Showing papers in "Death Studies in 2007"
TL;DR: The results suggest that more emphasis should be placed on the cause of increased death anxiety among 20-year-olds and on why women, but not men, experience a second anxiety spike during their 50s not seen in men.
Abstract: Two studies examined death anxiety across the adult years. In the first study, 304 men and women between 18 and 87 years completed the Collett-Lester Fear of Death scale. Death anxiety peaked in both men and women during their 20s and declined significantly thereafter. However, women displayed a secondary spike during their 50s not seen in men. In the second study, 113 women between 18 and 85 years completed the Templer Death Anxiety Scale. Death anxiety displayed the same bimodal distribution and significant decline with age seen in Study 1. The results suggest that more emphasis should be placed on the cause of increased death anxiety among 20-year-olds and on why women, but not men, experience a second anxiety spike during their 50s.
203 citations
TL;DR: The authors take the view that this term recovery is inadequate, and terminology guides the thinking of bereaved persons, clinicians, and researchers in this area, and the term recovery may produce bias toward viewing bereavement as a disordered state.
Abstract: Responding to D. E. Balk (2004) about use of the term recovery to describe bereavement outcome, the authors take the view that this term is inadequate. Among the points raised are (a) the term recovery may imply a response to psychological disorder, whereas bereavement responses are generally normative; (b) recovery does not easily allow for transformative outcomes in bereavement, e.g., posttraumatic growth; and (c) terminology guides the thinking of bereaved persons, clinicians, and researchers in this area, and the term recovery may produce bias toward viewing bereavement as a disordered state. More neutral terms such as change or resolution avoid some of these pitfalls.
156 citations
TL;DR: Drawing on the most current empirical reports, the epidemiology of Native American suicidal behaviors is reviewed, while situating risk and protective factors within a biopsychosocial framework is reviewed.
Abstract: The alarming prevalence of suicidal behaviors in Native American communities remains a major concern in the 21st-century United States. Recent reviews have demonstrated that prevention programs and intervention efforts using transactional–ecological models have effectively reduced suicidal behaviors in the American Indian and Alaska Native populations sampled. As a result, this article adopts a transactional–ecological framework for conceptualizing suicidality and identifying points of intervention. Drawing on the most current empirical reports, the epidemiology of Native American suicidal behaviors is reviewed, while situating risk and protective factors within a biopsychosocial framework. Opportunities for intervention are discussed with a focus on the interactions between individuals and their environments, and the antecedent conditions leading to zones of heightened suicide risk.
146 citations
TL;DR: Six dimensions of oscillation that warrant further consideration are identified and encourage others to help develop and refine all features of the IDWL and make it adaptable to other loss relationships.
Abstract: The Dual Process Model of Coping with Bereavement (M. Stroebe & H. Schut, 1999) suggests that the most effective adaptation involves oscillation between 2 coping processes: loss-orientation (LO) and restoration-orientation (RO). A 22-item Inventory of Daily Widowed Life (IDWL) was developed to measure these processes and the oscillation between them and assessed by examining 163 bereaved widow(er)s, ages 45–94 years. The LO and RO subscales produced alpha coefficients of .90 and .79, respectively. The more recently widowed demonstrated a high degree of oscillation balance between the two processes, while there was a greater emphasis on restoration-orientation among those bereaved longer. Both subscales generated significant relationships with the bereavement outcome measures used in this study. Furthermore, restoration-orientation was directly related to the level of self-care and daily living skills as well as personal growth. We identify six dimensions of oscillation that warrant further consideration a...
113 citations
TL;DR: Personal growth, a positive dimension of grief, was associated with all three coping dispositions; mothers' active coping, support seeking, and positive reframing suggesting more personal growth occurred in mothers exhibiting more of these coping disposition.
Abstract: Conceptualizing parental grief as a psychosocial transition, this cross-sectional study of bereaved mothers (N = 35) examined the relationship of dispositional factors, grief reactions, and personal growth. More optimistic mothers reported less intense grief reactions and less distress indicative of complicated grief. Additionally, mothers who usually coped actively had less intense grief reactions. Mothers who habitually coped using positive reframing had less intense grief reactions and less complicated grief. Personal growth, a positive dimension of grief, was associated with all three coping dispositions; mothers' active coping, support seeking, and positive reframing suggesting more personal growth occurred in mothers exhibiting more of these coping dispositions. These findings increase understanding of dispositional factors associated with bereaved mothers' grief responses and expand knowledge concerning personal growth as an outcome of bereavement.
