Impact Of Bereavement Research Articles

The impact of bereavement and loss on secondary and post-school students

The impact of bereavement and loss on secondary and post-school students

Impact of Bereavement on Progression of AIDS and HIV Infection: A Review

Human immunodeficiency virus (HIV) disease is associated with bereavement and grief reactions brought about by the disease process itself and by the losses of loved ones. The goal of this review is to assess the current literature regarding grief, HIV, and immunity. The authors reviewed applicable articles retrieved from a MEDLINE literature search with the search terms "bereavement/HIV," "grief/HIV," and "immunity/grief/HIV." Data continue to emerge that suggest a profound role for bereavement in mediating HIV illness and the need to effectively deal with bereavement issues. Patients who experience maladaptive grief show more rapid losses of CD4 T-cells over time, even when controlling for age, health status, use of antiretrovirals, and illicit drug abuse. This immune dysfunction may be managed by a variety of psychotherapeutic techniques.

User Perspective on Palliative Care Services: Experiences of Middle-aged Partners Bereaved through Cancer Known to Social Work Services in Northern Ireland

This qualitative research study explores experiences of partners bereaved through cancer, who were resident in an urban area of Northern Ireland and who had been service users of the social work services. Data were collected in 2004 from 10 individuals who participated in semi-structured interviews. Emergent themes were identified using thematic content analysis and findings analysed under four categories: cancer journey; impact of bereavement; process of adjustment and change; and experience of support services. Opportunities to facilitate communication were not always maximised, often resulting in poor bereavement outcomes. Although hospices undertook bereavement risk assessment, participants were unaware of its use and queried its accuracy without service user involvement. The most cited informal support was family and friends, although such help was time-limited. Service user feedback regarding social workers was generally positive; however, there was a lack of knowledge about their role in palliative care. Post-bereavement adjustment was influenced by the quality of social networks, the responsibilities of lone parenthood, and challenges to life values and core beliefs. A framework for palliative care social work has been recommended based on research findings.

Attempted suicide in bereaved individuals: The experience of a consultation-liaison psychiatric unit

Introduction:Bereaved individuals are at high risk for suicidal behavior, a fact well-known since antiquity as indicated by the Greek myth of Aegeas, who in his grief jumped into the sea in the mistaken belief that his son, Theseus, had been slain.Methods:We report the experience of our recently established Consultation-Liaison Psychiatric Unit in the management of bereaved patients who attempted suicide.Results:Between December 2006 and August 2007 we accepted 36 requests for consultation with patients who had attempted suicide. Five patients (13.8%) reported the loss through death of a beloved one 3 to 22 months prior to the attempt. The most common reasons for attempted suicide were hopelessness, loneliness and meaninglessness of life, which they attributed to the bereavement. All patients had suicidal ideation for weeks or months prior to the attempt and two patients had revealed it to a close person. Only one patient had been assessed by a psychiatrist. Patients as well as their relatives reported that they considered these feelings as part of the normal grief process, even if they were prolonged or overwhelming. Two patients denied any further psychiatric intervention, one dropped out after one month's follow-up and two patients display a good outcome after a period of more than 4 months' follow-up.Conclusion:When assessing patients in the Consultation-Liaison context, consultants should bear in mind the impact of bereavement, especially in cultures where complicated grief is easily misconstrued as a normal process than as a condition which merits psychiatric evaluation and care.

The impairment of Presidents Pierce and Coolidge after traumatic bereavement

The impact of bereavement in heads of government has been little studied. Two US presidents lost their teenaged sons in a traumatic manner, leaving them profoundly affected as they struggled to serve in office. We describe the bereavements of Presidents Franklin Pierce and Calvin Coolidge, using biographical and source material. Pierce and Coolidge were adversely affected by their bereavements, which almost certainly rendered them less effective in the discharge of their duties. The loss of their sons had a devastating effect on both men and deprived their presidential service of significant personal meaning. Lincoln's resilience in similar circumstances offers a contrasting perspective, however. We conclude that the psychiatric consequences of losing a child can adversely affect heads of government, may cause clinically significant distress, altered behavior, and reduced ability to provide effective leadership.

