Conjugal Bereavement Research Articles

Unique effects of daily perceived control on anxiety symptomatology during conjugal bereavement

The role of daily perceived control was examined in a recently bereaved sample of 34 older adult widows. Trait measures of environmental mastery and stress were measured in questionnaires, and state measures of anxiety, depression, stress, and control were assessed daily over ninety-eight days. Results highlight the critical role of daily control in the months immediately following conjugal loss. After controlling for concurrent depressive symptomatology, intra-individual analyses revealed significant reductions in the magnitude of the stress–anxiety correlation on days in which greater perceived control was present. Results also suggest different vulnerability and protective factors are implicated in the experience of daily anxiety. For widows with greater environmental mastery, there was significant attenuation in the magnitude of the within-person correlation between control and anxiety. In contrast, among widows with chronically high levels of stress, there was greater overlap in ratings of daily stress and anxiety.

Psychological resilience and the well-being of widowed women

The majority of older women in enduring relationships contend with conjugal bereavement. Although most experience considerable distress in the immediate aftermath of this loss, the majority adjusts over the course of time. The current study applies the theory of psychological resilience (or hardiness) to this topic. Results of this study suggest that psychological resilience is significantly associated with both satisfaction with life and (inversely) with psychiatric distress (N=232). These findings emerged despite statistical control for a myriad of sociodemographic factors (e.g., years married, preparation for death, duration of widowhood). Of the resilience factors, commitment to living appears most salient with respect to the well-being of widowed women. Limitations of the use of the Internet as a vehicle for data collection are considered as well as directions for future study.

The role of daily positive emotions during conjugal bereavement.

The role of daily positive emotions in the stress process was examined in a sample of 34 recently bereaved older adult widows. Humor coping and perceived stress were measured in questionnaires, and positive emotions, depression, anxiety, and stress were assessed daily for 98 days. Results highlight the critical role of daily positive emotions in the months immediately following conjugal loss. Intraindividual analyses revealed significant reductions in the magnitude of the stress-depression correlation on days in which greater positive emotions were present. Results also suggest that different vulnerability and resilience factors are implicated in the emotion differentiation process. For widows with greater humor coping skills, there was less overlap in daily ratings of positive emotions and depressive symptoms. In contrast, higher levels of chronic stress resulted in less differentiation of emotional responses.

Cognitive Adaptation and Women's Adjustment to Conjugal Bereavement

ABSTRACT Conjugal bereavement is experienced by the majority of older women in enduring relationships. Although most experience considerable distress in the immediate aftermath of this loss, the majority adjusts over the course of time. The current study of self-selected participants applies the theory of cognitive adaptation in an attempt to distinguish between women who have successfully adjusted to the death of their husbands versus those who exhibit prolonged distress. Results of this study suggest that positivity biases in personally relevant information processing (i.e., self-deception, marital aggrandizement, dispositional optimism) are significantly associated with life satisfaction and the absence of psychiatric distress. The contribution of cognitive adaptation is maintained over and above that provided by personality variables (i.e., neuroticism, extraversion, openness to experience). Intervention strategies to treat enduring distress among widowed women are considered on the basis of these findings.

Continuing bonds and adjustment at 5 years after the death of a spouse.

Thirty-nine bereaved individuals completed the Continuing Bonds Scale (CBS), assessing various aspects of the ongoing attachment to the deceased, at 60 months postloss in a longitudinal conjugal bereavement study. They also completed symptom measures at 6, 14, 25, and 60 months postloss. Higher CBS scores were associated with a more elevated grief-specific symptom pattern over the 5-year postloss period. Moreover, those who expressed greater helplessness and less blame toward the deceased during a monologue role-play involving their deceased spouse at 6 months postloss had higher CBS scores. Finally, greater satisfaction in the past relationship with the spouse was predictive of higher CBS scores. The results were discussed in relation to existing literature on the adaptiveness of continuing bonds.

Grief and loneliness in older people: Case study accounts of conjugal bereavement

Grief and its concomitant loneliness are common problems in the social process of ageing. Using case study accounts, this paper describes the perceptions of four elderly bereaved people and their experiences of loneliness following conjugal bereavement. Case study accounts provide an opportunity to explore, describe and interpret data that may not yield to a simple analysis. In this paper the accounts include a collection of information on the respondents' experience of loss in the form of ‘durable biographies’ (Walter, 1996) that were typical, revelatory and critical. The respondents took part in semi‐structured interviews about their experiences as part of a larger ethnographic study. This paper reflects on their comments and raises a number of interesting theoretical and practical issues to do with loneliness following conjugal bereavement. The paper points out that bereavement research is dominated by psycho‐analytical conceptualisations which place emphasis on the ‘grief work’ hypoThesis, with less attention paid to bereavement models that highlight the social impact of loss on older people.

