Showing papers in "Death Studies in 2003"
TL;DR: Recommendations are made for both researchers and clinicians in thanatology that could help to focus efforts to answer the questions of when and for whom grief counseling is helpful.
Abstract: Most bereavement caregivers accept as a truism that their interventions are helpful. However, an examination of the bereavement intervention literature suggests that the scientific basis for accepting the efficacy of grief counseling may be quite weak. This article summarizes the findings of four recent qualitative and quantitative reviews of the bereavement intervention literature. It then discusses three possible explanations for these surprising findings and concludes with recommendations for both researchers and clinicians in thanatology that could help to focus efforts to answer the questions of when and for whom grief counseling is helpful.
330 citations
TL;DR: Self-isolation is by far the best predictor of psychosocial distress in all three samples and it seems important to call attention to sudden and traumaticdeathingeneral as a factor to be associated with post-traumatic reactions and complicated mourning.
Abstract: This article compares the outcome and predictors of psychosocial distress of parents bereaved by young suicides, sudden infant death syndrome (SIDS), and child accidents One objective is to explore whether suicide bereavement is more difficult for those left behind than other forms of bereavement Data have been collected from 140 families, consisting of 232 parents, by the use of the Impact of Event Scale, the General Health Questionnaire, and the Inventory of Traumatic Grief Qualitative aspects of bereavement are assessed by in-depth interviews with family members from 40 families The results show that the similarities between the samples on outcome and predictors are more striking than the differences, which is explained by the common traumatic aspect of unexpected and violent deaths One and a half years post-loss, 57-78% of the survivors scored above the cut-off levels for traumatic grief reactions Although no significant differences are found between survivors of suicide and accidents, both grou
264 citations
TL;DR: The CG group experienced more additional life stressors, perceived less social support, and achieved less clinically significant change in MHI than the NCG group, and those results were persistent.
Abstract: The purpose of this cohort sequential study was to determine whether the presence of complicated grief (CG) measured at various points in the spousal bereavement process is associated with an increase in mental and physical health problems 18 months later. One hundred twelve participants provided data at four points in time. CG was measured with the Inventory of Complicated Grief (ICG), and mental health was measured with the Integra Outpatient Tracking Assessment, Mental Health Index (MHI), and illnesses by self-report. Twenty-nine participants were identified as experiencing CG. Beginning at 6 months after the death, MHI scores were significantly lower for the CG group and those results were persistent. The CG group experienced more additional life stressors, perceived less social support, and achieved less clinically significant change in MHI than the NCG group. Identification of CG at any point at 6 months or later in bereavement indicates a need for professional intervention. Implications for establishing CG as a DSM diagnosis are discussed.
219 citations
TL;DR: Quantitative and qualitative research methods were used to examine the influence of three types of a child's violent death and timesince death upon 4 parent outcomes (mental distress, post-tramatic stress disorder, acceptance of the child's death, and marital satisfaction).
Abstract: In this article, the authors revisit a controversial issue in the bereavement field: Does one violent cause of death of a child influence parents' outcomes more than another? To address this question, we observed 173 parents prospectively 4, 12, 24, and 60 months after their children's deaths by accident, suicide, or homicide. Quantitative and qualitative research methods were used to examine the influence of three types of a child's violent death and time since death upon 4 parent outcomes (mental distress, post-traumatic stress disorder [PTSD], acceptance of the child's death, and marital satisfaction). The results showed a significant interaction for the bereavement Group x Time effect for acceptance of death, a significant main effect for time for all four outcomes, and a significant main effect for group (homicide) for PTSD. Nearly 70% of the parents reported that it took either 3 or 4 years to put their children's death into perspective and continue with their own lives; however the child's cause of death did not significantly influence parents' sense of timing in this regard. Clinical and research implications of the findings are discussed.
202 citations
TL;DR: Parents who found meaning in the deaths of their children reported significantly lower scores on mental distress, higher marital satisfaction, and better physical health than parents who were unable to find meaning.
