatic events … Address correspondence to Suzan Song, MD, MPH, PhD, Department of Psychiatry, School of Psychiatry and Behavioral Sciences, George Washington University, Medical Faculty Associates, 2120 L St, NW Suite 600, Washington, DC 20037. E-mail: suzan.song{at}post.harvard.edu

Left behind parents: A qualitative study on the experience of parental abduction of a child in Portugal.

Parental abduction of a child occurs when the child is removed, by one parent, from the custody of the other parent or legally appointed guardians. The absence of the child has a profound impact on family members and significantly affects their lives. Also, parental abduction of a child is a relevant social problem which calls for further understanding. The aim of this research was to characterize the experiences of left behind parents in the context of parental abduction of a child. The data for this exploratory qualitative study were analyzed through thematic analysis of the semi-structured interviews carried out with eight male participants in Portugal. Participants' perceptions were organized around three main themes: the impact of this adverse event on different areas of their lives, recovery strategies, and perspectives regarding the future. Findings and their implications for professionals working with these families are discussed in light of the ambiguous loss and ambiguous boundaries frameworks.

Ambiguous Loss and Embodied Grief Related to Mexican Migrant Disappearances

ABSTRACT Since the 1990s, thousands of Latin Americans have died or disappeared along the US-Mexico border, following the funneling of migration through remote desert regions. The families of missing migrants face long-term “ambiguous loss,” a lived experience in which a loved one is physically absent but psychologically present. Mexican relatives of the missing in Arizona and Sonora report that these losses produce deep emotional suffering along a timeline – worrying about the crossing, learning of the disappearance, beginning to search, and finally, coping with the long-term impacts of unknowing. Close relatives experience embodied health effects including headaches, insomnia, anxiety, depression, and chronic disease.

Living Under the Shadows: Experiences of Latino Immigrant Families at Risk for Deportation

ObjectiveThe aim of this study was to examine the experiences of Latino youth and their parents who are at risk for detainment or deportation to gain an in‐depth understanding of the impact of the risk for parental deportation on psychosocial well‐being.BackgroundChildren born in the United States to foreign‐born parents comprise approximately 27% of the U.S. population. Approximately 5.7 million U.S.‐born children live with parents without legal residency documentation, and nearly 500,000 children had at least one parent detained or deported over a 2‐year period. There is a high risk for negative child and family outcomes associated with parental deportation.MethodA constructivist grounded theory design was used to complete semistructured interviews with families (N = 16) at risk for parental deportation. A quantitative trauma assessment was used to triangulate qualitative findings.ResultsResults indicated four core themes: (a) parents and youth experience emotional distress associated with the risk of deportation, (b) parents and youth experience injustices associated with the threat of deportation, (c) children experience their freedoms as conditional, and (d) children suffer.ConclusionsConcepts from ambiguous loss and developmental trauma may aid our understanding of family emotional distress associated with the risk for deportation and improve family services aimed to promote family well‐being.ImplicationsFamily scholar‐advocate and scholar‐activist approaches, in which we use our positions of privilege to educate others about the needs of underserved families, may be helpful for families at‐risk for deportation.

Ambiguous loss and disenfranchised grief among spouses of brain injury survivors

Acquired brain injury (ABI) represents a great burden for not only the person with ABI but also their partner. Grief among partners of adults with ABI is a broadly recognized phenomenon. However, few studies have examined partners’ experience of grief, and little is known about grief as a reaction to ambiguous loss. This article presents a phenomenological study that aimed to explore the experience of grief among caregiving partners. Four semi-structured interviews were conducted and analyzed by a phenomenological descriptive analysis. Through the analysis, nine themes were identified: the process of becoming a caregiver, grief emotions, loss, emotionally closer relations to the partner relations, dyadic coping, unmet needs for support, future opportunities, changes over the life course, and understanding of grief. The themes are interrelated and highlight various aspects of the phenomenon of grief as experienced by caregivers. Results reveal that grief is often a reaction to ambiguous loss and is experienced as disenfranchised. Furthermore, the study indicates that caregivers’ perception of grief and the situation in general were essential to the experience of grief.

Theorizing Ambiguous Gain: Opportunities for Family Scholarship

AbstractFamily stressors marked by ambiguity can place significant demands on families. Family scholars have written extensively about ambiguous stressors in the context of loss or separation—situations that represent ambiguous loss. Given extant demographic trends, including those that lead to changes in family structure, there remain valuable opportunities to highlight ambiguous stressors that arise from situations of family gain or acquisition—situations that represent ambiguous gain. A proposed definition for ambiguous gain is presented, namely, a situation of systemic relational acquisition, either physical or psychological, about which the facts are unclear. Building on foundational theoretical work, ambiguous gain is explicated as a distinct theoretical concept and conceptually positioned with respect to other related concepts, such as ambiguous loss, family boundary ambiguity, and ambivalence. Bolstering the concept of ambiguous gain might promote the theoretical and practical understanding of increasingly common family situations. Suggestions are offered for foregrounding ambiguous gain in family scholarship.

