Conscious and unconscious coping with loss.

Abstract

Sixty-seven persons were identified 1 to 2 months after the death or life-threatening illness of their spouse and followed for 25 months. Intake measures included a) a revised Ways of Coping Scale, a structured assessment of ego defenses, sociodemographic information, and other baseline variables. Fifty-six completed follow-up. Outcome measures included deaths, hospitalization, self-rated health, depressive symptoms, symptoms of anxiety, and separation distress. In our analyses, bereavement was used as a covariate and found to be unrelated to outcome. Low self-ratings on coping by making a change and problem-focused planning predicted higher scores on separation distress at 13 months (p < or = .05). Participants who used less problem-focused planning were at risk for higher depression scores 13 months after the stressful event (p < or = .05). Low ego-defensive work and high neurotic ego-defensive ratings predicted high depression scores at 13 months (p < or = .05). At 25 months, coping by self-blame was inversely related to scores on separation distress (p < or = .05). Coping variables predicted neither scores on anxiety symptom scales nor the outcomes of hospitalization or death over the 25-month study period. These observations counter some prevailing clinical assumptions about coping with a loss and emphasize the value of empirical studies of coping as a mediator of outcome during the stress of a loss.

Bereavement is associated with time-dependent decrements in cellular immune function in asymptomatic human immunodeficiency virus type 1-seropositive homosexual men

“…For lymphocyte proliferative response to PHA, the effect of active coping was equally prominent among the bereaved and the nonbereaved. Though prior research in bereavement-related psychosocial adaptation focused on the need to vent emotions, the present results suggest that venting emotions may be less important than using active coping styles, such as planning a strategy to deal with the stressor and carrying through such actions, not only for successful psychosocial adaptation to loss (31,68) but also for its physiological sequelae (23,25).…”

An Investigation of the Relationship of Personality, Coping, and Grief Intensity Among Bereaved Mothers

“…Meuser and Marwit (2000) proposed that the issue of particular coping styles and their impact on grief may be ''one of proportion and balance'' (p. 388); that while both task-oriented and emotion-oriented coping may serve important roles, a coping repertoire that includes a higher proportion of task-oriented coping may have a buffering effect on grief, whereas higher levels of emotion-oriented coping may indeed put people at greater risk for poor adjustment. A number of other studies of bereavement (e.g., Dijkstra et al, 1999;Gass & Chang, 1989;Jacobs, Kasl, Schaefer, & Ostfeld, 1994) have supported this suggestion.…”

The Relationship Between Adjustment and Bereavement-Related Distress: A Longitudinal Study

“…To date, there exists a wealth of work explicating models of bereavement (Atchley, 1975;Moos, 1995;Parkes, 1988;KublerRoss, 1969;Bowlby, 1980;Pollock, 1987), grief coping processes (Stroebe & Schut, 1999;Maxwell, 1995;Lindstrom, 1999;Jacobs, Kasl, Schaefer, & Ostfeld, 1994), and adjustment (Parkes, 1988;Schut, Stroebe, van den Bout, & Keijser, 1997;Stein, Folkman, Trabasso, & Richards, 1997). Attempts to classify an appropriate response to the loss of a spouse are numerous yet admittedly approximate.…”

“…Positive reappraisal, problem-focused goals, spiritual beliefs and practices, and drawing positive meaning from distressing events represent several coping approaches proposed to be efficacious when adjusting to bereavement (Folkman, 1997;Jacobs, Kasl, Schaefer, & Ostfeld, 1994). Among men, active approaches to "conquering" grief have demonstrated coping utility (Maxwell, 1995;Goodman, Black, & Rubinstein, 1996).…”