Grief In Survivors Research Articles

Personal Pilgrimage Aids in Processing of Traumatic Grief in Survivors of Parent Suicide

A twenty-six-year-old female suffers traumatic loss after her father’s suicide. Client has endured approximately four months of complicated grief to date. She experiences, among other things, preoccupation with the end story, intense sorrow, sleeplessness, and appetite issues. Embarking on a series of 45-minute weekly sessions just two weeks prior, Client and I have thus far addressed her grief through re-membering exercises and an experiential therapy tactic called the Personal Pilgrimage.

Paying your respects: Transgender women and detransitioning after death

This paper asks how do the deaths and the postmortem detransitioning (the verbal, visual, and material rejection of a person’s gender identity) of transgender women impact trans activism? After analyzing the case studies of Jennifer Gable and Leelah Alcorn, I outline how the contentious memorialization of transgender women and the disenfranchized grief of survivors influence trans activism. I conclude that activism is characterized by respecting the wishes of the deceased, by preventing the violence which transgender women experience, by advocating for trans elder care, by educating about end-of-life issues, and by lobbying for laws that protect transgender men and women after death.

Treatment of Complicated Grief in Survivors of Suicide Loss: A HEAL Report.

Suffering associated with complicated grief (CG) is profound. Because suicide loss survivors are susceptible to developing CG, identifying effective treatments for suicide loss survivors with CG is a high priority. This report provides data on the acceptability and effectiveness of antidepressant medication and complicated grief therapy (CGT), a CG-targeted psychotherapy, for suicide loss survivors with CG identified by an Inventory of Complicated Grief score ≥ 30. This is a secondary analysis of data collected from March 2010 to September 2014 for a 4-site, double-blind, placebo-controlled randomized trial comparing the effectiveness of antidepressant medication alone or in combination with CGT for participants with CG (score ≥ 30 on the Inventory of Complicated Grief) who were bereaved by suicide (SB; n = 58), accident/homicide (A/H; n = 74), or natural causes (NC; n = 263). Using mode of death as a grouping factor, we evaluated acceptability of treatments by comparing 12-week medication and 16-session CGT completion; we evaluated effectiveness by comparing response at week 20, defined by a score of 1 or 2 on the Complicated Grief Clinical Global Impressions-Improvement scale (CG-CGI-I), and additional secondary response measures. Among participants receiving medication alone, SB medication completion rates (36%) were lower than rates for A/H (54%) and NC (68%; χ² = 11.76, P < .01). SB medication completion rates were much higher for SB individuals receiving CGT (82%; χ² = 12.45, P < .001) than for SB individuals receiving medication alone. CGT completion rates were similar in the 3 groups (SB = 74%, A/H = 64%, NC = 77%; χ² = 2.48, P = .29). For SB participants receiving CGT, CG-CGI-I response rates were substantial (64%), but lower compared to the other groups (A/H = 93%, NC = 84%; χ² = 8.00, P < .05). However, on all other outcomes, changes from baseline for SB participants were comparable to those for A/H and NC participants, including number and severity of grief symptoms, suicidal ideation, and grief-related impairment, avoidance, and maladaptive beliefs. These results raise concern about the acceptability of medication alone as a treatment for complicated grief in treatment-seeking suicide-bereaved adults. In contrast, CGT is an acceptable and promising treatment for suicide-bereaved individuals with complicated grief. ClinicalTrials.gov identifier: NCT01179568.

Depression, Hopelessness, and Complicated Grief in Survivors of Suicide.

Suicide often has a severe impact on the surviving family and friends. There is a need to better understand the psychological and psychopathological consequences of losing a significant other by suicide. The aim of the present study was to assess hopelessness, depression, suicide risk, complicated grief, intrusive memories, and avoidance in a sample of suicide survivors. In this observational study, 35 bereaved individuals were recruited at the Suicide Prevention Centre of Sant’Andrea Hospital in Rome. Individuals were administered a series of validated instruments: the Beck Depression Inventory II (BDI), the Beck Hopelessness Scale (BHS), the Inventory of Complicated Grief (ICG), the Impact of Event Scale (IES), the Subjective Happiness Scale (SHS), and the Satisfaction With Life Scale (SWLS). Most survivors (62.8%) obtained high scores on measures of complicated grief. Scores on the measure of complicated grief were associated with intrusiveness of thoughts and memories, attempts to prevent the thoughts and emotions related to the event, depressive symptoms and hopelessness, and lower scores for feelings of happiness and satisfaction with life. A subgroup of suicide survivors may be at risk of severe psychological distress and suicidal behavior. Identification of these survivors is a necessary step for providing appropriate counseling and psychotherapy.