Children and young people's experience of UK childhood bereavement services

This paper describes the experiences of bereaved children and parents and their use of UK childhood bereavement services. It forms part of a larger qualitative study and was undertaken in the context of questions about the impact of bereavement on children and their status and participation in research, raising important methodological and ethical issues. Interviews were undertaken with 24 bereaved children and 16 parents who had used one of eight organizational case study services. Participant observation of six group interventions was undertaken. The study identified a multiplicity of bereavement experiences both within and between families. Children identified difficulties in managing and expressing their feelings, isolation, problems at school, and fear for their surviving parent. Parents found it difficult to maintain their parenting role as they struggled with their own bereavement and the disruption in their circumstances. Children and parents who participated in interventions were able to describe the significant ways in which they found it helpful, including the benefit of speaking to someone who understood their experience. Although some experienced difficulties in attending group interventions, bereaved parents welcomed the support to help them provide appropriate care for their bereaved child. By providing an “ecological niche” for bereaved children, UK childhood bereavement services contribute to meeting outcomes identified in recent policy initiatives.

Relationships between Bereavement and Cognitive Functioning in Older Adults

Background: Bereavement is often associated with increased levels of depression, anxiety, and stress. The question of whether grief is associated with cognitive deficits in older adults remains largely unanswered. Although Xavier and coworkers (see text) found preliminary evidence that grief, in the absence of depression, impacted on memory in a sample of the oldest-old in Brazil, the impact of bereavement on cognitive functioning, independent of the effects of mood, has not been adequately examined. Objective: To replicate and expand on the work of Xavier and colleagues to examine whether there is an association between bereavement due to spousal loss and performance in a range of cognitive functioning domains in older adults, independent of the effects of depression, stress, and anxiety. Methods: Samples of bereaved (n = 25) and non-bereaved (n = 25) participants, who were aged between 65 and 80 years and who were matched for age, gender, education, premorbid intellectual functioning, and general cognitive ability, were compared on a battery of tests designed to assess attention, verbal fluency, memory, and visuospatial ability. Depression, anxiety, and stress were also assessed, as were the presence of complicated grief and the adequacy of social support in the bereaved group. Cognitive tests that differed between the groups and correlated with depression, stress, or anxiety were analyzed using hierarchical multiple regression. Results: The bereaved groups were more depressed, anxious, and stressed, and performed more poorly on tests assessing attention, information-processing speed, and verbal fluency. With the exception of the attentional switching task, the cognitive measures on which the groups differed were correlated with mood. When mood was controlled statistically, the group differences in these cognitive tests disappeared. Twenty-eight percent of the bereaved group met the criteria for a diagnosis of complicated grief. This subgroup was younger than the other bereaved participants and had higher levels of stress. Conclusion: The evidence suggests that grief associated with death of a spouse has limited associations with cognition beyond those that would be expected to occur as a result of depression, anxiety, and stress.

Impact of bereavement among relatives in Italy and Sweden after the Linate airplane disaster

Objectives: Victims of major disasters are at risk for development of post-traumatic stress disorder (PTSD). The aim of this study was to compare two groups of bereaved relatives from Italy and Sweden, and to examine the role of psychosocial support and psychological reactions 18 months after traumatic bereavement. Methods: In all, 153 bereaved relatives of deceased victims in the Milano/Linate aeroplane crash were assessed by a questionnaire. Reactions of psychological distress were measured by the Impact of Event Scale-Revised (IES-R). Results: In the whole group, 53.2% showed symptoms indicating that they might meet the DSM-IV criteria for PTSD. The frequency was higher among the Italian relatives (58.7%) compared with the Swedish relatives (42.6%). Females showed more signs of post-traumatic reactions compared with males in the total population, as did spouses and parents within the Italian group. The general health status, measured by subjective evaluation, was significantly affected in both groups as a result of the disaster. A significant recovery after 18 months was reported, although not to the pre-accident level. The Swedish relatives had a pattern of using more psychotherapy compared with the Italians, among whom it was more common to use medication for both anxiety and sleeping problems. The need for psychotherapy and medication was related to higher scores on IES-R. Conclusions: (1) Traumatic losses deeply affect bereaved relatives. Health is affected and a large group of these relatives develop strong symptoms of post-traumatic stress. (2) Swedish bereaved relatives seem to be more apt to ask for professional help, e.g. psychotherapy, while in Italy it is more common to rely on family, friends and medication. (3) Acute organized psychosocial support in the aftermath can possibly facilitate for victims to handle a traumatic loss but it does not prevent the development of strong post-traumatic reactions. Future investigations may show how it is possible to optimize the help with more specific interventions of support and treatment.

