Background. We investigated the impact of widowhood on depression and how resources and contextual factors that define the meaning of loss modified this effect.

Method. In a prospective, nationally representative sample of women in the US aged 54 or older we compared 64 women who were widowed in the 3 years between data collection waves with 431 women who were stably married over the time interval.

Results. Those who became widowed reported more depression than controls for 2 years following the loss. However, this effect was confined to respondents whose husbands were not ill at baseline. Widowed women whose husbands were ill at baseline already had elevated depression in the baseline interview and did not become significantly more depressed after the death. Consistent with this result, women who were not depressed pre-bereavement were most vulnerable to depression following the loss of an ill spouse during the first year of widowhood.

Conclusions. Results suggest that spouses' illness may forewarn wives of their impending loss and these women may begin to grieve before his death. Those forewarned women who are not depressed pre-bereavement may experience the most post-bereavement depression. Findings are discussed in light of previous, more methodologically limited studies.