Dyadic Coping of Patients with Hematologic Malignancies and Their Partners and Its Relation to Quality of Life (original) (raw)
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BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of coping strategies after bereavement among spouses of cancer patients and (2) to explore the characteris-BACKGROUND: Whereas a grief-related disorder tapping prolonged disabling reactions might be included in the DSM 5, the mechanisms underlying it remain poorly described. Some studies highlighted the risk for bereaved spouses after a cancer to develop this disorder, especially when reporting an insecure attachment. However no qualitative study explores associations between attachment styles and adjustment to grief in this population. This study aims at enhancing knowledge about the delineation of this debilitating condition. METHOD: The interview of a male widower (57 years) of a cancer patient, presenting a disorganized attachment and meeting at 6 months post-death the criteria for PGD (Inventory of Complicated Grief, Prigerson et al., 1995) was subjected to an Interpretative Phenomenological Analysis (IPA, Smith, Flowers & Larkin, 2009). This standardized analysis targets the meaning making processes with regards to attachment styles. RESULTS: Three inter-related master themes are presented: (1) Forgetting, and continuing bonds;
Attachment in Coping With Bereavement: A Theoretical Integration
Review of General Psychology, 2005
Researchers have deplored shortcomings in theoretically based models of coping with bereavement. Integration of cognitive stress with attachment theory is proposed to predict adjustment to bereavement, describe different forms of effective coping, and resolve ongoing debates about continuing versus relinquishing bonds. These 2 generic approaches are integrated within a bereavement-specific perspective, the dual-process model of coping . Accordingly, (a) different coping styles are adopted by, and are differentially efficacious for, bereaved people according to their style of attachment; (b) bereaved people's ways of continuing bonds differ according to their attachment style; and (c) grief complications are associated with insecure attachment styles. The authors conclude that it is better for some bereaved individuals to work toward retaining ties and for others to work toward loosening ties.
Attachment and the Experience of Grief Following the Loss of a Spouse
OMEGA: The Journal of Death and Dying, 2003
Numerous studies have been conducted in the areas of attachment theory and grief. There is, however, very little research that explores the possible connection between attachment and grief. The present study examines the relationship between an adult's attachment style (i.e., secure or insecure) and an individual's experience of grief after the loss of a spouse. Seventy-seven widows and widowers completed a questionnaire package consisting of the Relationship Scales Questionnaire (Griffin & Bartholomew, 1994), the Grief Experience Inventory (Sanders, Mauger, & Strong, 1985a), and the Continuing Bonds Scale (Grund, 1998). Differences between participants who were secure in attachment to their spouse and those insecure in attachment (which includes preoccupied, dismissing, and fearful) were examined on the Grief Experience Inventory and the Continuing Bonds Scale. Findings revealed differences between securely and insecurely attached widowed people on subscales of the Grief Ex...
Continuing bonds and attachment in bereavement: The role of meaning-making
2019
Attachment security plays an important function in the grieving process. This study aimed to explore how individual differences in attachment security and meaning-made predict continuing bonds expression among bereaved adults (n ¼ 237) using a moderated mediation model. Results of multiple regression analysis revealed an indirect effect of meaningmade on the negative relationship between attachment avoidance and continuing bonds. Results suggest that loss may be less disruptive to the meaning system of avoidant individuals and, therefore, avoidant individuals may express continuing bonds to a lesser extent. Findings implicate bereavement adjustment and grief-related interventions tailored to individual differences in attachment.
Attachment Anxiety and Avoidance in Coping with Bereavement: Two Studies
Journal of Social and Clinical Psychology, 2013
although attachment theory has become one of the primary paradigms for understanding bereavement adaptation, there has been surprisingly little empirical work on this topic. two studies investigated the role of attachment in coping with the loss of a loved one. Study 1 examined the unique contribution of attachment anxiety and avoidance in prolonged grief symptomatology (PGS) in a sample of 656 recently bereaved young adults. When accounting for demographic factors (age, ethnicity, gender) and loss-related circumstances (relationship to deceased, violent versus natural loss), higher levels of attachment-related anxiety were associated with more PGS but avoidance failed to produce a unique effect. Study 2 investigated the role of attachment insecurities in the context of violent death bereavement. Participants were grouped by those who experienced a violent loss in the past two years (accident, suicide, homicide; n = 191) and a matched control group who had not experienced a loss (n = 191). individuals with higher levels of attachment anxiety reported worse physical and mental health symptoms. attachment avoidance was a salient predictor of poor post-bereavement functioning for violent loss survivors but avoidant attachment was not as relevant for nonbereaved persons. results of the second study support the worrisome role of attachment anxiety in the context of coping with bereavement, while also suggesting detrimental effects for avoidance in extreme cases of loss.
