Bereavement Group Research Articles

Family Death During Upbringing and Maladaptive Personality Traits

Major depression and other serious mental health concerns appear to follow parental or sibling death for many child and adolescent survivors. While grief and depression remain a central focus in bereavement research, the impact of sibling and parental death on personality development remains incompletely understood. This study focused on coarser personality adaptations that may occur in response to childhood or adolescent grief. Analysis was conducted on a crowdsourced survey sample (N = 2,398) which included respondents with parent (n = 143) or sibling (n = 102) death prior to age of 17. Parental death was associated with Callousness and Hostility as personality dimensions. Sibling death was linked to higher Callousness, Hostility, Physical Aggression, Depressivity, and Hypomanic trait scores. Callousness elevations (>1 SD) were more common among respondents classified in the sibling and parental bereavement groups (ORs of 3.02 & 2.17, respectively). Significant differences were found after control of variance associated with respondent age and childhood adversity exposure count. Parent and sibling suicide exclusions reduced trait differences between the bereaved and nonbereaved respondents. Sibling death was associated with more trait differences and larger effect sizes than parental loss. Questions remain regarding the nature of the psychological conditions that differentiate normative, resilient, and callous personality adaptations in the aftermath of early family tragedy. The prognostic value of the DSM-5-TR traumatic bereavement specifier was discussed.

State of the Science: Psychotherapeutic Interventions for Prolonged Grief Disorder

Prolonged grief disorder (PGD) is a distinct diagnostic entity that has recently garnered considerable attention as it describes an intense, enduring, distressing and disabling bereavement reaction experienced by a small minority of community-based mourners. In recent decades, research has exploded to address how best to treat PGD with different psychotherapeutic interventions. In this state-of-the-science review, the strength of the evidence will be discussed regarding common psychotherapeutic interventions used to treat grief. Specifically, we focus on the most commonly used interventions, cognitive behavioral (CB)-based therapies, bereavement and support groups, and brief contact interventions (BCIs), in an effort to summarize the relevant clinical takeaways of the current available research. A discussion of the use of these therapies in specific clinical populations is also included, with a focus on those traumatically bereaved, pediatric populations, communities of color, and underserved communities. Important foci and directions for future research are also discussed.

Virtual Bereavement Support Program in a Children’s Hospice Care Center During COVID-19 Pandemic and Beyond

In light of the COVID-19 pandemic, a pediatric hospice in Ottawa, Ontario, implemented a Virtual Bereavement Group Program, necessitating a reorganization of care delivery during the global crisis. This paper outlines the program and assesses the feedback of families who participated in the program following the death of a child or grandchild. Participants expressed high levels of satisfaction, indicating its potential as an effective approach for pediatric bereavement care beyond the pandemic.

Grief participation rights and the social support hierarchy: Exploring the communicative role of the bereaved in a social support interaction

This article explores how bereaved individuals co-construct social support and social norms in the social interaction of 14 bereavement group meetings in Denmark. To study this, we used a discourse analytical approach focusing on how the participants position their social supporters. The results show that the participants designate, uphold, and presuppose two hierarchical positions to bereaved and non-bereaved supporters with different abilities to understand them. Based on this finding, the concepts of “grief participation rights” and “social support hierarchy” are proposed to supplement existing notions of “rights to grieve” and “grief hierarchy.” These concepts suggest that non-bereaved supporters are not accorded the same participatory rights in social support conversations as bereaved individuals who have suffered a similar loss as the speaker. The concepts are discussed in relation to effective social support and in the context of research on social disconnection in grief.

Posttraumatic Growth Inventory-Expanded: Factor Structure, Test-Retest Reliability, and Validity in Trauma-Exposed and Bereaved Adults.

Posttraumatic growth (PTG) is a positive psychological change experienced after trauma and it has gained global recognition in recent years. The present study aimed to validate a South Korean version of the Posttraumatic Growth Inventory-Expanded (K-PTGI-X) for use with trauma-exposed and bereaved samples. A national sample comprising South Korean adults was used for the analysis. As a result, the 4-factor bi-factor model was best supported in both the trauma and bereaved groups in terms of personal strength, new possibilities, spiritual-existential change, and being able to relate to others. Additionally, the K-PTGI-X showed satisfying reliability, concurrent validity, and discriminant validity. Lastly, regarding the group differences, women showed higher rates of PTG than men and the bereaved group exhibited higher spiritual and existential growth in the PTG than the trauma group. Given these results, implications for adaptation in various fields when assessing and encouraging PTG in practical settings are discussed.

Revisiting the Factor Structure of the Centrality of Event Scale.