Health-related quality of life during the bereavement period of caregivers of a deceased elderly person

Few studies have addressed the health-related quality of life (HRQL) impact of bereavement. The objective of this study was to evaluate the HRQL of the main caregiver after the death of a close elderly relative. 142 caregivers were invited to participate in a phone interview with the SF-36. General population SF-36 norms, were used to calculate the gender and age standardised physical component summary (PCS) and mental component summary (MCS) scores. A MCS below 43 was used as an indicator of possible depression. Databases of several patient studies were additionally used to facilitate interpretation of results. 130 caregivers (91.5%) participated, the majority being women (80%), middle aged (56 years), and the spouse (22%) or son/daughter (56%) of the deceased person. Caregivers' SF-36 scores were lower than expected for mental health, role emotional and social functioning. Their MCS was below that expected by 0.6 SD units, whereas their PCS was above by 0.2 SD. The proportion of caregivers with possible depression was 33.8%. First-degree family relationship with the deceased (OR = 4.5), and lower age of the deceased (OR = 3.8) were significantly associated (p < 0.02) to a possible depression. The recent death of an elderly person is associated with significant emotional health impact on the caregiver.

Unproven assumptions about the impact of bereavement on children.

Unproven assumptions about the impact of bereavement on children.

Exile and bereavement

SUMMARY In this paper I describe the disruptions of external and internal reality in the experience of exile, the interplay of these, and the impact of bereavement in the context of trauma. I consider the factors which disturb the mourning process in such circumstances. I draw upon the psychoanalytic literature, particularly that related to the Holocaust and other ‘man-made disasters’, and upon my own clinical material. Particular attention is drawn to the importance of acknowledgment and containment, and to awareness of the symbolic value of traditional mourning practices.

Grieving men: thoughts, feelings, and behaviors following deaths of wives.

Despite the growing body of literature on bereavement, grief, and mourning, little attention has been given to the impact of bereavement on men. This is particularly true for studies on the impact of death of spouse on the survivor. Using in-depth interviews, we explored the thoughts, feelings, and behaviors of twenty men following the deaths of their wives. The findings do not support prevailing assumptions that men are less likely to be emotionally involved in the conjugal relationship and, thus, less likely to grieve than women; or, if emotionally involved, less likely to experience grief. This research suggests that men may be emotionally involved in the conjugal relationship and that the death of a wife may evoke intense feelings. The majority of the men in this study both hurt and knew they hurt. What they did not do was to reach out to others for help. This finding has important implications for bereavement program development.

Psychological toxicity of bereavement: Six months after the event

Abstract Bereavement is often a highly distressing experience that can have serious consequences. Therefore, it is important for health professionals to better understand the nature of this distress and trauma. However, further research is needed in this area, for there are few controlled bereavement studies that have used standardised measures of the impact of bereavement. Furthermore, there is a need for further controlled and systematic Australian research in this area, as data have consistently been reported from North America. In order to obtain a better understanding of the effects of bereavement, 55 persons were assessed on a number of psychological measures 2 weeks and 6 months after their spouse had died. They were compared on these measures to a control group matched for age, sex, marital status, and race. The results revealed significantly elevated prevalence of psychological disturbance among the bereaved 2 weeks and 6 months after the loss. Within the bereaved group, those who were disturbed ...

The bereaved caregiver: a prospective study of changes in well-being.

This study analyzes short-term bereavement adaptation among caregivers to spouses or parents with a progressive dementia, assessing changes in depression, mastery, overload, and guilt to examine the impact of bereavement on caregivers, and the characteristics of caregiver experience that affect bereavement adaptation. The bereavement group, as compared with active caregivers, dropped substantially in overload and increased in mastery and guilt. Depression showed a curvilinear trend, declining from the time of death and then rising to preloss levels by the end of the year. Caregiver stressors, baseline adaptation, relationship difficulties, and psychological preparation were all related to changes in well-being.

Is there a desolation effect after dementia? A comparative study of mortality rates in spouses of dementia patients following admission and bereavement

AbstractMortality rates following patient admission and patient death were measured in the surviving spouses of a sample of dementia patients admitted to a psychogeriatric unit between 1971 and 1986. The vital status of 85% of spouses was confirmed, and the ratio of observed to expected deaths (SMR) was calculated using regional and national mortality statistics.Spouse mortality following first admission to hospital was significantly lower than expected (p &lt; 0.006), and spouse deaths following bereavement were significantly fewer than expected (p &lt; 0.026). When male and female spouse mortality rates were compared, no significant differences were found, but there was a trend towards lower mortality in female spouses.The results give no support to the theory that hospital admission often follows a breakdown in the health of a caring spouse. Previous studies have shown an increase in mortality following conjugal bereavement, but the spouses of dementia patients were relative survivors and outlived their married and widowed counterparts in the general population. The possible relationships between dementia, anticipatory grief, and the impact of bereavement on the health of the surviving spouse are discussed.