“I feel like God doesn't like me”: Faith and Ambiguous Loss Among Transgender Youth

ObjectiveThe present study expands the use of ambiguous loss theory into the realm of religion and religious rejection for sexual‐ and gender‐minority people, an area that has previously been addressed primarily as an issue of minority stress.BackgroundResearch has demonstrated that religion‐based, nonaffirming messaging from family and faith communities is correlated with decreased health and well‐being of sexual‐ and gender‐minority persons, who are, like most Americans, likely to have been raised in religious (predominately Christian) homes. Existing research has begun to explain why nonaffirming faith affiliation seems to negatively impact sexual gender minority people, but it does not explain the mechanisms of long‐term distress.MethodsThis study is a qualitative thematic analysis of religion and family data from semistructured interviews with 63 transgender youth from the United States, Canada, and Ireland who reported being raised in religious Christian homes.ResultsAnalysis revealed that the narratives of participants who had been members of a psychological family of faith included all of the core elements of ambiguous loss, suggesting that individuals can experience ambiguous loss in relationship to a faith community and to God.DiscussionThis study presents a new application of Boss's ambiguous loss theory and offers a framework for understanding why sexual‐ and gender‐minority people from Christian backgrounds might experience long‐term distress in relation to faith and spirituality whether they stay in their faith communities of origin or move on to something else.ImplicationsThe experiences of transgender people examined through the framework of ambiguous loss and the concept of the psychological family of faith could be applied to research with people from any demographic in relation to loss of faith or faith community. This information may contribute to the study of family ruptures that occur as a result of family experiences of ideological or moral incompatibility (e.g., deconversion, political realignment, leaving a cult).

Prolonged grief disorder in refugees from Syria: qualitative analysis of culturally relevant symptoms and implications for ICD-11

ABSTRACT Prolonged Grief Disorder (PGD) is a new mental disorder recognised by the ICD-11. However, the cultural norms for grief in refugees or humanitarian migrants from Syria have not yet been established. Here we conduct an exploratory qualitative study of 10 key informant interviews with refugees from Syria with two main aims: (1) to identify common symptoms of normal or abnormal grief in refugees from Syria (2) to identify barriers to the acceptability of the new prolonged grief disorder. Three levels of qualitative analysis informed a new model of grief in Syrian refugees. Important culturally relevant symptoms such as “emotional outburst” and “weariness” emerged. The theme of “refugee experience” including sub-themes such as loss of homeland, lack of social network and ambiguous loss, emerged as potential predictors of grief severity. Finally, the level of culture and society revealed key barriers to the acceptability of the PGD diagnosis including stigma.

Pérdida ambigua: madres de personas desaparecidas en Tamaulipas, México

El objetivo del estudio es comprender la pérdida ambigua de cinco madres de personas que sufrieron desaparición forzada en el estado de Tamaulipas, México. Se realizaron entrevistas en profundidad y se efectuó un análisis fenomenológico-interpretativo. Los resultados muestran que las madres experimentan sufrimiento social y ruptura de la vida cotidiana ante la ausencia física de su hijo y que desarrollan un mecanismo para facilitar su presencia psicológica, aunque siguen experimentando malestar. Entre los elementos del contexto que prolongan el sufrimiento, se encuentran la ineficiencia institucional y el aislamiento social. Una de las limitaciones del estudio es no haber incorporado las voces de otros miembros de la familia, de las madres que han sufrido desplazamiento forzado y de aquellas que no denuncian la desaparición por miedo. Se concluye que es necesario que el Estado reconozca su participación en el origen y en la continuidad del sufrimiento social y que sus intervenciones incorporen la dimensión psicosocial y comunitaria.

Care leavers, ambiguous loss and early parenting: explaining high rates of pregnancy and parenting amongst young people transitioning from out-of-home care

AbstractThis paper is a narrative review examining the high prevalence of care leaver early parenting in the context of (i) key transitions from care studies taken from the last few decades, (ii) a structured review using Scopus of studies from 2015–2020 focussed specifically on young people transitioning from care and early parenting and (iii) Boss’s (2010) Ambiguous Loss theory. Young care leavers’ challenges, in general, put them at higher risk of protective interventions with their children and may contribute to the growing numbers of children being placed in increasingly over-stretched out-of-home care systems. Questions of surveillance bias for service-connected young people are examined in light of recent large-scale studies using administrative data sets. Serious oversights in responding to young people’s experiences of trauma and exploitation are identified. The relevance of sexual health programs for young people actively seeking pregnancies is discussed with emerging evidence that disengagement from schooling may have more of a role in explaining early pregnancy and parenting than previously thought. The authors test the relevance of Ambiguous Loss theory in understanding how removal from families of origin and placement experiences may affect young people and lead to ‘wanted’ pregnancies.

Transnational fathers: New theoretical and conceptual challenges

AbstractWe propose a transactional model of risk and resilience and ambiguous loss as theoretical guides to understanding transnational fathering. We also examine the risk and buffering conditions associated with each temporal aspect of the migrant journey of transnational fathers beginning with the initial decision to leave their country of origin to their process of resettlement in a destination country. In addition, we examine the effects of the absence of transnational fathers from their family on the fathers themselves, their partners, and their children. We critically explore the buffering effects of communication at a distance as a strategy for reducing the risks associated with the migration experience of transnational fathers and examine the buffering role of substitute caregivers in the home country as a means of reducing the risk associated with the absence of fathers on children. New directions for future work in this area are noted.