1
|
Kondo-Arita M, Becker CB. Changing Funerals and Their Effects on Bereavement Grief in Japan. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231158914. [PMID: 36803250 DOI: 10.1177/00302228231158914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Bereavement is an extremely personal feeling, but Japanese society tends to disapprove of displays of negative personal emotion or weakness. For ages, mourning rituals like funerals provided an exception where social permission was given to sharing grief and seeking support. However, the form and significance of Japanese funerals have changed rapidly over the past generation, and especially since the advent of COVID-19 restrictions on assembly and travel. This paper overviews the trajectory of changes and continuities in mourning rituals in Japan, looking at their psychological and social impacts. It goes on to summarize recent Japanese research showing that appropriate funerals are not merely of psychological and social benefit, but may have an important role in reducing or supporting grief that might otherwise require medical and social work intervention.
Collapse
Affiliation(s)
- Megumi Kondo-Arita
- President's Office, Global Center of Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Carl B Becker
- Policy Science Unit, School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
2
|
Lee SA, Bottomley JS. Personality and Grief-Related Panic Attacks: Analysis of Neuroticism, Worry, and Anxiety Sensitivity. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:849-861. [PMID: 33554746 DOI: 10.1177/0030222821992192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Grief-related panic attacks (GRPAs) are a relatively common yet debilitating psychological reaction to loss, the mechanisms of which remain poorly understood among scholars. The purpose of this study was to identify the personality traits that underlie GRPAs in a sample of 314 bereaved adults. The results indicate that GRPAs were relatively common (55.4%) and that anxiety sensitivity uniquely predicted both frequency and impairment associated with these kinds of attacks, while taking into account the effects of neuroticism, trait worry, grief, and gender. Findings suggest that anxiety sensitivity may be a risk factor for GRPAs and magnified grief for some mourners. Clinical implications and future directions are discussed.
Collapse
Affiliation(s)
- Sherman A Lee
- Department of Psychology, Christopher Newport University, Newport News, VA, USA
| | | |
Collapse
|
3
|
Chen MA, Fagundes CP. Childhood maltreatment, emotion regulation strategies and depressive symptoms during spousal bereavement. CHILD ABUSE & NEGLECT 2022; 128:105618. [PMID: 35344805 DOI: 10.1016/j.chiabu.2022.105618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 02/18/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Childhood maltreatment increases the risk of depression, especially after experiencing a stressful life event, such as bereavement. Employing emotion regulation strategies can mitigate the impact childhood maltreatment has on depression later in life following the loss of a spouse. OBJECTIVE We evaluated how cognitive reappraisal and expressive suppression moderated the impact of childhood maltreatment and depressive symptoms following spousal bereavement. PARTICIPANTS AND SETTING We examined 130 bereaved individuals 3 months after the death of a spouse, 4 months after the death of a spouse, and 6 months after the death of a spouse. METHODS We utilized a mixed model approach to test the interaction between childhood maltreatment and cognitive reappraisal and between childhood maltreatment and expressive suppression to predict depressive symptoms across 3 time points. RESULTS Cognitive reappraisal moderated the relationship between childhood maltreatment and depressive symptoms (b = - 0.17,p = .003); expressive suppression did not (b = 0.06,p = .452). Participants who used less cognitive reappraisal had a positive relationship between childhood maltreatment and depressive symptoms (b = 3.27,p < .001);participants who used more cognitive reappraisal did not (b = 1.09,p = .065). CONCLUSIONS Childhood maltreatment interacted with cognitive reappraisal, but not expressive suppression, to predict depressive symptoms following spousal bereavement. This study reveals how emotion regulation strategies can be utilized as a tool to buffer the impact of childhood maltreatment on mental health following a stressor later in life, which can serve as a target for future interventions for individuals experiencing a stressful life event.
Collapse
Affiliation(s)
- Michelle A Chen
- Department of Psychological Sciences, Rice University, Houston, TX, USA.
| | - Christopher P Fagundes
- Department of Psychological Sciences, Rice University, Houston, TX, USA; Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
4
|
Wu-Chung EL, Leal SL, Denny BT, Cheng SL, Fagundes CP. Spousal caregiving, widowhood, and cognition: A systematic review and a biopsychosocial framework for understanding the relationship between interpersonal losses and dementia risk in older adulthood. Neurosci Biobehav Rev 2022; 134:104487. [PMID: 34971701 PMCID: PMC8925984 DOI: 10.1016/j.neubiorev.2021.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 01/18/2023]
Abstract
Accumulating research suggests that stressful life events, especially those that threaten close intimate bonds, are associated with an increased risk of dementia. Grieving the loss of a spouse, whether in the form of caregiving or after the death, ranks among 'life's most significant stressors', evoking intense psychological and physiological distress. Despite numerous studies reporting elevated dementia risk or poorer cognition among spousal caregivers and widow(er)s compared to controls, no review has summarized findings across cognitive outcomes (i.e., dementia incidence, cognitive impairment rates, cognitive performance) or proposed a theoretical model for understanding the links between partner loss and abnormal cognitive decline. The current systematic review summarizes findings across 64 empirical studies. Overall, both cross-sectional and longitudinal studies revealed an adverse association between partner loss and cognitive outcomes. In turn, we propose a biopsychosocial model of cognitive decline that explains how caregiving and bereavement may position some to develop cognitive impairment or Alzheimer's disease and related dementias. More longitudinal studies that focus on the biopsychosocial context of caregivers and widow(er)s are needed.
Collapse
Affiliation(s)
| | | | - Bryan T. Denny
- Department of Psychological Sciences, Rice University, Houston, TX
| | | | - Christopher P. Fagundes
- Department of Psychological Sciences, Rice University, Houston, TX,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX
| |
Collapse
|
5
|
Incidence of Anxiety in Latest Life and Risk Factors. Results of the AgeCoDe/AgeQualiDe Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312786. [PMID: 34886512 PMCID: PMC8657712 DOI: 10.3390/ijerph182312786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
Research on anxiety in oldest-old individuals is scarce. Specifically, incidence studies based on large community samples are lacking. The objective of this study is to assess age- and gender-specific incidence rates in a large sample of oldest-old individuals and to identify potential risk factors. The study included data from N = 702 adults aged 81 to 97 years. Anxiety symptoms were identified using the short form of the Geriatric Anxiety Inventory (GAI-SF). Associations of potential risk factors with anxiety incidence were analyzed using Cox proportional hazard models. Out of the N = 702 older adults, N = 77 individuals developed anxiety symptoms during the follow-up period. The incidence rate was 51.3 (95% CI: 41.2-64.1) per 1000 person-years in the overall sample, compared to 58.5 (95% CI: 43.2-72.4) in women and 37.3 (95% CI: 23.6-58.3) in men. Multivariable analysis showed an association of subjective memory complaints (HR: 2.03, 95% CI: 1.16-3.57) and depressive symptoms (HR: 3.20, 95% CI: 1.46-7.01) with incident anxiety in the follow-up. Incident anxiety is highly common in late life. Depressive symptoms and subjective memory complaints are major risk factors of new episodes. Incident anxiety appears to be a response to subjective memory complaints independent of depressive symptoms.
Collapse
|
6
|
Singham T, Bell G, Saunders R, Stott J. Widowhood and cognitive decline in adults aged 50 and over: A systematic review and meta-analysis. Ageing Res Rev 2021; 71:101461. [PMID: 34534681 DOI: 10.1016/j.arr.2021.101461] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/02/2021] [Accepted: 09/11/2021] [Indexed: 01/21/2023]
Abstract
While widowhood is known to be associated with poorer physical and mental health outcomes, studies examining the association of widowhood with cognition have yielded mixed results. This review aimed to elucidate the link between widowhood and cognitive decline. A systematic search of Medline, Embase, PsycInfo, CINAHL and Scopus (until December 2020) was conducted to identify studies on the association between widowhood (vs. being married) and cognition in cognitively healthy adults aged 50 +. A cross-sectional meta-analysis (of 10 studies; n = 24,668) found a significant association of widowhood with cognition (g = - 0.36, 95% CI [- 0.47, - 0.25], p = < 0.001). Meta-regressions suggested that study design, cognitive domain measured, sample age, difference in mean age between widowed and married groups, and study continent did not account for observed heterogeneity. A longitudinal meta-analysis (of 3 studies; n = 10,378) found that the "continually widowed" group (from baseline to follow-up) showed significantly steeper declines in cognition compared to the "continually married" group (g = - 0.15, 95%CI [- 0.19, - 0.10], p = < 0.001). Findings indicate that widowhood may be a risk factor for cognitive decline. As there are no effective treatments for cognitive impairment, studying mechanisms by which widowhood might be associated with poorer cognition could inform prevention programs for those who have experienced spousal bereavement.