An attachment-based model of complicated grief including the role of avoidance
European Archives of Psychiatry and Clinical Neuroscience, 2007
Introduction-Complicated grief is a prolonged grief disorder with elements of a stress response syndrome. We have previously proposed a biobehavioral model showing the pathway to complicated grief. Avoidance is a component that can be difficult to assess and pivotal to treatment. Therefore we developed an avoidance questionnaire to characterize avoidance among patients with CG.
Attachment and Severity of Grief: The Mediating Role of Negative Appraisal and Inflexible Coping
According to the Dual Process Model of coping with bereavement (DPM; Stroebe & Schut, 1999), adjustment to bereavement involves a flexible oscillation between two types of coping strategies: loss-oriented (LO) and restoration-oriented (RO). This model postulates that extremely anxious or avoidant attachment disturbs the oscillation process by focusing more on one type of strategy, either LO or RO. The present study examined this assumption. We recruited 321 bereaved individuals who had lost a romantic partner. Our results showed that less negative appraisal of bereavement-related stressors, as well as higher use of RO strategies, mediated the link between attachment avoidance and low severity of grief reactions. However, the DPM variables were not found to mediate the link between attachment anxiety and elevated grief reactions. We discuss how these results provide an empirical basis of the DPM.
Attachment Security and Continuing Bonds: The Mediating Role of Meaning-Made in Bereavement
Journal of Loss and Trauma , 2020
Attachment security plays an important function in the grieving process. This study aimed to explore how individual differences in attachment security and meaning-made predict continuing bonds expression among bereaved adults (n ¼ 237) using a moderated mediation model. Results of multiple regression analysis revealed an indirect effect of meaningmade on the negative relationship between attachment avoidance and continuing bonds. Results suggest that loss may be less disruptive to the meaning system of avoidant individuals and, therefore, avoidant individuals may express continuing bonds to a lesser extent. Findings implicate bereavement adjustment and grief-related interventions tailored to individual differences in attachment.
Psycho-Oncology, 2010
Objective: Encouraging coping strategies that contribute to positive psychological states in bereaved individuals is assumed to be desirable; however, little is known about the components of positive psychological states and bereavement-specific coping strategies. The purpose of this study was to describe the components of psychological states and coping strategies after bereavement among the spouses of cancer patients. Methods: Semi-structured interviews were conducted among bereaved spouses of cancer patients. Meaning units of the psychological state and coping strategy in the interview records were grouped into categories and themes based on their similarities using content analysis and constant comparison methods. Negative/positive psychological states and general/bereavement-specific coping strategies were identified by discussion among the authors. The number of participants who responded to each category was determined by two raters who were unaware of the categorized procedure. Results: Seven men and 17 women participated in the interviews. Forty-two categories of psychological states identified from 784 meaning units were grouped into six themes: 'Anxiety', 'Yearning', 'Anger', and 'Depression' were negative psychological states, while 'Acceptance' and 'Future-oriented Feelings' were positive psychological states. Thirty-three categories of coping strategies identified from 559 meaning units were grouped into six themes: 'Avoidance', 'Distancing', 'Emotional Expression', and 'Seeking Support' were general coping strategies, while 'Continuing Bonds' and 'Reconstruction of Life' were bereavement-specific coping strategies. Conclusions: Several original components of positive psychological states after bereavement and bereavement-specific coping strategies were identified, whereas most of the other components were consistent with previous studies.
Social Science & Medicine, 2010
Limited research so far has examined coping processes that mediate between risk factors and bereavement outcome. Knowledge of these pathways is important, since it helps establish why some bereaved persons are more vulnerable than others and suggests possibilities for intervention. In this international longitudinal study, three potentially critical mediators, namely rumination, threatening grief interpretations and deliberate grief avoidance, were examined in relationship to previously established risk factors (e.g., expectedness of the death, attachment style) and four major outcome variables (grief, depressive symptoms, emotional loneliness and positive mood). Individuals who were recently bereaved (maximum 3 years) filled in questionnaires at three points in time. Results showed that rumination and e to a somewhat lesser extent e threatening grief interpretations played an important role in mediating the effects of various risk factors on outcomes. However, the contribution of these two mediators was dependent on the specific risk factor and outcome measure under consideration. For example, whereas the effect of neuroticism on grief was mediated by both processes (to the extent of 73%), the effect of neuroticism on positive mood was only mediated by rumination and to a smaller extent (23%). A few risk factors, such as current financial situation and spirituality, were not mediated by either coping strategy. Implications of these findings are discussed.