Life Will Never Be the Same Again: Examining Grief in Survivors Bereaved by Young Suicide

This article explores existing assumptions about the nature of bereavement by suicide. Drawing on data from a U.K. study of student suicide, we hope to contribute to a fuller understanding of the uniqueness of bereavement by suicide and new pathways for grief research. In this article we argue that bereavement by suicide has a number of common themes and characteristics. Analyzed in accordance with Jordan's (2001) review, our data supports the idea that the thematic content of the grief associated with suicide bereavement is distinctive and guilt is a particularly important feature. We argue that no other type of death is likely to bestow this particular negative emotion on survivors in equivalent measure. Findings on the impact of social processes and family systems were mixed. Explanations to account for these data along with recommendations for intervention and research are discussed.

Coping and Complicated Grief in Survivors of Homicide and Suicide Decedents

This article summarizes a comprehensive literature review and explores research of coping strategies used by survivors of homicide and suicide decedents. The relationship of these survivors' coping strategies to the development of complicated grief is also examined.

By Their Own Hand

The word suicide takes on a life of its own. People are both repulsed and intrigued by the word and the silence it brings. Those who survive a loved one's suicide face the inherent contradictions that exist in society: a mixture of sympathy and disgust, spectacle and removal. The author's sister was a clinical neurologist working at a well-known, top-tier medical institution who committed suicide in reaction to thwarted efforts to obtain a tenured position. As a result, the author faced within herself a mixture of horror and wonder, isolation and community, and anger and stillness. A survivor's grief has no structure, and feelings and thoughts meander without rhyme or reason like the primitive rhizome as an uncovered memory constantly stops in the middle and unfolds to another. This autoethnographic article explores Deleuze and Guattari's oppositional binaries and the author's compelling need to search the silence.

Coping and Complicated Grief in Survivors of Homicide and Suicide Decedents

Coping and Complicated Grief in Survivors of Homicide and Suicide Decedents

Acute psychological impact of disaster and large-scale tauma: limitations of traditional interventions and future practice recommendations.

Nearly everyone will experience emotional and psychological distress in the immediate aftermath of a disaster or other large-scale traumatic event. Although extremely upsetting and disruptive, the reaction is understood best as a human response to inordinate adversity, which in the majority of cases remits over time without formal intervention. Nevertheless, some people experience sustained difficulties. To prevent chronic post-traumatic difficulties, mental health professionals provide early interventions soon after traumatic exposure. These interventions typically take the form of single-session debriefings, which have been applied routinely following disasters. The research bearing on these traditional forms of early crisis interventions has shown that, although well-received by victims, there is no empirical support for their continued use. However, promising evidence-based, early interventions have been developed, which are highlighted. Finally, traumatic bereavement and complicated grief in survivors of disasters, an area largely neglected in the field, is discussed.

Complicated grief in survivors of suicide.

Complicated grief is a newly defined and distinctive psychiatric disorder that occurs in response to a significant loss through death. New findings suggest that survivors who were close to the deceased are at heightened risk for complicated grief. Little is known about whether close kinship (spouses, parents, children, siblings, vs. in-laws, aunts/uncles, nieces/nephews, friends, or coworkers) to a suicide victim also represents a heightened risk for complicated grief. Assessing for complicated grief is important, especially with survivors of suicide, because of the potential for associated health risks. This report contains preliminary data from an exploratory, descriptive pilot study examining complicated grief in adult survivors of suicide. Sixty bereaved subjects, within one month after the suicide of a family member or significant other, were assessed for complicated grief symptoms. Statistically significant differences, as measured with the Inventory of Complicated Grief, were noted between closely related and distantly related survivors of the suicide victim. These preliminary results indicate that health care professional's assessments and interventions for complicated grief should take into consideration the bereaved's familial and/or social relationship to the deceased. The closely related survivors of suicide had higher levels of complicated grief and could be at risk of developing physical and/or mental health problems, including suicidal ideation, in the future.