Collapse
|
7
|
Vedder A, Stroebe MS, Schut HAW, Boerner K, Stokes JE, Boelen PA. Loneliness in Bereavement: Measurement Matters. Front Psychol 2021; 12:741762. [PMID: 34589033 PMCID: PMC8473627 DOI: 10.3389/fpsyg.2021.741762] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
The role of loneliness in the bereavement experience has been reported as substantial, with the death of a close person leaving a considerable void in the life of the bereaved. Yet, there is lack of agreement about its precise role and, notably, whether loneliness should be included as a core symptom for diagnosis of grief complications. The ongoing threat of heightened social isolation due to the COVID-19 pandemic underlines the need to understand the impact of loneliness, and to accurately chart its prevalence, intensity, duration, and associated difficulties in the context of bereavement. Assessment issues are central to this endeavor. In this article, we review the scientific literature to examine how loneliness after bereavement has been operationalized and measured. Sixty-three articles analyzing 51 independent datasets were reviewed. Results show major disparities: approximately half of the projects assessed loneliness by means of one of two validated scales (spanning different versions); the remainder included only single- or few-item measures. Diverse instructions, content and answer categories were used. While one size does not fit all, awareness of assessment options and dis/advantages may aid selection of the most appropriate measure, to suit the goals of a particular study and the specific groups under investigation. Our conclusion is that, in selecting a loneliness measure, health care professionals should come to their own well-informed decision, aided by the information provided in our review.
Collapse
Affiliation(s)
- Anneke Vedder
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Margeret S Stroebe
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands.,Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Henk A W Schut
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Kathrin Boerner
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, United States
| | - Jeffrey E Stokes
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, United States
| | - Paul A Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands.,ARQ National Psychotrauma Centre, Diemen, Netherlands
| |
Collapse
|
8
|
Vedder A, Boerner K, Stokes JE, Schut HAW, Boelen PA, Stroebe MS. A systematic review of loneliness in bereavement: Current research and future directions. Curr Opin Psychol 2021; 43:48-64. [PMID: 34293651 DOI: 10.1016/j.copsyc.2021.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022]
Abstract
Bereaved people suffer from loneliness and loneliness is associated with poor mental health. In this study, this topic is reviewed. An agenda is suggested for future research. Research that is theory-driven, addresses measurement consistency, correlates of loneliness in bereaved and non-bereaved, and treatment is necessary for prevention and intervention.
Collapse
Affiliation(s)
- Anneke Vedder
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands.
| | - Kathrin Boerner
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Jeffrey E Stokes
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Henk A W Schut
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Paul A Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; ARQ National Psychotrauma Centre, Diemen, the Netherlands
| | - Margaret S Stroebe
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
9
|
Fuller JT, Choudhury TK, Lowe DA, Balsis S. Hallucinations and Delusions Signal Alzheimer's Associated Cognitive Dysfunction More Strongly Compared to Other Neuropsychiatric Symptoms. J Gerontol B Psychol Sci Soc Sci 2021; 75:1894-1904. [PMID: 30877750 DOI: 10.1093/geronb/gbz032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Neuropsychiatric symptoms (NPS) are common among individuals with dementia of the Alzheimer's type (DAT). We sought to characterize which NPS more purely relate to cognitive dysfunction in DAT, relative to other NPS. METHOD Demographic, neurocognitive, neuroimaging, and NPS data were mined from the Alzheimer's Disease Neuroimaging Initiative database (n = 906). Using factor analysis, we analyzed the degree to which individual NPS were associated with DAT-associated cognitive dysfunction. We also employed item response theory to graphically depict the ability of individual NPS to index DAT-associated cognitive dysfunction across a continuum ranging from cognitively normal to mild DAT. RESULTS Psychotic symptoms (hallucinations and delusions) were more strongly related to the continuum of DAT-associated cognitive dysfunction than other NPS, with the strength of the relationship peaking at high levels of disease severity. Psychotic symptoms also negatively correlated with brain volume and did not relate to the presence of vision problems. Aberrant motor behavior and apathy had relatively smaller associations with DAT-associated cognitive dysfunction, while other NPS showed minimal associations. DISCUSSION Psychotic symptoms most strongly indexed DAT-associated cognitive dysfunction, whereas other NPS, such as depression and anxiety, were not as precisely related to the DAT-associated cognitive dysfunction.
Collapse
Affiliation(s)
- Joshua T Fuller
- Department of Psychological and Brain Sciences, Boston University, Massachusetts.,Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Tabina K Choudhury
- Department of Psychological and Brain Sciences, Texas A&M University, College Station
| | - Deborah A Lowe
- Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Steve Balsis
- Department of Psychology, University of Massachusetts Lowell
| | | |
Collapse
|
10
|
Park D, Kim S, Shin C, Suh S. Prevalence of and factors associated with nightmares in the elderly in a population based cohort study. Sleep Med 2020; 78:15-23. [PMID: 33373930 DOI: 10.1016/j.sleep.2020.11.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Nightmares are extremely unpleasant and vivid recurring dreams that are accompanied with awakening during sleep. However, earlier studies were mostly conducted with children and adults, with very few studies on nightmares in older adults. This population-based study aims to investigate the prevalence of nightmares and its associated factors nightmares in the elderly. METHODS This study utilized a subsample from the Korean Genome and Epidemiology Study (KoGES). Participants (n = 2940; mean age 63.71 ± 6.73) completed the questionnaires on nightmares (Disturbing Dream and Nightmare Severity Index; DDNSI), depression, suicidal ideation, sleep quality and stress. RESULTS Among the sample, 2.7% (n = 79) were classified into the nightmare group (NG), which was classified with DDNSI scores. In the age group over 70, prevalence of nightmares was 6.3% (n = 37), which was significantly higher than other age groups. Marital status, employment status and family income were associated with nightmares. Additionally, NG reported significantly more sleep problems, higher suicidal ideation, depression and stress compared to the non-nightmare group (N-NG). Logistic regression analyses results indicated that the NG was 4.35 times at higher risk for depression, and 3.16 higher risks for stress, and 3.45 higher risks for suicidal ideation compared to the N-NG after controlling for covariates. CONCLUSIONS Our results indicate that psychological and demographic factors are associated with nightmares in the elderly. Furthermore, this population-based cohort study showed the prevalence of nightmares increased after age 70, which suggests the need for further studies of nightmares in older populations.
Collapse
Affiliation(s)
- Dasom Park
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea
| | - Soriul Kim
- Institute for Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Chol Shin
- Institute for Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea; Division of Pulmonary Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea.
| |
Collapse
|
11
|
Abstract
There are normal changes to sleep architecture throughout the lifespan. There is not, however, a decreased need for sleep and sleep disturbance is not an inherent part of the aging process. Sleep disturbance is common in older adults because aging is associated with an increasing prevalence of multimorbidity, polypharmacy, psychosocial factors affecting sleep, and certain primary sleep disorders. It is also associated with morbidity and mortality. Because many older adults have several factors from different domains affecting their sleep, these complaints are best approached as a multifactorial geriatric health condition, necessitating a multifaceted treatment approach.
