The young widow: depressive symptomatology throughout the grief process

The purpose of this investigation was to examine patterns of abatement of depressive symptomatology in 30 young widows at three time periods: immediately following the death of the husband, a year later, and at present. Data on all three time periods were gathered during one interview. The study thus provides retrospective information on patterns of depressive symptomatology. It was expected that such information would enhance understanding of the stages of the grief process described by Glick et al. and by Maddison.     

Rumination and psychological distress among bereaved partners.

Recently bereaved men who evidenced more negative ruminative thoughts in free-response interviews showed greater psychological distress on several outcome measures both 1 month and 12 months after their loss and less increase in positive morale over this 12-month period. Men who engaged in more analysis of themselves and the meaning of their loss reported greater positive morale 1 month after their loss but showed more persistent depression and absence of positive states of mind over the 12 months following their loss. Finally, men who reported more social friction also evidenced more enduring depressive symptoms over the year than did men who reported less social friction. These results are generally consistent with other studies that have shown that self-reflective, ruminative coping with negative emotions and social friction are associated with longer and more severe periods of depressed mood following stressful events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of the family bereavement program on multiple indicators of grief in parentally bereaved children and adolescents.

Objectives: This article reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentally bereaved children and adolescents over a 6-year period. Method: Participants were 244 youths (ages 8–16, mean age = 11.4 years) from 156 families that had experienced the death of a parent. The sample consisted of 53% boys and 47% girls; ethnicity was 67% non-Hispanic White and 33% ethnic minority. Families were randomly assigned to the FBP (N = 135) or a literature control condition (N = 109). Two grief measures, the Texas Revised Inventory of Grief and the Intrusive Grief Thoughts Scale (IGTS) were administered at 4 times over 6 years: pretest, posttest, and 11-month and 6-year follow-ups. A 3rd measure, an adaptation of the Inventory of Traumatic Grief (ITG) was administered only at the 6-year follow-up. Results: Compared with the control group, the FBP group showed a greater reduction in their level of problematic grief (IGTS) at posttest and 6-year follow-up and in the percentage at clinical levels of problematic grief at the posttest. The FBP also reduced scores on a dimension of the ITG, Social Detachment/Insecurity, at 6-year follow-up for 3 subgroups: those who experienced lower levels of grief at program entry, older youths, and boys. Conclusion: These are the first findings from a randomized trial with long-term follow-up of the effects of a program to reduce problematic levels of grief of parentally bereaved youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting depressive symptomatology: Cognitive-behavioral models and postpartum depression.

170 women (mean age 26.6 yrs), seen in their 2nd trimester of pregnancy, were followed-up about 3 mo postpartum. Level of depression (Beck Depression Inventory) was just as high during pregnancy as during the postpartum period. Several variables assessed during pregnancy and during the postpartum period were significant predictors of postpartum depression level, including measures of prepartum depression, attributional style, delivery stress, and stressful life events. The predictor variables accounted for about 40% of the variance in level of postpartum depression. Predictor variables from earlier research such as history of menstrual problems, parity, education, and income did not account for significant variance in postpartum depression level. These findings provide some evidence for the role of cognitive-behavioral factors and stressful life events in depression. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Levels of specificity of autobiographical memories and of biographical memories of the deceased in bereaved individuals with and without complicated grief.

Traumatized individuals experiencing posttraumatic stress have difficulty retrieving specific autobiographical memories to cue words on the Autobiographical Memory Test (AMT; J. M. G. Williams & K. Broadbent, 1986). This may represent a generalized, functional avoidance of the personal past. However, such individuals also often report specific intrusive memories of their trauma in the day-to-day. This raises the possibility that memories tied to the source of the person's distress are immune to this putative avoidance process. This was investigated in bereaved individuals with complicated grief (CG) who reported intrusive, specific memories from the life of their deceased loved one, and matched bereaved controls without CG. Participants performed the AMT and two Biographical Memory Tests (BMTs), cueing memories from the life of the deceased (BMT-Deceased) and from a living significant other (BMT-Living). To negative word cues, the CG group showed reduced specificity for the AMT and BMT-Living, relative to controls, but this effect was reversed on the BMT-Deceased. These data support the proposal that memories tied to the source of an individual's distress are immune to the processes that underlie the standard reduced specificity effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance use and symptomatology among adolescent children of alcoholics.

