Many theories have been proposed that attempt to explain response and adaptation to loss. However, no one theory has been shown to be universally applicable to all individuals suffering a loss. This paper presents an overview of many of these theories, paying special attention to the relationship between the theories of loss and adaptation to disability. The theories include the psychoanalytic model of loss, stage models of adaptation to loss, the value change theory of acceptance of loss, chronic sorrow, the cognitive adaptation theory, the stress and coping model, developmental theory, and the existential perspective on loss and grief. The possible influence that factors such as age, gender, culture and variables specific to disability may have on loss are also discussed. A new conceptualization of loss is introduced that tries to integrate many of the key ideas of these theories. This integrated approach takes into account the unique situation of each person, emphasizing the interaction between environmental and personal factors in adapting to loss. The model contends that due to the uniqueness of the individual, to the many possible combinations of environmental and psychological factors, and to the nature of the loss itself, any one or combination of loss theories could be in effect for any single loss. The intent of this thesis is to encourage the reader to become familiar with different perspectives on the subject of loss and grief to help select the method that best fits the individual situation of the person seeking counseling.

Following the loss of a loved one, grief is a near-universal experience. While most grieving individuals are able to cope effectively and return to baseline functioning over time, some develop persistent complex bereavement disorder (PCBD). This dissertation aims to elucidate the ways in which cognitive and emotional processing go awry in the context of PCBD. More specifically, it examines the relationship between the types of language that bereaved individuals use and their trajectories of adjustment in the first year following a loss. In particular, this dissertation examines context sensitivity in word use. Context sensitivity describes the degree to which an individual is attuned to the particular demands of a given task or situation. In the present study, linguistic context-sensitivity was measured by analyzing the use of words pertaining to certain categories within specific contexts (e.g., participants were asked to discuss a recent positive event, and the use of positive emotion words within their responses was analyzed). Results indicated that, among those individuals who display high levels of grief immediately following the loss of their spouse, the use of context-sensitive language predicted a favorable course of adjustment in the first year of bereavement with low levels of grief at one- year post-loss. Conversely, the use of context insensitive language predicted high levels of grief at one-year post-loss. These findings indicate that context sensitivity may instrumental in the development of PCBD and, as such, may help predict an individual’s course of adjustment immediately following a significant loss. A better understanding of these early signs of PCBD may greatly assist in the timely detection of the disorder so that intervention may be most effective. Furthermore, this field of inquiry also has the potential to deeply inform treatment modalities designed to help individuals cope in the wake of bereavement.

The incidence of congenital anomalies or potential congenital anomalies of fetuses is two to three percent. Most women who have a positive diagnosis of a congenital anomaly choose to terminate the pregnancy. A review of the literature identifies conflict preabortion and grief postabortion as key variables for women terminating pregnancies for genetic indications. The purpose of this study was to study the degree of conflict in the decision-making process preabortion and the intensity of grief six weeks postabortion and to determine if a relationship exists between the conflict and grief variables. This was a descriptive, correlational study which used summary statistics to analyze the data. Women responded to a questionnaire six weeks postabortion about conflict experienced pretermination and current grief experienced. The sample included nine women who aborted in the second trimester of pregnancy following either ultrasound, chorionic villi sampling, or alpha-fetoprotein analysis of the fetus. The findings indicated that the women experienced conflict while deciding whether or not to abort the fetus and that at six weeks posttermination the intensity of grief experienced was still high. A scatter plot revealed a curvilinear relationship showing grief plateauing and then decreasing as the conflict scores rose. Recommendations were that objective counselling in the decision-making period prior to the termination be provided, and grief counselling should continue longer than six weeks posttermination for those who need counselling. / Applied Science, Faculty of / Nursing, School of / Graduate

This survey examined anticipatory grief as a process of grieving that occurs when a loved-one has been diagnosed with a life-threatening illness. The inevitability of loss creates certain needs and feelings for the survivor. The study examined these needs, the extent to which these needs were satisfied, and the feelings. Finally, the relationship between dissatisfaction of important needs and certain feelings was observed. Findings show that certain needs, such as the need to gain knowledge about illness and to feel emotional support from family members rate as extremely important by the greatest number of respondents. These needs were not, however, rated as highly satisfied. It was also found that feelings such as anger, loneliness, and frustration were rated as occurring frequently when prognosis of death was within a year. Lastly, there was found to be a positive relationship between dissatisfaction of needs and these feelings.

published_or_final_version / abstract / Psychology / Master / Master of Philosophy