109 citations
TL;DR: A numerically aided phenomenological approach is used to elucidate common profiles of growth in a sample of 52 adults who lost a loved one in a traumatic mine explosion, and suggests that a better understanding of the processes of PTG may be realized by taking a more refined approach to the assessment of loss and growth, and by drawing distinctions between personal growth and benefits.
Abstract: The dominant model of posttraumatic growth (PTG) suggests that growth is precipitated by significant challenges to one's identity or to core assumptions that give one's life meaning, and develops as one goes through meaning-making or schema reconstruction processes. Other perspectives suggest, however, that such growth occurs by other means. We use a numerically aided phenomenological approach to elucidate common profiles of growth in a sample of 52 adults who lost a loved one in a traumatic mine explosion 8 years earlier. Of the three clusters extracted, 1 captured the essence of the PTG model, including threat to sense of self, meaning-making, and personal growth; 1 featured an inability to find meaning and an absence of growth; and 1 featured minimal meaning threat with modest growth. Those most likely to report PTG interpreted the experience as threat to self, with growth coming from development of new self-understanding. The data suggest that a better understanding of the processes of PTG may be realized by taking a more refined approach to the assessment of loss and growth, and by drawing distinctions between personal growth and benefits.
98 citations
TL;DR: This article examines C. R. Snyder's theory of hope and its application for understanding suicide to form the basis for future empirical investigation of suicide-related behavior using the framework of hope theory.
Abstract: This article examines C. R. Snyder's (1994, 2000a) theory of hope and its application for understanding suicide. Strengths, weaknesses, and gaps in the suicide literature are outlined, and A. T. Beck's theory of hopelessness is compared with Snyder's hope theory. Hope theory constructs are used to examine the relationship of suicide to hope/hopelessness, goals, pathways thinking, and agency thinking. This critical review is intended to broaden our theoretical understanding of suicide and is meant to form the basis for future empirical investigation of suicide-related behavior using the framework of hope theory. Implications for suicide prevention programs and approaches to treating suicidal individuals are outlined.
96 citations
TL;DR: The present study is a comparison of these 2 professional programs' current offerings on death education, using data gathered via a mailed survey from the 122 medical schools in 2005 and the 580 baccalaureate nursing programs in 2006.
Abstract: Medical and nursing schools in the United States have traditionally had a limited emphasis on end-of-life care. The present study is a comparison of these 2 professional programs' current offerings on death education. Data were gathered via a mailed survey from the 122 medical schools in 2005 and the 580 baccalaureate nursing programs in 2006. Return rates of 81% and 71%, respectively, were received. All medical schools and 99% of nursing schools reported offering something on death and dying, with over 90 % of students in these programs participating. The average number of hours offered in both professional programs is less than 15. Over 87% in both programs have offerings in palliative care. Whereas nursing programs rely almost solely on nurses for end-of-life course provisions, medical schools are more interdisciplinary by faculty. End-of-life issues are presented in both medical and nursing curricula, though on a limited basis. This emphasis exposes students to the issues, though not in an in-depth way.
92 citations
TL;DR: Personality characteristics that may be importantly involved in the adjustment to widowhood are identified and implications of mediators vs. moderators in this process are discussed.
Abstract: The purpose of the present study was to examine dispositional resilience in the perceived stress–life satisfaction relation following conjugal loss. The sample included 55 widows, assessed on average, 1 month following the death of a spouse. Results supported dispositional resilience as a mediator (the initial relation between perceived stress and life satisfaction was significant, but reduced to a non-significant level once dispositional resilience was included in the model) and a moderator (the interaction between perceived stress and dispositional resilience significantly predicted life satisfaction) between perceived stress and life satisfaction. This research identifies personality characteristics that may be importantly involved in the adjustment to widowhood and discusses implications of mediators vs. moderators in this process.
84 citations
TL;DR: A critical review of significant factors such as age, gender, religious and spirituality issues, acculturation, social support, familial dynamics, social integration as well as gay/lesbian/bisexual orientations are examined.
