Previous stress and acute psychological defence as predictors of perinatal grief—An exploratory study

Abstract

We evaluated whether the emotional reactions of women at 2-6 weeks after the prenatal diagnosis of a lethal anomaly and at 3 months after perinatal loss might be predicted by previous stress and acute psychological defence reactions to the diagnosis. Previous stress was defined objectively as a history of major life event(s) and having received professional mental health treatment in the past, and subjectively as the disposition for feelings of inadequacy and anxiety. Forty-one women were interviewed and completed measures on their history of major life events, whether they had received professional mental health treatment in the past, inadequacy, acute psychological defence reactions and perinatal grief. Regression analyses showed that inadequacy was the most strongly positive predictor of perinatal grief shortly after receiving the unfavourable diagnosis and three months after perinatal loss. In addition to inadequacy, having received professional mental health treatment in the past led to significantly more intense grief, but only shortly after receiving the unfavourable diagnosis. Previous life events intensified grief three months after perinatal death. The grieving process was significantly moderated by the defence of 'principalization' while it was significantly intensified by 'turning aggression against oneself', but only shortly after receiving the unfavourable diagnosis. These effects were not contaminated by relationships with pregnancy-related variables. Our findings imply that psychological support for women with perinatal loss should particularly be offered to those who have been identified as generally anxious, who have reported previous major life events and have received professional mental health treatment in the past.

Affective state of women following a prenatal diagnosis: predictors of a negative psychological outcome

“…A high trait anxiety level was predictive of a negative psychological outcome. This finding corresponds with those of other authors34, who stress the impact of high trait anxiety embedded in the personality structure on mourning reactions and coping styles34–36. Implementation of negative coping strategies (i.e.…”

Affective state of women following a prenatal diagnosis: predictors of a negative psychological outcome

“…A high trait anxiety level was predictive of a negative psychological outcome. This finding corresponds with those of other authors34, who stress the impact of high trait anxiety embedded in the personality structure on mourning reactions and coping styles34–36. Implementation of negative coping strategies (i.e.…”

Prediction and course of grief four years after perinatal loss due to congenital anomalies: A follow‐up study

“…In addition, a strong positive association was found between the personality trait inadequacy (i.e. feeling anxious, insufficient, depressed, and having low self-esteem) and grief (Hunfeld, Wladimiroff & Passchier, 1995).…”

Negative self‐conscious emotion and grief: An actor–partner analysis in couples bereaved by stillbirth or neonatal death

“…Personality is one of the important predictors of grief following bereavement (Sanders, 1993; Stroebe & Schut, 2001). Specifically, a number of personality variables have been shown to predict grief in parents bereaved by perinatal death (Franche, 2001; Hunfeld, Wladimiroff, Verhage, & Passchier, 1995; Janssen, Cuisinier, de Graauw, & Hoogduin, 1997; Tangney & Dearing, 2002; Wijngaards‐de Meij et al, 2007a; Zeanah, Danis, Hirshberg, & Dietz, 1995), including proneness to shame and guilt (Barr, 2004; Barr & Cacciatore, 2007–2008). In the context of personality, shame and guilt are distinct from personality types (Einstein & Lanning, 1998) but nonetheless stable, idiosyncratic and recurring constructs that organize responses to a variety of life situations in terms that correspond to these emotions (Ekman & Davidson, 1994; Izard & Malatesta, 1987; Malatesta, 1990; Malatesta & Wilson, 1988).…”

Affective state of women following a prenatal diagnosis: predictors of a negative psychological outcome

“…A high trait anxiety level was predictive of a negative psychological outcome. This finding corresponds with those of other authors34, who stress the impact of high trait anxiety embedded in the personality structure on mourning reactions and coping styles34–36. Implementation of negative coping strategies (i.e.…”

Prediction and course of grief four years after perinatal loss due to congenital anomalies: A follow‐up study

“…In addition, a strong positive association was found between the personality trait inadequacy (i.e. feeling anxious, insufficient, depressed, and having low self-esteem) and grief (Hunfeld, Wladimiroff & Passchier, 1995).…”

Negative self‐conscious emotion and grief: An actor–partner analysis in couples bereaved by stillbirth or neonatal death

“…Personality is one of the important predictors of grief following bereavement (Sanders, 1993; Stroebe & Schut, 2001). Specifically, a number of personality variables have been shown to predict grief in parents bereaved by perinatal death (Franche, 2001; Hunfeld, Wladimiroff, Verhage, & Passchier, 1995; Janssen, Cuisinier, de Graauw, & Hoogduin, 1997; Tangney & Dearing, 2002; Wijngaards‐de Meij et al, 2007a; Zeanah, Danis, Hirshberg, & Dietz, 1995), including proneness to shame and guilt (Barr, 2004; Barr & Cacciatore, 2007–2008). In the context of personality, shame and guilt are distinct from personality types (Einstein & Lanning, 1998) but nonetheless stable, idiosyncratic and recurring constructs that organize responses to a variety of life situations in terms that correspond to these emotions (Ekman & Davidson, 1994; Izard & Malatesta, 1987; Malatesta, 1990; Malatesta & Wilson, 1988).…”

Affective state of women following a prenatal diagnosis: predictors of a negative psychological outcome

“…A high trait anxiety level was predictive of a negative psychological outcome. This finding corresponds with those of other authors34, who stress the impact of high trait anxiety embedded in the personality structure on mourning reactions and coping styles34–36. Implementation of negative coping strategies (i.e.…”

Prediction and course of grief four years after perinatal loss due to congenital anomalies: A follow‐up study

“…In addition, a strong positive association was found between the personality trait inadequacy (i.e. feeling anxious, insufficient, depressed, and having low self-esteem) and grief (Hunfeld, Wladimiroff & Passchier, 1995).…”

Negative self‐conscious emotion and grief: An actor–partner analysis in couples bereaved by stillbirth or neonatal death

“…Personality is one of the important predictors of grief following bereavement (Sanders, 1993; Stroebe & Schut, 2001). Specifically, a number of personality variables have been shown to predict grief in parents bereaved by perinatal death (Franche, 2001; Hunfeld, Wladimiroff, Verhage, & Passchier, 1995; Janssen, Cuisinier, de Graauw, & Hoogduin, 1997; Tangney & Dearing, 2002; Wijngaards‐de Meij et al, 2007a; Zeanah, Danis, Hirshberg, & Dietz, 1995), including proneness to shame and guilt (Barr, 2004; Barr & Cacciatore, 2007–2008). In the context of personality, shame and guilt are distinct from personality types (Einstein & Lanning, 1998) but nonetheless stable, idiosyncratic and recurring constructs that organize responses to a variety of life situations in terms that correspond to these emotions (Ekman & Davidson, 1994; Izard & Malatesta, 1987; Malatesta, 1990; Malatesta & Wilson, 1988).…”