Abstract: Finding meaning in the death of a loved one is thought to be extremely traumatic when the circumstances surrounding the death is perceived to be due to negligence, is intentional, and when the deceased suffered extreme pain and bodily harm immediately prior to death. We addressed this assumption by obtaining personal narratives and empirical data from 138 parents 4, 12, 24, and 60 months after an adolescent's or young adult child's death by accident, suicide, or homicide. Using the Janoff-Bulman and Frantz's (1997) framework of meaning-as-comprehensibility and meaning-as-significance, the purposes were to identify the time course to find meaning, present parents' personal narratives describing finding meaning in their experiences, identify predictors of finding meaning, and compare parents who found meaning versus those who did not on five health and adjustment outcomes. The results showed that by 12 months post death, only 12% of the study sample had found meaning in a child's death. By 60 months post death, 57% of the parents had found meaning but 43% had not. Significant predictors of finding meaning 5 years post death were the use of religious coping and support group attendance. Parents who attended a bereavement support group were 4 times more likely to find meaning than parents who did not attend. Parents who found meaning in the deaths of their children reported significantly lower scores on mental distress, higher marital satisfaction, and better physical health than parents who were unable to find meaning. Recommendations for future research are made.
201 citations
TL;DR: The article investigated the relationship between death anxiety, attitudes toward older adults, and personal anxiety toward one's own aging in a group of 197 older men and women, and predicted negative attitudes toward other older adults were predicted by personal anxieties about aging and death, and fear of the unknown.
Abstract: The article investigated the relationship between death anxiety, attitudes toward older adults, and personal anxiety toward one's own aging in a group of 197 older men and women As predicted, negative attitudes toward other older adults were predicted by personal anxieties about aging and death, and, more specifically, fear of the unknown In addition, several distinctive anxieties were noted for particular subgroups of respondents Older women scored higher on the Fear of the Dead subscale of the Multidimensional Fear of Death Scale (MFODS) than did men Caucasian participants displayed higher Fear of the Dying Process than did older African American participants Lastly, older African American participants reported higher levels of death anxiety on 3 of the subscales of the Multidimensional Fear of Death Scale (Fear of the Unknown, Fear of Conscious Death, and Fear for the Body after Death) when compared with older Caucasian participants and also tended to accord less social value to the elderly These findings are interpreted in terms of patterns of socialization, and their implications for end-of-life care preferences are noted
181 citations
TL;DR: The psychometric properties of the Dutch version of the Inventory of Traumatic Grief were investigated in two studies with bereaved adults who had suffered the loss of a first-degree relative, providing evidence in favor of the predictive validity of the ITG.
Abstract: The psychometric properties of the Dutch version of the Inventory of Traumatic Grief (ITG) were investigated in two studies with bereaved adults who had suffered the loss of a first-degree relative. In Study 1, exploratory factor analysis indicated that the items of the ITG clustered together into one underlying factor. In addition, the internal consistency of the ITG and its short-term temporal stability were found to be high. In Study 2 it was found that the ITG exhibited adequate discriminative, concurrent, and construct validity. Furthermore, an ITG cutoff score for a diagnosis of traumatic grief was determined, with a sensitivity of 86% and a specificity of 76%, providing evidence in favor of the predictive validity of the ITG.
175 citations
TL;DR: A revision of the Collett-Lester Fear of Death Scale is presented, eliminating a deviant item that reduced the reliability of the scale.
Abstract: A revision of the Collett-Lester Fear of Death Scale is presented, eliminating a deviant item that reduced the reliability of the scale. Using a sample of 191 undergraduates, four 7-item subscales were derived with adequate reliabilities and factorial congruence for 2 of the subscales (Fear of Death of Self and Fear of Dying of Self).
161 citations
TL;DR: The central finding of the study points to "the intense pursuit of what matters" as a major avenue for meaning making in the aftermath of homicide, one which is expressed in action.
Abstract: Although sense making or finding benefit are well documented examples of meaning making processes, meaning making grounded in action has received less attention. This article adds a specific demonstration of the relevance of performed meanings to homicide survivors and other traumatized populations through a qualitative study of 38 members of 14 families. The central finding of the study points to "the intense pursuit of what matters" as a major avenue for meaning making in the aftermath of homicide, one which is expressed in action. Implications of this mode of meaning reconstruction are discussed relative to the re-establishment of a sense of coherence and self-continuity.
125 citations
TL;DR: Parentally bereaved children's locus of control and self-esteem were examined as stress-moderators or stress-mediators of their internalizing and externalizing mental health problems and revealed that self- esteem was a significant mediator of the relations between stress and both child and parent reports of internalizing problems but not externalizing problems.