Abstract: The current review begins with an acknowledgment of the diversity within the Asian American population as well as the scarcity of information on suicide among this particular racial/ethnic minority group. In analyzing what is known and what still needs to be learned about suicide among Asian Americans, the current article provides a critical review of significant factors such as age, gender, religious and spirituality issues, acculturation, social support, familial dynamics, social integration as well as gay/lesbian/bisexual orientations. In examining these factors, recommendations related to interventions and the existing research gaps are also discussed.
83 citations
TL;DR: The authors propose that the concept adaptation best captures the process of change following bereavement and that the desired outcome of such adaptation is denoted by the term resilience.
Abstract: Using a contextual resilience framework, the authors examine the processes whereby bereaved persons change over time. Rather than the concept recovery, the authors propose that the concept adaptation best captures the process of change following bereavement and that the desired outcome of such adaptation is denoted by the term resilience. Adaptation occurs over time and is shaped by environmental and individual level risk and protective factors. By use of a “contextual resilience” framework, the authors emphasize the central role that person–environment transactions play versus the heavy emphasis on intrapersonal processes in some other approaches to resilience.
TL;DR: Common patterns and differences among these populations, along with social-cultural practices that may explain suicide phenomenology among these U.S. indigenous peoples who—while small in numbers when compared with the total U. s.
Abstract: The authors present a comprehensive review on U.S. Pacific Islander suicide and suicide-related behaviors to extend the knowledge and understanding of suicide and suicide-related behaviors among the indigenous peoples of the state of Hawai'i, the territories of American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and the Pacific Island Nations of Micronesia (Federated States of Micronesia, the Republic of Belau [Palau], and the Republic of the Marshall Islands). Historical, geographic, epidemiological, social, and cultural information is presented on these Pacific Island populations. Suicide behavioral data are presented for Pacific Islanders living within the U.S. and affiliated Pacific territories and nations from the existing scientific literature along with archival data and 2 epidemiological studies that assess suicidal behaviors and related psychosocial factors and measures of psychopathology among large community samples of youth in Hawai'i. The authors describe common patterns and differences among these populations, along with social-cultural practices that may explain suicide phenomenology among these U.S. indigenous peoples who--while small in numbers when compared with the total U.S. population--possess striking health disparities when compared to other populations within the U.S. and in their island homelands.
TL;DR: In this article, the authors surveyed 135 health care professionals (74 nurses, 32 physicians, and 29 social workers) to examine their personal death attitudes and experiences in relation to their reported advance directive communication practice behavior.
Abstract: The study surveyed 135 health care professionals (74 nurses, 32 physicians, and 29 social workers) to examine their personal death attitudes and experiences in relation to their reported advance directive communication practice behavior. Negative correlations were found between collaborating with other health care professionals regarding the directives and fear of death, avoidance of death, and escape acceptance of death. Approach acceptance of death positively correlated with initiating the discussion of advance directives. Practitioners indicating recent personal experiences with terminal illness reported disclosing more information about the documents.
TL;DR: This article reviews the scientific literature related to suicide behavior among Latino/a adolescent since 1990 and finds no explanatory variables that may account for the differences among groups or that help explain the meaning of the suicide behavior were found.
Abstract: Suicide is the cause of 11.7 % of all deaths among youth and young adults aged 10 to 24 years in the United States (J. A. Grunbaum et al., 2004). Suicide is third leading cause of death for young Latinos/as aged 10 to 24 years (National Institute of Mental Health, 2001). Latino/a youth are at a greater risk of suicide behavior than other ethnic groups (G. Canino & R. E. Roberts, 2001). Latinos/as have less access to mental health services than do Whites and are less likely to receive needed care (U.S. Department of Health and Human Services, 2001). This article reviews the scientific literature related to suicide behavior among Latino/a adolescent since 1990. Conceptual and methodological issues in research are examined and the role of contextual and developmental factors on suicide behavior is discussed. The empirical findings of comparative ethnic minority studies, studies focused on Latino/a youth, and within-group studies are reviewed. Research on Latino/a adolescent suicide behavior is limited, few s...
