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Features for Senior Citizens
Negative Grief Indicators Decline about Six Months
after Death of Loved One
Study of five-stage grieving process finds some
surprises
 Feb. 20, 2007 – A study of the five-stage grieving
process following the death of a loved one from natural causes finds
"acceptance" and "yearning" for the deceased are the normal responses of
most people. They also found that "disbelief" was not the initial,
dominant grief indicator as suggested by the accepted five stages of
grief.
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Features for Senior Citizens |
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“The notion that a natural psychological response
to loss involves an orderly progression through distinct stages of
bereavement has been widely accepted by clinicians and the general
public,” the authors provide as background information in the article in
the February 21 issue of JAMA that is an empirical examination of the
stage theory of grief.
The five-stage theory of grief (disbelief,
yearning, anger, depression and acceptance) has become well-known and
generalized to a wide variety of losses.
“The identification of the patterns of typical
grief symptom trajectories is of clinical interest because it enhances
the understanding of how individuals cognitively and emotionally process
the death of someone close. Such knowledge aids in the determination of
whether a specific pattern of bereavement adjustment is normal or not.”
Paul K. Maciejewski, Ph.D., from the Yale
University School of Medicine, New Haven, Conn., and colleagues analyzed
data collected between January 2000 and January 2003 from 233
individuals participating in the Yale Bereavement Study.
The study participants had a family member or loved
one who died from natural, not traumatic causes; and had at least one
complete assessment of the five grief indicators included in the stage
theory of grief within 24 months following the death.
The vast majority (83.8 percent) of participants
were spouses of the deceased. The remaining participants (16.2 percent)
were adult children, parents, or siblings of the deceased.
“Counter to stage theory, disbelief was not the
initial, dominant grief indicator,” the researchers found.
“Acceptance was the most frequently endorsed item
and yearning was the dominant negative grief indicator from one to 24
months postloss.
"In models that take into account the rise and fall
of psychological responses, once rescaled, disbelief decreased from an
initial high at one month postloss, yearning peaked at four months
postloss, anger peaked at five months postloss, and depression peaked at
six months postloss.”
The authors add that “acceptance increased steadily
through the study observation period ending at 24 months postloss.”
“Identification of the normal stages of grief
following a death from natural causes enhances understanding of how the
average person cognitively and emotionally processes the loss of a
family member,” the authors write.
“Regardless of how the data are analyzed, all of
the negative grief indicators are in decline by approximately six months
postloss.
"The persistence of these negative emotions beyond
six months is therefore likely to reflect a more difficult than average
adjustment and suggests the need for further evaluation of the bereaved
survivor and potential referral for treatment,” the authors conclude.
Editor's Note: This work was supported by grants
from the National Institute of Mental Health, the National Cancer
Institute, and the National Institute of Neurological Disorders and
Stroke. Funding was also provided by the Center for Psycho-Oncology and
Palliative Care Research, Dana-Farber Cancer Institute, and Women’s
Health Research at Yale University.
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