The push and pull of grief: Approach and avoidance in bereavement

Maccallum, Fiona; Sawday, Simon; Rinck, Mike; Bryant, Richard A.

doi:10.1016/j.jbtep.2015.02.010

Cited by 29 publications

(33 citation statements)

References 30 publications

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“…Our results support prior findings that elevated anxiety [3–9] and depressive symptoms [7; 9–14] may hold particular importance following a loss, especially in regard to the social adjustment of the widow or widower. Additionally, social support may act as a protective factor against potentially adverse effects of stressful life events, as has been found previously; specifically, high levels of social support were associated with low depressive symptoms [10; 12; 43; 44].…”

Section: Discussionsupporting

confidence: 90%

“…Older adults are more likely to experience declining physical health [93], bereavement [94], greater social isolation [95], and a loss of social support [96]. During such a pivotal time, anxious reactions to spousal loss are common [3–9], as the loss of one’s spouse often signifies the beginning of feeling socially isolated [32; 97]. Supporting prior theories that anxiety reactions to bereavement in older adulthood lead to social withdrawal to conserve one’s energy for personal coping [31], and contextualizing findings that less well-adjusted reactions to grief evoke frustration and low compassion from others [49], the current findings suggest that anxiety following bereavement substantially contributes to one’s level of social support during this pivotal time.…”

Section: Discussionmentioning

confidence: 99%

“…One study found that over a course of 2.5 years, 8.1% of older adults reported losing a spouse [2]. Bereavement also was associated with both anxiety [3–9] and depressive symptoms [7; 9–14]. Additionally in those experiencing bereavement, higher anxiety was associated with higher perceived loss of control [15], lower energy [16], increased suicidal ideation [17], increased risk of a heart attack [17], increased risk of stomach problems [17], poorer health [16], and greater difficulty sleeping [16] compared to those with lower anxiety.…”

mentioning

confidence: 99%

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Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression

Jacobson

Lord

Newman

2017

Journal of Affective Disorders

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Background Prior research has shown that anxiety symptoms predict later depression symptoms following bereavement. Nevertheless, no research has investigated mechanisms of the temporal relationship between anxiety and later depressive symptoms or examined the impact of depressive symptoms on later anxiety symptoms following bereavement. Methods The current study examined perceived emotional social support as a possible mediator between anxiety and depressive symptoms in a bereaved sample of older adults (N = 250). Anxiety and depressive symptoms were measured at Wave 1 (immediately after bereavement), social support was measured at Wave 2 (18 months after bereavement), and anxiety and depressive symptoms were also measured at Wave 3 (48 months after bereavement). Results Using Bayesian structural equation models, when controlling for baseline depression, anxiety symptoms significantly positively predicted depressive symptoms 48 months later, Further, perceived emotional social support significantly mediated the relationship between anxiety symptoms and later depressive symptoms, such that anxiety symptoms significantly negatively predicted later emotional social support, and emotional social support significantly negatively predicted later depressive symptoms. Also, when controlling for baseline anxiety, depressive symptoms positively predicted anxiety symptoms 48 months later. However, low emotional social support failed to mediate this relationship. Conclusions Low perceived emotional social support may be a mechanism by which anxiety symptoms predict depressive symptoms 48 months later for bereaved individuals.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression

Jacobson

Lord

Newman

2017

Journal of Affective Disorders

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“…This study demonstrated the existence of an avoidance tendency to loss-related stimuli during 1500–10000 ms in high ruminators experiencing bereavement, which confirmed no vigilance inclination and subsequent disengagement in the first 1500 ms. However, Maccallum et al (2015) used a modified approach-avoidance task and showed that approaching and avoidance co-existed in PG participants, which was inconsistent with the findings of the previous study.…”

Section: Introductioncontrasting

confidence: 86%

Avoidance of Bereavement-Related Stimuli in Chinese Individuals Experiencing Prolonged Grief: Evidence from a Dot-Probe Task

Tang

Wang

et al. 2017

Front. Psychol.

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Background: Attentional bias refers to a preference for (e.g., vigilance) or a shifting away (e.g., avoidance) of one’s focus with respect to specific stimuli. Accumulating evidence suggests that an attentional bias toward death/threat-related stimuli exists in bereaved individuals experiencing prolonged grief (PG). Measuring for different processing may reflect different cognitive characteristics. Therefore, this study sought to compare information-processing biases in Chinese individuals with high versus low levels of PG symptomatology at supraliminal and subliminal levels, respectively.Method: A 2 (grief level) × 2 (consciousness level) × 2 (word type) three-factor mixed design with supraliminal and subliminal tasks was utilized in the current study. Based on their Prolonged Grief Questionnaire-13 (PG-13) scores, 38 participants were included in the low-PG group, and 34 individuals were included in the high-PG group. All the participants completed a dot-probe task in which they were primed with death-related and life-related words paired with neutral stimuli.Results: High-PG individuals were slower in reacting to the death-related information in both supraliminal and subliminal tasks. After controlling for other symptoms in the backward deletion regression, PG-13 scores significantly predicted the avoidance tendency to death-related words in the supraliminal task, while anxiety was the best predictor of turning one’s vision away from death-related stimuli in the subliminal trials.Conclusion: The results suggested that high PG is associated with a tendency to avoid death-related words. Future research is needed to explore interventions that address the avoidance of death-related stimuli among individuals with elevated, or diagnosable, levels of PG.

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“…basal ganglia) as seen in prior work (22) and regulation-related regions (i.e. insula and OFC) may indicate the simultaneous yearning towards the deceased as well as distancing from the deceased that is unique to grieving (35). By controlling for a living attachment and an anonymous demographic avatar this task specifically targeted the unique combination of attachment (i.e.…”

Section: Discussionmentioning

confidence: 84%

Tracking Deceased-Related Thinking With Neural Pattern Decoding of a Cortical-Basal Ganglia Circuit

Schneck

Haufe

et al. 2017

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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Background Deceased-related thinking is central to grieving and potentially critical to processing of the loss. Self-report measurements might fail to capture important elements of deceased-related thinking and processing. Here, we used a machine learning approach applied to fMRI - known as neural decoding - to develop a measure of ongoing deceased-related processing. Methods 23 subjects grieving the loss of a first-degree relative, spouse or partner within 14 months underwent two fMRI tasks. They first viewed pictures and stories related to the deceased, a living control and a demographic control figure while providing ongoing valence and arousal ratings. Second, they performed a 10-minute Sustained Attention to Response Task (SART) with thought probes every 25–35 seconds to identify deceased, living and self-related thoughts. Results A conjunction analysis, controlling for valence/arousal, identified neural clusters in basal ganglia, orbital prefrontal cortex and insula associated with both types of deceased-related stimuli vs. the two control conditions in the first task. This pattern was applied to fMRI data collected during the SART, and discriminated deceased-related but not living or self-related thoughts, independently of grief-severity and time since loss. Deceased-related thoughts on the SART correlated with self-reported avoidance. The neural model predicted avoidance over and above deceased-related thoughts. Conclusions A neural pattern trained to identify mental representations of the deceased tracked deceased-related thinking during a sustained attention task and also predicted subject-level avoidance. This approach provides a new imaging tool to be used as an index of processing the deceased for future studies of complicated grief.

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The push and pull of grief: Approach and avoidance in bereavement

Cited by 29 publications

References 30 publications

Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression

Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression

Avoidance of Bereavement-Related Stimuli in Chinese Individuals Experiencing Prolonged Grief: Evidence from a Dot-Probe Task

Tracking Deceased-Related Thinking With Neural Pattern Decoding of a Cortical-Basal Ganglia Circuit

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