Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-18T19:16:55.208Z Has data issue: false hasContentIssue false
  • English
  • Français

The Role of Threatening Misinterpretations and Avoidance in Emotional Problems After Loss

Published online by Cambridge University Press:  17 December 2007

Paul A. Boelen  and
Marcel A. van den Hout
Paul A. Boelen*
Affiliation:
Utrecht University, The Netherlands
Marcel A. van den Hout
Affiliation:
Utrecht University, The Netherlands
*
Reprint requests to Paul A. Boelen, Department of Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands. E-mail: p.a.boelen@uu.nl
Get access Rights & Permissions [Opens in a new window]

Abstract

There is uncertainty about the role of avoidance behaviours in recovery from loss. Some authors have noted that avoidance exacerbates grief, whereas others have claimed that avoidance, at some times during the grieving process, can foster recovery. In the current study, it was hypothesized that avoidance behaviours are particularly detrimental when mourners have threatening misinterpretations about the consequences of confronting the loss, but less detrimental when mourners do not have such misinterpretations. To test this hypothesis, 400 mourners completed questionnaires tapping threatening misinterpretations, avoidance, and complicated grief (CG) and depression. In support of the prediction, situational avoidance, ruminative avoidance, and efforts to maintain ties with the deceased were only linked with depression in those who strongly endorsed misinterpretations. In addition, misinterpretations magnified the associations of ruminative avoidance and efforts to continue ties, with CG. Findings suggest that avoidance interacts with threatening misinterpretations in affecting particular emotional problems after loss.

