Few research studies have examined the panoramic landscape of family caregivers from dementia diagnosis to the final bereavement of the person with dementia for whom they are caring. The route and pathways of care undertaken during a caregiver's journey will be individual to each person, yet invariably there will be some similarities as to how they anticipate, approach and mange this journey. From the caregiver's perspective, caring for someone with dementia is related to more than the cognitive loss experienced by their family member, there are many losses involved, This research study aims to explore the complex emotional experiences of thirty caregivers in relation to sense of self. change, grief, loss and bereavement, to elucidate a deeper understanding of the lived experience, the perceived and understood reality of the experiential journey of caregivers. To explore the experiences of caregiving, this research study uses a hermeneutic phenomenological approach and draws on an adaptation of the theoretical framework of anticipatory grief and loss by Fulton and Fulton (1971) and Fulton and Gottesman (1980). The study uses a convenience sample and semi structured interview format and involves two non-comparative participant groups of family caregivers living in urban and rural communities within the North East of England. Group one comprises of twenty bereaved participants, nineteen of whom are spousal caregivers and one adult-caregiving daughter, who were interviewed once to explicated a retrospective perspective of the caring experience. Group two comprises of ten participants, nine spousal caregivers and one adult-caregiving daughter, who are currently caring for a family member living with an advanced stage experience of dementia. Group two participants were interviewed on three occasions across an eighteen-month time period to explore the retrospective and prospective experience of their caregiving role. The analysis of data reveals expressions of change, grief and loss within a complex and tri-dimensional landscape. Within this landscape, participants highlight defined periods of their journey, particularly with regard to their experience of a protracted middle period, which they referred to as being "the long road". However, intersecting with this layered landscape, the analysis of data also reveals a key aspect of caregiving - the emergence of a conceptual framework involving three interconnected yet fluctuating schemas of self experienced by participants. the first scheme, the individual 'me-self'. related to the participant's perception of their core self and envisaged sense of self. the second schema, the 'relationship-self', illustrates participant's physical and psychological experiences and bonded connection between themselves and the cared-for spousal partner or parent, as well as other family members and care workers. The third schema, the 'caregiving-self', is associated with the acquisition and undertaking of their role of familial caregiver. The findings of this study highlight the 'lived-world' experience of family caregivers as being a journey which subjects them to a cyclical maelstrom of emotion and fluctuating perception of their schemas of self.

No description available.

This study sought to explore the lived experience of the bereaved-by-suicide and to provide a detailed description of their experience with the loss of a loved one. The study participants were 12 bereaved-by-suicide individuals between the ages of 21 and 65 who had experienced the loss of a loved one by suicide two or more years before the interviews. The research question was made up of three parts, "How do the bereaved-by-suicide describe their grief in personal, practical, and existential terms?" The theoretical framework for the study was derived from Neimeyer's meaning reconstruction theory. Data were collected via individual interview and coded according to the themes acquired from the study participants. The primary themes of grief that emerged from their narratives included the following: (a) the initial shock, (b) episodes of anger, (c) feeling a sense of loss, (d) living in a world of grief, (e) inability to trust and the resulting isolation, (f) thoughts on life after death, (g) preparing to say good-bye, and (h) building stronger relationships. The research confirmed the overwhelming effect of suicide on those bereaved; their daily lives were disrupted, and there was a higher risk of mental instability even two or more years after the suicide. The broader implications of these findings pertain to developing strategies to increase social awareness about the grief experienced by the bereaved-by-suicide, despite the person's efforts to appear strong and hide their grief and fears. The results of this study may add to the current research and can contribute to bringing about social change in development of prevention programs, enhancements in bereavement training, support group development, and in how the bereaved-by-suicide are viewed.

