Conflicted or close: Which relationships to the deceased are associated with loss‐related psychopathology?

Objectives: Prior studies have shown that pre‐loss closeness and conflict with a deceased person are associated with the severity of symptoms of prolonged grief and/or depression. Nevertheless, mechanisms underlying these relationships are not well understood. We propose a theoretical model in which...

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Published in:British Journal of Clinical Psychology Vol. 61; no. 2; pp. 510 - 527
Main Authors: Sekowski, Marcin, Prigerson, Holly G.
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Jun2022
Online Access:View this record in EBSCOhost
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      dt: Jun2022
      vid: 61
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        156361529
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        10.1111/bjc.12344
        156361529
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        atl: Conflicted or close: Which relationships to the deceased are associated with loss‐related psychopathology?
      aug:
        au:
          Sekowski, Marcin
          Prigerson, Holly G.
        affil: Department of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
      sug:
        subj:
          Psychopathology
          Conflict (Psychology)
          Grief
          Depression
          Extended Family
          Bereavement
          Human
          Female
          Male
          Models, Theoretical
          Surveys
          Psychological Tests
          Scales
          Interpersonal Relations Evaluation
          Questionnaires
          Structural Equation Modeling
          Path Analysis
          Regression
          Multivariate Analysis
          Data Analysis Software
          Descriptive Statistics
          Female
          Male
      ab: Objectives: Prior studies have shown that pre‐loss closeness and conflict with a deceased person are associated with the severity of symptoms of prolonged grief and/or depression. Nevertheless, mechanisms underlying these relationships are not well understood. We propose a theoretical model in which past closeness and conflict are related to prolonged grief and depression via concrete and symbolic continuing bonds (CB). The aim of our study was to test this model in a sample of bereaved family members. Methods: Individuals (N = 244) who had lost a family member from 0.5 to 8.0 years before the survey completed the Quality of Relationships Inventory‐Bereavement Version, the Continuing Bonds Scale, the Prolonged Grief Disorder‐13 scale, and the Patient Health Questionnaire‐9. Results: The findings partially confirmed our model. Closeness was positively and moderately associated with symptoms of prolonged grief but not with symptoms of depression. Conflict was positively and weakly associated with symptoms of depression and prolonged grief. All of these relationships were only partially mediated by concrete/maladaptive and symbolic/adaptive CB. Conclusions: The differences in the relationship of past closeness and conflict to prolonged grief and depression symptoms suggest that inter‐ and intrapersonal mechanisms of prolonged grief and depressive symptoms may be distinct. If future, especially longitudinal studies, confirm our model, CB would be a possible target for interventions for bereaved persons who had a close and/or conflicted relationship with a deceased family member and experience loss‐related psychopathology. Practitioner points: Continuing bonds (CB) are a potential target of interventions for bereaved persons who had a close and/or conflicted relationship with a deceased family member and experience symptoms of prolonged grief and/or depression.Internalization of the capacity to care for yourself and feel autonomous in a safe and stable therapeutic relationship may lead to increased self‐confidence, promote working through past experiences in the relationship with the deceased, and gradual reduction of concrete forms of CB.Increasing awareness and acceptance of emotional experiences may contribute to the appreciation of past relationship with a deceased person and the growth of symbolic forms of CB.Future research should focus on verifying the effectiveness of the attachment‐informed therapeutic approach to working with CB.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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