Living with Loss: Middle-Aged Men Face Spousal Bereavement

Spousal bereavement is one of the most profoundly disturbing events encountered in the human life span. Research has shown that conjugal bereavement has significant physical and psychological consequences for the surviving spouse. In American culture, men and women experience bereavement in different ways. The author used in-depth interviews in the tradition of phenomenology to collect data from 8 men aged 41 to 54 years who had experienced the death of their spouse within the previous 8 months to 6 years. The research revealed the lived experience of spousal bereavement to be a journey from the realization of irreconcilable loss through themes of responding to the loss and living through the loss toward reclamation and reconstruction of a life.

Attachment Style in Adjustment to Conjugal Bereavement

This study examined the role of attachment style in adjustment to bereavement. Midlife bereaved individuals whose spouse had died in the previous year completed the Reciprocal Attachment Questionnaire (RAQ; West & Sheldon-Keller, 1994) and a measure assessing aspects of appraising and coping with the loss. They also were administered repeated symptom measures at 6, 14, 25, and 60 months post-bereavement. Complete symptom measures data over the course of the 5-year period were available for 32 participants. The RAQ compulsive care-seeking measure of anxious attachment was predictive of appraised inability to cope with the loss and of more severe symptomatology over the course of 5 years. Furthermore, appraised inability to cope with the loss was shown to mediate the relationship between compulsive care-seeking and symptoms. The RAQ compulsive self-reliance measure of avoidant attachment was not related to symptomatology, however. Finally, the RAQ angry withdrawal measure of ambivalent attachment was predictive of 6 and 14 months post-loss symptoms, but not of 25-or 60-month symptoms. The differences in the pattern of findings for compulsive care-seeking and angry withdrawal are discussed in the context of previous findings in the bereavement literature on the role of dependency and ambivalence in bereavement-related adjustment.

Object relations as a predictor of adjustment in conjugal bereavement.

The impact of object relations on adjustment in conjugal bereavement was examined. At approximately 6 months postbereavement, 46 midlife bereaved participants engaged in a narrative interview in which they were asked to discuss their past relationship with their deceased spouse. The Westen et al. object relations scoring system was applied to these narratives. Participants also completed depression and grief-specific symptom measures at 6 months and again at 14 and 25 months postbereavement. Object relations correlated differently with grief-specific symptoms and depression: it was more strongly negatively associated with 6 month postloss grief-specific symptoms while more strongly negatively correlated with depression at 25 month postloss. In a growth curve analysis, more mature object relations was also predictive of a faster rate of decrease in depression over time. The results were discussed in terms of current theoretical perspectives on what is required in successful adaptation to conjugal bereavement.

Expectancy of Spousal Death and Adjustment to Conjugal Bereavement

Previous findings on the role of expectancy of spousal death in adjustment to bereavement are inconclusive due to methodological shortcomings. This study examined the impact of subjective and objective expectancy on adjustment, while addressing the methodological problems of previous studies. At six months postbereavement, 97 midlife bereaved adults responded to interview questions regarding expectancy of their spouse's death. They also completed the Beck Depression Inventory and Texas Revised Inventory of Grief, at 6, 13, and 25 months postbereavement. Greater objective expectancy was associated with lower symptoms at all three postbereavement periods. Subjective expectancy was not related to symptoms, however. The clinical implications of objective expectancy's role on bereavement-related adjustment are addressed.

BEREAVEMENT COPING SELF-EFFICACY IN CANCER WIDOWS

This study applied social cognitive theory to help explain the differential outcomes observed in conjugal bereavement. Specifically, a measure of bereavement coping self-efficacy was created and relationships tested with psychological, spiritual, and physical health outcomes. One hundred and one women whose husbands had died from cancer within the last year served as participants. Mean age of this relatively well-educated, predominately Caucasian sample was 54 years old. Median time since death was between 6 months and a year. Results supported the hypotheses that bereavement coping self-efficacy was a significant predictor of emotional distress, psychological well-being, spiritual well-being, and physical health perceptions after controlling for several other important factors. Theoretical and clinical ramifications of these findings are discussed.