Perceptions of Sensationalism among U.S. and Mexican News Audiences

News researchers have used two somewhat different concepts of news sensationalism. Some work treats as a researcher-defined property of communication contents, such as bloody graphics or crime news. Content analysis can measure such contents quite readily.1 The other concept emphasizes audience reactions or perceived sensationalism, of which Danielson et al. provided one influential conceptualization: Sensationalism means that stories in a publication are underdistanced: ... they supply more sensations and emotional reactions than we desire emotionally or that society has deemed proper ... It ... has to do with the psychological distance we wish to keep between ourselves and our perceptions of events in the world.2 Based on this definition, Tannenbaum and Lynch devised Sendex,3 a measure that compares a person's perception of content with the meaning of to him or her. Initially applied to constructed news stories, the technique has been used recently to measure changes in perceptions of U.S. newspapers after Rupert Murdoch acquired them.4 Those studies' findings indicated that in addition to shifting to more sensational layouts and news selection, Murdoch's newspaper acquisitions had also shifted to greater local coverage.5 Thus the readers' perception of shifts toward greater could have been as much a function of exposure to more local content as it was a function of layout and news-selection. If perception of underdistanced news reflects greater perception of sensationalism, then the underdistance (i.e., proximity) of local news has something to do with perceived sensationalism. Indeed, proximity has been long considered a strong determinant of news selection.6 This study (a) compares conceptions of news among residents of Mexico and of the United States, and (b) tests a hypothesis that residents of each country will perceive coverage of events in their home country as particularly sensational. Method The study used a 2 (nationality) x 4 (news story) experimental design. Respondents were students at the Autonomous University of Guadalajara in Mexico (N=107) and at a Southern university in the United States (N=125). Students received a booklet containing a news story. The students were told (through an interpreter in Mexico) that the study concerned perceptions of news and that they would read an Associated Press story distributed to newspapers worldwide. Actually, the stories were composite wire service news accounts from the past.7 In the booklet, participants were initially asked to define the term sensationalism via 12 bipolar adjectives (accurate-inaccurate, good-bad, responsible-irresponsible, wise-foolish, acceptable-unacceptable, colorful-colorless, interesting-uninteresting, exciting-unexciting, hot-cold, active-passive, agitated-calm and bold-timid). Those semantic differential scales, on which a subject can rate his/her concept of sensationalism, represent the core of the Sendex technique? Students then read the news story (one of four treatments that concerned violent gangs or airplane crashes). The news accounts were chosen for their symmetry relative to the United States and Mexico and for their ordinal geographic distance from either group of students. The stories were typeset in newspaper-style columns without headlines. Randomized combinations of booklets were used to assign each subject to a story. Full details of the complete stories are available from the authors. Briefly, the news-story variable was manipulated as follows: * Mexico--far from border, near Mexican study site: Crash of an airplane bound for Puerto Vallarta, fairly near to Guadalajara. Graphic detail of observers' accounts and grief of survivors. * Border--Mexican side: Story about a drug smuggling cult that had killed many people near Matamoros, on the U.S. border. Reportage of gruesome sacrificial and black magic practices. …

Can professionals and nonprofessionals work together following a suicide?

Suicide is the taking of one's own life by one's own hand. It is often sudden and creates many emotional reactions for the survivors left behind. Survivor responses can be impacted by a range of circumstances, from how the person died to the reactions of people to the survivor. This contribution examines the uniqueness of survivor grief and how best to help survivors. It is suggested that their grief may be too quickly viewed as pathological, resulting in the premature medicalization of basically normal reactions. It is time for professionals and nonprofessionals to recognize boundaries and work toward mutual goals of health for those persons left behind after a suicide.

The suicide survivor's grief and recovery.

While official estimates report approximately 30,000 completed suicides each year, some researchers claim the numbers range much higher. Each suicide has severe and prolonged effects on the family members and friends left behind. Those left behind, the survivors of the suicide, tend to experience a very complicated form of bereavement. This is due to the combination of the sudden shock, the unanswered question of "why," and possibly the trauma of discovering or witnessing the suicide. Survivors' grief reactions can become even more exacerbated by inappropriate responses from the community to the suicide. A mental health professional can help the survivor through this difficult grieving process by direct and indirect means.

Impact of a Grief-Crisis Intervention Immediately after a Sudden Violent Death on the Survivor's Ability to Cope

A challenging concern of grief-crisis intervention is providing appropriate emotional and educational support immediately after a sudden violent death. Research suggests that coping after this type of loss is laborious for the entire family, including children, adolescents, and adults. The survivor's grief response is intense with a prolonged trauma. The consensus of the research indicates that grief-crisis intervention helps the survivors to want to go on living in the face of disaster and positively affects their ability to cope.

The grief of parents of murdered children: a suggested model for intervention.

The grief of parents who have lost children to murder is extreme, prolonged, and unique. The authors, themselves bereaved by homicide, suggest a model to facilitate understanding such grief and to guide intervention. The model postulates that homicide survivor grief occurs in three arenas: the private, personal world; the public world of the media; and the world of the criminal justice system. Each arena contains features unique to homicide survivor bereavement. These features are described for the reader.