Abstract: Parentally bereaved children's locus of control and self-esteem were examined as stress-moderators or stress-mediators of their internalizing and externalizing mental health problems. Seventy-six children ages 8 to 16 and their surviving parent were assessed 4 to 34 months after the death. Stress, locus of control, and self-esteem were measured by child report questionnaires. Internalizing and externalizing mental health problems were measured by child report on both questionnaires and a structured interview and by parent report questionnaires. The results revealed that self-esteem was a significant mediator of the relations between stress and both child and parent reports of internalizing problems but not externalizing problems. No significant mediation effects were found for locus of control. Neither locus of control nor self-esteem was a significant moderator of the relations between stress and children's internalizing and externalizing problems. Implications for understanding parentally bereaved child...
116 citations
TL;DR: The results show that although the patterns of postbereavement depressive mood and positive psychological states were similar, some of their predictors differed, supporting the inclusion of both positive and negative psychological states in studies of postBereavement adjustment.
Abstract: The purpose of the current study was to document the course and 1-month postbereavement predictors of both positive and negative psychological states in bereaved gay male caregivers for 3 years following the death of their partners. The results show that although the patterns of postbereavement depressive mood and positive psychological states were similar, some of their predictors differed. Given that the processes that produce positive psychological states are not the same as those that produce negative states, our findings support the inclusion of both positive and negative psychological states in studies of postbereavement adjustment.
TL;DR: Although there was no control group, the research offers tentative support for the efficacy of training peer helpers in suicide risk assessment and indicates the importance of additional training for peer helpers.
Abstract: Literature reviews on suicide prevention programs have presented conflicting results on the efficacy of school-based prevention programs. Gatekeeper training and peer helping are both recommended as part of a comprehensive school-based prevention program, yet there is no literary evidence of the systematic evaluation of gatekeeper training for peer helpers. This study evaluated the efficacy of such training with high school peer helpers using a repeated measures design. Significant gains in knowledge about suicide and skills for responding to suicidal peers were evident immediately after training and 3 months later. There was also a significant improvement in positive attitudes toward suicide intervention following training. Although there was no control group, the research offers tentative support for the efficacy of training peer helpers in suicide risk assessment and indicates the importance of additional training for peer helpers.
TL;DR: The authors propose to move beyond the dichotomy that was created by the two paradigms and conceive of it as a process of transformation that involves both disengagement and connection.
Abstract: Over the past decade, there has been a paradigm shift in the field of bereavement: From the traditional view that insists on the necessity of disengagement, toward a position that postulates the need for a continuing connection. The authors propose to move beyond the dichotomy that was created by the two paradigms and conceive of it as a process of transformation that involves both disengagement and connection. Drawing on theoretical frameworks of control and adaptation, the authors suggest that the relationship with the deceased may be transformed to mental representations of this person that carry substitute value.
TL;DR: It is argued that the perspective of the relation to the deceased is an insufficiently acknowledged source of traumatic disruption following bereavement and the importance of the relational aspects in this case of trauma supports the use of the Two-Track Model of Bereavement.
Abstract: The article re-examines trauma and bereavement and the category of loss considered to be traumatic bereavement. It is argued that the perspective of the relation to the deceased is an insufficiently acknowledged source of traumatic disruption following bereavement. The significance of the relational aspect in bereavement is present in the paradigm of the Two-Track Model of Bereavement (S. Rubin, 1981, 1999). The implications of this approach are examined in the case of a soldier exposed to trauma and death. The case is examined from a traditional trauma perspective stressing exposure to life threat and again from a perspective stressing the significance of the relationship to the deceased. An examination of the different intervention strategies and their outcome lends support to the importance of the relational aspects in this case of trauma and supports the use of the Two-Track Model of Bereavement. The location of trauma as basic to the experience of all bereavement for its impact on the reorganization ...
TL;DR: The article recommends that future research needs to concentrate on finding the most effective way of supporting routinely bereaved children, their families, and teachers.