Assessed the magnitude and specificity of parental alcoholism as a risk factor for internalizing symptomatology, externalizing symptomatology, and alcohol and drug use in adolescence. Parents' and children's reports of symptomatology and children's reports of alcohol and drug use were evaluated in a community sample of 454 adolescents. The results showed that parental alcoholism was a moderate to strong risk factor, with stronger risk associated with recent (rather than remitted) parental alcoholism. Multivariate analyses showed that the specificity of risk varied with the outcome measure. In predicting externalizing symptomatology, the risk associated with parental alcoholism was mediated by co-occurring parental psychopathology and environmental stress. However, in predicting alcohol use, the father's alcoholism was a specific risk factor above and beyond the more generalized effects of stress and family disruption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers.

The study examined how social constraints on discussion of a traumatic experience can interfere with cognitive processing of and recovery from loss. Bereaved mothers were interviewed at 3 weeks (Tl ), 3 months (T2), and 18 months (T3) after their infants' death. Intrusive thoughts at Tl, conceptualized as a marker of cognitive processing, were negatively associated with talking about infant's death at T2 and T3 among socially constrained mothers. The reverse associations were found among unconstrained mothers. Controlling for initial level of distress, there was a positive relation between T1 intrusive thoughts and depressive symptoms over time among socially constrained mothers. However, higher levels of T1 intrusive thoughts were associated with a decrease in T3 depressive symptoms among mothers with unconstrained social relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized controlled trial of a coping group intervention for adults with HIV who are AIDS bereaved: Longitudinal effects on grief.

The authors sought to study the longitudinal effects of a cognitive-behavioral group intervention for coping with AIDS bereavement among a diverse sample of adults who were HIV positive. Participants (N = 267) were randomly assigned to receive the 12-week intervention or individual therapy upon request. Measures were administered at baseline, postintervention, and 4-, 8-, and 12-month follow-ups. Longitudinal data were analyzed with linear mixed models to examine change in grief by condition across the study period and the effect of the intervention on grief through its interaction with psychiatric distress. The authors used the Grief Reaction Index to assess grief and the Symptom Checklist-90-Revised to assess global psychiatric distress. Participants in both conditions reported decreases in grief severity. However, among those with higher levels of psychiatric distress, participants in the group intervention had significantly lower grief severity scores compared with participants in the individual therapy condition. The long-term effectiveness of this AIDS-bereavement intervention for psychiatrically distressed people with HIV/AIDS supports the need for tailored interventions among those at risk for complicated grief responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting treatment retention among cocaine users

Few studies have addressed treatment retention among cocaine-using samples. The current study develops and tests a model of treatment retention at the individual level, employing data from 110 cocaine users who initiated outpatient treatment. The model includes measures of extent of drug involvement, social isolation and support, motivation, and demographic characteristics. Logistic regression is used to fit a final model, which includes measures of the following: living alone, use of multiple substances prior to treatment, length of cocaine use, and external motivation. Treatment implications and directions for further research are discussed.     

Health-related quality of life in bereaved HIV-positive adults: Relationships between HIV symptoms, grief, social support, and Axis II indication.

Objective: This study evaluated a model of the impact of borderline and antisocial personality disorder indications on HIV symptoms and health-related quality of life (HRQoL) in AIDS-bereaved adults, accounting for grief severity, social support, and years since HIV diagnosis. Design: Structural equation modeling was used to test the proposed model in a sample of 268 HIV-seropositive adults enrolled in an intervention for coping with AIDS-related bereavement. Main Outcome Measures: Functional assessment of HIV infection, HIV symptoms. Results: The proposed model demonstrated excellent fit with study data and all hypothesized paths were supported. Personality disorder indication was directly related to HIV symptoms and HRQoL and indirectly related through both social support and grief severity. Social support was negatively related to HIV symptoms and positively related to HRQoL, while grief severity was positively related to HIV symptoms and negatively related to HRQoL. Finally, HIV symptoms had a direct negative relationship with HRQoL. Conclusion: Personality disorders have a direct negative effect on HIV symptoms and HRQoL and indirect effects through grief severity and social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of change in depressive symptomatology among gay men with AIDS

