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At least 19 recordsLinked to original sources
PubMed1992

Electroencephalographic sleep in spousal bereavement and bereavement-related depression of late life.

Although spousal bereavement in late life is common and frequently leads to major depression, the boundary between bereavement without a depressive syndrome and bereavement-related depression has been insufficiently studied from a physiological perspective. Because other forms of depression are associated with physiological changes, including sleep, we have attempted to clarify the relationship of bereavement and bereavement-related depression by investigating electroencephalographic (EEG) sleep in 31 elderly volunteers with recent spousal bereavement, stratified by the presence (n = 15) or the absence (n = 16) of major depression (Research Diagnostic Criteria). Entry into the study was limited to volunteers without a personal history of psychiatric disorder. As hypothesized, bereaved subjects with major depression had significantly lower sleep efficiency, more early morning awakening, shorter rapid eye movement (REM) latency, greater REM sleep percent, and lower rates of delta wave generation in the first nonREM (NREM) period, compared with bereaved subjects without depression. Furthermore, the sleep of bereaved subjects with single-episode major depression resembled that of elderly patients with recurrent unipolar major depression (n = 15) on measures noted above. Sleep in bereavement without depression was similar to that of 15 healthy control subjects (neither bereaved nor depressed). These findings suggest that the current DSM-III-R concept of uncomplicated bereavement is not confirmed, as the sleep patterns of subjects who develop a depressive syndrome in the context of bereavement, many of whom might be considered to have "uncomplicated bereavement" by DSM-III-R standards, are identical to sleep patterns found in major depressive episodes. To our knowledge, this is the first study of EEG sleep in spousal bereavement with and without major depression.

Aged↗
PubMed2026

"Orphaned bereavement": Toward a public health model for bereavement.

Bereavement is increasingly recognized as a public health concern, yet support systems in many welfare states continue to allocate support according to the circumstances of death rather than the functional needs of bereaved families. Existing bereavement frameworks have substantially advanced understanding of social recognition and public legitimacy but provide more limited guidance for understanding how institutional responsibility for bereaved families is organized. using Israel as a bereavement-saturated case, this study introduces the concept of orphaned bereavement to describe bereavement in which no institution holds clearly defined and continuing responsibility for identifying needs, coordinating support, and ensuring continuity of care. Drawing on 25 semi-structured interviews with five bereaved family members and 20 professionals, analyzed using reflexive thematic analysis, the analysis generated three interrelated themes: institutionalized invisibility and unequal recognition; reorganizing life in the absence of institutional support; and pathways toward a needs-based model of bereavement support. The findings extend existing theories of disenfranchized grief and grievability by introducing institutional responsibility as a complementary lens for understanding bereavement inequality and support a needs-based public health approach in which support is organized according to families' evolving functional needs rather than the circumstances of death.

Journal Article↗
PubMed1990

Suicide bereavement and recovery patterns compared with nonsuicide bereavement patterns.

This study compared bereavement experiences of suicide survivors with those of other survivors. The primary focus of investigation was upon grief reactions suggested to be unique to suicide bereavement and upon quality of grief resolution 2-4 years after death. Fifty-seven women and men, between the ages of 24 and 48, who had experienced the death of a marital partner were interviewed. Subjects were assigned to one of four groups by mode of death (suicide, accident, unanticipated natural, and expected natural). Analyses of variance and Scheffe procedures indicated no significant differences among survivors on frequencies of grief reactions considered common to all bereavements. The suicide survivors were significantly different from all others on certain grief measures, including rejection and unique grief reactions. On various other grief measures, significant differences were indicated among the groups of survivors. Four primary conclusions, implications of the findings, and limitations of the study are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

The effect of a bereavement group experience on bereaved children's and adolescents' affective and somatic distress.

Losing loved ones through death is a common experience for children. Children living in urban centers may be at greater risk for death of family members as a result of increased daily stress and poverty. Children who experience permanent loss of family members without support to grieve are at greater risk for mental health problems. Manifestations of grief that frequently occur in children are psychosomatic complaints and affective distress. This study investigates the prevalence of loss by death among two groups of inner city youths, and the impact of a bereavement group experience on subjects' affective distress and somatic complaints. A significant difference was found between pretest and post-test scores on somatic complaints for the elementary school aged group.

Adolescent↗
PubMed1992

Unique patterns of bereavement in HIV: implications for counselling.