This dissertation is an exploration of the putative mediators of complicated grief treatment (CGT) in an effort to gain a better understanding of the mechanisms by which the treatment exerts its effects. This three-paper dissertation utilizes data from an NIMH-funded randomized controlled trial of CGT (Shear et al., 2005), which showed that CGT is more effective than Interpersonal Psychotherapy (IPT) in reducing symptoms of complicated grief (CG). The first paper examines a broad range of ancillary outcomes including symptoms of anxiety, depression, complicated grief and sleep disturbance due to bad dreams. Antidepressant use is examined as a possible moderator since half the sample was taking antidepressants and those taking antidepressants had a marginally better response rate in CGT than those not taking them (59% vs. 42% in CGT and 40% vs. 19% in IPT). CGT was more effective than IPT in reducing cognitive symptoms of anxiety, depression as measured by the Hamilton Rating Scale for Depression (HRSD), somatic symptoms of depression, guilt/self-blame, negative thoughts about the future, avoidance and poor sleep due to bad dreams. The difference in treatment effect on the HRSD for CGT over IPT was more pronounced for participants not taking antidepressants where CGT reduced depression but IPT did not. Paper two examines possible mediators specific to the model of CGT including: guilt/self-blame specific to the death or deceased; negative thoughts about the future; avoidance of reminders of the loss; anxiety and depression (intense negative emotions). Antidepressants are also examined as a potential moderator to explore whether their use affects the mediating role of the identified variables. All of these variables emerged as either full or partial mediators of CGT. Antidepressant use had no effect on the mediating role of these variables. Paper three examines whether alliance (measured at week 4) predicts subsequent change in grief symptoms (controlling for early symptom change) and if so, whether it accounts for the difference in treatment effect between CGT and IPT (mediation). Working alliance emerged as a mediator of CGT, accounting for 28% of the treatment effect found between CGT/IPT and grief symptoms. Discussion sections for each paper summarize study findings, limitations and implications for future research.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-05-22T12:03:44Z No. of bitstreams: 1 Gabriella Costa Pessoa.pdf: 800244 bytes, checksum: ccb3ae65a3df79a26456e841935f1d42 (MD5) / Made available in DSpace on 2017-05-22T12:03:44Z (GMT). No. of bitstreams: 1 Gabriella Costa Pessoa.pdf: 800244 bytes, checksum: ccb3ae65a3df79a26456e841935f1d42 (MD5) Previous issue date: 2017-05-12 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Among all happenings capable of altering one’s family dynamics, the death is one to require adaptive answers, especially in regard of the ensuing grief. Bereavement occurs whenever there was a bond with the deceased person. Its process entails a variety of subjective aspects, unique to each loss. For children, the understanding of death differs from the adult experience, according to the child’s developmental stage. A loss occurred during childhood will likely be revisited and resignified throughout a lifetime, regarded that the bond between siblings bears potential for intense and diverse life experiences. When one loses a sibling, also loses the possibility of a future shared with someone from the same generation, who partakes the same family origins. In addition, a child who loses a sibling has grieving parents that may not be able to provide the needed atmosphere for a healthy development. The exploratory research focuses on long-term sibling bereavement, aiming to understand better how the loss of a sibling during childhood reflects into adulthood. We used the qualitative method with discourse analysis applied to a single meeting interview with two young adults of 18-35 years old who lost a 0-12-years-old brother or sister during childhood. The grief process was understood from the categories: understanding of death in childhood; participation in related events; grief reactions; find refuge; parental grief; communication; support; disenfranchised grief; having another child; Recurrence; fantasy; curiosity; ambiguity; presumed world; religion; personal growth; continuing bond; therapy. The results indicate that the loss of a brother or sister during childhood can produce changes in different aspects of the emotional development of the life of the bereaved and that talking about it is beneficial / Entre os acontecimentos que podem alterar a dinâmica de uma família, a morte é um evento que requer respostas adaptativas. O luto ocorre quando há vínculo com a pessoa perdida. Seu processo engloba uma diversidade de aspectos subjetivos próprios a cada perda. A compreensão da morte por crianças difere da compreensão de um adulto, conforme seu nível de desenvolvimento. Uma perda ocorrida na infância será revisitada e ressignificada ao longo da vida, uma vez que a relação fraterna traz consigo potencial para vivências intensas e variadas. Ao perder um irmão, perde-se a possibilidade de um futuro junto a alguém da mesma geração, com quem se compartilham as origens familiares. Uma criança que perde um irmão possui pais também enlutados, que podem não conseguir proporcionar o ambiente necessário para seu desenvolvimento saudável. O estudo exploratório teve como foco o luto de irmãos a longo termo, buscando compreender a percepção do adulto jovem sobre a perda do seu irmão. Utilizou-se o método qualitativo com análise de discurso aplicada à entrevista em um único encontro realizada com dois adultos jovens de 18-35 anos participantes da pesquisa que perderam irmão(ã) entre 0-12 anos na infância. O processo de luto foi compreendido a partir das categorias: compreensão da morte na infância; participação nos eventos relacionados; reações ao luto; encontrar refúgio; luto dos pais; comunicação; suporte; luto não reconhecido; ter outro filho; recorrência; fantasia; curiosidade; ambiguidade; mundo presumido; religião; crescimento pessoal; vínculo contínuo; terapia. Os resultados apontam que a perda de um irmão na infância pode produzir transformações em diferentes aspectos do desenvolvimento emocional da vida do enlutado e que versar sobre o luto é benéfico

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2004. / For the purpose of this reserach journey I sought to document the experiences of one family living with HIV/AIDS. I became particularly interested in learning how they coped with sadness, grief and loss and what it was that contributed to hope in their lives. I undertook to find an answer to the research curiosity: How does a family living with HIV/AIDS experience and cope with bereavement and loss and how would a researcher's life-story be changed during this research? ...