Mortality following conjugal bereavement, Belgium 1991-96: The unexpected effect of education

This paper examines excess mortality following spousal bereavement by time since bereavement, sex, age, and education. The main hypothesis challenged is that higher education buffers the harmful effects of spousal loss. Using a log-rate model, death-rate ratios (widowed/married) are estimated for 49,849 and 126,746 Belgian widowers and widows and an equal number of non-bereaved controls matched to the bereaved on their socio-demographic characteristics. The hypothesis that the more educated suffer less excess mortality is not supported. Although higher educational levels are associated with lower mortality in general, they do not alleviate the effects of bereavement. On the contrary, in the period immediately following spousal loss, the more highly educated seem to have more, rather than less, excess mortality. Three possible arguments are suggested to account for this: education-related differences in the partner-relationship, structural differences in the availability of appropriate social support, and cultural differences in potential support networks.

Promoting positive affect and diminishing loneliness of widowed seniors through a support intervention.

Seniors are most vulnerable to conjugal bereavement. Although social support buffers the effects of bereavement, widows and widowers have lower levels of social support than married individuals. Self-help/support groups can supplement support from their depleted natural networks. Accordingly, the aim of this demonstration project was to examine the impact of support groups on widowed seniors' loneliness, affect, and perceived support. Four face-to-face support groups for widowed seniors were conducted weekly for a maximum of 20 weeks. Participants completed pretest, posttest, and delayed posttest measures of support need and support satisfaction, positive and negative affect, and loneliness/isolation. The statistically significant impacts of the intervention were enhanced support satisfaction, diminished support needs, and increased positive affect. There was a trend toward decreased social isolation and emotional loneliness. In postintervention semistructured interviews, bereaved seniors reported increased hope, improved skills in developing social relationships, enhanced coping, new role identities, and less loneliness. Community health nurse researchers could conduct randomized controlled trials of face-to-face and telephone support groups for bereaved people of all ages. Community health nurse practitioners could benefit from lessons learned about timing, duration, and selection of sensitive outcomes.

Grief and older people: the making or breaking of emotional bonds following partner loss in later life

The aim of this ethnographic study was to explore retrospectively the grief experiences of 12 older people whose partners had recently died in hospital, following a period of terminal illness. The rationale was based upon developing an understanding of the grief experiences of newly bereaved older people. In doing so, it is important to consider that grief is not only shaped by culture and social context but also by the nature of the relationship between the mourner and the deceased. For most of this century, the dominant conceptualization relating to grief and the social experience of bereavement has been based on the psychoanalytical school of thought. This process is said to involve the mourner passing through a number of stages or phases and forms the basis of the 'grief work hypothesis'. Using in-depth ethnographic interviews, the mourner's reactions to and perceptions of the loss were explored. Tape-recorded interview data were analysed using the inductive process of both content analysis and discourse evaluation. The findings from this study shed light on an area of conjugal bereavement that has received little attention in the past and challenges traditional models of grief. The indications are that in the first year of bereavement, the bereaved retain and modify the emotional relationship with their deceased partners, through a range of symbolic behaviours. The discussion raises issues concerning the need to consider the extent to which contemporary conceptualizations of grief explain the reactions of older people whose grief experiences are shaped by their social situation. The study also highlights important issues concerning the need to understand the complexity of grief experiences and bereavement support for older people which has a number of implications for nurses in both hospital and community settings.

Appraisals of Blame in Adjustment in Conjugal Bereavement

Bereaved individuals who had lost a spouse through death (on average 7.2 months previously) engaged in an “empty-chair” monolog task in which they imagined that they had one last opportunity to speak to their deceased spouse. The verbal content of their monolog speech was rated by judges on the appraisal categories deceased as blameworthy and self as blameworthy. As predicted, deceased as blameworthy was associated with greater anger toward the deceased, whereas self as blameworthy was related to greater guilt on a repeated measure assessing affective experience when thinking about the deceased in daily life. In addition, these appraisal categories were positively correlated with measures of symptomatic distress; specifically, deceased as blameworthy was related to general psychological symptoms, whereas self as blameworthy correlated with grief-specific symptoms. Furthermore, deceased as blameworthy was predictive of 14 months post-loss general psychological distress symptoms when statistically controlling for these symptoms at the time of the monolog in a hierarchical regression analysis, thus providing support for its mediating role in later adjustment. The implications of the findings for the assessment of grief outcome and directions for future research are discussed.