OBJECTIVE: The aim of this study was to examine the nature and extent of bereavement problems in HIV + ve clients and the counselling input required. DESIGN: Ninety individuals referred consecutively for counselling by the medical teams after HIV diagnoses were included in the study. Specific bereavement data was gathered by each counsellor according to schedule and semi-structured interviews for all 90 subjects. These data were analysed in conjunction with medical referral letters. SETTING: HIV positive clients attending for treatment at an inner London Hospital. SUBJECTS: The subjects were 91% males and 9% females, mean age 33.82 years (SD 7.2, range 15 to 50 years, mode 28). 44.8% were diagnosed as HIV + ve (asymptomatic), 42.5% had an AIDS diagnosis and the remainder were coded as AIDS Related Complex or unclear. MAIN OUTCOME MEASURES: The subjects were monitored for the presence or absence of bereavement issues, the nature and extent of the reactions and counselling input. The occurrence of single and multiple bereavements was monitored, as were the relationship to the index patient and the health status of the bereaved. RESULTS: Bereavement was mentioned in 28.2% of referrals from medical practitioners yet 43.1% of the patients had been bereaved and used bereavement counselling. 43% spontaneously commenced the session with bereavement issues. They had lost 348 people (average of 12.9 deaths per person reporting). These were overwhelmingly due to AIDS with only 12 (5.6%) not HIV related. 65% linked the bereavement to their own death. Emotional reaction seemed to be independent of the relationship with the deceased but linked with the diagnosis status of the bereaved. CONCLUSION: The emotional consequences of a loss can be severe and long term. The advent of AIDS/HIV has revealed a wave of deaths in a population unused to facing traumatic loss to this extent. There are particular features surrounding AIDS and HIV infection which may differ dramatically from other sorts of loss and challenge previously held notions of bereavement such as the age of the clients, the fact that bereavements are often multiple the illness state of the bereaved person, the taboo surrounding AIDS which often presents barriers to wider social support and the catalogue of losses which any individual has to face. The frequency and high rate of bereavement, often not noted by referrers, suggests similarity with disaster literature in terms of counselling demand.

AIDS-Related Complex↗
PubMed1991

Bereavement and heightened existential awareness.

"Ask not for whom the bells toll; they toll for thee." John Donne's admonition, though written 350 years ago, endures with astonishing freshness; it speaks to something self-evident, to a truth that is well known to many who have experienced bereavement--that the death of a significant other has the potential to hurl the survivor into a confrontation with his/her own death. A confrontation with death--should we seek it? There is evidence in the clinical literature that in terminally ill patients such a confrontation may lead to pronounced positive psychological changes. Research (Yalom 1980) has documented that terminally ill patients may undergo a series of positive personal changes; they communicate more openly with family and close friends, they experience fewer fears, they rearrange their life priorities, they are less preoccupied with the trivialities of life, they live life more immediately rather than postpone experience and pleasure into the future. Does spousal bereavement in our culture confront individuals with their own personal death? Does it cause some widow/widowers to regard their existence in a different manner? If so, might it be possible that those bereaved individuals who examine their life deeply may have a different course of bereavement than those who do not look within? Might it even be possible that bereavement, for some individuals, results in psychological shifts analogous to the positive changes reported by terminally ill patients? These are the basic questions of our research inquiry. We designed a project which would allow us to determine, in a nonclinical sample of bereaved spouses, differences in the degree of existential awareness and the consequences of such awareness on the course of bereavement. We also attempted to determine which subjects were more likely to develop heightened existential awareness. The participants studied were part of an intervention project on bereavement in which we studied a sample of widows and widowers in the first few months of bereavement and then offered them an opportunity to participate in an eight-meeting support group. Reports of the clinical issues emerging in our short-term bereavement groups and of the efficacy of these groups were published elsewhere (Yalom and Vinogradov 1988; Lieberman and Yalom 1991).

Awareness↗
PubMed1990

Bereavement and depression.

Bereavement is the reaction to the loss of a loved one by death and usually occurs in three stages: numbness, depression, and recovery. The length of time it takes for bereavement to resolve varies from person to person. During the depression stage, the bereaved person may experience all the symptoms of the typical depressed patient, with the exception of retardation. However, a depressed patient has more symptoms than a bereaved person and reports feeling changed, not his or her usual self, whereas the bereaved person expects to have such symptoms. The essence of the morbidity of bereavement is the increased use of alcohol, tranquilizers, hypnotics, cigarettes, and other substances during this stressful time. Increased mortality occurs in men aged 75 years or younger in the first year of bereavement, but mortality does not increase in women or parents during that first year. Pathologic grief, defined as a continued depressive symptom, occurs in about 15% of bereaved persons when they are initially widowed. Treatment for the bereaved person should be that which is given to any depressed patient.

Aged↗
PubMedDate not supplied

[A study of the effectiveness of the bereavement program of Severance Hospice].

Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much as been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learn more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated by the researcher. Data was obtained from bereaved family members (54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a moderately positive correlation to appetite disturbance (r = .41, P less than .01) and loss of vigor (r = .37, P less than .01) A moderately positive correlation was found between the number of contacts and sleep disturbance (r = 2.38, P less than .01) Significant differences were found between men and women in regard to guilt (t = 2.38, P less than .05), social isolation (t = 2.44, P less than .05) and depersonalization (t = 2.07, P less than .05) with men having the more intense grief. Significant differences were found in the grief responses of somatization (F = 5.82, P less than .001), physical symptoms (F = 5.87, P less than .001), appetite disturbance (F = 4.40, P less than .01), despair (3.79, P less than .01), anger (Fp2.83, P less than .05), social isolation (F = 3.61, P less than .05), guilt (F = 3.62, P less than .05) and depersonalization (F = 2.58, P less than .05).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1990

Identification of spouses at high risk during bereavement: a preliminary assessment of Parkes and Weiss' Risk Index.

The Risk Index developed by Parkes and Weiss (1983) is a brief structured assessment tool for identifying bereaved spouses who may be at high risk for developing complications during bereavement. The present study was undertaken to evaluate the utility of the Risk Index in predicting outcome during the first year of bereavement in spouses of deceased hospice patients. Professional staff at the hospice completed the Risk Index shortly after the spouse died and outcome was then assessed after 1, 3, 6, and 12 months. High-risk bereaved were younger than low-risk bereaved. Number of young children at home, existence of close relationships, and financial status were important predictors of outcome during the first year of bereavement. The findings suggest that the Risk Index may serve as a cost-effective means of assessing risk for complications during the first year of bereavement.

Abstracting and Indexing↗
PubMed1991

Depression in recently bereaved prepubertal children.

OBJECTIVE: The purpose of this study was to ascertain depressive symptoms in recently bereaved prepubertal children and compare these symptoms with those of depressed prepubertal children. METHOD: The subjects were 38 children who had recently experienced the death of one but not both of their parents. They had to meet strict inclusion criteria so that the effects of bereavement per se, rather than other significant stressors, could be assessed. The comparison group consisted of 38 hospitalized, depressed children individually matched to each bereaved subject for age, sex, and socioeconomic status. All of the children underwent systematic and comprehensive evaluation. They and their parents were independently evaluated by trained interviewers using the parent and child versions of the Diagnostic Interview for Children and Adolescents. Family histories and basic demographic information were also obtained. RESULTS: The recently bereaved children endorsed many depressive symptoms. Thirty-seven percent of them met the DSM-III-R criteria for a major depressive episode. The depressed children, however, had more depressive symptoms on average than the bereaved children. The factors associated with increased depressive symptoms in the bereaved children were 1) the mother as the surviving parent, 2) preexisting untreated psychiatric disorder in the child, 3) family history of depression, and 4) high socioeconomic status. CONCLUSIONS: A considerable number of the bereaved children developed the clinical symptoms of a major depressive episode immediately after the death of a parent. The relation of these symptoms to the subsequent course of grief and to major depressive disorder remains unknown and should be studied further.

Adult↗
PubMed1991

An exploratory study of drawings by bereaved children.

Bereaved and non-bereaved children made drawings of a person, themselves, their family, and a topic of their choice; the drawings were then analysed to investigate whether the experience of bereavement was expressed in drawing in any reliable way. Bereaved children were no more likely than non-bereaved children to include indicators of emotional disturbance in their human figure drawings. Bereaved children, however, were reliably more likely than non-bereaved children to include themselves in a drawing of their family.

Adaptation, Psychological↗
PubMed1976

A study of bereavement in general practice.

Forty six bereaved relatives were assessed by a general practitioner four to eight weeks after the bereavement. In 36 (78.3 per cent) the immediate reaction to bereavement was one of numbness or stupefaction; in seven (15.2 per cent) emotional relief occurred; and in three cases (6.5 per cent) there was no obvious immediate reaction. The numbness reaction was limited in duration to a week or less in 31 of the 36 instances.At four to eight weeks after bereavement 29 (63.0 per cent) of the subjects continued to experience difficulty in coming to terms with their loss. Twenty subjects reported guilt feelings and a similar number expressed aggressive reactions. The bereaved subjects tended to increase their consumption of cigarettes and alcohol, while their appetite and weight tended to be reduced. Thirty six (78.3 per cent) of the subjects reported physical symptoms, notably headache, dizziness, generalised aches, and abdominal complaints.THE MOST PROMINENT PSYCHOLOGICAL FEATURES OF BEREAVEMENT WERE FOUND TO BE: preoccupation with thoughts of the deceased, idealisation of the lost person, depressive mood, and loneliness.The findings are discussed and reference made to the role of the family doctor in the management of bereavement reactions.

