Behavioural approaches to bereavement

Ramsay, R.W.

doi:10.1016/0005-7967(77)90097-3

Cited by 90 publications

(33 citation statements)

References 7 publications

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“…Furthermore, these avoidance strategies, in turn, were all related to the severity of traumatic grief and depression, again also when the frequency of grief reactions and relevant background variables were controlled. These findings are in line with theoretical notions (Horowitz, 1986;Ramsay, 1977) and earlier empirical findings (e.g., Folkman, Chesney, Collette, Boccellari, & Cooke, 1996;Nolen-Hoeksema, McBride, & Larson, 1997) indicating that both behavioural and cognitive avoidance strategies may prolong and exacerbate distress following loss.…”

Section: Discussionsupporting

confidence: 89%

The role of negative interpretations of grief reactions in emotional problems after bereavement

Boelen

Bout

Hout

2003

Journal of Behavior Therapy and Experimental Psychiatry

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Section: Discussionsupporting

confidence: 89%

The role of negative interpretations of grief reactions in emotional problems after bereavement

Boelen

Bout

Hout

2003

Journal of Behavior Therapy and Experimental Psychiatry

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“…In addition, to curb DA, therapists could use pleasant event scheduling (helping the person to schedule activities he/she previously enjoyed and that will likely give a sense of achievement) and systematic activation (helping the person to achieve specific occupational, recreational, and social goals by identifying and planning steps towards these goals). There is quite some evidence for the effectiveness of exposure in the treatment of CG/PGD Ramsay, 1977;. Less clear is the effectiveness of directly targeting DA using the aforementioned and other interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly though, no studies have yet directly tested the role of depressive and anxious avoidance strategies. That is not to say that researchers have not theorised about (e.g., Ramsay, 1977) and investigated the role of avoidance in grief. For instance, in several studies we ourselves found distinct measures of cognitive avoidance (e.g., thought suppression, rumination) and behavioural avoidance (avoidance of places that remind of the loss) to be correlated with CG/PGD severity and related symptoms (e.g., Boelen, 2009;Boelen & van den Hout, 2008;.…”

mentioning

confidence: 99%

Anxious and Depressive Avoidance and Symptoms of Prolonged Grief, Depression, and Post-Traumatic Stress Disorder

Boelen¹,

Bout

2010

PSYCHOL BELG

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Following loss, people can develop symptoms of depression, Post-Traumatic Stress Disorder (PTSD), or Complicated Grief (CG) -also termed Prolonged Grief Disorder (PGD). A recent cognitive-behavioural model has proposed that avoiding confrontation with the reality of the loss (called "anxious avoidance" [AA]) and refraining from activities that could foster adjustment (called "depressive avoidance" [DA]) both play a critical role in CG/ PGD. The present study examined this assumption, using self-reported data from 161 mourners. Findings showed that items constituting AA and DA represented two distinct factors. Both factors were strongly correlated with other measures of bereavement-related avoidance and both accounted for a unique part of the explained variance in CG/PGD severity, beyond relevant background variables, negative cognitions, and concomitant symptom-levels of depression and PTSD. DA also explained unique variance in depression beyond these variables. Moreover, AA and DA mediated the linkages of neuroticism, attachment anxiety, and attachment avoidance with symptomlevels of CG/PGD. IntroductionThere is increasing evidence that in an estimated 5 to 20% of bereaved people a loss gives rise to serious mental health problems such as depression, Post-Traumatic Stress Disorder (PTSD), or Complicated Grief (CG;Forstmeier & Maercker, 2007;Prigerson & Jacobs, 2001). CG, or Prolonged Grief Disorder (PGD) as it is recently termed, entails chronic, intense grief-reactions including separation distress, difficulties accepting the loss, preoccupation, and recurrent images of the lost person that cause significant impairments in functioning for at least 6 months (Prigerson, Horowitz, Jacobs, Parkes, Aslan, Goodkin et al., 2009;Prigerson, Vanderwerker, & Maciejewski, 2008). Parallel to the development of validated criteria for CG/PGD, there is increasing attention for the treatment of this condition. For instance, Shear, DOI: http://dx.doi.org/10.5334/pb-50-1-2-49 50 ANXIOUS AND DEPRESSIVE AVOIDANCE IN GRIEF, Frank, Houck, and Reynolds III (2005) found "complicated grief treatment" -a novel treatment containing elements of interpersonal therapy and cognitive-behavioural therapy (CBT) -to be effective in the reduction of CG/PGD symptoms. Boelen, de Keijser, van den Hout, and van den Bout (2007) found evidence for the effectiveness of brief cognitive-behavioural therapy for CG/ PGD. Although these findings are encouraging, not all patients included in these studies improved, leaving room to further improve and refine treatments. For the refinement of effective treatments for CG/PGD, it is essential to have more knowledge about intrapersonal processes that are involved in the development and maintenance of this condition.Recently, we developed a cognitive-behavioural (CB) conceptualisation of CG/PGD that was designed to offer a framework for the generation of hypotheses about processes involved in this condition and to inform efficacious treatment for it . This model proposes that CG/PGD develops and persists under t...