Abstract: The ways in which teachers in British schools manage bereaved children are under-reported. This article reports the impact of students' bereavement and their subsequent management in primary and secondary school classrooms in Southeast London. Thirteen school staff working in inner-city schools took part in in-depth interviews that focused on the impact of bereaved children on the school and how teachers responded to these children. All respondents had previously had contact with a local child bereavement service that aims to provide support, advice, and consultancy to children, their parents, and teachers. Interviews were audiotaped, transcribed verbatim, and analyzed using ATLAS-ti. Three main themes were identified from analysis of interview data. Firstly, British society, culture, local communities, and the family were significant influences in these teachers' involvement with bereaved students. Secondly, school staff managed bereaved students through contact with other adults and using practical classroom measures such as "time out" cards and contact books. Lastly, teachers felt they had to be strong, even when they were distressed. Surprise was expressed at the mature reaction of secondary school students to deaths of others. The article recommends that future research needs to concentrate on finding the most effective way of supporting routinely bereaved children, their families, and teachers.
TL;DR: It appears that Bill C-51 may have had an impact on suicide rates, even after controls for social variables.
Abstract: Suicide is a multiply determined behavior, calling for diverse prevention efforts. Gun control has been proposed as an important component of society's response, and an opportunity for studying the effects of legislative gun control laws on suicide rates was provided by Canada's Criminal Law Amendment Act of 1977 (Bill C-51). This article reviews previous studies of the impact of this act on the total population of Canada and subpopulations by age and gender and, in addition, presents the results of 2 new studies: a different method of analysis, an interrupted time-series analysis, and the results of a multiple regression analysis that controls for some social variables. It appears that Bill C-51 may have had an impact on suicide rates, even after controls for social variables.
TL;DR: Although participants were not actively inspired to be religious as a result of their illness, they did hold a number of spiritual perspectives that were actively at play, and the majority did not seek religious comfort or conversion as a response to the challenge of terminal illness.
Abstract: One of the assumptions that underpins the literature on spirituality is the belief that facing a terminal illness is a life crisis that intensifies the search for meaning, leaving individuals predisposed to embrace religion. To date, however, there is scant empirical research on the topic. This article seeks to make a contribution to this topic by reporting findings from a qualitative study that address the question of whether individuals embrace religious beliefs when faced with the challenge of a serious illness. The data were gathered from open-ended interviews with 14 hospice patients, audiotaped, transcribed verbatim, and thematically analyzed. The findings indicate the majority did not seek religious comfort or conversion as a response to the challenge of terminal illness, even when this was seen as desirable. Although participants were not actively inspired to be religious as a result of their illness, they did hold a number of spiritual perspectives that were actively at play.
TL;DR: Results suggest that knowledge of a variety of aspects of a family's structure and process shortly after a death may help predict the later grief of the loss of a loved one.
Abstract: The present study explored the question of whether the grief process affects the characteristics of relationships within the family system or, alternatively, whether family characteristics affect the experience of grief symptoms. Sixty-one people who had recently experienced the death of a parent (82%) or spouse (18%) completed a questionnaire to assess their current grief symptomatology and characteristics of the relationships within their family 4-5 weeks after the death, and again six months later. Results from cross-lagged panel analyses suggested that increased expression of family affect, family cohesion, and both higher total Family Environment Scale and Family Assessment Measure Version III General scores were predictors of fewer grief symptoms over time. Overall, these results suggest that knowledge of a variety of aspects of a family's structure and process shortly after a death may help predict the later grief of the loss of a loved one.
TL;DR: This study examines 1,987 deceased writers from four different cultures: American, Chinese, Turkish, and Eastern European to find that male and female poets had the shortest life spans of all four types of writers.
Abstract: Although several investigations have found that poets tend to die younger than other types of writers, these studies often do not take into account variables of gender and culture. This study examines 1,987 deceased writers from four different cultures: American, Chinese, Turkish, and Eastern European. Both male and female poets had the shortest life spans of all four types of writers (fiction writers, poets, playwrights, and non-fiction writers), and poets had the shortest life spans in three of the four cultures (and the second shortest life span among Eastern European writers). Possible reasons for the poet's shorter life span are then discussed.
TL;DR: A framework for the critical analysis and production of eulogia that draws from comforting mechanisms recognized in the interpersonal communication, social psychology, and grief therapy literatures is introduced.
