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Bereavement: reeling in the years

Science News, Feb 7, 1987 by Bruce Bower

Bereavement: Reeling in the Years

It is a chilling statistic: Sudden, traumaticaccidents are the number-one killer of persons aged 44 and under in the United states, claiming approximately 150,000 victims annually, with nearly one-third of those deaths stemming from car crashes. Yet the psychological impact of these losses on family members and the time required to complete the mourning process remain largely unexplored.

An extensive follow-up study of individualswho lost a spouse or child in a motor vehicle crash now indicates that emotional recovery is longer and more difficult than has often been assumed by clinicians and researchers. Four to seven years after the accident, bereaved spouses and parents in the study reported marked depression and a failure to resolved their loss.

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"Our data clearly indicate that followingthe traumatic loss of one's spouse or child, lasting distress is not a sign of individual coping failure but rather a common response to the situation," says Camille B. Wortman of the University of Michigan in Ann Arbor, who conducted the study along with Michigan's Darrin R. Lehman and Allan F. Williams of the Insurance Institute for Highway Safety in Washington, D.C.

The data also undermine current theoriesof bereavement that assume an individual will return to normal functioning within several years after a loss has occurred. One view is that a bereaved person goes through several stages of emotional distress, including shock, anger and depression, followed by resolution of the loss. Failure to achieve such resolution after several years, according to psychoanalytic theory, signals an inability to free oneself from the emotional bond to a deceased loved one.

Despite these contentions, say the researchers,only the new study and a Harvard University project have carefully examined the effects of bereavement beyond two years after the loss. In the Harvard study, 59 widows and widowers were interviewed two to four years after their spouses died. More than 40 percent were rated as showing moderate to severe anxiety compared with nonbereaved controls. Those with brief or no warning of their spouse's death did much more poorly than those with at least two weeks to prepare themselves for the loss.

Lehman and his colleagues, whosereport is in the January JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY, looked even farther down the road of the mourning process after a sudden loss. They used state records to identify every motor vehicle fatality in Wayne County, Mich., between 1976 and 1979. Potential subjects were then located and asked to be interviewed in 1983 in their homes. The spouse study included 39 bereaved individuals (most of them women) and 39 nonbereaved controls matched for sex, age, income, education and number and ages of children. The parent study was conducted with 41 pairs of bereaved parents and 41 matched pairs of nonbereaved parents.

Though individual responses varied,responses to structured interviews generally showed bereaved spouses to be doing significantly poorer than controls on several indicators of general functioning, such as depression, anxiety and other psychiatric symptoms, social contacts, satisfaction with current life situation, apprehension about the future and confidence in the ability to cope with serious problems.

Among those who had lost a child,significant differences in functioning, especially depression, were observed between bereaved and control parents, but these were not as pervasive as differences in the spouse study. Part of the reason, suggest the researchers, may be that a spouse is a more critical source of support and security than a child.

Nearly all of the bereaved subjects saidthe deceased continued to occupy their thoughts and conversations, often making them feel "hurt and pained." About two-thirds said they had not found any meaning in the death.

The researchers concentrated ongroup differences and did not identify bereaved individuals who achieved a good level of functioning or factors distinguishing them from the majority still experiencing substantial distress. But since about half of the bereaved persons they originally attempted to contact had either died or refused to participate in the study, Wortman says, "our estimates of psychological distress among the bereaved dealing with a sudden, unexpected loss are conservative." When there is time to prepare for the loss, she adds, distress is probably less severe but comparably long-lasting.

A majority of the same bereaved subjects,notes Wortman, reported that well-intentioned comments from family and friends about the loss were often unsupportive of their continuing distress. Such comments included "Don't question God's will," "Your wife is at peace" and "I know how you feel." Nonjudgmental support -- for instance, "I'm here anytime if you need to talk" -- from family and friends in particularly important, she says, because many bereaved people do not seek out psychotherapy or support grops.

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Bereavement: reeling in the years

Science News, Feb 7, 1987 by Bruce Bower

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