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“…There are a few reports about specific psychotherapeutic strate gies, pointing out the efficacy of the use of'linking objects' (e.g. personal possessions of the deceased) as a means of provoking 're-grief work [28], a behavioural technique of 'guided mourning' [29], a semi-behavioural forced mourning procedure [30], flooding and prolonged expo sure [31], and a combination of cognitive and analytic approaches to modify the patient's self-image [19], The various psychotherapeutic approaches share some fea tures. Most therapies provide the bereaved with informa tion about what to expect, attempt to put order in their puzzling array of feelings and behaviours, encourage the expression of emotions and affects, endeavour to help the bereaved to reconcile themselves with their new relation ship with the dead person, and attend to the bereaved individual's new identity [1], Parkes [3] remarks that techniques aimed at bringing about the expression of grief are only appropriate when there is evidence of avoidance and repression of grief, while in other patients it may be important to give the patient permission to stop grieving, being careful not to collude with any tendency to consider grief as an obligation to the dead.…”

Section: Treatment Optionsmentioning

confidence: 99%

Clinical and Biological Aspects of Bereavement and Loss-Induced Depression: A Reappraisal

Biondi

Picardi²

1996

Psychother Psychosom

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Loss and bereavement can be regarded as risk factors for the development of psychiatric and medical illness. Vulnerability to physical illness and mortality are increased during the first 2 years of bereavement, with men at higher risk than women. Symptoms of anxiety and a frank depressive syndrome are common during the first months of bereavement and, although depressive symptoms are usually transient and self-limited, bereaved individuals not rarely go on to develop major depression. In our perspective, loss perceived as irreparable, and persistence of perceived loss may favour the development of complicated grief and depression. Factors such as unexpectedness, absence of social support, concurrent loss or illness, and grief proneness may predict poor adjustment after bereavement. Complicated bereavement should be distinguished from uncomplicated bereavement, because patients with the latter need no treatment. In humans, there is evidence of increased adrenocortical activity and altered immune function following bereavement, whereas in non-human primates, biogenic amine systems appear to be involved in the response to maternal or social separation. According to a ‘psychosomatic view of the brain’, critical life events can both affect brain neurotransmitters and contribute to psychological and somatic symptoms of depression. Emotional events may be transduced into long-lasting brain changes, involving neurotransmitters, neuropeptides and receptors. Although only very limited evidence exists, long-term consequences could involve changes at the gene expression level.

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Behavioural approaches to bereavement

Cited by 90 publications

References 7 publications

The role of negative interpretations of grief reactions in emotional problems after bereavement

The role of negative interpretations of grief reactions in emotional problems after bereavement

Anxious and Depressive Avoidance and Symptoms of Prolonged Grief, Depression, and Post-Traumatic Stress Disorder

Clinical and Biological Aspects of Bereavement and Loss-Induced Depression: A Reappraisal

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