Similarity of Perceptions of Bereavement Experiences between Widows and Professionals

Widows and four groups of professionals (clergy, physicians, counselors, and funeral directors) were compared in regards to their perceptions of conjugal bereavement. Results suggested consistent differences between widows' self-perceptions and professionals' views regarding the impact of bereavement and the necessity for adaptative coping mechanisms to deal with loss. Professionals saw bereavement as having a more negative impact and requiring the use of coping skills to a greater extent than did widows. Such differences remained when age at bereavement or length of widowhood were taken into account. Professionals' perceptions of conjugal bereavement were similar to one another. Help-seeking behaviors, age at bereavement, and length of bereavement differentiated widows, while experience in counseling widows failed to separate professionals. Both age-related experiential differences with loss and gender differences in coping with loss may explain these findings. These data underscore the importance of efforts to bring widows and professionals into direct contact with one another in order to lessen misperceptions of conjugal bereavement.

Parenting after perinatal bereavement - a review of the literature

Abstract The literature concerning the psychosocial aspects of parenting after the death of a child in the perinatal period is reviewed. The impact of bereavement on the parents and the siblings is discussed with effects on the mental health of the family, the decision to embark on further pregnancies and the implications for child-rearing practice. The concept of the ‘replacement child’ is explored with suggestions as to how psychopathological mechanisms may be avoided.

Individual and Situational Differences in Recovery from Bereavement: A Risk Group Identified

The Tübingen Longitudinal Study of Bereavement was designed to provide information on (a) health deterioration and recovery following bereavement, (b) risk factors in bereavement, and (c) selection and social desirability as potential biases in health findings in this type of research. A sample of widows and widowers were interviewed three times during the first two years following their loss. Measures of their health and well‐being were compared to those of a matched sample of married individuals. Data were also collected on the health status of some of the widowed who refused participation. The findings suggest the following conclusions: (1) Partner loss is associated with an increased level of depressive and somatic symptoms during the first six months, but the majority of bereaved gradually recover over the two‐year period. (2) Individuals with low internal control beliefs who have experienced an unexpected loss constitute a risk group of individuals who suffer most and recover least. (3) Due to selection, the impact of bereavement is likely to be underestimated for widowers and overestimated for widows. Implications of these findings are discussed.

Bereavement and Health: The Psychological and Physical Consequences of Partner Loss.

Does the popular notion of a 'broken heart' have some grounding in reality? How can grief affect the body in ways that necessitate medical care and may even be life-threatening? Bereavement and Health constitutes a comprehensive review of what is known about the impact of bereavement on surviving partners. Drawing on the work of psychologists, sociologists, epidemiologists, and psychiatrists, Wolfgang and Margaret Stroebe offer a theoretically coherent perspective focused on conjugal loss. After a thorough discussion of stress and depression models of bereavement, the authors present their own theoretical approach, emphasizing social contacts and the interpersonal nature of grief. They then examine the psychological and medical consequences of bereavement: Are the bereaved at higher risk than those who have not lost a partner? What has research revealed about the causes, symptoms, and outcomes of grief? Key questions about recovery from grief are also addressed: Is the health risk of bereavement severe enough to have lasting or even fatal consequences? Is it possible to identify those bereaved who are at high risk before their health suffers? What are the strategies that are most likely to lead to effective coping? Can attempts at intervention be effective? The Stroebes' combination of theoretical integration and methodological rigor will make Bereavement and Health a standard text for years to come.

Impact of Bereavement on the Self‐Conceptions of Older Surviving Spouses

The purpose of this longitudinal study was to assess the extent to which the social anchorage dimension of the self‐concept is impacted by the death of a spouse among a sample of older surviving spouses. Social anchorage was measured by the Twenty Statements Test (TST) in mailed questionnaires and consisted of self‐statements that signify important social relationships and group memberships. As hypothesized, the 42 bereaved persons had lower social anchorage scores than the 72 nonbereaved controls. This significant effect was evident as early as three to four weeks following the death, and it persisted through five more measurement periods that covered the first two years of bereavement.