Are there gender differences in prolonged grief trajectories? A registry-sampled cohort study

Lundorff, Marie; Bonanno, George A.; Johannsen, Maja; O’Connor, Maja

doi:10.1016/j.jpsychires.2020.06.030

Cited by 51 publications

(44 citation statements)

References 32 publications

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“…The current preliminary findings have implications for the tailored provision of postvention and grief support. For example, while men and women demonstrated similar levels of avoidant coping strategies (after accounting for all variables of interest and demographics), the tendency for men in this study to report less utilization of adaptive emotion- and problem-focused coping strategies in the initial six-month period following loss may correspond to patterns observed in previous studies (e.g., [ 44 ]) and it may be particularly useful for practitioners to focus on enhancing adaptive coping strategies in men during this earlier period, which may serve to facilitate grief resolution and contribute to the prevention of suicidal behaviors and other adverse outcomes [ 6 ]. Naturally, this relies upon people getting access to timely and appropriate postvention supports which may be impeded by (real or perceived) experiences of stigma and shame [ 23 , 46 , 47 ].…”

Section: Discussionsupporting

confidence: 82%

“…In our study, in the final models after accounting for all variables of interest and demographics, bereaved women were more likely to use problem- and emotion-focused adaptive coping than bereaved men, but there were no differences for avoidant coping. Gender differences in coping with grief have long been discussed [ 43 ], and recent research implies that gender may influence the trajectory of ‘prolonged grief’ over time, with men experiencing more pronounced grief initially which decreased and vice versa for women (there were no differences between genders for more stable and resilient grief profiles [ 44 ]). However, there may be few differences regarding actual self-reported symptoms of prolonged grief experienced between genders [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

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Coping Styles Utilized during Suicide and Sudden Death Bereavement in the First Six Months

Mathieu

Todor

Leo

et al. 2022

IJERPH

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Individuals bereaved by suicide experience substantial emotional distress and are at risk for poorer mental health, substance use concerns, and suicidal behaviors. This study aimed to explore whether those bereaved by suicide reported different coping styles compared to those bereaved by sudden death in the first six months. It also aimed to determine whether a previous mental health diagnosis (PMHD) and experiencing stigma and/or shame impacted the utilization of adaptive and maladaptive coping. The sample was constituted by individuals bereaved by suicide (n = 142) compared to those bereaved by sudden death (n = 63), six months after loss. The study included immediate family members who were 18 years or older and understood the English language. After controlling for demographics there were no significant differences in coping styles between bereavement types. Regardless of bereavement type, having a PMHD was associated with increased avoidant and problem-focused coping, and stigma and shame were each associated with increased avoidant coping. Women were also more likely to report using adaptive coping. Findings demonstrate no difference by bereavement type and have implications for the tailoring of grief/postvention supports that are sensitive to perceived stigma/shame to better facilitate utilization of adaptive emotion-focused coping, particularly for men and those with pre-existing mental health problems.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Coping Styles Utilized during Suicide and Sudden Death Bereavement in the First Six Months

Mathieu

Todor

Leo

et al. 2022

IJERPH

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“…It is therefore possible that ICD-11 criteria are less prone to gender effects than previous algorithms. Support for this line of argument comes from a recent registry-sampled cohort study in spousal bereavement ( 49 ): using the new ICD-11 criteria and growth-mixture modeling, Lundorff and colleagues demonstrated that all trajectories of prolonged grief comprised similar proportions of men and women. Another recent study, however, reported female gender as a risk factor for PGD according to ICD-11 in three convenience samples ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Prolonged Grief Disorder in a German Representative Population Sample: Unexpectedness of Bereavement Contributes to Grief Severity and Prolonged Grief Disorder

et al. 2022

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Most people adapt to bereavement over time. For a minority, the grief persists and may lead to a prolonged grief disorder (PGD). Identifying grievers at risk of PGD may enable specific prevention measures. The present study examined the extent to which the subjective unexpectedness of the death predicted grief outcomes above and beyond known sociodemographic and objective loss-related variables in a sample drawn from a population-representative investigation. In our sample (n = 2,531), 811 participants (Mage 55.1 ± 17.8 years, 59.2% women) had experienced the loss of a significant person six or more months ago. Participants provided demographic and loss-related information, perceptions of the unexpectedness of the death and completed the Prolonged Grief Disorder-13 + 9 (PG-13 + 9). The PG-13 + 9 was used to determine PGD caseness. A binary logistic regression investigated predictors of PGD caseness, and a linear regression predictors of grief severity. ANCOVAs compared PGD symptoms between the groups who had experienced an “expected” vs. “unexpected” loss, while controlling for the relationship to the deceased and time since loss. The loss of a child (OR = 23.66; 95%CI, 6.03–68.28), or a partner (OR = 5.32; 95%CI, 1.79–15.83), the time since loss (OR = 0.99; 95%CI, 0.99–1.00) and the unexpectedness of the death (OR = 3.58; 95%CI, 1.70–7.69) were significant predictors of PGD caseness (Nagelkerke’s R2 = 0.25) and grief severity. Participants who had experienced the loss as unexpected (vs. expected) reported higher scores on all PGD symptoms. Unexpectedness of the death emerged as significant risk factor for PGD, even after controlling for demographic and other loss-related variables. While our findings replicate previous research on the importance of the relationship to the deceased as a risk factor for PGD, they also highlight the importance of assessing the subjective unexpectedness of a death and may help to identify risk groups who can profit from preventive interventions.

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“…However, these studies are limited by small sample sizes, relatively short follow-up assessments, or other methodological issues. Further studies, particularly those with larger sample sizes or longer-term time frames, have observed distinct trajectories in which most people are resilient to the effects of bereavement, a smaller but significant proportion have grief symptoms improving over time, others have moderate and persistent symptoms, and a smaller group exhibits high levels of grief symptoms that do not improve over time (i.e., prolonged grief) 91,92 . It appears that, whereas prolonged grief disorder and depression follow some of the same trajectories after bereavement, there are also trajectories unique to each 93 .…”

Section: Review Of the Evidencementioning

confidence: 99%

Emerging experience with selected new categories in the ICD‐11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder

et al. 2022

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Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.

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Are there gender differences in prolonged grief trajectories? A registry-sampled cohort study

Cited by 51 publications

References 32 publications

Coping Styles Utilized during Suicide and Sudden Death Bereavement in the First Six Months

Coping Styles Utilized during Suicide and Sudden Death Bereavement in the First Six Months

Predictors of Prolonged Grief Disorder in a German Representative Population Sample: Unexpectedness of Bereavement Contributes to Grief Severity and Prolonged Grief Disorder

Emerging experience with selected new categories in the ICD‐11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder

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