Abstract: In an ever more deadly and uncertain world, rhetoric honoring the deceased is still examined as though that was its primary, if not only, function. Some critics of eulogia also identify the consolation of survivors but rarely define it precisely or analyze its rhetorical execution. This article introduces a framework for the critical analysis and production of eulogia that draws from comforting mechanisms recognized in the interpersonal communication, social psychology, and grief therapy literatures. Self-disclosure, problem-focused coping, positive reappraisal, and the affirmation and continuation of relationships with the deceased are shown to inform criticism of five contemporary eulogies. Challenges inherent in the invention and appreciation of eulogy rhetoric are thus illuminated and addressed.
TL;DR: Findings showed that mortality salience led to higher intentions to drive recklessly than the control condition only among men who perceived driving as relevant to their self-esteem, no such differences were found among women.
Abstract: A study, based on Terror Management Theory, examined the effects of mortality salience on young men's and women's behavioral intentions to drive recklessly. Participants (N = 206) reported on the relevance of driving to their self-esteem. Half of them were exposed to a mortality salience induction and the remaining to a control condition. Then they were asked about their willingness to drive recklessly in various scenarios. Findings showed that mortality salience led to higher intentions to drive recklessly than the control condition only among men who perceived driving as relevant to their self-esteem. No such differences were found among women. Results are discussed in light of the self-enhancing and cultural-world views-validating mechanisms proposed by the Terror Management Theory.
TL;DR: Gender-related differences were significant in the Kuwaiti sample, that is, females attained higher mean score than their male counterparts, whereas there were no significant gender differences in the American sample.
Abstract: Two samples of Kuwaiti (n = 460) and American (n = 273) male and female undergraduates responded to the Death Obsession Scale (DOS) in Arabic and English, respectively. Cronbach's alpha reliability statistics were .96 and .91, respectively, denoting high internal consistency. In the same vein, all the item-remainder correlations in both samples were significant denoting item validity and content validity. A general factor of death obsession was disclosed in the Kuwaiti sample, whereas two salient factors (death rumination, and death dominance and repetition) were extracted in the American sample. Gender-related differences were significant in the Kuwaiti sample, that is, females attained higher mean score than their male counterparts, whereas there were no significant gender differences in the American sample. Kuwaiti students attained significantly higher mean DOS score than their American counterparts in the total and all the individual items of the DOS.
TL;DR: This article examines the intentions of the burial from the perspective of two groups of family members who lost loved ones: survivors who remain politically isolated and those involved in advocacy or political organizations.
Abstract: In the aftermath of tragedy, memorials and gravesites are frequently constructed. Research needs to pay attention to the goals of mourners for such places. The 1995 massacre at Srebrenica in Bosnia-Herzegovina left over 7,000 Muslim men missing and presumed dead. Five years later, families fought to bury the remains that had been collected. Qualitative interviews with 67 people, including survivors and key informants were completed over thesummer of 2000. This article examines the intentions of the burial from the perspective of two groups of family members who lost loved ones: survivors who remain politically isolated and those involved in advocacy or political organizations. For the politically isolated, burial was important in reshaping individual mourning after mass death and in the face of unidentified remains. For those involved in advocacy groups, burial was a means of recognizing the past massacre, understanding the massacre's impact on current political divisions, and shaping future directions. B...
TL;DR: Using G. Jasso's (1999) index on perceived income inequality, the author found that perceivedincome inequality is related more strongly and more consistently to male suicide rates than female suicide rates.
Abstract: Sociological studies on cross-national male and female suicide rates have found numerous factors related to variation in suicide rates. The present study focuses on how perceived differences in income inequality impact suicide rates in 12 different countries, unlike most prior studies on income inequality and suicide that use measures of actual income inequality.Using G. Jasso's (1999) index on perceived income inequality, the author found that perceived income inequality is related more strongly and more consistently to male suicide rates than female suicide rates. Relative to other variables used in this analysis,perceived income inequality also accounts for most of the difference in the gender gap of male versus female suicide rates.
TL;DR: A complementary perspective is offered by archetypal psychology, which considers the deceased to exist outside the mourner'ssubjectivity as an autonomous image, illustrated by an exemplary case: a woman named Verda who experienced the death of her twin sister, Vera.
