More effective psychosocial interventions that target uncomplicated bereavement are needed for those actively seeking support. The objective of this study was to assess the feasibility of evaluating a unique meaning-based group counseling (MBGC) intervention with a randomized controlled trial (RCT) design. Twenty-six bereft individuals were randomly assigned to either MBGC or a control bereavement support group. Twenty participants (11 experimental, nine control) completed all aspects of the study including self-report measures at baseline, postintervention, and 3-month follow-up of meaning in life, anxiety, depression, and grief. Results support the feasibility of an RCT with MBGC.

This study aimed to test the hypothesis that meaning making is a mediating process in the relationship between risk factors for prolonged grief disorder (PGD) and subsequent emergence of PGD symptomatology. A survey design was employed with prospective measurement of PGD. The following variables were assessed 2-12 months postloss among adults across North America and Europe (N ϭ 357): (a) risk factors for PGD (insecure attachment, social support, neuroticism, violent loss, and spousal loss) and (b) meaning made. Meaning made was measured using the Grief and Meaning Reconstruction Inventory (GMRI) as well as using the Integration of Stressful Life Experiences-Short Form (ISLES-SF). At a 7-10-months follow-up (n ϭ 171) symptoms of PGD were assessed. The mean age at the second assessment point was 44.3 years (SD ϭ 16.1) and the majority of the sample identified as female (71.9%). Process analysis was employed to test a series of simple mediation models. When the GMRI was used as a measure of meaning, the indirect effect of each risk factor on PGD symptoms, as mediated by meaning made, was significant (95% CI). When the ISLES-SF was used to measure meaning, the indirect effect of each risk factor with the exception of violent loss was significant (95% CI). The study demonstrates that meaning making serves to mediate the adverse impact of multiple PGD risk factors on the development of PGD symptomatology. Specifically, the study suggests that PGD risk factors exacerbate symptoms of PGD by impeding the meaning-making process. Public Significance StatementThis study provides support for the role of meaning making in the development of prolonged grief disorder symptomatology, suggesting that risk factors for prolonged grief worsen symptoms of prolonged grief by hindering meaning making such that the bereft struggle to "make sense" of the death. These findings facilitate understanding of how severe grief develops and suggest a clinical focus on facilitating meaning making among at-risk grievers.

The principle finding of the review was the highlighting of potential risks that culturally diverse female caregivers are likely to face at the end of life. The application of social justice theory provides a number of implications for practice and policy. Specifically, the identifying significant concerns regarding female caregivers in palliative home care, as well as suggesting ways to appropriately attend to these concerns, and oppression of women is less likely to be perpetuated, specific areas for future research in this domain are identified.

Objective:: To address the etiology of prolonged grief disorder (PGD) by examining whether rumination moderates the role of meaning-making in mediating the impact of PGD risk factors. Method:: A survey assessing PGD risk factors (low social support, insecure attachment, violent loss, neuroticism, and loss of a spouse), meaning, and rumination was administered 2-12 months postloss among adults across North America and Europe (mean age = 44.3, 71.9% female). At a 7-10 months follow-up, symptoms of PGD were assessed (n = 171). Results:: When measuring meaning with the Grief and Meaning Reconstruction Inventory, the moderated mediation pathway was significant for each PGD-risk factor. However, when measuring meaning with the Integration of Stressful Life Experiences-Short Form, the pathway was significant for every risk factors except violent loss.Conclusions:: Rumination appears to moderate meaningmaking in the development of PGD symptomatology. These findings highlight rumination as a target for intervention with atrisk grievers.Author note: This publication is one in a series of separate manuscripts that report findings from an ongoing project. The first manuscript, currently under review, establishes meaning made as a mediator of PGD symptomatology. The second manuscript (Milman et al., 2018), examines which specific themes of meaning mediate the relationship between violent loss and PGD symptomatology. Finally, the current manuscript describes a detrimental relationship between rumination and meaning-making following bereavement. Please contact the authors regarding relevant publications and presentations.This study was conducted jointly with the Jewish