Killing Death (That Bastard's Been Here Again)

Regarding the recent passing of Toni Flores and Marea Teski, the ever‐gentle Miles Richardson said to me that it was enough to "make you want to stand and shake a fist." I agree. Death enrages and defeats. Sometimes it inspires retaliation. The present piece engages death in a poetic mode properly called romantic irony. Its absurdity is therefore licensed. The ethnographic setting is an Irish pub. It is very easy to find someone in a classic Irish pub who will talk about anything, if not someone who is an expert on everything. Smooth and influential talk—blarney —is common in such settings. Sometimes deceitful, it is seldom just bullshit. Blarney draws its mark in fact from a sacred stone. And the best blarney always contains a bittersweet truth. In this case, a recent passing creates great sadness and raises the ancient and perennial prospect of giving personified death a dose of its own project—of defeating death by killing it. The magic weapon is language. Talking is balm for the survivor's grief, and it protects others from more of the same, even as it chokes the life out of death itself. The text is marked for performance context.

Incorporation of a "Coping with the Death of a Child" module into the pediatric advanced life support (PALS) curriculum.

To develop an educational module for health professionals (HPs) addressing the clinical reality of death as an outcome of pediatric resuscitation efforts. Module goals were to: 1) reduce HPs' discomfort with situations involving patient death and survivor grief, 2) assist HPs coping with their own emotions surrounding a patient death, and 3) provide specific strategies useful in clinical management. The module was designed to be presented as part of the American Heart Association (AHA) and the American Academy of Pediatrics (AAP) Pediatric Advanced Life Support (PALS) provider course. A multidisciplinary team created a module addressing both survivors' and HPs' needs regarding a PALS course "Coping with the Death of a Child" module. The module was presented to 964 PALS course participants. Content was revised after analysis of survey data collected from these participants. The revised module was presented to 601 PALS course participants; evaluations were obtained from 590 participants. On a 4-point Likert scale, ratings were: 79% "excellent," 18% "good," 2% "fair," and <1% "poor." The PALS course offers an opportunity to target HPs likely to encounter pediatric deaths for special education. While this is a challenging and potentially controversial topic to present to a diverse audience, incorporation of a "Coping with the Death of a Child" module into the PALS provider curriculum appears to be both feasible and useful.

Traumatic grief as a risk factor for mental and physical morbidity.

The aim of this study was to confirm and extend the authors' previous work indicating that symptoms of traumatic grief are predictors of future physical and mental health outcomes. The study group consisted of 150 future widows and widowers interviewed at the time of their spouse's hospital admission and at 6-week and 6-, 13-, and 25- month follow-ups. Traumatic grief was measured with a modified version of the Grief Measurement Scale. Mental and physical health outcomes were assessed by self-report and interviewer evaluation. Survival analysis and linear and logistic regressions were used to determine the risk for adverse mental and physical health outcomes posed by traumatic grief. Survival and regression analyses indicated that the presence of traumatic grief symptoms approximately 6 months after the death of the spouse predicted such negative health outcomes as cancer, heart trouble, high blood pressure, suicidal ideation, and changes in eating habits at 13- or 25-month follow-up. The results suggest that it may not be the stress of bereavement, per se, that puts individuals at risk for long-term mental and physical health impairments and adverse health behaviors. Rather, it appears that psychiatric sequelae such as traumatic grief are of critical importance in determining which bereaved individuals will be at risk for long-term dysfunction.

AIDS, euthanasia and grief.

Almost 50% of people with AIDS in the Netherlands make the necessary arrangements for a possible death by the administration of thanatic drugs. In approximately 50% of those who arranged for it, euthanasia is performed. Euthanasia is a well-considered decision. By means of euthanasia people with AIDS want to prevent unbearable suffering and a degrading existence. Those who have arranged for euthanasia were proven to have adapted to the disease better than those who had not. No relationship was found between ending life by means of euthanasia and complicated grief in survivors. However, if the euthanasia process itself was complicated, the risk of complicated grief increased.

Family Grief in the Emergency Department

Emergency physicians frequently face death, yet many are unprepared to deal with the family survivors of a patient who has died unexpectedly. Without the benefit of establishing prior rapport with the family, the emergency physician must anticipate the family's grief response so that he or she can intervene to avoid an unnecessarily prolonged or morbid grief reaction. Factors predisposing to a pathologic grief response in the death of a spouse or of an infant or child must be recognized, and the physician's power to assuage survivor guilt should be used. Certain key actions in the process of notifying survivors, viewing the body, concluding the emergency department visit, and following up after the patient's death help facilitate survivor grief in the least traumatic way possible. Emergency Departments can improve their dealing with death by instituting a team approach using doctors, nurses, social workers, and clergy to better support family members in their emergency department experience and to provide a link with community service organizations helpful to the family after they leave the hospital.