Keywords

Avoidancecomplicated-griefdeath-and-dyinggrief
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 36 , Issue 1 , January 2008 , pp. 71 - 87
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aiken, L. S. and West, S. G. (1991). Multiple Regression: testing and interpreting interactions. Newbury Park, CA: Sage.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. Text Revision). Washington DC: American Psychiatric Association.Google Scholar
Arrindell, W. A. and Ettema, J. (2003). Symptom Checklist. Handleiding bij een multidimensionele psychopathologie-indicator. [Symptom Checklist. Manual for a multidimensional indicator of psychopathology.] Lisse: Swets and Zeitlinger.Google Scholar
Boelen, P. A., de Keijser, J., van den Hout, M. A. and van den Bout, J. (2007). Treatment of complicated grief: a comparison between cognitive behavioral therapy and supportive counseling. Journal of Consulting and Clinical Psychology, 75, 277–284.CrossRefGoogle ScholarPubMed
Boelen, P. A. and van den Bout, J. (in press). Complicated grief and uncomplicated grief are distinguishable constructs. Psychiatry Research.Google Scholar
Boelen, P. A., van den Bout, J., de Keijser, J. and Hoijtink, H. (2003). Reliability and validity of the Dutch version of the Inventory of Traumatic Grief. Death Studies, 27, 227–249.CrossRefGoogle ScholarPubMed
Boelen, P. A., van den Bout, J. and van den Hout, M. A. (2003). The role of negative interpretations of grief reactions in emotional problems after bereavement. Journal of Behavior Therapy and Experimental Psychiatry, 34, 225–238.CrossRefGoogle ScholarPubMed
Boelen, P. A., van den Hout, M. A. and van den Bout, J. (2006). A cognitive-behavioral conceptualization of complicated grief. Clinical Psychology: Science and Practice, 13, 109–128.Google Scholar
Boelen, P. A., Schut, H. A. W., Stroebe, M. S. and Zijerveld, A. (2006). Continuing bonds and grief: a prospective analysis. Death Studies, 30, 767–776.CrossRefGoogle ScholarPubMed
Bonanno, G. A. (2004). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20–28.CrossRefGoogle ScholarPubMed
Bonanno, G. A. and Kaltman, S. (1999). Toward an integrative perspective on bereavement. Psychological Bulletin, 125, 760–776.CrossRefGoogle ScholarPubMed
Bonanno, G. A., Keltner, D., Holen, A. and Horowitz, M. J. (1995). When avoiding unpleasant emotions might not be such a bad thing: verbal-autonomic response dissociation and midlife conjugal bereavement. Journal of Personality and Social Psychology, 69, 975–989.CrossRefGoogle Scholar
Bonanno, G. A., Neria, Y., Mancini, A., Coiffman, K. G., Litz, B. and Insel, B. (2007) Is there more to complicated grief than depression and PTSD? Journal of Abnormal Psychology, 116, 342–351.CrossRefGoogle Scholar
Derogatis, L. R. (1983). SCL-90-R: Administration, Scoring, and Procedures. Manual II (2nd ed.). Towson, Maryland: Clinical Psychometric Research.Google Scholar
Forstmeier, S. and Maercker, A. (2007). Comparison of two diagnostic systems for complicated grief. Journal of Affective Disorders, 99, 203–211.CrossRefGoogle ScholarPubMed
Hayes, S. C., Strosahl, K. D. and Wilson, K. G. (1999). Acceptance and Commitment Therapy: an experiential approach to behavior change. New York: The Guilford Press.Google Scholar
Horowitz, M. J. (1997). Stress Response Syndromes (3rd ed.). Northvale NJ: Jason Aronson.Google Scholar
Jacobs, S. C. (1999). Traumatic Grief: diagnosis, treatment and prevention. Philadelphia: Brunner/Mazel.Google Scholar
Kelly, A. E. and Kahn, J. H. (1994). Effects of suppression of personal intrusive thoughts. Journal of Personality and Social Psychology, 66, 998–1006.CrossRefGoogle Scholar
Kraut, R., Olson, J., Banaji, M., Bruckman, A., Cohen, J. and Couper, M. (2004). Psychological research online: report of board of scientific affairs' advisory group on the conduct of research on the internet. American Psychologist, 59, 105–117.CrossRefGoogle Scholar
Kraemer, H. C., Stice, E., Kazdin, A., Offord, D. and Kupfer, D. (2001). How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry, 158, 848–856.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569–582.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S., McBride, A. and Larson, J. (1997). Rumination and psychological distress among bereaved partners. Journal of Personality and Social Psychology, 72, 855–862.CrossRefGoogle ScholarPubMed
Prigerson, H. G. and Jacobs, S. C. (2001). Traumatic grief as a distinct disorder: a rationale, consensus criteria, and a preliminary empirical test. In Stroebe, M. S., Hansson, R. O., Stroebe, W. and Schut, H. A. W. (Eds.), Handbook of Bereavement Research: consequences, coping, and care (pp. 613–647). Washington DC: American Psychological Association Press.CrossRefGoogle Scholar
Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., Frank, E., Doman, J. and Miller, M. (1995). Inventory of complicated grief: a scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 65–79.CrossRefGoogle ScholarPubMed
Prigerson, H. G., Vanderwerker, L. C. and Maciejewski, P. K. (in press). Prolonged Grief Disorder as a mental disorder: inclusion in DSM. In Stroebe, M., Hansson, R., Stroebe, W. and Schut, H. (Eds.), Handbook of Bereavement Research and Practice: 21st century perspectives. Washington DC: American Psychological Association Press.Google Scholar
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: a cognitive account. Behavioural Psychotherapy, 19, 6–19.CrossRefGoogle Scholar
Steil, R. and Ehlers, A. (2000). Dysfunctional meaning of posttraumatic intrusions in chronic PTSD. Behavioural Research and Therapy, 38, 537–558.CrossRefGoogle ScholarPubMed
Stroebe, M. S. and Schut, H. (1999). The dual process model of coping with bereavement: rationale and description. Death Studies, 23, 197–224.Google ScholarPubMed
Stroebe, M. S. and Stroebe, W. (1991). Does “grief work” work? Journal of Consulting and Clinical Psychology, 59, 479–482.CrossRefGoogle Scholar
Wijngaards-de Meij, L., Stroebe, M., Stroebe, W., Schut, H., van den Bout, J., van den Heijden, P. G. M. and Dijkstra, I. (in press). Parents grieving the loss of their child: interdependence in coping. British Journal of Clinical Psychology.Google Scholar
Submit a response

Comments

No Comments have been published for this article.