This three-paper dissertation aims to enhance our understanding of the role of positive psychology constructs, hope, and positive emotions during bereavement among older adults. The study will be mainly guided by the Broaden-and-Build Theory of Positive Emotion, the Hope Theory, and the Revised Stress and Coping Theory. This dissertation is based on secondary data analysis using two different data - the Health and Retirement Study (HRS) for Paper 1 and the Complicated Grief Treatment in Older Adults Study (CGTOA) for Paper 2 and Paper 3. Paper 1 examines the level of positive and negative emotions before and after bereavement, and the impact of positive emotions on bereavement adjustment outcomes such as depression and purpose in life among a nationally representative sample of widowed older adults. Paper 1 finds that recently widowed older adults experience a significant decrease in positive emotions and an increase in negative emotions (compared to the married comparison group) after the loss of their spouse, but they still experience a considerable level of positive emotions during bereavement. The level of post-loss positive emotions was significantly associated with better adjustment outcomes, lower odds of having depression, and a higher level of purpose in life. A significantly greater impact of positive emotions on purpose in life was found among the widowed group compared to the married counterparts. However, the beneficial impact of positive emotions on depression did not differ between the widowed and married groups. Paper 2 and Paper 3 explore hope among the bereaved older adults with complicated grief using data from the CGTOA Study, a randomized clinical trial, which compared the treatment efficacy of complicated grief treatment (CGT) with interpersonal psychotherapy (IPT). Paper 2 focuses on evaluation of the psychometric properties of the Trait Hope Scale (THS) among older adults with complicated grief before proceeding to address the role of hope in CGT in Paper 3. Paper 2 suggests that overall the THS is a valid and reliable tool to measure hope among older adults with complicated grief. The THS demonstrated its sensitivity to change with treatment, showing a significantly greater increase in hope score among treatment responders (in both CGT and IPT) compared to non-responders. However, unlike the theoretically supported two-factor structure of the THS (Pathways and Agency), a different two-factor structure was identified in the study, which suggests that further validation of the factor structure of the THS in older adults with complicated grief is necessary in future studies. Paper 3 investigates the role of hope in CGT, particularly examining hope as a potential moderator and/or mediator of treatment effects. Paper 3 found that both CGT and IPT groups increased their hope scores significantly during the treatment. However, there was no significant difference in increases in hope between CGT and IPT groups. Mediation analysis showed that hope is not a mediator of treatment effects of CGT over IPT. However, significant treatment effects of CGT (over IPT) were found for reduction in the level of grief-related avoidance among those with lower baseline hope, but not for those with higher baseline hope, which confirmed hope is a moderator of treatment effects for only the grief-related avoidance outcome. The findings of this dissertation suggest that 1) positive emotions during bereavement may play a beneficial role in adaption to bereavement, 2) the Trait Hope Scale is a valid and reliable tool to measure hope among older adults with complicated grief, and 3) hope can be improved in complicated grief interventions (both CGT and IPT), and regaining hope may be an important factor associated with the resolution of complicated grief symptoms.

Despite the introduction of road safety measures and media campaigns, crashes are a leading cause of death in Western Australia. While economic costs of crashes are relatively easy to determine, their psychosocial burden remains appreciably under-studied, as are the social, cultural, historical, temporal, and political contexts within which grief experiences are housed. As such, I explored the experience of grief resulting from losing a loved one in a crash in Western Australia and described the influence of contextual factors on those grief experiences.

Thesis (MSD(Play therapy))--University of Pretoria, 2006. / Abstract in English and Afrikaans. Includes bibliographical references. Available on the Internet via the World Wide Web.

Loss is an inevitable human experience. How each individual reacts to loss may be affected by various factors among these is ones attachment style. The present studies examine the ultimate form of loss, the death of a significant attachment relationship in ones life. Specifically, the research focuses on how people respond to and cope with the death of an attachment figure. In so doing, the relationship between grief and attachment theory is discussed and an integrated model of grief and attachment is proposed, which accounts for various differences in how individuals respond to the death of an attachment figure in adulthood.<p> Study 1 examined the notion that in order to maintain an ongoing relationship with a deceased person and engage in behaviours that maintain this relationship, one must have had a close relationship to the deceased prior to his or her death. Seventy-three undergraduate students who reported having experienced the death of someone they knew were recruited to complete the online survey. This study utilized a measure specifically designed for the present research, the Ongoing Relationship Scale (Waskowic & Chartier, 2006), to demonstrate the necessity of a close relationship in order to engage in behaviours that maintain an ongoing relationship with the deceased.<p> The ORS was used to distinguish between whether one perceived engaging in ongoing behaviours with the deceased attachment figure as positive or negative, that is, whether engaging in certain behaviours brought an individual comfort or discomfort. The findings showed that those who identified themselves as having had a closer relationship to the deceased were more likely to engage in behaviours consistent with maintaining an ongoing relationship; whereas those who did not report having had a close relationship to the deceased were less likely to do so. Preliminary psychometric data for the ORS demonstrated good reliability. Convergent and discriminant validity for the measure are also provided.<p> Study 2 extends the findings from the first study by exploring a specific type of close relationship, the attachment relationship, and how one copes with the grief upon the death of the attachment figure. One hundred and ninety three participants who experienced the death of either a partner or parent were recruited to participate in the study. Participants were asked to complete a survey containing measures of attachment style, relationship closeness, grief, coping with the loss, interpersonal dependency, ongoing relationship with the deceased, and resilience. Utilizing Stroebe, Schut, and Stroebes (2005) Dual Processing Model and OLeary and Ickovicss (1995) Outcome of Challenge Model the differences in coping with the death of an attachment figure were explored based on ones type of attachment. Based on the findings from the present research that there are differences between the four types of attachment (i.e., secure, preoccupied, fearful, and dismissing) in how each copes with the death of a significant attachment figure, a new comprehensive model of grief, which integrates previous theories within an attachment theoretical framework is offered. This new model, referred to as the Grief Attachment Model, accounts for observed differences in the way people cope with the death of a significant attachment figure in their lives, and suggests that researchers focus on the attachment relationship to explain variability in a persons grief response.<p> The results of Study 2 provide support for this new integrated model and encourage others to consider using attachment theory, and its theoretical speculations, for how individuals with different attachment styles (i.e., secure, preoccupied, fearful, and dismissing) will respond to the death of an attachment figure in adulthood.<p> The present studies findings advance our understanding of the relationship between attachment theory and grief in that they go beyond present theory and provide empirical data for the current theoretical assertions. Further, the findings are reported in regards to specific attachment styles, rather than the secure versus insecure distinction that has been more commonly utilized when conducting research on attachment style differences. Implications and directions for future research are also proposed.