Collapse
|
12
|
Lancel M, Stroebe M, Eisma MC. Sleep disturbances in bereavement: A systematic review. Sleep Med Rev 2020; 53:101331. [PMID: 32505968 DOI: 10.1016/j.smrv.2020.101331] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022]
Abstract
Severe, persistent and disabling grief occurs among a sizable minority experiencing bereavement, with diagnostic manuals newly including complicated grief (CG) disorders. Sleep disturbances/disorders have been established as worsening affective and stress-related conditions. However, the role of sleep difficulties in bereavement and CG has not received similar scientific attention. We therefore conducted a systematic review with narrative syntheses on this topic to clarify the role of sleep in bereavement (PROSPERO: CRD42018093145). We searched PubMed, Web of Science and PsychInfo for peer-reviewed English-language articles including (at least one) bereaved sample and sleep disturbance measure. We identified 85 articles on 12.294 participants. We answered seven pre-defined research questions demonstrating: high prevalence of sleep disturbances in bereavement; positive associations of grief intensity with sleep difficulties; preliminary indications of risk factors of post-loss sleep disturbance; higher prevalence of sleep disturbances in CG, enhanced by psychiatric comorbidity (i.e., depression); and initial evidence of causal relationships between (complicated) grief and sleep. Grief therapy partly improves sleep difficulties, yet no intervention studies have specifically targeted sleep problems in bereaved persons. Causal relationships between sleep and grief require further examination in intensive longitudinal investigations, including randomized trials, thereby clarifying whether treating sleep problems enhances CG treatment effects.
Collapse
Affiliation(s)
- Marike Lancel
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Psychiatric Sleep Center Assen, Mental Health Services Drenthe, the Netherlands.
| | - Margaret Stroebe
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Maarten C Eisma
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
13
|
Zhang XX, Rost DH, Wang JL, Reynolds KJ. Active and Passive Social Networking Sites Usage and Negative Emotions: A Reciprocal Relationship? JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2020. [DOI: 10.1521/jscp.2020.39.3.195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: The increasing popularity of social networking sites (SNS) has stimulated research on the relationship between SNS usage and users' mental health. The current study aims to shed light on the possible reciprocal relationship between type of SNS usage and subsequent mental health among Chinese college students. Method: A latent variable cross-lagged panel analysis (two waves) was conducted (N = 266). Results showed that negative emotions (loneliness, depression) at Time 1 (T1) was positively related to both active SNS usage and passive SNS usage at Time 2 (T2). However, neither active nor passive SNS usage at T1 was found to be associated with negative emotions at T2. Discussion: In this current research, the key finding is that type of usage did not impact on users' mental health. Future research might investigate the role of individual and social factors (e.g., self-esteem and life satisfaction) in moderating the relationship between SNS use and mental health.
Collapse
Affiliation(s)
| | - Detlef H. Rost
- Southwest University, Chongqing, China
- Philipps-Universität Marburg, Marburg, Germany
| | | | | |
Collapse
|
14
|
Chen MA, Lewis MR, Chirinos DA, Murdock KW, Fagundes C. Differential psychological reactions to grief: The role of childhood adversity for depression symptoms among bereaved and non-bereaved adults. DEATH STUDIES 2019; 44:778-786. [PMID: 31094661 PMCID: PMC6858533 DOI: 10.1080/07481187.2019.1614107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Childhood maltreatment dysregulates an individual's physiological response to stress, increasing reactivity to stressors across the lifespan. Given the prevalence and impact of bereavement, we examined whether the association between childhood maltreatment and depression was exacerbated by spousal bereavement. We identified an interaction between childhood maltreatment and bereavement using linear regression analysis (B = 0.79, p < .001). A simple slopes test indicated a positive association between childhood maltreatment and depressive symptoms among those who were bereaved (B = 0.86, p < .001), but such association did not emerge among those who were not bereaved (B = 0.06, p = .60).
Collapse
Affiliation(s)
- Michelle. A. Chen
- Department of Psychological Sciences, Rice University, 6500 Main Street, Houston, TX 77030
| | - Megan R. Lewis
- Department of Psychological Sciences, Rice University, 6500 Main Street, Houston, TX 77030
- Department of Medicine, Dell Medical School, 1501 Red River Street, Austin, TX 78712
| | - Diana A. Chirinos
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 East Ontario, Suite 7-200, Chicago, IL 60611
| | - Kyle W. Murdock
- Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802
| | - Christopher Fagundes
- Department of Psychological Sciences, Rice University, 6500 Main Street, Houston, TX 77030
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX 77030
- Department of Psychiatry, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030
| |
Collapse
|
15
|
Garcini LM, Galvan T, Brown R, Chen M, Klonoff EA, Ziauddin K, Fagundes CP. Miles over mind: Transnational death and its association with psychological distress among undocumented Mexican immigrants. DEATH STUDIES 2019; 44:357-365. [PMID: 30821636 PMCID: PMC7077993 DOI: 10.1080/07481187.2019.1573862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: This study examined the association between transnational death and psychological distress among undocumented Mexican immigrants. The Minority Stress Model and a disenfranchised grief perspective were used as frameworks for this study.Method: Respondent driven sampling (RDS) was used to collect data from clinical interviews with 248 undocumented Mexican immigrants residing near the US-Mexico border.Results: After controlling for relevant covariates, experiencing transnational death was a significant predictor of clinically significant distress in this at-risk population.Conclusions: Our findings underscore the need to contextualize transnational death among undocumented immigrants from a perspective of disenfranchised grief that requires the development of contextually and culturally sensitive interventions aimed at addressing the high prevalence of transnational death and its associated distress in this marginalized population.
Collapse
Affiliation(s)
- Luz M. Garcini
- Department of Psychology, Rice University, Houston, Texas, USA
| | - Thania Galvan
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | - Ryan Brown
- Department of Psychology, Rice University, Houston, Texas, USA
| | - Michelle Chen
- Department of Psychology, Rice University, Houston, Texas, USA
| | - Elizabeth A. Klonoff
- Office of Research and Commercialization, University of Central Florida, Orlando, Florida, USA
| | | | | |
Collapse
|
16
|
Huang FY, Hsu AL, Hsu LM, Tsai JS, Huang CM, Chao YP, Hwang TJ, Wu CW. Mindfulness Improves Emotion Regulation and Executive Control on Bereaved Individuals: An fMRI Study. Front Hum Neurosci 2019; 12:541. [PMID: 30745865 PMCID: PMC6360180 DOI: 10.3389/fnhum.2018.00541] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/31/2018] [Indexed: 01/30/2023] Open
Abstract
The grief of bereavement is recognized as a severe psychosocial stressor that can trigger a variety of mental and physical disorders, and the long-lasting unresolved grief has a detrimental effect on brain functionality. Literature has documented mindfulness-based cognitive therapy (MBCT) as an efficient treatment for improving well-being, specifically related to the mood and cognition, in a variety of populations. However, little attention has been devoted to neural mechanisms with regard to bereaved individuals' cognition after MBCT intervention. In this study, we recruited 23 bereaved participants who lost a significant relative within 6 months to 4 years to attend 8-week MBCT course. We used self-reporting questionnaires to measure emotion regulation and functional magnetic resonance imaging (fMRI) with the numerical Stroop task to evaluate the MBCT effect on executive control among the bereaved participants. The self-reported questionnaires showed improvements on mindfulness and reductions in grief, difficulties in emotion regulation, anxiety, and depression after the MBCT intervention. The fMRI analysis demonstrated two scenarios: (1) the activity of the fronto-parietal network slightly declined accompanied with significant improvements in the reaction time of incongruent trials; (2) the activities in the posterior cingulate cortex and thalamus were positively associated with the Texas Revised Inventory of Grief, implying emotional interferences on cognitive functions. Results indicated that MBCT facilitated the executive control function by alleviating the emotional interferences over the cognitive functions and suggested that the 8-week MBCT intervention significantly improved both executive control and emotion regulation in bereaved individuals.