“Filling the Void”: Grief and Loneliness in Older Adults

Loneliness is often associated with conjugal bereavement, particularly in older adults. Bereavement is also cited as one of the most common causes of loneliness in later life. This article focuses on the findings from research interviews conducted with 16 older adults following partner loss. The argument is made that social forces both external and internal to the mourner determine the duration and shape of the older adult's experience of grief. Loneliness in later life is seen as an embedded and transparent problem that needs to be seen as a separate experience from grief. The findings from this research suggest that grief may be seen as an initiating mechanism of loneliness in older adults. Helping older adults to consider grief and loneliness as separate but related experiences, initiated by loss, may enable them to make sense of the distressing effects of bereavement that take place in later life.

Representations of Self and Other in Conjugal Bereavement

A semantic space perspective on representations of self and other was applied to investigate the perceived quality of the past relationship with the spouse in relation to adjustment in conjugal bereavement. According to this perspective, the proximity, or extent to which representations of self and others share similar trait content features, may have important affective implications. Forty-seven bereaved individuals rated different representations of themselves and important others on a set of idiographic features as a basis for determining proximities among the representations. Proximities addressing the quality of the past relationship with the spouse were predictive of the extent and type of blame-related emotions (anger versus guilt) aroused in an empty-chair role-play involving their deceased spouse. These proximities were also predictive of the SCL-90-R global severity index measure of psychological adjustment, and the results indicated that this relationship was partly mediated by the blame-related emotions in the role-play.

Coping with bereavement in relation to different feminine gender roles

The effect of gender role on coping with conjugal bereavement was studied in 44 Norwegian widows. A "traditional" and a "modern" feminine gender role were juxtaposed. Information was collected by two semi-structured interviews concerning coping with bereavement, and by a health inventory (UHI). The information was analysed qualitatively in relation to central elements in the coping process (appraisals, problems, coping strategies, self-evaluations of coping, future expectancies of coping, and relevance of external resources). The findings revealed considerable differences in coping between the two gender roles, favouring the modern feminine gender role.

Conjugal Bereavement and Well-Being of Elderly Men and Women: A Preliminary Study

Considerable variation in the effects of the loss of the spouse have been reported, and there is lack of agreement regarding the effects of gender and bereavement on well-being. The objective of this article is to examine time-differences in the consequences of bereavement for men and women. Cross-sectional data are used on 4642 married or widowed late mid-life and elderly people. Analyses show that bereaved participants score significantly lower on well-being, and a clear gender-effect is found in connection with the time period of bereavement. Men score considerably lower than women when they are up to two years bereaved, but not when they are bereaved longer than two years. Hence, analyses of variance revealed an interaction effect for gender * time period. In addition, while the largest part of the variance in well-being can be explained by different means of achieving well-being, the effects of marital status, gender, and adjustment to widowhood over time do not disappear completely.

Selective Attrition Effects in Bereavement Research: A Three-Year Longitudinal Analysis

The study examined the effects of selective attrition on the picture of bereavement adjustment painted by longitudinal studies. Originally, 185 conjugally and nonconjugally bereaved adults ( M age = 50, range 20–82) were administered a battery of self-report measures indexing psychological functioning and adjustment to loss. Complete data gathered six months later were available from 166 persons (133 completers, 33 dropouts), while for a follow-up conducted three years later, complete data were available from ninety-six completers and seventy dropouts. Based on the women in this sample, discriminant function analysis conducted at the six-month follow-up suggested that nonconjugally bereaved completers had been older, had been more recently bereaved, had experienced more loneliness, had reported their health relative in age peers to be less adequate, and had been more active copers. At three years, nonconjugally bereaved completers had been older, more affluent, and had been more lonely. No differences between refusers and completers were found for the conjugally bereaved at either the six-month or three-month occasions. Regarding attrition effects, these data suggest that distinctions between short-term and long-term time frames and between conjugal and nonconjugal bereavement are necessary. These data also indicate that longitudinal studies of nonconjugal bereavement may be presenting an inaccurate picture of post-death adjustment, while attrition bias in studies or conjugal bereavement may be less distorting in its impact.