TL;DR: Findings indicate that the experience of maternal loss influenced aspects of the women's identity development and initiated a need to seek new connections and redefine aspects of self in order to integrate the loss.
Abstract: A qualitative approach was used to study the influence of adolescent maternal loss on identity development in 6 young women. In-depth, semi-structured interviews were audiotaped, transcribed, and analyzed for recurrent themes. Three metathemes emerged from the narratives: Loss of Mother Impacts Identity, Relatedness on the Path of Identity Development, and Integration of Loss into Emergent Identity. Findings indicate that the experience of maternal loss influenced aspects of the women's identity development and initiated a need to seek new connections and redefine aspects of self in order to integrate the loss. Practical implications of these findings are presented for clinicians who work with bereaved young women.
TL;DR: The theoretical opinions of bereaved adults about ethical issues such as attitudes toward bereavement research, timing and methods of recruitment, and competency to consent are examined to guide bereavement researchers and research ethics boards in the design and review of bereavement studies.
Abstract: Few studies examine ethical issues in bereavement research and none survey the opinions of bereaved individuals who have not previously participated in bereavement research. This study examined the theoretical opinions of bereaved adults about ethical issues such as attitudes toward bereavement research, timing and methods of recruitment, and competency to consent. Participants felt positively about bereavement research, although opinions about timing and method of recruitment were varied. The results also suggest that bereaved individuals should be considered competent to consent to bereavement research participation. Conclusions may guide bereavement researchers and research ethics boards in the design and review of bereavement studies.
TL;DR: The authors argue that estimates of the net economic cost of suicide should go beyond accounting for direct medical costs and indirect costs from loss of earnings by those who commit suicide and consider potential savings from not having to treat the depressive and other psychiatric disorders of those who kill themselves.
Abstract: These authors argue that estimates of the net economic cost of suicide should go beyond accounting for direct medical costs and indirect costs from loss of earnings by those who commit suicide There are potential savings from: (a) not having to treat the depressive and other psychiatric disorders of those who kill themselves; (b) avoidance of pension, social security and nursing home care costs; and (c) assisted-suicide By combining all of these costs and savings, it is concluded that the net economic cost of the 30,906 completed suicides in 1990 entailed an economic gain for the society of roughly $507 billion in year--2005 dollars This calculation does not include estimated costs due to the psychological pain and suffering of the survivors Suicide should be prevented based on humane considerations, not on the economic cost involved
TL;DR: It is concluded that cause of death from violence or suicide is not a very useful indicator of bereaved children's need for or likelihood of benefiting from an intervention.
Abstract: This article considers the implications of suicide and violent deaths (including suicide, homicide, and accidents) for the development of interventions for parentally bereaved children. Analyses of data from the Family Bereavement Program find minimal differences in children's mental health problems, grief or risk and protective factors based on cause of parental death. In addition, cause of death did not substantially affect the relations between risk and protective factors and bereaved children's outcomes. It is concluded that cause of death from violence or suicide is not a very useful indicator of bereaved children's need for or likelihood of benefiting from an intervention.
TL;DR: A postmodern perspective in which no single concept is considered relevant for framing what goes on or what is desirable following bereavement might be best.
Abstract: The concept of recovery following bereavement can be both useful and misleading. As a metaphor, the concept of recovery highlights some aspects of bereavement and obscures others. Bereaved people interviewed in 3 different studies typically did not bring up the term recovery so it did not seem to be a term that described their experience. Across cultures, the concept of recovery can be irrelevant or even misleading in understanding what goes on following bereavement. Arguably, a postmodern perspective in which no single concept is considered relevant for framing what goes on or what is desirable following bereavement might be best.
TL;DR: The authors examine the literature related to cultural protective factors that buffer African Americans from suicide risk, and review the culture and worldview of African Americans, to examine the degree to which these cultural variables protect against suicide risk.
Abstract: Suicide among African Americans has been acknowledged by the U.S. Surgeon General as a growing crisis. However, suicide remains understudied in this population. In this article, the authors examine the literature related to cultural protective factors that buffer African Americans from suicide risk. They present an overview of suicide among African Americans, review the culture and world-view of African Americans, and examine the degree to which these cultural variables protect against suicide risk. Finally, they discuss the limitations of the extant research on African American suicide, set an agenda for future research, and discuss its implications for clinical practice and public policy.