Collapse
Affiliation(s)
- Feng-Ying Huang
- Department of Education, College of Education, National Taipei University of Education, Taipei, Taiwan
| | - Ai-Ling Hsu
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Li-Ming Hsu
- Department of Radiology and Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jaw-Shiun Tsai
- Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
- Center for Complementary and Integrated Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Ping Chao
- Graduate Institute of Medical Mechatronics, Chang Gung University, Taoyuan, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Changwei W. Wu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Research Center of Brain and Consciousness, Shuang Ho Hospital, New Taipei, Taiwan
| |
Collapse
|
17
|
Welzel FD, Stein J, Röhr S, Fuchs A, Pentzek M, Mösch E, Bickel H, Weyerer S, Werle J, Wiese B, Oey A, Hajek A, König HH, Heser K, Keineidam L, van den Bussche H, van der Leeden C, Maier W, Scherer M, Wagner M, Riedel-Heller SG. Prevalence of Anxiety Symptoms and Their Association With Loss Experience in a Large Cohort Sample of the Oldest-Old. Results of the AgeCoDe/AgeQualiDe Study. Front Psychiatry 2019; 10:285. [PMID: 31139097 PMCID: PMC6518947 DOI: 10.3389/fpsyt.2019.00285] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/12/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Anxiety in adults is a common mental health problem. However, studies on anxiety in the oldest-old are lacking. We sought to identify the age- and gender-specific prevalence of anxiety symptoms in a large sample of general practice patients. Furthermore, we investigated relevant associations of anxiety specifically with respect to recent experience of loss. Methods: Based on the German Study on Ageing, Cognition and Dementia in general practice patients, a sample of 897 patients aged 82 years and older was assessed. Anxiety was assessed using the short form of the Geriatric Anxiety Inventory (GAI-SF). For the assessment of loss, patients were asked whether there were cases of death in their closer social environment since the last assessment. Descriptive and logistic regression analyses were run. Results: Of the oldest-old individuals (aged 82+ years, mean age: 86.8), 14.5% (95% CI 12.4-16.8) suffered from anxiety symptoms. Highest prevalence rates were found for 82- to 85-year-old women (17.2%, 95% CI 12.6-22.1) and for 86- to 90-year-old patients (both sexes) in general (15.9%, 95% CI 12.6-19.2). Older individuals who experienced cases of death in their close social environment within the last 18 months had almost twice the odds [odds ratio (OR) 1.91, 95% confidence interval (CI) 1.15-3.17] of reporting anxiety compared to those without a recent loss. As expected, depression and impaired cognitive status were associated with the presence of anxiety symptoms. No relation was found between social network, gender, age, frailty, or physical illness and anxiety in regression analysis. Conclusions: This study provides for the first time age- and gender-specific prevalence rates of anxiety symptoms and associated risk factors among a large population-based sample of oldest-old primary care attenders. Anxiety is highly prevalent in individuals aged 82 years and older. Depression, impaired cognitive status, and recent experience of loss are associated with late-life anxiety. Our findings support the idea that recent experience of loss should be taken seriously in the context of clinical practice with respect to diagnosing and treating anxiety in old age.
Collapse
Affiliation(s)
- Franziska D Welzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Birgitt Wiese
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Luca Keineidam
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carolin van der Leeden
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| |
Collapse
|
18
|
Camacho D, Pérez-Nieto MÁ, Gordillo F. The role of rumination in the guilt associated with bereavement according to cause of death. Psychiatry Res 2018; 270:1053-1058. [PMID: 30196977 DOI: 10.1016/j.psychres.2018.04.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 02/05/2018] [Accepted: 04/27/2018] [Indexed: 10/16/2022]
Abstract
The purpose of this study was to analyse the role rumination plays in the relationship between cause of death and the guilt present during bereavement. The sample consisted of 90 people that had suffered a loss due to an expected or unexpected natural death, suicide or accident. The results suggest that rumination increases the levels of guilt felt by people that had suffered a loss due to suicide compared to those whose loss was due to an expected natural death. These findings contribute to a better understanding of the mechanisms with an influence on bereavement.
Collapse
Affiliation(s)
- Dulce Camacho
- Alaia Association. C/ Fernández de los Ríos, 87. 28015 Madrid, Spain.
| | | | | |
Collapse
|
19
|
Prior A, Fenger-Grøn M, Davydow DS, Olsen J, Li J, Guldin MB, Vestergaard M. Bereavement, multimorbidity and mortality: a population-based study using bereavement as an indicator of mental stress. Psychol Med 2018; 48:1437-1443. [PMID: 28851470 DOI: 10.1017/s0033291717002380] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Mental stress is associated with higher mortality, but it remains controversial whether the association is causal or a consequence of a higher physical disease burden in those with a high mental stress load. Understanding causality is important when developing targeted interventions. We aimed to estimate the effect of mental stress on mortality by performing a 'natural' experiment using spousal bereavement as a disease-independent mental stressor. METHODS We followed a population-based matched cohort, including all individuals in Denmark bereaved in 1997-2014, for 17 years. Prospectively recorded register data were obtained for civil and vital status, 39 mental and physical diagnoses, and socioeconomic factors. RESULTS In total, 389 316 bereaved individuals were identified and 137 247 died during follow-up. Bereaved individuals had higher all-cause mortality than non-bereaved references in the entire study period. The relative mortality in the bereaved individuals was highest shortly after the loss (adjusted hazard ratio (aHR), first month: 2.50, 95% confidence interval (CI) 2.37-2.63; aHR, 6-12 months: 1.38, 95% CI 1.34-1.42). The excess mortality rate associated with bereavement rose with increasing number of physical diseases (1.33 v. 7.00 excess death per 1000 person-months for individuals with 0 v. ⩾3 physical conditions during the first month) and was exacerbated by the presence of mental illness. The excess mortality among bereaved individuals was primarily due to death from natural causes. CONCLUSIONS Bereavement was associated with increased short-term and long-term mortality, even after adjustment for morbidities, which suggests that mental stress may play a causal role in excess mortality.
Collapse
Affiliation(s)
- A Prior
- Research Unit for General Practice,Department of Public Health,Aarhus University,Bartholins Allé 2, Aarhus,Denmark
| | - M Fenger-Grøn
- Research Unit for General Practice,Department of Public Health,Aarhus University,Bartholins Allé 2, Aarhus,Denmark
| | - D S Davydow
- Department of Psychiatry and Behavioral Sciences,University of Washington,Box 359911,325 Ninth Ave,Seattle, WA,USA
| | - J Olsen
- Department of Clinical Epidemiology,Aarhus University Hospital,Olof Palmes Allé 43-45,Aarhus N,Denmark
| | - J Li
- Department of Clinical Epidemiology,Aarhus University Hospital,Olof Palmes Allé 43-45,Aarhus N,Denmark
| | - M-B Guldin
- Research Unit for General Practice,Department of Public Health,Aarhus University,Bartholins Allé 2, Aarhus,Denmark
| | - M Vestergaard
- Research Unit for General Practice,Department of Public Health,Aarhus University,Bartholins Allé 2, Aarhus,Denmark
| |
Collapse
|
20
|
Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression. J Affect Disord 2017; 211:83-91. [PMID: 28103522 PMCID: PMC5304338 DOI: 10.1016/j.jad.2017.01.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 12/03/2016] [Accepted: 01/03/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Prior research has shown that anxiety symptoms predict later depression symptoms following bereavement. Nevertheless, no research has investigated mechanisms of the temporal relationship between anxiety and later depressive symptoms or examined the impact of depressive symptoms on later anxiety symptoms following bereavement. METHODS The current study examined perceived emotional social support as a possible mediator between anxiety and depressive symptoms in a bereaved sample of older adults (N =250). Anxiety and depressive symptoms were measured at Wave 1 (immediately after bereavement), social support was measured at Wave 2 (18 months after bereavement), and anxiety and depressive symptoms were also measured at Wave 3 (48 months after bereavement). RESULTS Using Bayesian structural equation models, when controlling for baseline depression, anxiety symptoms significantly positively predicted depressive symptoms 48 months later, Further, perceived emotional social support significantly mediated the relationship between anxiety symptoms and later depressive symptoms, such that anxiety symptoms significantly negatively predicted later emotional social support, and emotional social support significantly negatively predicted later depressive symptoms. Also, when controlling for baseline anxiety, depressive symptoms positively predicted anxiety symptoms 48 months later. However, low emotional social support failed to mediate this relationship. CONCLUSIONS Low perceived emotional social support may be a mechanism by which anxiety symptoms predict depressive symptoms 48 months later for bereaved individuals.
Collapse
|
21
|
Abstract
There are normal changes to sleep architecture throughout the lifespan. There is not, however, a decreased need for sleep and sleep disturbance is not an inherent part of the aging process. Sleep disturbance is common in older adults because aging is associated with an increasing prevalence of multimorbidity, polypharmacy, psychosocial factors affecting sleep, and certain primary sleep disorders. It is also associated with morbidity and mortality. Because many older adults have several factors from different domains affecting their sleep, these complaints are best approached as a multifactorial geriatric health condition, necessitating a multifaceted treatment approach.
