Goals and grief

It's normal to feel grief and sadness after the death of a loved one yet for some people the effects can be much worse. People who go on to develop what psychologists call prolonged grief disorder (PGD) experience persistent yearning for their lost loved ones, difficulty in accepting their loss, numbness and a shattered sense of identity. Paul A. Boelen from Utrecht University in the Netherlands looked into how people's goals and wishes for the future affected their grieving process in a study of 160 bereaved people. The participants in the study were asked to write down seven important personal goals and to complete questionnaires designed to measure their levels of PGD and depression. The study found that more severe PGD was associated with goals which were less specific, felt to be - at least partially - beyond people's control, and which had a lower perceived likelihood of being achieved. Mourners with more PGD had goals that were associated with loss and feelings rather than with work, education or relationships.

Boelen, Paul A. - Personal Goals and Prolonged Grief Disorder Symptoms Clinical Psychology & Psychotherapy doi: 10.1002/cpp.731

Parents' death and adolescent suicide risk

Most young people who lose a parent actually adjust remarkably well but a minority go on to develop mental-health problems which are, in turn, known to be a risk factor for suicide, something attempted by 5-8% of adolescents in Western societies. A Danish study - by researchers from the University of Southern Denmark and Odense University Hospital - looked into the links between parental death and suicide in a sample of 72,765 teenagers. They found that young people who had lost one biological parent had a 71% greater risk of going on to kill themselves than those whose parents were still alive while young people who lost more than one parent had a risk that was 2.7 times greater.

Jakobsen, Ida Skytte and Christiansen, Erik - Young people’s risk of suicide attempts in relation to parental death: A population-based register study Journal of Child Psychology and Psychiatry  (2010)doi:10.1111/j.1469-7610.2010.02298.x

Losing parents and children's mental health

Children who lose a parent to suicide are more likely to commit suicide themselves and are also at a greater risk of other mental-health problems. Researchers from the Johns Hopkins Children's Center in Baltimore looked at suicides, psychiatric hospitalisations and violent-crime convictions over a period of 30 years in more than 500,000 Swedish children, teenagers and young adults who had lost a parent to suicide, illness or an accident and four million who hadn't. They found that those children who lost a parent to suicide as children or teenagers were three times more likely to kill themselves than children with living parents although there was no increase in risk for children who were eighteen or over when their parent committed suicide. Children whose parents had died in an accident were twice as likely to kill themselves as unaffected children but again the differences disappeared when children were older when they were bereaved. Children who lost a parent to illness did not have an increased risk of suicide. Children who lost parents to suicide were nearly twice as likely to be hospitalised for depression whereas those who lost their parents to accidents or illness had a 30-40% greater risk. Losing a parent for whatever reason increased a child's risk of committing a violent crime.

You can find out more about this research at

http://www.sciencedaily.com/releases/2010/04/100421160013.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Reader

Dying newborns and survivor siblings

Researchers at Dartmouth-Hitchcock Medical centre in the U.S. looked into the effects of the deaths of children in neonatal intensive care units on their surviving siblings. The qualitative (feelings not numbers) study of 13 adults and 1 adolescent found that they felt a sense of confusion surrounding the event. They reported a lack of communication about the death itself and believed that their parents had never mourned the loss of the child. The study also found that rituals, photographs and shared memories played an important part in the healing process.

Suicide and bereavement

It is estimated that one person in the world kills themselves every 40 seconds. For every person who commits suicide it has been estimated that six people will feel intense grief - around 35,000 people in the U.K. each year. Although the effects of such a bereavement are not necessarily more severe than bereavement following other causes of death there are certain aspects, such as stigmatisation and a sense of rejection that may make coping particularly difficult. Researchers from the University of York looked into studies on the effectiveness of interventions for people bereaved by suicide. They found evidence of some benefit from: a cognitive-behavioural family intervention of four sessions with a psychiatric nurse; a psychologist-led 10-week bereavement group intervention for children; and an 8-week group therapy intervention for adults delivered by a mental-health professional and a volunteer. Studies which compared more than one different type of intervention had produced unclear results.

McDaid, Catriona ... [et al] - Interventions for people bereaved through suicide: systematic review British Journal of Psychiatry 193(6), 438-443

Parents and grief

The death of a child can be a devastating experience that places a parent at heightened risk of psychological suffering and impairments in functioning. The death of a child is out of sequence with the 'life-cycle' of a family and can often come unexpectedly. Although the majority of bereaved parents find a way to live productive lives some do experience severe and long-lasting mental-health problems. A study of 157 parents who had lost children, by reseachers at the University of Memphis Tennessee, found that the violence of the child's death, the age of the child at death and the length of bereavement all accounted for significant differences in grief symptoms. Cause of death was the only objective risk factor that significantly predicted the intensity of complicated (or more severe) grief. The most important predictor of the severity of grief was 'sense-making' with those parents who said they had made little or no sense of their child's death being more likely to report a greater intensity of grief.

Keesee, Nancy J., Currier, Joseph M. and Neimeyer, Robert A. - Predictors of grief following the death of one's child: the contribution of finding meaning Journal of Clinical Psychology October 2008, 64(10), 1145-1163

Intrusive mental images in grief

Intrusive mental images can be defined as 'fragments of specific autobiographical events or imaginal extensions of such events that predominantly possess sensory qualities and enter awareness suddenly and unintentionally.' Flashbacks have long been known to be part of post-traumatic stress disorder (PTSD) but intrusive mental images have also been implicated in depression, anxiety and other mental disorders. A team of Dutch researchers looked into intrusive images in grief, studying a sample of 131 mourners. They examined the frequency and correlates of four specific types of intrusive image: positive intrusive memories of the deceased, intrusive images of the death, re-enactment fantasies, and negative images of the future. All were common and all were correlated with the severity of complicated grief symptoms. Intrusive images of death, re-enactment fantasies and negative images of the future were all correlated with the severity of symptoms of depression and anxiety.

Boelen, Paul A. and Huntjens, Rafaele J. C. - Intrusive images in grief: an exploratory study Clinical Psychology and Psychotherapy July-August 2008, 15(4), 217-226

Grief and the brain

Everyone experiences grief at some point in their life. Most people move on and accept the loss but for a substantial minority - those suffering from complicated grief - it is impossible to let go, and, even years later any reminder of their loss (such as a picture or a memory) brings on a fresh wave of grief and yearning. Complicated grief can be debilitating involving recurrent pangs of painful emotions, intense yearning, longing and searching for the deceased and a preoccupation with thoughts of the loved one. A team of researchers at UCLA, U.S. examined what goes on in the brain when we experience grief by showing 23 participants - 11 of whom had complicated grief - photographs of dead loved ones while they underwent an MRI scan. All the groups showed increased activity in the dorsal anterior cingulate cortex and the insula, areas of the brain implicated in perceptions of pain. However, those women suffering from complicated grief also experienced increased activity in the nucleus accumbens, a region of the brain most commonly associated with reward and one that has also been shown to play a role in social attachment such as sibling and maternal affiliation.

You can find out more about this research at

http://psychcentral.com/news/2008/06/23/new-insights-on-grief-recovery/2484.html