The present experiment investigated the ability of the opiate receptor antagonist naltrexone to block the increased locomotion and rearing produced acutely by amphetamine as well as the sensitization of these responses produced when this drug is administered repeatedly. Rats in different groups received an injection of amphetamine (1.5 mg/kg, i.p.) or saline preceded 30 min earlier by an injection of naltrexone (0, 0.5, 1.0, 5.0 or 10.0 mg/kg, i.p.). Naltrexone dose-dependently reduced the rearing but had no effect on the locomotion produced by this dose of amphetamine. The locomotion and rearing observed following saline were not affected. This pattern of results was observed following each of six additional pairs of injections, one pair of injections given every third day. Once, soon (2-4 days) and once, long (9-12 days) after the last injection, all animals were injected with amphetamine (0.75 mg/kg, i.p.) in the absence of naltrexone (tests for sensitization). Animals having been pre-exposed to amphetamine preceded by naltrexone showed no evidence of sensitized rearing on either test, indicating that naltrexone blocked sensitization of this response to amphetamine. These animals, however, exhibited sensitized locomotion on both tests. These results suggest an important but complex role for dopamine-opioid interactions not only in the production of acute locomotor responding to amphetamine but also in the sensitization of locomotor responding when this drug is administered repeatedly. The present findings also suggest that amphetamine-induced rearing is more dependent than locomotion on neuronal mechanisms involving dopamine-opioid interactions.     

Psychiatric symptomatology among alcoholics: Comparisons between African Americans and Caucasians.

Using data collected on 190 patients in a hospital-based substance abuse treatment center in a large midwestern city, this study compared psychiatric symptomatology between 39 African-American and 151 Caucasian adults. Although the groups were equivalent in consumption and frequency of usage, African-American alcoholics used significantly more substances (beyond alcohol) than did Caucasians. With regard to psychiatric symptomatology, African Americans reported higher levels of somatization, obsessive–compulsive behavior, depression, hostility, paranoid ideation, and psychoticism, and an overall higher degree of stress. Although the overall level of alcoholic self-reported severity did not distinguish the 2 groups, African Americans exhibited lower levels of global functioning as assessed by trained clinical staff. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnic and age differences in eating disorder symptomatology among Albertan women.

Ethnic and age differences in body mass index (BMI), body shame, and eating disorder symptomatology were investigated in a representative, nonclinical sample (N = 601) of women from the Province of Alberta. Women reported ethnicity (White, Hispanic, Aboriginal, Asian), age, height, and weight (used to calculate BMI), and items measuring body shame and eating disorder symptomatology. Strong ethnic differences were observed. Aboriginal women reported significantly higher BMI than Hispanic and Asian women. Hispanic women reported higher body shame than White women. Hispanic women also reported more bulimic behaviour than White, Aboriginal, and Asian women. White women reported lower body satisfaction than Asian and Aboriginal women. Aboriginal women reported the highest body satisfaction. Bulimic behaviour was lowest in older women (65+ years) compared with other age groups. Body satisfaction was greatest in older women (65+ years). These study findings have important implications for theory, research, and practise, as our society continues to place an inordinate value on thinness and beauty as ideals for women and girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

AIDS-related bereavement among gay men: The inadequacy of current theories of grief.

AIDS-related grief among gay men has specific and unique characteristics that differentiate it from other types of loss. To understand the phenomenon and address adequately the needs of grieving gay men, clinicians need to take into account several components of AIDS-related grief. They are (1) the adverse effects of multiple, cumulative loss; (2) the unique characteristics of the gay male subculture and the relevance of "gay grief"; (3) the shortcomings of popular grief models; and (4) the importance of finding meaning in ongoing adversity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of depressive symptomatology among adult daughter caregivers of a parent with cancer