Adolescent↗
PubMed1991

Immune variables, depression, and plasma cortisol over time in suddenly bereaved parents.

Bereavement has been associated with increased morbidity and mortality. The authors monitored a previously unstudied population, parents who had experienced sudden death of a formerly healthy child, for immunological changes, plasma cortisol level, and depression. Nine bereaved parents were matched case-for-case with nonbereaved controls and concurrently monitored 2, 4, 6, and 8 months post-bereavement. The bereaved parents showed significantly decreased T-suppressor cells, significantly increased T-helper cells, and depression compared with controls, but no difference in cortisol levels. The bereaved also showed nonsignificant but elevated blastogenesis in mitogen-stimulated cells. These changes persisted throughout the first 8 months of bereavement.

Adolescent↗
PubMed1990

Anxiety disorders during acute bereavement: risk and risk factors.

Forty-four percent of bereaved spouses reported at least one type of anxiety disorder during the first year of bereavement in a survey of a representative sample composed of a subgroup (N = 48) assessed 6 months after bereavement and another subgroup (N = 54) assessed 12 months after bereavement. The bereaved spouses experienced 6-month prevalence rates for panic disorder and generalized anxiety disorders that were higher than community prevalence rates for the same metropolitan area (p less than .01). Past personal history of anxiety disorder was an independent risk factor (p less than .05), and anxiety disorders were associated with severe grief (p less than .01) and depression (p less than .05). The large overlap of anxiety disorders with major depression observed in this study indicates that the estimated rates of anxiety disorder are not independent of major depression in most cases and raises questions about whether the anxiety disorders of bereavement are prodromal, concomitant, or residual with respect to major depression.

Adult↗
PubMed1990

The cultural bereavement interview: a new clinical research approach for refugees.

The large number of refugees in the world must cope with the loss of family and homeland. This paper proposes a new concept of cultural bereavement and presents a framework for its identification in the clinical interview with refugees. The cultural bereavement interview explores reactions to personal losses and to losses of both the social systems and the cultural meanings. Eleven areas are systematically explored, the first nine are indicators of bereavement and the tenth and eleventh are "antidotes" to cultural bereavement. The cultural bereavement interview can provide a clinical framework for exploring the patient's personal and cultural bereavement, clarify the "structure" of the patient's reactions to loss, complement the currently used psychiatric diagnostic categories, acknowledge the cultural system of meaning held by the patient, and provide information to be used in planning social supports or interventions.

Acculturation↗
PubMed1990

Retrospective assessment of marital adjustment and depression during the first 2 years of spousal bereavement.

Two hundred twelve bereaved elders rated marital adjustment using items drawn from the Locke and Wallace (1959) Marital Adjustment Test and completed the Beck Depression Inventory 2 months, 12 months, and 30 months after the loss of their spouses. Their responses were compared with those of 162 nonbereaved individuals of comparable age who were tested at the same times. More positive ratings of marital adjustment were made by bereaved subjects than by nonbereaved subjects. Among nonbereaved elders, more severe ratings of depression were associated with lower ratings of marital adjustment. In the bereaved sample, however, the opposite was found: More severe ratings of depression were associated with higher ratings of marital adjustment. This pattern of results changed only slightly over the 2.5-year course of bereavement and was not influenced by gender. These results are discussed in terms of cognitive processes (e.g., idealization) that influence retrospective assessments of marital adjustment during bereavement.

Adaptation, Psychological↗
PubMed1992

Management of sudden bereavement in the accident and emergency department.

OBJECTIVE: To assess facilities available for the suddenly bereaved in accident and emergency departments and variations in care of bereaved relatives. DESIGN: Postal questionnaire survey. SETTING: England and Wales. SUBJECTS: All 98 accident and emergency departments treating over 50,000 patients a year, 78 of which replied. MAIN OUTCOME MEASURES: Number of departments with specific facilities, staff training, and procedures for dealing with bereavement. RESULTS: 60 hospitals had a specific room for bereaved relatives; the remainder used multipurpose rooms. In 49 hospitals relatives were taken to the room by a nurse with sole responsibility for caring for them. In 40 hospitals the nurse stayed with the relatives and 66 updated relatives on the patient's condition. Facilities for viewing the body privately were poor, and relatives often had to ask to be left alone. 25 departments gave no written information on bereavement and only four routinely followed up relatives. Further training was requested by staff in 44 departments. CONCLUSIONS: Although facilities could be improved, immediate care of relatives is good. Care over subsequent weeks and preparation for this period is invariably inadequate.

Bereavement↗