This thesis explores mothers' reactions to, and methods of dealing with, the sudden death of a child, using a constructivist approach. The study focusses on the meanings that mothers construe in relation to the sudden death of their child and the role of these constructions in her "recovery" from this loss. It also explores the grieving process, the effect of the loss on the mother, including a focus on changes in her value system, her role as a mother and as a wife, as well as the impact of this loss on the family system. The study was conducted on the basis of qualitative research methodology, making use of the case study method. The sample consisted of three mothers, selected purposively. The data gathered was analysed inductively. / Psychology / M.A.(Clinical Psychology)

Text in Afrikaans / Summaries in English and Afrikaans / Die dood van 'n ouer he! 'n effek op die totale lewe van die kind en dompel die kind in emosionele nood wat terapeutiese begeleiding noodsaak. Na afloop van die afsterwe van 'n ouer, vind daar fisieke, emosionele, sosiale en kognitiewe veranderinge in die kind se lewe plaas waarop hy nie voorbereid is nie, en wat hy ook nie verstaan nie. Hierdie veranderinge veroorsaak dat die kind se leefwereld in so mate verander dat sy funksionering benadeel word. Daar is met hierdie studie gepoog om vas te stel watter effek die dood van 'n ouer op die kind he! en tot watter mate terapeutiese begeleiding die kind se emosionele nood kan verlig. Daar is in die studie gevind dat rou inderdaad 'n gekompliseerde proses is wat lei tot die ontstaan van talle onbeantwoorde vrae, gevoelens van magteloosheid en emosionele pyn. Kinders wat in rousmart verkeer word dikwels deur die samelewing misgekyk en kry as gevolg hiervan nie voldoende hulp nie. Di! lei tot die ontstaan van persoonlikheidsontwikkelingsprobleme, relasionele probleme en intra-psigiese probleme soos 'n swak selfbeeld, ego-verdedigingsmeganismes, persoonlike kwesbaarheid, ongunstige betekenisgewing en ongunstige belewenisse. Hierdie probleme veroorsaak dat die kind in sy selfaktualisering gerem word en as gevolg hiervan nie sy gegewe moontlikhede verwerklik nie. Die studie het verder bewys dat die kind wat 'n ouer aan die dood afgestaan het, wel deur middel van terapeutiese begeleiding deur 'n sielkundige gehelp kan word om die verlies van 'n ouer in so 'n mate te hanteer dat die faktore wat die kind se selfaktualisering rem, opgehef kan word. Die studie voorsien die sielkundige van riglyne ten opsigte van die proses van terapeutiese begeleiding aan die kind wat 'n ouer aan die dood afgestaan het. Riglyne word gebied ten opsigte van die hantering van die kind se onmiddellike situasie, die evaluasie van die kind-inrousmart, die vasstelling van doelstellings en doelwitte vir terapeutiese begeleiding, die selektering van terapeutiese tegnieke, die terapeutiese hulpverlening aan die kind, die hulpverlening aan die oorblywende ouer en die hulpverlening aan die onderwyser wat gemoeid is met die kind-in-rousmart. Riglyne word ook gebied ten opsigte van die terminering van terapie. / The death if a parent has an influence on the total life of a child and causes emotional trauma that necessitates therapeutic guidance. After the death of a parent, physical, emotional, social and cognitive changes occur in the child's life for which he is not prepared and that he also does not understand. These factors cause such a change in the child's life-world that his functioning is hampered. In this study it was endeavoured to determine what effect the death of a parent has on a child's life and to what extent therapeutic guidance can alleviate the child's emotional trauma. In this study it was found that mourning is indeed a complicated process that gives rise to countless unanswered questions, feelings of helplessness and emotional pain. Children suffering grief in mourning are often ignored by society and as result of this, they do not receive adequate assistance. This leads to problems concerned with the development of the personality, relational problems and intrapsychological problems such as a poor self-concept, ego defence mechanisms, personal vulnerability, negative ways of acquiring meaning and unfavourable ways of experiencing life. These problems give rise to the hampering of the child's selfactualisation and because of this he cannot realise his potential. The study has furthermore proved that the child who has lost a parent through death, can be helped by a psychologist. This can be done by means of therapeutic guidance so that the child can handle the loss of a parent to such an extent that the factors that hamper his self-actualisation can be removed. The study provides guidelines for therapeutic guidance to the child who has Jost a parent through death. Guidelines are given on handling the child's immediate situation, the evaluation of the child in mourning, the determination of aims and objectives for therapeutic guidance, the selection of therapeutic techniques, therapeutic assistance to the child, assistance to the remaining parent and assistance to the educator who is involved with the child in mourning. Guidelines are also given for the termination of therapy. / Educational Studies / D.Ed (Clinical Psychologist)