Collapse
Affiliation(s)
- Brienne Miner
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
| | - Meir H Kryger
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516, USA
| |
Collapse
|
22
|
Abstract
A Dual Process Model of Bereavement, which considers the impact of loss- and restoration-oriented variables on widowers' levels of well-being, is tested on 200 widowed men during the second year of bereavement. Those who were widowed less than 500 days exhibited significantly more negative affect, less positive affect, and lower well-being that those widowed more than 500 days. Multiple regression analyses revealed that both loss and restoration variables were important throughout bereavement. Loss variables influenced negative affect and were especially critical during the early stages. Restoration variables significantly affected positive affect and had greater impact on the later bereaved. The results support a dual process model of bereavement, but also suggest that certain events, such as circumstances of death, are more important during early bereavement while reinvestment activities, such as dating, become relevant later. Some circumstances, such as a wife's suffering, have prolonged effects.
Collapse
|
23
|
Fitzpatrick TR, Spiro A, Kressin NR, Greene E, Bossé R. Leisure Activities, Stress, and Health among Bereaved and Non-Bereaved Elderly Men: The Normative Aging Study. OMEGA-JOURNAL OF DEATH AND DYING 2016. [DOI: 10.2190/gu4q-8w3e-21de-0qfa] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Few studies have examined the effect that a resource such as leisure activities might have on the relationship between stress and health among elderly men. Data from the Normative Aging Study (NAS) were used to examine whether specific groups of leisure activities (social, solitary, and mixed activities; activities performed either alone or with others) moderated the effect of stress on the health of elderly men and whether there were differences in this effect between bereaved and non-bereaved men. The sample of 799 men was divided into two groups: a group bereaved of family and friends and a group of non-bereaved. Hierarchical regression analyses compared an initial model, a direct effect model, and a moderating model. The results indicate that for both groups of men, mixed leisure activities moderated the effect of stress on physical but not mental health. Additionally, for the bereaved group, social activities moderated the effects of stress on physical health. The negative effects of life stressors (other than bereavement) can be moderated by engaging in leisure activities for both bereaved and non-bereaved elderly men. Implications of the findings for future practice and research are discussed.
Collapse
Affiliation(s)
| | - Avron Spiro
- VA Medical Center, Bedford, Massachusetts and Boston University School of Public Health
| | - Nancy R. Kressin
- Boston University School of Public Health and Center for Health Quality, Outcomes and Economic Research, Bedford, Massachusetts
| | - Evelyn Greene
- KPMG Strategic Health Solutions Practice, Boston, Massachusetts
| | | |
Collapse
|
24
|
Health-related quality of life of among elders in rural China: the effect of widowhood. Qual Life Res 2016; 25:3087-3095. [PMID: 27294437 PMCID: PMC5102975 DOI: 10.1007/s11136-016-1338-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/10/2022]
Abstract
Purpose China has an enormous and rapidly growing population of widowed elders. Little is known about how losing a spouse affects elders’ health-related quality of life (QOL), especially in the rural areas where most Chinese elders live. This article analyzes QOL data collected in 2014 among rural Chinese elders to address this question. Methods SF12 questionnaires and information about individual and household characteristics were collected from 3053 elders aged 60 and above in rural China. We compared the physical component summary (PCS) and mental component summary (MCS) scores between 1925 married elders and 1060 widowed elders in a bivariate model stratifying by gender and age group and in a general factorial ANOVA multivariate analysis that examined and controlled for other predictors of PCS and MCS scores including education, chronic disease, and family and household factors. Results Widowed male and female elders’ physical health and mental health were in decline with age. Widowed men had lower PCS and MCS scores than married men. Widowed women also had lower PCS scores, but differences in MCS scores did not reach statistical significance. In multivariate analysis, widowhood was associated with lower PCS and MCS scores overall. Support from children was associated with better QOL and, based on interaction analysis, appeared to mitigate negative effects of widowhood. Conclusions Widowed rural elders in China have lower physical and mental quality of life than their married counterparts. These elders rely on their children for care, and a supportive family is associated with better QOL.
Collapse
|
25
|
Coelho A, Barbosa A. Family Anticipatory Grief: An Integrative Literature Review. Am J Hosp Palliat Care 2016; 34:774-785. [DOI: 10.1177/1049909116647960] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite all the investment in research, uncertainty persists in anticipatory grief (AG) literature, concerning its nuclear characteristics and definition. This review aimed to synthesize recent research in order to develop further knowledge about the family experience of AG during a patient’s end of life. An integrative review was performed using standard methods of analysis and synthesis. The electronic databases Medline, Web of Knowledge, and EBSCO and relevant journals were systematically searched since 1990 to October 2015. Twenty-nine articles were selected, the majority with samples composed of caregivers of terminally ill patients with cancer. From systematic comparison of data referring to family end-of-life experience emerged 10 themes, which correspond to AG nuclear characteristics: anticipation of death, emotional distress, intrapsychic and interpersonal protection, exclusive focus on the patient care, hope, ambivalence, personal losses, relational losses, end-of-life relational tasks, and transition. For the majority of family caregivers in occidental society, AG is a highly stressful and ambivalent experience due to anticipation of death and relational losses, while the patient is physically present and needed of care, so family must be functional and inhibit grief expressions. The present study contributes to a deeper conceptualization of this term and to a more sensitive clinical practice.
Collapse
Affiliation(s)
- Alexandra Coelho
- Palliative Medicine Unit, Santa Maria Hospital, Lisbon, Portugal
| | - António Barbosa
- Medicine Faculty, Palliative Medicine Unit, Santa Maria Hospital, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
26
|
Meysner L, Cotter P, Lee CW. Evaluating the Efficacy of EMDR With Grieving Individuals: A Randomized Control Trial. JOURNAL OF EMDR PRACTICE AND RESEARCH 2016. [DOI: 10.1891/1933-3196.10.1.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study compared the effectiveness of eye movement desensitization and reprocessing (EMDR) with an integrated cognitive behavioral therapy (CBT) intervention for grief. Nineteen participants (12 females and 7 males) who identified themselves as struggling with grief were randomly allocated to treatment conditions. Each participant was wait-listed for 7 weeks and then received 7 weeks of therapy. There were no significant improvements on any measure in the wait-list period. In contrast, participants in both treatment groups improved on measures of grief (ηp2 = .47), trauma symptoms (ηp2 = .60), and distress (ηp2 = .34). There was no significant improvement in participants’ scores on a quality of life measure (ηp2 = .11). Neither treatment approach produced better outcomes than the other. For those who scored in the clinical range at intake, 72% achieved clinical and reliable change on the grief measure and 82% on the trauma measure. The study had several strengths, including randomization to treatment condition, multiple therapists, formal assessment of treatment fidelity, and the pretreatment and follow-up assessments were conducted by researchers blind to treatment assignment. Overall, the findings indicate that EMDR and CBT are efficacious in assisting those struggling with grief, and that those individuals reporting higher levels of distress and lower levels of functioning may benefit the most from an intervention.
Collapse
|
27
|
Gobrogge K, Wang Z. Neuropeptidergic regulation of pair-bonding and stress buffering: Lessons from voles. Horm Behav 2015; 76:91-105. [PMID: 26335886 PMCID: PMC4771484 DOI: 10.1016/j.yhbeh.2015.08.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 08/22/2015] [Accepted: 08/24/2015] [Indexed: 11/19/2022]
Abstract
This article is part of a Special Issue "SBN 2014". Interpersonal attachment is a critical component of the human experience. Pair-bonding ameliorates the severity of several mental and physical diseases. Thus, a better understanding of how the central nervous system responds to and encodes social-buffering during stress is a valuable research enterprise. The prairie vole (Microtus ochrogaster), as a laboratory animal model, provides the gold standard for the investigation of the neurobiology underlying attachment. Furthermore, emerging research in voles, additional laboratory rodents, transgenic mice, primates, and humans has provided novel insight into the neurochemical mechanisms underlying the therapeutic effects of social bonds reducing anxiety, depression, and drug abuse liability. In the present review, we highlight the work from this burgeoning field and focus on the role(s) of the neuropeptides oxytocin (OT), vasopressin (AVP), and corticotrophin releasing hormone (CRH) mediating stress buffering. Together, the data suggest that OT underlies social bonding to reduce stress-induced psychological illness while AVP and CRH facilitate arousal to enhance autonomic reactivity, increasing susceptibility to adverse mental and physical health.