TL;DR: The relationship between hardiness and both grief symptoms and personal growth were investigated and results suggest the need for future research focused on the comprehensive evaluation of the potential non-linear relationship between these constructs.
Abstract: The relationship between hardiness and both grief symptoms and personal growth were investigated in a sample of bereaved college students. Hardiness was inversely associated with grief symptoms and offered prediction of grief misery above and beyond that provided by more commonly investigated individual and death-related variables. Hardiness was not linearly associated with personal growth; however, results suggest the need for future research focused on the comprehensive evaluation of the potential non-linear relationship between these constructs. Closeness to the deceased was a significant and linear predictor of personal growth. Directions for future research and implications for practice are discussed.
TL;DR: A Spanish version of the Collett-Lester Fear of Death Scale is developed and its correlations with death anxiety were higher than that with general anxiety, supporting its discriminant validity.
Abstract: The Collett-Lester Fear of Death Scale (CL-FODS) consists of 4 subscales: Death of Self, Dying of Self, Death of Others, and Dying of Others. The aim of this study was to develop a Spanish version of the CL-FODS and to explore its psychometric properties. The revised version of the scale was translated into Spanish from English. Then, the back translation technique was carried out. A sample of 281 Spanish nursing students and professionals responded to the Spanish CL-FODS, along with 2 instruments assessing death anxiety and general anxiety. Good internal consistency and satisfactory test–retest reliability of the 4 subscales of the Spanish CL-FODS were achieved. Its correlations with death anxiety were higher than that with general anxiety, supporting its discriminant validity. The principal component analysis forced to 4 components provided a distribution of loadings that is more coherent with the theoretical formulation of the 4 components than those obtained in previous studies. These results justify ...
TL;DR: Assessment of how different facets of aging anxiety contributed to the prediction of tangible and existential death anxiety revealed that the aging anxiety dimensions of physical appearance concern and fear of losses each positively predicted tangible death anxiety.
Abstract: To assess how different facets of aging anxiety contributed to the prediction of tangible and existential death anxiety, 167 Americans of various Christian denominations completed a battery of questionnaires. Multiple regression analyses, controlling for demographic variables and previously demonstrated predictors of death anxiety, revealed that the aging anxiety dimensions of physical appearance concern and fear of losses each positively predicted tangible death anxiety. In addition, the aging anxiety dimension of fear of losses predicted existential death anxiety. Results are discussed with respect to the multifaceted nature of death anxiety and how different forms of aging anxiety contribute to anxieties about death.
TL;DR: Most widows observed a year of traditional ukuzila mourning practices, which made them a threat to others and which is difficult to carry out in the social upheaval of modern South Africa.
Abstract: Interviews were carried out with 16 South African Zulu widows. Much of what the widows had to say seemed like what one might hear from widows in economically developed countries, but there were also striking differences. All the widows lived in poverty, and for some their grief seemed much more about the poverty than about the husband's death. Most widows observed a year of traditional ukuzila mourning practices, which made them a threat to others and which is difficult to carry out in the social upheaval of modern South Africa. Widowhood was in some cases a struggle with witchcraft--as cause of the death or as an accusation directed at the widow.
TL;DR: A qualitative analysis of revisiting exercise narratives provided by bereaved individuals undergoing complicated grief (CG) treatment found that the absence, rudeness, or aggression of others distressed and angered grieving participants, and implications for the role of social support in CG are discussed.
Abstract: The authors performed a qualitative analysis of revisiting exercise narratives provided by 22 bereaved individuals undergoing complicated grief (CG) treatment. Revisiting entails telling the story of the death. Most participants described social interactions in the narratives, viewing others as helpful (n = 7), unhelpful (n = 7), or both (n = 6). Many noted the presence of helpful individuals, yet perceived helpfulness was not sufficient to protect against developing CG, and helpfulness was not associated with lower depressive, grief, or trauma symptoms. However, the absence, rudeness, or aggression of others distressed and angered grieving participants. Implications for the role of social support in CG are discussed.
TL;DR: Findings partially support terror management theory and suggest that death attitudes, gender norms, and diagnostic status influence social distancing from individuals with cancer.