Traumatic experiences that become self-defining impact posttraumatic outcomes, yet exact mechanisms are currently being studied. Recent research has used the Centrality of Event Scale (CES). However, the factor structure of the CES has been in question. We analyzed archival data (N = 318) split into homogenous groups of participants to examine whether the factor structure of the CES differed based on event type (bereavement vs. sexual assault) or by levels of PTSD (meeting clinical cut off score vs. group of lowest scorers). Exploratory factor analyses with subsequent confirmatory analyses revealed a single factor model in the bereavement group, sexual assault group, and the low PTSD group. A three-factor model emerged in the high PTSD group, with the factors' themes matching previous findings. Event centrality appears to be a universal theme when people endure and process a diversity of adverse events. These distinct factors may illuminate pathways in the clinical syndrome.

The Information Seeking Behaviors and Needs of Suicide Survivors During Bereavement

Abstract The suicide of one person impacts 60 people, known as suicide survivors. These survivors are at an increased risk for negative mental health outcomes including PTSD, suicidal ideation, and suicide contagion. Despite these consequences, there have not been any information science studies that have explored the information behaviors of people who have recently survived the suicide of a loved one. This article takes a unique approach in combining autoethnography with traditional survey research. One hundred and ninteen participants sourced from a private Facebook suicide bereavement group responded to a survey asking them about their information-seeking after a loved one committed suicide. The qualitative data were fragmented and grouped into like-responses and thematic codes that gave explanation to the research questions. These results are coupled with the author’s ethnographic recounting of a similar experience. Brenda Dervin’s sense-making is employed as the methodological lens through which the study is conducted. It is found that suicide survivors are highly unlikely to have their informational needs met. In the immediate aftermath of their loss, they are most likely to look for information related to the suffering of the deceased. As time passes, they begin to look for information about coping with their loss and preventing suicide of other people; either those close to them or in a larger community scale. Being a survivor motivated many participants to advocacy work. Finally, the author argues that the findings of this article should compel further research and the creation of information policy to aid survivors and prevent suicide contagion.

Rewriting grief following bereavement and non-death loss: a pilot writing-for-wellbeing study

ABSTRACT This mixed-method Writing-for-wellbeing pilot study used a pre–post-follow-up design with 20 adults in two groups (10 in a bereaved group and 10 in a non-death/living losses group) to assess the feasibility, acceptability, and potential efficacy of a longitudinal writing intervention in helping participants to work through their grief. Participants completed measures of prolonged grief, adaptive coping, anxiety and depression, and meaning reconstruction. The qualitative analysis was based on a satisfaction questionnaire that included open-ended questions. The intervention was well-received, safe, and personally valuable. The bereaved group reported reductions in symptoms of anxiety, depression, and prolonged grief, and increases in adaptive meaning, help seeking, and spiritual support. The living losses group reported a decrease in help seeking.

Posttraumatic stress response following the loss of significant close others in the Great East Japan Earthquake: Fukushima Health Management Survey.

During the Great East Japan Earthquake, many people experienced the loss of family and friends, among other traumatic events. This study sought to clarify the impact of the loss of significant close others on posttraumatic stress symptoms (PTSS), as well as the factors associated with PTSS, among individuals who experienced the loss of significant close others (i.e., bereaved group). Self-administered questionnaires were mailed to men and women (N = 180,604) aged 16 years and older living in municipalities that included evacuated areas surrounding the Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Station, which was significantly damaged following an earthquake and tsunami in March 2011, causing subsequent radiation leakage; this mailing yielded a 40.7% response rate, with 57,388 valid responses, in 2012. We used the Posttraumatic Stress Disorder Checklist-Specific (PCL-S) to measure PTSS as the outcome variable. Loss of significant close others in the disaster and respondents' relationship with the deceased constituted the explanatory variables. Basic characteristics and disaster-related factors were the confounding variables. Data were analyzed using chi-square tests and logistic regression analyses. The bereaved group showed more severe PTSS than the nonbereaved group, aOR = 1.58, 95% CI [1.50, 1.67]. The risk of developing PTSS increased if the deceased was a respondent's spouse, aOR = 1.67, 95% CI [1.22, 2.29]; child, 1.51 [1.01, 2.25]; or friend, 1.33 [1.16, 1.53]. Individuals who lose significant close others, including both family and friends, in disasters require close mental health care and, if necessary, should be referred for psychiatric treatment.