Collapse
Affiliation(s)
- Kyle Gobrogge
- Department of Psychology, Tufts University, Medford, MA 02155, USA.
| | - Zuoxin Wang
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
| |
Collapse
|
28
|
Buckley T, Spinaze M, Bartrop R, McKinley S, Whitfield V, Havyatt J, Roche D, Fethney J, Tofler G. The nature of death, coping response and intensity of bereavement following death in the critical care environment. Aust Crit Care 2015; 28:64-70. [PMID: 25801350 DOI: 10.1016/j.aucc.2015.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 01/15/2015] [Accepted: 02/25/2015] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Bereavement, defined as the situation of having recently lost a significant other, is recognised as one of life's greatest stressors and may lead to decrements in health status, psychological morbidity and excess risk of mortality. AIM The aim of this study was firstly to describe the relationships between the nature of death and bereavement intensity following death in the adult critical care environment and secondly to examine the modifying effects of coping responses on intensity of bereavement reaction. METHOD Prospective evaluation of the impact of the nature of death and coping responses on bereavement intensity. 78 participants completed a nature of death questionnaire within 2 weeks of bereavement and at 3 and 6 months completed the Core Bereavement Items Questionnaire (CBI-17) and Brief COPE Inventory. RESULTS At 6 months, univariate variables significantly associated with bereavement intensity were: being unprepared for the death (p<0.001), a drawn out death (p<0.001), a violent death (p=0.007) and if the deceased appeared to suffer more than expected (p=0.03). Multivariate analysis revealed being unprepared for the death appears to account for these relationships. Regarding coping, there were significant increases from 3 to 6 months in both acceptance scales (p=0.01) and planning (p=0.02) on The Brief COPE Inventory. Greater use of emotional support (p=0.02), self-blame (0.003) and denial (p<0.001) were multivariate variables associated with higher bereavement intensity at 6 months. CONCLUSION The results from this evaluation provide insight into the impact of bereavement after death in the critical care environment and inform potential preventative approaches at the time of death to reduce bereavement intensity.
Collapse
Affiliation(s)
- Thomas Buckley
- Royal North Shore Hospital, Sydney, Australia; University of Sydney, Australia.
| | | | - Roger Bartrop
- Royal North Shore Hospital, Sydney, Australia; University of Sydney, Australia
| | | | | | | | - Diane Roche
- Royal North Shore Hospital, Sydney, Australia; University of Sydney, Australia
| | | | - Geoffrey Tofler
- Royal North Shore Hospital, Sydney, Australia; University of Sydney, Australia
| |
Collapse
|
29
|
Vable AM, Subramanian SV, Rist PM, Glymour MM. Does the "widowhood effect" precede spousal bereavement? Results from a nationally representative sample of older adults. Am J Geriatr Psychiatry 2015; 23:283-92. [PMID: 24974142 PMCID: PMC5511695 DOI: 10.1016/j.jagp.2014.05.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 05/09/2014] [Accepted: 05/13/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Increased mortality risk following spousal bereavement (often called the "widowhood effect") is well documented, but little prior research has evaluated health deteriorations preceding spousal loss. DESIGN Data are from the Health and Retirement Study, a nationally representative sample of Americans over 50 years old. METHOD Individuals who were married in 2004 were considered for inclusion. Outcome data from 2006 on mobility (walking, climbing stairs), number of depressive symptoms, and instrumental activities of daily living (IADLs) were used. Exposure was characterized based on marital status at the time of outcome measurement: "recent widows" (N=396) were bereaved between 2004 and 2006, before outcomes were assessed; "near widows" (N=380) were bereaved between 2006 and 2008, after outcomes were assessed; "married" individuals (N=7,330) remained married from 2004 to 2010, the follow-up period for this analysis. Linear regression models predicting standardized mobility, depressive symptoms, and IADLs, were adjusted for age, race, gender, birthplace, socio-economic status, and health at baseline. RESULTS Compared to married individuals, recent widows had worse depressive symptoms (β=0.71, 95% confidence interval (CI): [0.57, 0.85]). Near widows had worse depressive symptoms (β=0.21, 95% CI: [0.08, 0.34]), mobility (β=0.14, 95%CI: [0.01, 0.26]), and word recall (β=-0.13, 95%CI: [-0.23, -0.02]) compared to married individuals. CONCLUSIONS Health declines before spousal death suggests some portion of the "widowhood effect" may be attributable to experiences that precede widowhood and interventions prior to bereavement might help preserve the health of the surviving spouse.
Collapse
Affiliation(s)
- Anusha M. Vable
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - S. V. Subramanian
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Pamela M. Rist
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA,Division of Preventive Medicine, Department of Medicine, Brigham and Woman’s Hospital, Harvard Medical School, Boston, MA, USA
| | - M. Maria Glymour
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA,Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco
| |
Collapse
|
30
|
Stahl ST, Schulz R. Changes in routine health behaviors following late-life bereavement: a systematic review. J Behav Med 2014; 37:736-55. [PMID: 23881308 PMCID: PMC4197803 DOI: 10.1007/s10865-013-9524-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 07/03/2013] [Indexed: 02/06/2023]
Abstract
This systematic review examines the relationship between late-life spousal bereavement and changes in routine health behaviors. We review six behavioral domains/modifiable risk factors that are important for maintaining health among elderly populations: physical activity, nutrition, sleep quality, alcohol consumption, tobacco use, and body weight status. Thirty-four articles were identified, derived from 32 studies. We found strong evidence for a relationship between bereavement and nutritional risk and involuntary weight loss, and moderate evidence for impaired sleep quality and increased alcohol consumption. There was mixed evidence for a relationship between bereavement and physical activity. We identify several methodological shortcomings, and describe the clinical implications of this review for the development of preventive intervention strategies.
Collapse
Affiliation(s)
- Sarah T Stahl
- Department of Psychiatry, University Center for Social and Urban Research, University of Pittsburgh, 3343 Forbes Ave., Pittsburgh, PA, 15260, USA,
| | | |
Collapse
|
31
|
Bandini J, Thompson EH. “Widowerhood”: Masculinities and Spousal Loss in the Late-1960s. OMEGA-JOURNAL OF DEATH AND DYING 2014; 68:123-41. [DOI: 10.2190/om.68.2.c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the distinctly gendered experiences of young widowers. Using qualitative longitudinal data from the 1960's Harvard Bereavement Study, we evaluated the interview transcripts of 19 widowers (median age = 38) who had been interviewed 3 weeks, 8 weeks, 13 months, and 2–4 years after the wife's death. Our findings indicate that the off-time spousal loss ruptured the ontological security that marriage provided and created two types of difficult situations for the widowers. Coping with deep sadness and grief, the men divulged their unspoken dependency on their marriage and on their late wife. They also struggled as single fathers, especially if they tried to singlehandedly care for their children. Becoming an off-time widower in the 1960s compelled the men to reclaim their masculine identity. Men's identity-rebuilding strategies involved promptly returning to work, and many men began dating and repartnering to recoup the normalcy of being married.
Collapse
|
32
|
Sun P, Smith AS, Lei K, Liu Y, Wang Z. Breaking bonds in male prairie vole: long-term effects on emotional and social behavior, physiology, and neurochemistry. Behav Brain Res 2014; 265:22-31. [PMID: 24561258 DOI: 10.1016/j.bbr.2014.02.016] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
Abstract
Social relationships are essential for many fundamental aspects of life while bond disruption can be detrimental to mental and physical health. Male prairie voles form enduring social bonds with their female partners, allowing the evaluation of partner loss on behavior, physiology, and neurochemistry. Males were evaluated for partner preference formation induced by 24h of mating, and half were separated from their partner for 4 wk. In Experiment 1, partner loss significantly increased anxiety-like behaviors in the elevated plus maze and light-dark box tests and marginally increased depressive-like behaviors in the forced swim test. In addition, while intruder-directed aggression is common in pair bonded prairie voles, separated males were affiliative and lacked aggression toward an unfamiliar female and an intruding male conspecific. Partner loss increased the density of oxytocin-immunoreactivity (-ir), vasopressin-ir, and corticotrophin-releasing hormone-ir cells in the paraventricular nucleus of the hypothalamus and oxytocin-ir cells in the supraoptic nucleus. Tyrosine hydroxylase-ir was not affected. In Experiment 2, partner preference was observed after 2 wk of partner loss but eliminated after 4 wk partner loss. Body weight gain and plasma corticosterone concentrations were elevated throughout the 4 wk. No effects were observed for plasma oxytocin or vasopressin. Together, partner loss elicits anxiety-like and depression-like behaviors, disrupts bond-related behaviors, and alters neuropeptide systems that regulate such behaviors. Thus, partner loss in male prairie voles may provide a model to better understand the behavior, pathology, and neurobiology underlying partner loss and grief.