BACKGROUND: As a consequence of advances and changes in the detection and treatment of cancer, increasing demands are being placed on familial caregivers of elderly cancer patients. Understanding the factors that place familial caregivers at risk of poor psychological outcomes and threaten their ability to provide adequate care is important for maintaining chronically ill patients in the community. METHODS: Dyads comprised of 164 cancer outpatients (ages 60-90 years) and their adult caregiving daughter completed structured telephone interviews. Hierarchical regression was used to determine the individual and cumulative effect of five domains of potential predictors on the daughters' depressive symptomatology (Center for Epidemiologic Studies Depression Scale [CES-D]). RESULTS: The domains that were shown to be significantly predictive of a daughter's level of depressive symptomatology were daughter sociodemographics, constraints on/facilitators of caregiving, and caregiver burden. The domains of disease/patient characteristics and the daughter's appraisal of the caregiving situation were not found to be significant. The total model suggests that having a health-limiting condition, a greater sense of filial obligation, and greater caregiver burden were correlated with higher CES-D scores, whereas having graduated college, having other social roles, having favorable attitudes regarding her caregiving experience, and providing care in a greater number of domains of care were correlated with lower scores. CONCLUSIONS: These findings demonstrate the importance of focusing on situational factors that may function to constrain or facilitate caregiving when investigating caregiver depression.     

Reconsidering the transference paradigm in treatment with the bereaved

In 5 experiments, 4 monkeys and 1 ape chose between 2 food sources, each held in 1 of the experimenter's hands while he stood in front of a cage. When choosing between 2 sources of the same food that differed in amount, preference for the larger amount decreased as the size of each good proportionately increased. A second finding was that subjects were indifferent between a 2-food mixture and a single food that was part of the mixture if the single food was the preferred food of the mixture, a result suggesting the less preferred food had no value. Experiment 6 replicated these effects in 4 additional monkeys. These effects may be incompatible with previous theorizing about animal choice and may reflect a cognitive difference between nonhuman primates and humans.     

Personality and physical correlates of bulimic symptomatology among Mexican American female college students.

Although eating disorders have been the focus of much research, the inclusion of minority populations in such investigations has been minimal. Thus, the purpose of this study was to examine personality and physical correlates of bulimic symptomatology in a sample of Mexican American female college students. Hierarchical regression analysis revealed that body mass and endorsement of U.S. societal values concerning attractiveness were related positively to bulimic symptomatology, accounting for a combined 38% of the variance. Age, body satisfaction, and acculturation level, however, were unrelated to bulimic symptoms. Implications for counseling interventions as well as directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting medical compliance among adolescents with cystic fibrosis.

Developed an incomplete stories assessment tool based on a competency/coping skills model in predicting medical compliance of adolescents with cystic fibrosis (CF). Data from 40 CF patients (aged 13–23 yrs) were compared to objective measures of each S's medical compliance. Results show that the test was positively correlated with compliance and discriminated compliant from noncompliant Ss. It is suggested that data derived from Ss' responses could be used projectively to provide information useful to clinicians treating adolescents with CF. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Creating therapeutic rituals in the psychotherapy of the bereaved.

Suggests that the creation of rituals in therapy for the bereaved offers methods of addressing grief work and constitutes an adjunct to traditional forms of counseling and psychotherapy. Nine specifically therapeutic properties of rituals are discussed. Psychological, social, physical, cultural, religious, and philosophical characteristics specific to the loss should determine the design of the therapeutic ritual. Case vignettes are included. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men

This study investigated whether finding meaning in response to an HIV-related stressor was associated with changes in immune status and health. Forty HIV-seropositive men who had recently experienced an AIDS-related bereavement completed interviews assessing cognitive processing and finding meaning after the loss and provided blood samples for a 2- to 3-year follow-up. AIDS-related mortality over an extended follow-up was determined from death certificates. As predicted, men who engaged in cognitive processing were more likely to find meaning from the loss. Furthermore, men who found meaning showed less rapid declines in CD4 T cell levels and lower rates of AIDS-related mortality (all ps < .05), independent of health status at baseline, health behaviors, and other potential confounds. These results suggest that positive responses to stressful events, specifically the discovery of meaning, may be linked to positive immunologic and health outcomes.