A therapist-supported internet-based intervention for bereaved siblings: A randomized controlled trial

Background: The loss of a sibling can have a long-term impact on the mental and physical health of the surviving sibling throughout adolescence and later adulthood. Even though bereaved siblings can be identified as a high-risk group, evidence-based interventions for this bereavement group are still missing. Aim: To evaluate the treatment effects of an internet-based writing intervention for bereaved siblings aged 16–65 years. Design: A two-armed randomized controlled trial (DRKS00011514) compared the intervention to a waiting list control group. The 6-week intervention consisted of six structured writing assignments that were based on cognitive behavioral therapy, focusing on the specific situation of bereaved siblings. Setting/participants: Eighty-six bereaved siblings (loss >1 month ago, no severe psychiatric symptoms) were randomly allocated to the intervention group (n = 47) or the waiting list control group (n = 39). Primary outcomes were symptoms of prolonged grief disorder and depression; secondary outcomes were posttraumatic stress symptoms and survivor guilt. Results: Symptoms of depression and prolonged grief disorder improved significantly in the intention-to-treat analyses from pre-to post-measurement compared with the control group (gDepression = −0.62, gGrief = 0.33). In the intervention group, all primary and secondary outcomes decreased significantly from baseline to 12-month follow-up (gs = −0.38 to −1.04). A significant clinical change could be found for depression (34%) compared to the waitlist control group (10%). Conclusions: Bereaved siblings profited from this brief internet-based writing intervention in the short- and long-term. However, future research, such as dismantling studies, may help to further optimize the benefits of an intervention aimed at bereaved siblings.

Constructivist Correlates to Anniversary Reactions Across Bereavement and Sexual Violence.

Anniversary reactions are an accepted part of bereavement, but recent research demonstrates that ARs can be seen across many traumatic events. The present study explores how constructivist theories could characterize ARs caused by the death of a loved one or sexual violence. N = 234 women answered questionnaires regarding their posttraumatic adjustment, meaning made of the trauma, trauma centrality, and social validation or invalidation of their trauma. Our data demonstrate that ARs are marked by statistically and clinically significant increases posttraumatic stress disorder symptoms. Participants in this study did not endorse significant posttraumatic growth during their AR. The women in the sexual violence group endorsed more social validation and invalidation as well as less meaning made of their trauma compared to the bereavement group. There were no group differences regarding trauma centrality. Results of this study provide empirical support for an understudied yet significant phenomenon and directions of future study.

The Effectiveness of the Moving to Emptiness Technique on Clients Who Need Help During the COVID-19 Pandemic: A Real-World Study.

With Western therapeutic techniques prevailing in Chinese therapies, some techniques that include Chinese traditional cultural features are required since some cultural factors are not considered in the Western method. Our study introduced a new technique, the moving to emptiness technique (MET), which combines Western structural progress and core factors of Chinese culture. Seventeen therapists treated 107 clients with the MET. Clients reported their target symptoms initially, and therapists helped them transfer invisible symptoms to perceivable stuff and remove their jarring stuff using the psychological emptiness area. At the end of the consultations, we found that MET could eliminate symptoms immediately. By grouping target symptoms according to their frequency, the results showed that clients in the high-frequency symptom group had higher rehabilitation rates than those in the low-frequency symptom group. Additionally, the results of the bereavement group were better than those of the non-bereavement group, indicating that the MET can significantly alleviate clients' target symptoms. In future studies, the replication and stability of the MET can be assessed by integrating questionnaires, experimental designs, and neurological equipment.

Evaluation of a grandparent bereavement support group in a Pediatric Palliative Care Hospice

This study aimed to explore grandparents’ experiences of grief after the death of a grandchild, their perception of socially supportive behavior as well as their satisfaction with a bereavement support care. A six-session bereavement support group was implemented, followed by a cross-sectional survey with open-ended questions. The death happened mostly in the last 2 years (26, 90%). The findings revealed the presence of grief (mean score of 67, SD 13) and existing perception of socially supportive behaviors (mean score of 79, SD 23) after participation in the bereavement group. The thematic analysis showed three themes of ‘We are feeling it; There are ways to heal and return to a different normal; We want to help our family’. This study adds to the existing literature about the experience of grandparents coping with grief, explores some of their challenges, and needs after the death of a grandchild.

Do Social Timing and Gender Matter to Parental Depression Aroused by Traumatic Experience of Child Bereavement? Evidence from China.

Child loss is a rare but traumatic life event that often has a detrimental effect on parental wellbeing. However, parents’ resources and strategies in coping with the stressful child bereavement event may depend on timing of the event. This study intends to examine how parental depression could be aroused by the occurrence and timing of child bereavement, and how the influences vary by child gender. Drawing on the theoretical framework of the stress and life course, and using three waves of data from the China Health and Retirement Longitudinal Study, we find that both the occurrence and timing of child bereavement are significantly associated with parental depression in later life. Bereaved parents are more likely to report depression than non-bereaved parents. Child bereavement in children’s young adulthood is more likely to spark off parental depression than that occurring in children’s midlife or later. Further analysis confirms that the timing effect of child bereavement differs by child gender. Parents whose son died during young adulthood are more likely to report depression than their counterparts whose daughter died. Future studies need to address how to build up a specific social welfare program targeting child bereavement groups in different life stages.

