Rumination in bereaved parents: Psychometric evaluation of the Swedish version of the Utrecht Grief Rumination Scale (UGRS)

Abstract

BackgroundBereaved parents may be at higher risk to develop persistent, severe and disabling grief, termed prolonged grief. Grief rumination, repetitive thinking about the causes and consequences of the loss, is a malleable cognitive process that maintains prolonged grief. Grief rumination can be measured with the Utrecht Grief Rumination Scale (UGRS). The present study aimed to examine the psychometric properties of the new Swedish version of the UGRS in a sample of bereaved parents.MethodsA Swedish nationwide postal survey including measures of demographic and loss-related variables, grief rumination (UGRS), and symptoms of prolonged grief, posttraumatic stress, anxiety, depression, and insomnia, was completed by 226 parents (133 mothers and 93 fathers) who lost a child to cancer in the past five years. Psychometric properties of the UGRS were examined through confirmatory factor analyses (CFA), reliability analyses, and assessment of UGRS score associations with symptoms of prolonged grief, posttraumatic stress, depression, anxiety, and insomnia.ResultsThe internal consistency of the Swedish UGRS was good. The CFA yielded an acceptable fit for a two-factor hierarchical model with five sub-factors. Grief rumination was positively associated with all psychopathology symptom measures. Higher scores on UGRS were found in parents with possible prolonged grief disorder compared to those without (d = 1.47). Moreover, the Swedish UGRS was associated with prolonged grief symptoms over and above loss-related and demographic variables and other psychopathology symptoms.ConclusionsThe Swedish UGRS demonstrated good psychometric properties, which supports its use as a measure to assess grief rumination in Swedish bereaved parents in research and practice.

Regret and unfinished business in parents bereaved by cancer: A mixed methods study

“…However, as unfinished business–related distress was similarly associated with prolonged grief, 15 an alternative explanation is that parents’ focus on regrets and/or unfinished business hinders the processing of grief and adaptation, 45 maintaining prolonged grief symptoms over time. Both prolonged grief 46,47 and regret 11 have been linked to ruminative thinking, which is more common in women. 48 This may be in part why a greater proportion of mothers than fathers reported regrets and unfinished business.…”

“…48 This may be in part why a greater proportion of mothers than fathers reported regrets and unfinished business. 47…”

Psychological symptoms in widowed parents with minor children, 2–4 years after the loss of a partner to cancer

“…The UGRS consists of 15 items rated on a 5‐point scale (1 = never, 5 = very often), with higher scores indicating more rumination (range: 15–75). The Swedish version of the UGRS has been validated and reliability‐tested with good results 29 . The internal consistency of the UGRS in this sample was good (Cronbach's α = 0.93).…”

Feasibility and preliminary efficacy of guided internet-delivered cognitive behavioral therapy for insomnia after the loss of a child to cancer: Randomized controlled trial

“…The present study is part of a larger project on parents of children who were diagnosed with a malignancy before the age of 17 years and died due to the malignancy before the age of 25 years, between 2010 and 2015. Cancer-bereaved parents were invited to take part in a Swedish nationwide postal survey, which has been described in greater detail in Pohlkamp et al (2018) and Sveen et al (2019) . Of 512 eligible individuals, 372 consented to participate and received the survey, 63 declined to participate and 76 parent could not be contacted.…”