The study examined the long-term effects of a death of a child on a variety of parental psychological and physical outcomes, incorporating several methodological and conceptual innovations over previous research. Prior bereavement research typically has focused on functioning within a short time period after the death and often has utilized self-selected samples of grieving parents; thus current models of grief may be inadequate. In contrast, this study broadened the timeframe in which bereavement is studied (average time since death= 20 years), and examined a sample of bereaved parents who were not self-selected. Participants were members of the Wisconsin Longitudinal Study (713 bereaved and 713 non-bereaved parents) who were assessed in 1957, 1975/77, and 1992/94 and were matched on family of origin demographic variables. Results show that bereaved parents reported a higher sense of purpose in life than non-bereaved parents. Further, higher levels of purpose in life was associated with lower levels of depression in bereaved parents, and with lower levels of physical illness in bereaved men. As expected, bereaved parents exhibited higher levels of depression than non-bereaved parents. For bereaved women, having someone with whom to share private thoughts and feelings was correlated with higher levels of depression, indicating that social support may be sought when functioning is poor. Higher job satisfaction was associated with lower levels of depression in bereaved women suggesting that role variegation is a factor promoting resiliency. Further, having another child after the death of a child was associated with lower levels of depression for bereaved women. Contrary to expectations, having other children in the home at the time of death was associated with lower social support and higher divorce rates for bereaved women. In sum, the current study suggests that the negative effects of the death of a child are longstanding. Several factors (e.g., purpose in life, role variegation) may promote resiliency and thus merit more scientific study and clinical attention.

Loss is an inevitable human experience. How each individual reacts to loss may be affected by various factors among these is ones attachment style. The present studies examine the ultimate form of loss, the death of a significant attachment relationship in ones life. Specifically, the research focuses on how people respond to and cope with the death of an attachment figure. In so doing, the relationship between grief and attachment theory is discussed and an integrated model of grief and attachment is proposed, which accounts for various differences in how individuals respond to the death of an attachment figure in adulthood.<p> Study 1 examined the notion that in order to maintain an ongoing relationship with a deceased person and engage in behaviours that maintain this relationship, one must have had a close relationship to the deceased prior to his or her death. Seventy-three undergraduate students who reported having experienced the death of someone they knew were recruited to complete the online survey. This study utilized a measure specifically designed for the present research, the Ongoing Relationship Scale (Waskowic & Chartier, 2006), to demonstrate the necessity of a close relationship in order to engage in behaviours that maintain an ongoing relationship with the deceased.<p> The ORS was used to distinguish between whether one perceived engaging in ongoing behaviours with the deceased attachment figure as positive or negative, that is, whether engaging in certain behaviours brought an individual comfort or discomfort. The findings showed that those who identified themselves as having had a closer relationship to the deceased were more likely to engage in behaviours consistent with maintaining an ongoing relationship; whereas those who did not report having had a close relationship to the deceased were less likely to do so. Preliminary psychometric data for the ORS demonstrated good reliability. Convergent and discriminant validity for the measure are also provided.<p> Study 2 extends the findings from the first study by exploring a specific type of close relationship, the attachment relationship, and how one copes with the grief upon the death of the attachment figure. One hundred and ninety three participants who experienced the death of either a partner or parent were recruited to participate in the study. Participants were asked to complete a survey containing measures of attachment style, relationship closeness, grief, coping with the loss, interpersonal dependency, ongoing relationship with the deceased, and resilience. Utilizing Stroebe, Schut, and Stroebes (2005) Dual Processing Model and OLeary and Ickovicss (1995) Outcome of Challenge Model the differences in coping with the death of an attachment figure were explored based on ones type of attachment. Based on the findings from the present research that there are differences between the four types of attachment (i.e., secure, preoccupied, fearful, and dismissing) in how each copes with the death of a significant attachment figure, a new comprehensive model of grief, which integrates previous theories within an attachment theoretical framework is offered. This new model, referred to as the Grief Attachment Model, accounts for observed differences in the way people cope with the death of a significant attachment figure in their lives, and suggests that researchers focus on the attachment relationship to explain variability in a persons grief response.<p> The results of Study 2 provide support for this new integrated model and encourage others to consider using attachment theory, and its theoretical speculations, for how individuals with different attachment styles (i.e., secure, preoccupied, fearful, and dismissing) will respond to the death of an attachment figure in adulthood.<p> The present studies findings advance our understanding of the relationship between attachment theory and grief in that they go beyond present theory and provide empirical data for the current theoretical assertions. Further, the findings are reported in regards to specific attachment styles, rather than the secure versus insecure distinction that has been more commonly utilized when conducting research on attachment style differences. Implications and directions for future research are also proposed.

Thesis (D. Phil.(Psychotherapy))--University of Pretoria, 2003. / Includes bibliographical references.