Abstract: In a study designed to examine correlates of cancer-related stigma, 405 college students were assigned randomly to listen to an audiotaped interview in which the target's cancer type and smoking status were manipulated. In the lung cancer conditions, target gender also was manipulated. Social distance and emotional responses differed according to participant gender, death anxiety, and target cancer type. Participant gender and target characteristics also were associated with perceptions of the target's character. Findings partially support terror management theory and suggest that death attitudes, gender norms, and diagnostic status influence social distancing from individuals with cancer.
TL;DR: Results of this study suggest that there are significant differences between levels of adaptive characteristics in women and men and should be useful in preparing more specific target interventions for preventing suicide and strengthening coping skills among young adults.
Abstract: Differences in suicidal behavior and adaptive characteristics were examined in college students with a particular emphasis on gender differences. Participants consisted of 344 undergraduate students who were administered a revised version of the Suicide Behaviors Questionnaire (SBQ), the Expanded Reasons for Living Inventory (RFL), and a demographic questionnaire. Results of this study suggest that there are significant differences between levels of adaptive characteristics in women and men. Women consistently scored higher on the Survival and Coping Beliefs, Responsibility to Family, Child-Related Concerns, and Fear of Suicide subscales of the RFL. No difference between genders was found for suicidal behavior. The current study provides insight into the similarities as well as the differences in adaptive characteristics and suicidal behavior between genders. The results of this study should be useful in preparing more specific target interventions for preventing suicide and strengthening coping skills among young adults.
TL;DR: Clinical examples of interventions after a loved one's death from a chronic illness are used to illustrate how interventions can help identify critical developmental systems and leverage points supporting positive development and giving priority to the bereaved's own goals for grief and growth.
Abstract: This article explores the concept of recovery in the wake of a loved one's death, using a cultural and developmental systems approach to understanding child, adult, and family bereavement outcomes as evolving, interdependent adaptive responses to changed circumstances of development within highly specific contexts in intergenerational time and cultural space. An integrative life span perspective on developmental psychopathology and resilience emphasizes the multi-dimensional nature of grief responses and their interweaving with ongoing and new interdependent adaptive strategies designed to accomplish specific, evolving tasks of shared life cycle development. This approach redefines bereavement "symptoms" as problematic when they interfere with negotiation of next steps in interdependent development within realistic ecologies and available resources in cultural contexts. The article uses clinical examples of interventions after a loved one's death from a chronic illness to illustrate how interventions can help identify critical developmental systems and leverage points supporting positive development and giving priority to the bereaved's own goals for grief and growth. This intervention model emphasizes patient-centered perspectives, conducts an ethical inquiry about consequences of adaptive strategies for all family members, and constructs collaborations between care providers and families.
TL;DR: The results that those living with family have significantly higher death anxiety are not in agreement with past western studies and may reflect cultural differences in anxiety about death.
Abstract: The present study examines the effect of age, gender, and living circumstances on elderly persons' death anxiety. For this purpose, 299 persons attending public parks (average age = 70 years) were interviewed using the Death Anxiety Survey Schedule, which is a set of 10 questions related to death anxiety from an Indian perspective. Women, those relatively older, and those living with family were significantly more anxious about the word death. The gender and age results in this Indian sample are similar to that in some western samples. The results that those living with family have significantly higher death anxiety are not in agreement with past western studies and may reflect cultural differences in anxiety about death.
TL;DR: TMT offers a strong base of experimentally validated ideas and the experimental paradigms to test the broad array of defenses enumerated in Firestone's Separation Theory, and would be beneficial to a fuller understanding of psychological defenses against death anxiety.
Abstract: The author attempts to integrate Terror Management Theory (TMT) and R. W. Firestone's Separation Theory (1984 1994). Both theories emphasize defense against death anxiety as a key human motive. Whereas TMT focuses extensively on self-esteem and cultural worldview, Firestone posited additional defenses such as gene survival, self-nourishing behaviors, addictive couple bonds, and adopting an anti-sexual approach to life. TMT offers a strong base of experimentally validated ideas and the experimental paradigms to test the broad array of defenses enumerated in Firestone's Separation Theory. Therefore, an integration of the two theories would be beneficial to a fuller understanding of psychological defenses against death anxiety.