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The Role of Threatening Misinterpretations and Avoidance in Emotional Problems After Loss

  • Paul A. Boelen (a1) and Marcel A. van den Hout (a1)

Abstract

There is uncertainty about the role of avoidance behaviours in recovery from loss. Some authors have noted that avoidance exacerbates grief, whereas others have claimed that avoidance, at some times during the grieving process, can foster recovery. In the current study, it was hypothesized that avoidance behaviours are particularly detrimental when mourners have threatening misinterpretations about the consequences of confronting the loss, but less detrimental when mourners do not have such misinterpretations. To test this hypothesis, 400 mourners completed questionnaires tapping threatening misinterpretations, avoidance, and complicated grief (CG) and depression. In support of the prediction, situational avoidance, ruminative avoidance, and efforts to maintain ties with the deceased were only linked with depression in those who strongly endorsed misinterpretations. In addition, misinterpretations magnified the associations of ruminative avoidance and efforts to continue ties, with CG. Findings suggest that avoidance interacts with threatening misinterpretations in affecting particular emotional problems after loss.

Copyright

Corresponding author

Reprint requests to Paul A. Boelen, Department of Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands. E-mail: p.a.boelen@uu.nl

References

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Aiken, L. S. and West, S. G. (1991). Multiple Regression: testing and interpreting interactions. Newbury Park, CA: Sage.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. Text Revision). Washington DC: American Psychiatric Association.
Arrindell, W. A. and Ettema, J. (2003). Symptom Checklist. Handleiding bij een multidimensionele psychopathologie-indicator. [Symptom Checklist. Manual for a multidimensional indicator of psychopathology.] Lisse: Swets and Zeitlinger.
Boelen, P. A., de Keijser, J., van den Hout, M. A. and van den Bout, J. (2007). Treatment of complicated grief: a comparison between cognitive behavioral therapy and supportive counseling. Journal of Consulting and Clinical Psychology, 75, 277284.
Boelen, P. A. and van den Bout, J. (in press). Complicated grief and uncomplicated grief are distinguishable constructs. Psychiatry Research.
Boelen, P. A., van den Bout, J., de Keijser, J. and Hoijtink, H. (2003). Reliability and validity of the Dutch version of the Inventory of Traumatic Grief. Death Studies, 27, 227249.
Boelen, P. A., van den Bout, J. and van den Hout, M. A. (2003). The role of negative interpretations of grief reactions in emotional problems after bereavement. Journal of Behavior Therapy and Experimental Psychiatry, 34, 225238.
Boelen, P. A., van den Hout, M. A. and van den Bout, J. (2006). A cognitive-behavioral conceptualization of complicated grief. Clinical Psychology: Science and Practice, 13, 109128.
Boelen, P. A., Schut, H. A. W., Stroebe, M. S. and Zijerveld, A. (2006). Continuing bonds and grief: a prospective analysis. Death Studies, 30, 767776.
Bonanno, G. A. (2004). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 2028.
Bonanno, G. A. and Kaltman, S. (1999). Toward an integrative perspective on bereavement. Psychological Bulletin, 125, 760776.
Bonanno, G. A., Keltner, D., Holen, A. and Horowitz, M. J. (1995). When avoiding unpleasant emotions might not be such a bad thing: verbal-autonomic response dissociation and midlife conjugal bereavement. Journal of Personality and Social Psychology, 69, 975989.
Bonanno, G. A., Neria, Y., Mancini, A., Coiffman, K. G., Litz, B. and Insel, B. (2007) Is there more to complicated grief than depression and PTSD? Journal of Abnormal Psychology, 116, 342351.
Derogatis, L. R. (1983). SCL-90-R: Administration, Scoring, and Procedures. Manual II (2nd ed.). Towson, Maryland: Clinical Psychometric Research.
Forstmeier, S. and Maercker, A. (2007). Comparison of two diagnostic systems for complicated grief. Journal of Affective Disorders, 99, 203211.
Hayes, S. C., Strosahl, K. D. and Wilson, K. G. (1999). Acceptance and Commitment Therapy: an experiential approach to behavior change. New York: The Guilford Press.
Horowitz, M. J. (1997). Stress Response Syndromes (3rd ed.). Northvale NJ: Jason Aronson.
Jacobs, S. C. (1999). Traumatic Grief: diagnosis, treatment and prevention. Philadelphia: Brunner/Mazel.
Kelly, A. E. and Kahn, J. H. (1994). Effects of suppression of personal intrusive thoughts. Journal of Personality and Social Psychology, 66, 9981006.
Kraut, R., Olson, J., Banaji, M., Bruckman, A., Cohen, J. and Couper, M. (2004). Psychological research online: report of board of scientific affairs' advisory group on the conduct of research on the internet. American Psychologist, 59, 105117.
Kraemer, H. C., Stice, E., Kazdin, A., Offord, D. and Kupfer, D. (2001). How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. American Journal of Psychiatry, 158, 848856.
Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569582.
Nolen-Hoeksema, S., McBride, A. and Larson, J. (1997). Rumination and psychological distress among bereaved partners. Journal of Personality and Social Psychology, 72, 855862.
Prigerson, H. G. and Jacobs, S. C. (2001). Traumatic grief as a distinct disorder: a rationale, consensus criteria, and a preliminary empirical test. In Stroebe, M. S., Hansson, R. O., Stroebe, W. and Schut, H. A. W. (Eds.), Handbook of Bereavement Research: consequences, coping, and care (pp. 613647). Washington DC: American Psychological Association Press.
Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., Frank, E., Doman, J. and Miller, M. (1995). Inventory of complicated grief: a scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 6579.
Prigerson, H. G., Vanderwerker, L. C. and Maciejewski, P. K. (in press). Prolonged Grief Disorder as a mental disorder: inclusion in DSM. In Stroebe, M., Hansson, R., Stroebe, W. and Schut, H. (Eds.), Handbook of Bereavement Research and Practice: 21st century perspectives. Washington DC: American Psychological Association Press.
Salkovskis, P. M. (1991). The importance of behaviour in the maintenance of anxiety and panic: a cognitive account. Behavioural Psychotherapy, 19, 619.
Steil, R. and Ehlers, A. (2000). Dysfunctional meaning of posttraumatic intrusions in chronic PTSD. Behavioural Research and Therapy, 38, 537558.
Stroebe, M. S. and Schut, H. (1999). The dual process model of coping with bereavement: rationale and description. Death Studies, 23, 197224.
Stroebe, M. S. and Stroebe, W. (1991). Does “grief work” work? Journal of Consulting and Clinical Psychology, 59, 479482.
Wijngaards-de Meij, L., Stroebe, M., Stroebe, W., Schut, H., van den Bout, J., van den Heijden, P. G. M. and Dijkstra, I. (in press). Parents grieving the loss of their child: interdependence in coping. British Journal of Clinical Psychology.

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The Role of Threatening Misinterpretations and Avoidance in Emotional Problems After Loss

  • Paul A. Boelen (a1) and Marcel A. van den Hout (a1)

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The Role of Threatening Misinterpretations and Avoidance in Emotional Problems After Loss

  • Paul A. Boelen (a1) and Marcel A. van den Hout (a1)
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