Loss and bereavement: A focus on cancer and families, death of a parent, death of a young child, and sudden or violent death in families.

Abstract

All individuals will undoubtedly experience losses of both minor and major magnitude across their life course (Harvey & Weber, 1998). When a major loss occurs, particularly the loss of a loved one through death, the bereaved are commonly thrust into a period of grieving. Bereavement is a broad term used to describe the period of time that occurs after a loss during which grief is experienced. Grief, however, is primarily the intrapsychic, emotional response an individual experiences as a reaction to loss (Stroebe et al., 2008). Typical grief reactions can include sadness, numbness, shock, dis belief or denial, anxiety, mourning (i.e., external, public expressions of grief), changes in appetite, lethargy, apathy, intrusive thoughts, difficulty concentrating, and preoccupation with the deceased (e.g., Stroebe et al., 2008). Although grief reactions often overlap with symptoms of depression, anxiety, or post traumatic stress disorder (PTSD), research suggests these are uniqueCopyright American Psychological Association. Not for further distribution. 220 • Benson et al. (Shear, 2012). How a person grieves in response to the loss of a loved one is contingent on several factors, including the personality of the bereaved person; their coping skills, support network, psychiatric history, and relationship to the deceased; any unresolved conflict or unfinished business with the deceased; socioeconomic status; and cultural and religious beliefs (Yamashita et al., 2017).Several stage models of typical grief have been proposed to suggest that grieving is a linear process involving specific and ordered emotional reactions from those who become bereaved or experience loss (Stroebe et al., 2017). However, these models have largely been contested due to a lack of empirical support. Most grief and bereavement scholars do agree that most grief dissipates over time as the loss is gradually accepted and typical daily activities resume (Jacobs, 1993). Although a number of consistent thoughts, feelings, and behaviors typify typical grief reactions (e.g., sadness, yearning, disinterest in daily activities), the patterning of these reactions, as well as the degree of intensity, varies across individuals (Shear, 2012). In many grief responses, intense, omnipresent, and painful feelings of sadness transform into what Shear (2012) described as "acceptance of the inevitability of the loss, integration of its reality into ongoing life, and reimagining a future with the possibility of joy and satisfaction" (p. 2).Complicated grief, also referred to as abnormal, chronic, traumatic, pathologic, or disordered grief, occurs in individuals who continue to experience elevated levels of grief after approximately 6 to 12 months (PDQ Supportive & Palliative Care Editorial Board, 2020). Complicated grief occurs in about 15% to 30% of bereaved individuals (Bonanno, 2004). Risk factors for complicated grief can include histories of a mood or anxiety disorder, previous trauma or accumulated loss, or an insecure attachment style (Shear, 2012). Certain types...