Risk factors for dysfunctional grief and functional impairment for all causes of death during the COVID-19 pandemic: The mediating role of meaning

The COVID-19 pandemic, coupled with significant social changes due to legislative and public health requirements, has changed the way in which people experience grief. We examined whether dysfunctional grief symptoms, disrupted meaning, risk factors, and functional impairment differed between people bereaved from COVID-19 and from other natural or violent causes in this same period. A sample of 409 participants (67.73% male; M = 37.54 years) completed an online survey in June 2021. There were no statistically significant differences between the three groups on any of the outcome variables; all three groups manifested clinical levels of functional impairment equal to or greater than bereaved groups diagnosed with complicated or prolonged grief disorder prior to the pandemic. Disrupted meaning partially mediated the relationship between risk factors on the one hand and functional impairment and dysfunctional grief symptoms on the other. Findings indicate that deaths during COVID-19, rather than deaths from COVID-19, may precipitate symptoms of significant clinical concern.

Support for and involvement of family caregivers in Comprehensive Cancer Center - an Assessment of the Palliative Care Working Group within the network of Comprehensive Cancer Center funded by the German Cancer Aid

ZusammenfassungEinleitung Eine leitliniengerechte onkologische Versorgung umfasst nicht nur die frühzeitige palliativmedizinische Mitbetreuung unheilbar erkrankter Patienten, sondern auch die Mitbetreuung ihrer Angehörigen. Untersuchungen zur Umsetzung im klinischen Alltag in Deutschland fehlen. Methoden Die AG Palliativmedizin im Netzwerk der von der Deutschen Krebshilfe geförderten Onkologischen Spitzenzentren (CCC) führte mit einem selbstgestalteten Fragebogen eine systematische Erfassung aller Angebote in den CCC/in der spezialisierten Palliativversorgung (SPV) im CCC/lokal außerhalb des CCC an allen Standorten durch. Ergebnisse Gut etabliert in den 17 CCC/in der SPV sind die psychoonkologische (100 %/94 %), sozialrechtliche (94 %/100 %) und seelsorgerische Beratung der Angehörigen (je 94 %) sowie Angebote für Kinder erkrankter Eltern (88 %/100 %) und Informationsmaterialien (je 88 %). Häufiger als im restlichen CCC werden in der SPV pflegerische Schulungen (77 %/94 %) und Familienkonferenzen (59 %/88 %) durchgeführt. SOPs sind mit 23 %/18 % selten etabliert, ebenso wie Screenings der Angehörigenbedürfnisse (0/24 %). Trauer- und Selbsthilfegruppen sind mit je 82 % häufiger außerhalb der CCC verfügbar. Die psychoonkologische/sozialrechtliche Beratung und Angebote für Kinder erkrankter Eltern (je 94 %) wurden als am wichtigsten für ein CCC eingeschätzt. Für die SPV waren es zudem die pflegerische Schulung sowie Informationsmaterialien (je 94 %). SOPs wurden mit 47 %/41 % als sehr/extrem wichtig betrachtet, und Screenings der Angehörigenbedürfnisse mit 53 %/65 %. Schlussfolgerung Psychosoziale/seelsorgerische Beratung der Angehörigen sowie Angebote für Kinder erkrankter Eltern sind in den CCC entsprechend ihrer Bedeutung gut etabliert, in der SPV auch pflegerische Schulungen und Familienkonferenzen. SOPs zur Mitbetreuung und Einbeziehung von Angehörigen sowie Screenings der Angehörigenbedürfnisse müssen dringend implementiert werden.

An exploratory study of self-reported complicated grief symptoms in parentally bereaved adults with intellectual disability.