Collapse
Affiliation(s)
- P Sun
- Animal Academy of Scientific and Technology, Henan University of Science and Technology, Luoyang 471003, China; Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
| | - A S Smith
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
| | - K Lei
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
| | - Y Liu
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA
| | - Z Wang
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306, USA.
| |
Collapse
|
33
|
Characteristics of the bereavement experience of older persons after spousal loss: An integrative review. Int J Nurs Stud 2013; 50:1108-21. [DOI: 10.1016/j.ijnurstu.2012.11.026] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 11/23/2012] [Accepted: 11/29/2012] [Indexed: 11/16/2022]
|
34
|
Asgeirsdóttir HG, Valdimarsdóttir U, Fürst CJ, Steineck G, Hauksdóttir A. Low preparedness before the loss of a wife to cancer and the widower's chronic pain 4-5 years later-a population-based study. Psychooncology 2013; 22:2763-70. [PMID: 23839720 DOI: 10.1002/pon.3345] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 04/18/2013] [Accepted: 05/27/2013] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The focus of this study was on the impact of spousal loss on the development of chronic pain thereafter. More specifically, the aim was to investigate the effect of experiencing low preparedness before a wife's death and the widower's chronic pain 4-5 years after loss. METHODS In a population-based study in the years 2004-2005, anonymous questionnaires were sent out to 907 men in Sweden who had lost a wife to cancer in 2000 and 2001. The questionnaires contained questions on the man's preparedness for his wife's death and his physical and psychological health at follow-up. RESULTS Altogether, 691 out of 907 questionnaires were retrieved (76%). Younger widowers (38-61 years old) with a low degree of preparedness for their wife's death had an increased risk of experiencing symptoms of chronic pain (odds ratio 6.67; 2.49-17.82) 4-5 years after loss. The same results did not apply for older widowers (62-80 years old) (odds ratio 0.81; 0.32-2.05). Widowers who experienced chronic pain were at an increased risk for psychological morbidity, depression (relative risk [RR] 2.21; 1.31-3.74), anxiety (RR 2.11; 1.33-3.37), and sleep disorders (RR 2.19; 1.30-3.69). CONCLUSION Our data suggest that low preparedness for a wife's death may increase risk of chronic pain among younger widowers 4-5 years after loss. In addition, we found comorbidity between psychological symptoms and chronic pain among widowers. These findings call for studies on possible mechanisms in the association between low preparedness and morbidity and on how to increase preparedness for a wife's death to cancer.
Collapse
|
35
|
|
36
|
Ling SF, Chen ML, Li CY, Chang WC, Shen WC, Tang ST. Trajectory and Influencing Factors of Depressive Symptoms in Family Caregivers Before and After the Death of Terminally Ill Patients With Cancer. Oncol Nurs Forum 2012; 40:E32-40. [DOI: 10.1188/13.onf.e32-e40] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
37
|
Abstract
Grief behaviors of 17 elderly persons with dementia living at nursing homes were observed. When compared with bereaved with normal cognitive ability, both similarities and differences were found. Similarities seemed to exist for irritability, lost appetite, increased sedative medication, bodily complaints, less physical activity, and less interest in happy events. Differences were found, for example, social activity, as they did not isolate themselves. The workload of staff increased when a caretaker was bereaved. Repeated information to the patients with dementia about the loss, their seeking for the dead and crying outbursts remembering the loss, and the need of comfort was common, although several had their loss more than months ago. Proper interventions including facilitating programs for both staff and caretakers are recommended, as also a larger study group.
Collapse
Affiliation(s)
- Åsa K. Johansson
- Department of Geriatric Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Agneta Grimby
- Department of Geriatric Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| |
Collapse
|
38
|
Holm AL, Severinsson E. Systematic review of the emotional state and self-management of widows. Nurs Health Sci 2012; 14:109-20. [DOI: 10.1111/j.1442-2018.2011.00656.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
39
|
Rumination and avoidance as predictors of prolonged grief, depression, and posttraumatic stress in female widowed survivors of war. J Nerv Ment Dis 2011; 199:921-7. [PMID: 22134449 DOI: 10.1097/nmd.0b013e3182392aae] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study examined independent contributions of rumination and experiential avoidance in predicting symptoms of psychological distress among female widowed survivors of war. A decade after the war in Kosovo, 100 widowed survivors of war completed measures of rumination, experiential avoidance, depression, posttraumatic stress, and prolonged grief. Results showed that both rumination and experiential avoidance significantly predicted the symptom severity of prolonged grief, depression, and posttraumatic stress. Furthermore, rumination accounted for additional variance above and beyond experiential avoidance and vice versa. Finally, the interaction of rumination and experiential avoidance did not provide significant explanatory power over and above the individual main effects. These findings suggest that rumination and experiential avoidance may be significant factors in understanding and treating psychological distress following exposure to potentially traumatic events and loss due to violence.
Collapse
|
40
|
Hauksdóttir A, Valdimarsdóttir U, Fürst CJ, Steineck G. Long-term mental health of men who lose a wife to cancer--a population-based follow-up. Psychooncology 2011; 22:352-61. [PMID: 22069225 DOI: 10.1002/pon.2096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 10/05/2011] [Accepted: 10/10/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study investigated the long-term risk of psychological morbidity for men after losing a wife to cancer. A further aim of the study was to investigate if being in a new relationship at the time of follow-up affects the risk of psychological morbidity. METHOD In a population-based cohort study, we collected data from 907 men in Sweden who lost a wife to cancer in the breast, ovary or colon 4-5 years earlier. A control group of 330 married men was also included. RESULTS Six hundred ninety-one of the widowers (76%) and 262 of the controls (79%) answered a questionnaire. Widowers in a new relationship had a similar risk of psychological morbidity compared with a control group of married men. However, compared with widowers in a new relationship, single widowers reported increased risks of (among other symptoms) the following: depression (RR 2.2, confidence interval [CI] 1.5-3.2), anxiety (RR 1.6, CI 1.1-2.5) emotional numbness (RR 2.2, CI 1.7-2.8), and waking up at night with anxiety (RR 2.2, CI 1.4-3.7). CONCLUSIONS Men who lost a wife to cancer in Sweden in 2000 or 2001 and are single 4-5 years later have increased risks of psychological morbidity, both compared with widowers who are in a new relationship at the time of follow-up and with married men. Further scientific effort is needed for improved understanding of the most likely underlying mechanisms; that is, that enhanced emotional support of a new relationship after the loss of a wife protects against psychological morbidity, or alternatively, that the healthiest widowers enter a new relationship.
Collapse
Affiliation(s)
- Arna Hauksdóttir
- Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | | | | | | |
Collapse
|
41
|
Oliffe JL, Han CSE, Ogrodniczuk JS, Phillips J, Roy P. Suicide From the Perspectives of Older Men Who Experience Depression. Am J Mens Health 2011; 5:444-54. [DOI: 10.1177/1557988311408410] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Depression can be a pathway to older men’s suicide, yet the mechanisms by which this can occur are poorly understood. A qualitative study of 22 older men who self-identified or were formally diagnosed with depression was conducted to describe the connections between masculinity, depression, and suicide. Analyses of individual interviews revealed that cumulative losses around social bonds were central to older men’s depression, apathy for living, and thoughts about suicide. Prominent were men’s self-assessments of failing to fulfill breadwinner roles, judgments that led participants to ruminate on their shortcomings amid recognizing their older age as limiting opportunities for redemption. Stigma featured as a barrier for men acting on their suicidal thoughts, and guilt about the pain their suicide would evoke on family and friends was a strong deterrent for men’s self-harm. Overall, participants’ alignment to masculine ideals influenced both the connectedness and detachment between older men’s depression and suicide.