Abstract: Contemporary research recognizes the existence of an ongoing attachment between the mourner and the deceased. This research tends to focus on the subjective aspects of the attachment--the mourner's memory and emotions. A complementary perspective is offeredby archetypal psychology, which considers the deceased to exist outside the mourner'ssubjectivity as an autonomous image. This approach is illustrated by an exemplary case: a woman named Verda who experienced the death of her twin sister, Vera. Their account suggests that Verda's mourning derives from her encounters with Vera's continuing imaginal presence.
TL;DR: The article discusses one historical condition: times of rapid change in power arrangements: China under Chairman Mao and the Wahhabi reform in Arabic Islam.
Abstract: The article is a contribution to a cross-cultural theory of grief. It examines the relationship between individual/family continuing bonds with the dead and cultural narratives that legitimize political power. The dead are collective representations (Dirkheim) that mediate the larger culture to individuals and to smaller communities and that reinforce social solidarity and identity. The political question is which collective--family, community, church, party, nation--owns the dead and controls the rituals by which bonds with the dead are maintained or relinquished? The article discusses one historical condition: times of rapid change in power arrangements. Bonds with the dead have a power in individual, family, or tribal life that can threaten the narrative that legitimizes the new political power holders. Ancestor rituals that support identity as a family or tribal member are surpressed and replaced by allegiance to collective representations of the new political order. Two historical examples are given:...
TL;DR: The findings indicate that the supportive elements of the intervention were associated with the groups' perceived contribution and the clinical implications are discussed.
Abstract: This study evaluates various aspects of groupwork with bereaved parents who lost a child during military service. More specifically, it assesses the unique and cumulative contributions of various features of groupwork to the participants' satisfaction with the group support. One hundred and thirty-eight bereaved parents, who participated in 16 support groups, answered a battery of questionnaires tapping 3 aspects of the groupwork: their motives for joining the group, the interpersonal relations among the group members, and the group leadership style. In addition, the participants were asked to evaluate the contribution of the intervention to their adjustment. The findings indicate that the supportive elements of the intervention were associated with the groups' perceived contribution. The clinical implications of these results are discussed.
TL;DR: Caregivers who are themselves survivors appeared more sensitive to some of the emotional aspects of homicide bereavement, such as the potential for retraumatization in therapy, which was deemed harmful to survivors.
Abstract: The opinions of 116 homicide bereavement caregivers of interventions recommended for survivors were solicited. Presenting problems, optimum treatment framework, and reasons for treatment failure were also surveyed. Respondents preferred methods associated with crisis intervention and grief counseling. Other clinical techniques were rated as moderately helpful, except family therapy, which was highly rated. Suppression of trauma imagery was deemed harmful to survivors, though diversion was recommended often in cases of complicated grief. Caregivers who are themselves survivors appeared more sensitive to some of the emotional aspects of homicide bereavement, such as the potential for retraumatization in therapy.
TL;DR: The authors describe the integration of service learning into 2 upper-division general education death-related courses and suggest that this pedagogical strategy offers exciting potential for grounding death education in real life experiences.
Abstract: The authors describe the integration of service learning into 2 upper-division general education death-related courses. An overview of these courses, 1 in sociology and 1 in political science, is followed by an explanation of the rationale and the specific ways in which service learning infused these educational offerings. The discussion then proceeds by outlining the preparation, action, reflection, and evaluation involved in making service learning an indispensable course feature. Feedback gathered from students, on-site supervisors, and the authors clearly indicates that this pedagogical strategy offers exciting potential for grounding death education in real life experiences.
TL;DR: Analyses reveal that the LGHS is a valid and reliable instrument for measuring hardiness and that it is sensitive enough to detect changes in the construct over time.
Abstract: The process of development and testing of the Lang and Goulet Hardiness Scale (LGHS), a self-report instrument designed to measure hardiness in bereaved parents following the death of their fetus/infant, is presented. Hardiness is a personal resource, composed of 3 interdependent components that are characterized by a sense of personal control over the outcome of life events and hardships such as the death of a fetus/infant, an active orientation toward meeting the challenges brought on by the loss, and a belief in the ability to make sense of one's own existence following such a tragedy. The concept of hardiness has been studied by various disciplines and in a multitude of settings to understand its ability to lessen potentially negative effects of life stress. However, it has never been studied within the context of parental bereavement. The LGHS was developed systematically, originating from a concept analysis. A panel of 15 experts was used to establish content validity. A pretest was conducted on 73 ...