Complicated grief involves the experience of grief-related symptoms at a time, and severity, beyond which could be considered adaptive, while persistent complex bereavement disorder (PCBD) has been identified as a condition that requires further study in the typical population. The aims of this study are to (1) explore the symptoms of complicated grief associated with parental bereavement as self-reported by adults with intellectual disabilities (IDs) who have experienced a parental bereavement and (2) conduct an initial examination of how the existing criteria for PCBD apply to this group. This study uses a comparative group design, assessing self and staff (proxy) reports for a group of parentally bereaved individuals and a matched group of non-bereaved individuals using the Complicated Grief Questionnaire - ID Self-Report. Participants were 46 individuals with ID, 30 (65%) of whom who had experienced a parental bereavement within the previous 2years. The age range was 23-67years (mean=43.8; SD=10.3). The results highlight the presence of a range of symptoms of complicated grief in individuals' self-reports, although there was some evidence that separation distress-related symptoms were more apparent. An analysis of individual symptoms showed patterns of higher reports among the bereaved group as would be expected. Comparing staff and self-reports, key criteria showed higher levels in self-reports among the bereaved group. This study has demonstrated the capacity of people with ID to self-report personal experience of symptoms of complicated grief, when appropriate and accessible assessment tools are used. Some symptoms were more evident among bereaved individuals (compared with non-bereaved participants), and they tended to be from separation distress criteria. This may indicate the relevance of these symptoms for people with ID and question the existing criteria for PCBD in this population, which may have clinical implications for supporting people with ID experiencing a more complicated bereavement response.

Self-Help/Mutual Aid Groups and Peer Support

Abstract English-language social and behavioral science research into US self-help/mutual aid groups and nonprofit organizations (e.g., Alcoholics Anonymous, Parents Without Partners, or bereavement groups) is reviewed. The review begins in the 1960s and proceeds into the new millennium, when institutionalized self-help/mutual aid was co-opted and renamed “support groups” by professionals. SHGs are intentionally created, single-issue, voluntary member-run mutual benefit groups that value the authority of lived experience, are cost-free, and where peers give and receive help from each other. Research attention expanded to European and Asian research in the 1990s, but has now switched to mental health peer support.

Spousal Loss and Cognitive Functioning: Do Pre-Loss Marital Quality and Gender Matter?

Prior research has found that the risk of cognitive decline increases after the death of a spouse. In general, the impact of life transitions is contingent on contextual factors such as socio-demographic characteristics or relationship quality. However, there is limited research on how marital quality before spousal loss and gender influence the association between spousal loss and cognitive change. The current study examines the effects of spousal loss on change in cognitive functioning as well as the moderating effects of pre-loss marital quality and gender. Data from two waves of the Midlife in the United States (MIDUS) study were analyzed (MIDUS2: 2004-05, MIDUS3: 2013-14). The analytic sample consists of two groups: (1) 179 bereaved adults who were age 54 or older at MIDUS2 (M = 65.2, SD = 9.5) and whose spouses died between MIDUS2 and MIDUS3, and (2) 179 non-bereaved adults, matched with the bereaved group on age and gender, who did not experience spousal loss between the two waves. Cognitive function was assessed via BTACT (Brief Telephone Adult Cognition Test) at both waves. Regression results show that both pre-loss marital quality and gender significantly moderate the association between spousal loss and change in cognitive functioning. Specifically, relative to their counterparts, men and those who reported better marital relationships prior to spousal death had a greater risk of cognitive decline after a spouse’s death. The findings suggest the significance of pre-loss marital quality and gender for cognitive changes in widowhood and have implications for the development of efficient interventions

Experiences of participation in bereavement groups from significant others\u2019 perspectives; a qualitative study

BackgroundWhen death ends a life, the impact of caring for person who suffered a period of illness or disease continues for significant others who are left to grieve. They should be offered support to avoid complicated grief. This can be provided in different ways and individually or in groups. This study aims to describe significant others’ experiences of participation in bereavement groups.MethodsTen bereavement groups that each met five times offered support for the significant others of deceased loved ones who had been cared for by a palliative-care team. After the five meetings, the grieving members (n = 46) completed written comments about the role of the groups; they also commented one year after participating (n = 39). Comments were analyzed with qualitative content analysis with a directed approach using the theory of a good death according to the 6S’s: self-image, self-determination, social relationships, symptom control, synthesis and summation, and surrender.ResultsBereavement groups were found to be a source for alleviating grief for some significant others, but not all experienced relief. Moreover, grief was found to persist during participation. Another finding involved the impact of the role of the palliative home-care team on bereavement support. To evaluate the experience of participating in a bereavement group, the use the 6S’s as a model was a strength of the analysis. Bereavement groups could enhance the self and offer relief from grief. Participation was described as social relationships that offered a sense of coherence and understanding in grief. The effects of participation were more meaningful close to the loss and could lose efficacy over time. Bereavement support provided before a loved one’s death was seen as valuable.ConclusionOverall, the bereavement groups eased the grief of significant others close to the death of their loved one. However, moving forward, several of the significant others were not sure that their participation eased their grief. To identify persons who may remain in a state of complicated grief, a routine of planned contacts with the bereaved should begin before death and be followed up later than six months after the death of a loved one.