Collapse
Affiliation(s)
- John L. Oliffe
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - J.Craig Phillips
- University of British Columbia, Vancouver, British Columbia, Canada
| | | |
Collapse
|
42
|
Abstract
AbstractObjective:The Bereavement Risk Assessment Tool (BRAT) was designed to consistently communicate information affecting bereavement outcomes; to predict the risk for difficult or complicated bereavement based on information obtained before the death; to consider resiliency as well as risk; and to assist in the efficacy and consistency of bereavement service allocation. Following initial development of the BRAT's 40 items and its clinical use, this study set out to test the BRAT for inter-rater reliability along with some basic validity measures.Method:Case studies were designed based on actual patients and families from a hospice palliative care program. Bereavement professionals were recruited via the internet. Thirty-six participants assessed BRAT items in 10 cases and then estimated one of 5 levels of risk for each case. These were compared with an expert group's assignment of risk.Results:Inter-rater reliability for the 5-level risk scores yielded a Fleiss’ kappa of 0.37 and an intra-class correlation (ICC) of 0.68 (95% CI 0.5-0.9). By collapsing scores into low and high risk groups, a kappa of 0.63 and an ICC of 0.66 (95% CI 0.5-0.9) was obtained. Participant-estimated risk scores yielded a kappa of 0.24. Although opinion varied on the tool's length, participants indicated it was well organized and easy to use with potential in assessment and allocation of bereavement services. Limitations of the study include a small sample size and the use of case studies. Limitations of the tool include the subjectivity of some items and ambiguousness of unchecked items.Significance of results:The collapsed BRAT risk levels show moderately good inter-rater reliability over clinical judgement alone. This study provides introductory evidence of a tool that can be used both prior to and following a death and, in conjunction with professional judgment, can assess the likelihood of bereavement complications.
Collapse
|
43
|
VANDERWERKER LAURENC, PRIGERSON HOLLYG. SOCIAL SUPPORT AND TECHNOLOGICAL CONNECTEDNESS AS PROTECTIVE FACTORS IN BEREAVEMENT. JOURNAL OF LOSS & TRAUMA 2010. [DOI: 10.1080/15325020490255304] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - HOLLY G. PRIGERSON
- b Department of Psychiatry and Department of Epidemiology and Public Health , New Haven, Connecticut, USA
| |
Collapse
|
44
|
Gataric G, Kinsel B, Currie BG, Lawhorne LW. Reflections on the Under-Researched Topic of Grief in Persons With Dementia: A Report From a Symposium on Grief and Dementia. Am J Hosp Palliat Care 2010; 27:567-74. [DOI: 10.1177/1049909110371315] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article describes a symposium about the clinical challenges of providing care to persons with dementia and their families. The plenary session addressed the bereavement process in the general older adult population, neurocognitive processes that alter the grief process in persons with dementia, and therapeutic approaches to support grieving persons in different stages of dementia. Participants from diverse health care disciplines met in small groups to identify (1) current responses to persons with dementia and their families who experience a loss; (2) barriers to providing effective responses; and (3) possible interventions to improve care. Two general types of interventions emerged: practical/agency support and spiritual/affective engagement.
Collapse
Affiliation(s)
- Gordana Gataric
- Department of Geriatrics, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA,
| | - Beth Kinsel
- Department of Social Work, Wright State University, Dayton, OH, USA
| | | | - Larry W. Lawhorne
- Department of Geriatrics, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA
| |
Collapse
|
45
|
Khodyakov D, Carr D. The Impact of Late-Life Parental Death on Adult Sibling Relationships: Do Parents' Advance Directives Help or Hurt? Res Aging 2009; 31:495-519. [PMID: 20686628 DOI: 10.1177/0164027509337193] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors examined whether the effect of parental death on adults siblings' relationship quality varies on the basis of the presence and perceived effectiveness of a deceased parent's formal preparations for end-of-life care. The authors used data from the Wisconsin Longitudinal Study and focused on the relationship quality of a bereaved adult child and his or her randomly selected sibling. Parental death was associated with a decrease in sibling closeness. The parent's use of advance directives (living will and durable power of attorney for health care) did not have uniformly positive effects on adult siblings' relationship quality. Sibling relationships suffered when the living will was believed to "cause problems," but relationships improved when the deceased parent named someone other than his or her spouse or a child as durable power of attorney for health care. The authors discuss the implications for developing effective end-of-life preparations that benefit both the decedent and surviving kin.
Collapse
|
46
|
Kim SH. The influence of finding meaning and worldview of accepting death on anger among bereaved older spouses. Aging Ment Health 2009; 13:38-45. [PMID: 19197688 DOI: 10.1080/13607860802154457] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of the study was to identify the course and the mechanisms of the experience of anger over a 4-year period after spousal death among older adults. METHOD The study used a longitudinal prospective design with three-wave panel data (6, 18 and 48 months after spousal death), utilizing the Changing Lives of Older Couples data. RESULTS Latent growth modeling analysis showed that conjugally bereaved older adults, on average, experienced a low level of anger at 6 months with a very slight decrease over a 4-year period, but individuals had a different level of anger at 6 months. Finding meaning in the death and worldview of accepting death were the significant predictors for a lower level of anger. Social support predicted a lower level of anger indirectly through finding meaning in the loss. CONCLUSION Although older adults are generally resilient to spousal loss, a substantial minority of people experience psychological distress. The relationships found suggest that it might be possible to reduce the anger of bereaved older spouses by supporting them to find meaning in the loss and by focusing bereavement support on those who have worldview of not accepting death.
Collapse
Affiliation(s)
- Su Hyun Kim
- School of Nursing, Kyungpook National University, Junggu, Daegu, Republic of Korea.
| |
Collapse
|
47
|
|
48
|
Minton ME, Barron CR. Spousal Bereavement Assessment: A Review of Bereavement-Specific Measures. J Gerontol Nurs 2008; 34:34-48. [DOI: 10.3928/00989134-20080801-08] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
49
|
Johnson JG, Zhang B, Prigerson HG. Investigation of a developmental model of risk for depression and suicidality following spousal bereavement. Suicide Life Threat Behav 2008; 38:1-12. [PMID: 18355104 DOI: 10.1521/suli.2008.38.1.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Data from a community-based multi-wave investigation were used to examine a developmental model of risk for depression and suicidality following the death of a spouse. Measures of perceived parental affection and control during childhood were administered to 218 widowed adults 11 months after the death of the spouse. Self-esteem, spousal dependency, depression, and suicidality were assessed 9 months later. Dependency on the deceased spouse mediated a significant association between retrospectively reported parental control during childhood and post-loss depressive symptoms. Depressive symptoms mediated significant associations of dependency on the deceased spouse and low self-esteem with suicidal ideation and behavior.
Collapse
Affiliation(s)
- Jeffrey G Johnson
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032, USA.
| | | | | |
Collapse
|
50
|
Grimby A, Johansson ÅK, Sundh V, Grimby G. Walking Habits in Elderly Widows. Am J Hosp Palliat Care 2008; 25:81-7. [DOI: 10.1177/1049909107307388] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Walking habits were studied in 3 groups of elderly widows. The average walking time per week was calculated from interviews or questionnaires. There was in a small studied group a tendency for walking time to be lower at 3 and 12 months after loss than at 4 or 5 years. An increased odds ratio was demonstrated in larger groups of widows for walking less than 120 minutes per week in those who “did not feel healthy,” or who had “musculoskeletal health problems,” or “cardiovascular health problems.” Widows from a population-based study also showed increased odds ratio for not walking as long with “lack of friends” and “not being active in associations.” This was not found in married women from the population study. Our results indicate that newly bereaved women may reduce their physical activity, and that the change in exercise habits may be associated with reduced perception of being healthy and a decreased social network.
Collapse
Affiliation(s)
- Agneta Grimby
- Department of Geriatrics, Sahlgrenska University Hospital, Göteborg, Sweden,
| | - Åsa K. Johansson
- Department of Geriatrics, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Valter Sundh
- Institute of Community Medicine Goteborg University
| | - Gunnar Grimby
- Institute of Neuroscience and Physiology-Rehabilitation Medicine Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
| |
Collapse
|