3.4 Affective Disorders
Week 3
Grief
,Grief
Bonanno et al (2002)
Resilience to Loss and Chronic Grief: A Prospective Study From
Preloss to 18-Months Postloss
Introduction
● Death of a spouse assumed to be one of the most stressful experiences
● Individual differences in how much and for how long people grieve
● Patterns of grief
○ Prolonged or chronic grief
○ Noticeable absence of grief symptoms
○ Delayed grief responses
● Often in grief research data is aggregated → not possible to identify patterns
○ Preloss data is necessary
● Investigate effects of absence of stress as a resilience factor
● This article → address issues in previous research on grief
Identifying divergent reactions to conjugal loss
● Chronic grief
○ 10-20% prevalence
○ Relationship with preexisting psychopathology may be present
■ Depression related memory biases may inflate relationship between
current & prior difficulties
■ Intensity & emotional difficulties may be overestimated
■ Important to distinguish chronic depression from chronic grief reactions
● Absence of grief → pathology or resilience
○ Historically seen as pathological as it is important to work through the emotional
pain
○ A majority believe that it stems from denial or inhibition and is maladaptive in the
long run
○ More and more people now believe it is linked to quick adjustment following
expected loss or personality factors that promote resilience to loss
○ A large portion of conjugally bereaved people do not exhibit significant distress or
depression following loss → calls into question whether it is pathological
● Delayed grief & improved functioning during bereavement
○ Traditional perspective → absence of overt signs will eventually be manifested
into delayed reaction
○ Percentage of those experiencing delayed grief is extremely low
, ○ In some cases improvements after the loss → of spouse had a serious illness or
if marital relationship was highly stressful
■ Little is known
○ Two groups within those distressed after loss are possible
■ Distress both before and after the loss (no difference)
■ Distress caused by the loss
○ Two groups within those not distressed after loss are possible
■ Resilient group who experiences little distress prior to and after death
■ Distress prior to loss, improvement following death
● Preloss predictors of divergent reactions to conjugal loss
○ Qualities of the conjugal relationship
■ Chronic grief hypotheses
● Conflict in the relationship
● Ambivalence towards the spouse
● Excessive dependency
● Anxious/ambivalent or preoccupied attachment styles
● Depression
■ Absent grief hypotheses
● Superficial attachment
● Prolonged relationship conflict
● Emotionally distant
● Avoidant or dismissive attachment style
○ Coping resources
■ Moderate adjustment to stressful life events
■ Personality traits
● Emotional stability → buffer from destabilization
● Other good traits → conscientiousness, agreeableness, openness
to experience, tendency to introspect, perceived confidence in
coping
■ Religious involvement
● Fosters resilience
● Support from community
● Especially the factors personal devotion & personal conservatism
○ Meaning (world view)
■ Finding meaning is a core component of the grieving process
● Unable to find meaning → prolonged grief reaction
■ Chronic grief → world is meaningless, unjust, uncontrollable
■ People who do not actively search for meaning following loss → respond
well to trauma & loss
● If prior world view accommodates possibility of loss, less need to
search for meaning
○ Context
■ Perceived social support
■ Instrumental support (eg financial resources)
Week 3
Grief
,Grief
Bonanno et al (2002)
Resilience to Loss and Chronic Grief: A Prospective Study From
Preloss to 18-Months Postloss
Introduction
● Death of a spouse assumed to be one of the most stressful experiences
● Individual differences in how much and for how long people grieve
● Patterns of grief
○ Prolonged or chronic grief
○ Noticeable absence of grief symptoms
○ Delayed grief responses
● Often in grief research data is aggregated → not possible to identify patterns
○ Preloss data is necessary
● Investigate effects of absence of stress as a resilience factor
● This article → address issues in previous research on grief
Identifying divergent reactions to conjugal loss
● Chronic grief
○ 10-20% prevalence
○ Relationship with preexisting psychopathology may be present
■ Depression related memory biases may inflate relationship between
current & prior difficulties
■ Intensity & emotional difficulties may be overestimated
■ Important to distinguish chronic depression from chronic grief reactions
● Absence of grief → pathology or resilience
○ Historically seen as pathological as it is important to work through the emotional
pain
○ A majority believe that it stems from denial or inhibition and is maladaptive in the
long run
○ More and more people now believe it is linked to quick adjustment following
expected loss or personality factors that promote resilience to loss
○ A large portion of conjugally bereaved people do not exhibit significant distress or
depression following loss → calls into question whether it is pathological
● Delayed grief & improved functioning during bereavement
○ Traditional perspective → absence of overt signs will eventually be manifested
into delayed reaction
○ Percentage of those experiencing delayed grief is extremely low
, ○ In some cases improvements after the loss → of spouse had a serious illness or
if marital relationship was highly stressful
■ Little is known
○ Two groups within those distressed after loss are possible
■ Distress both before and after the loss (no difference)
■ Distress caused by the loss
○ Two groups within those not distressed after loss are possible
■ Resilient group who experiences little distress prior to and after death
■ Distress prior to loss, improvement following death
● Preloss predictors of divergent reactions to conjugal loss
○ Qualities of the conjugal relationship
■ Chronic grief hypotheses
● Conflict in the relationship
● Ambivalence towards the spouse
● Excessive dependency
● Anxious/ambivalent or preoccupied attachment styles
● Depression
■ Absent grief hypotheses
● Superficial attachment
● Prolonged relationship conflict
● Emotionally distant
● Avoidant or dismissive attachment style
○ Coping resources
■ Moderate adjustment to stressful life events
■ Personality traits
● Emotional stability → buffer from destabilization
● Other good traits → conscientiousness, agreeableness, openness
to experience, tendency to introspect, perceived confidence in
coping
■ Religious involvement
● Fosters resilience
● Support from community
● Especially the factors personal devotion & personal conservatism
○ Meaning (world view)
■ Finding meaning is a core component of the grieving process
● Unable to find meaning → prolonged grief reaction
■ Chronic grief → world is meaningless, unjust, uncontrollable
■ People who do not actively search for meaning following loss → respond
well to trauma & loss
● If prior world view accommodates possibility of loss, less need to
search for meaning
○ Context
■ Perceived social support
■ Instrumental support (eg financial resources)
