Coping flexibility, forward focus and trauma focus in older widows and widowers

Authors

  • Lindsey M Knowles
  • Mary-Frances O'Connor

Keywords:

aging, widow, bereavement, grief, coping, complicated grief

Abstract

Abstract

Coping strategies play a significant role in overall adjustment to bereavement, and recent emphasis has been placed on flexibility in coping versus unilateral strategies that are seemingly beneficial or maladaptive. The Dual Process Model of coping informed the conceptualisation of coping flexibility as the oscillation between ‘trauma focus’ and ‘forward focus’ coping strategies. The primary aim of the present study was to assess whether trauma focus and forward focus coping strategies, and using strategies from both flexibly, would predict grief severity. Trauma focus and forward focus were assessed using the Perceived Ability to Cope with Trauma (PACT) scale, measured cross-sectionally in older widows and widowers. In addition, we modeled symptoms of loneliness, yearning and perceived stress from PACT scale scores. Results showed that greater forward focus and coping flexibility predicted lower grief severity, and also predicted lower yearning, loneliness, and perceived stress. Additionally, length of time that participants were bereaved moderated the relationships of forward focus coping and coping flexibility to grief symptoms, such that having greater forward focused coping and coping flexibility matter the most early in bereavement.

References

American Psychiatric Association (2013). Conditions for further study. Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed) Arlington, VA: American Psychiatric Publishing.

Bonanno GA, Burton CL (2013). Regulatory flexibility: an individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science 8(6) 591–612.

Bonanno GA, Diminich ED (2013). Annual research review: positive adjustment to adversity—trajectories of minimal-impact resilience and emergent resilience. Journal of Child Psychology and Psychiatry 54(4) 378–401.

Bonanno GA, Papa A, Lalande K, Westphal M, Coifman K (2004). The importance of being flexible: the ability to both enhance and suppress emotional expression predicts long-term adjustment. Psychological Science 15(7) 482–487.

Bonanno GA, Pat-Horenczyk R, Noll J (2011). Coping flexibility and trauma: the perceived ability to cope with trauma (PACT) scale. Psychological Trauma: Theory, Research, Practice, and Policy 3(2) 117–129.

Bonanno GA, Wortman CB, Nesse RM (2004). Prospective patterns of resilience and maladjustment during widowhood. Psychology and Aging 19(2) 260–271.

Burton CL, Yan OH, Pat-Horenczyk R et al (2012). Coping flexibility and complicated grief: a comparison of American and Chinese samples. Depression and Anxiety 29(1) 16–22.

Byrne GJA, Raphael B (1994). A longitudinal study of bereavement phenomena in recently widowed elderly men. Psychological Medicine 24(2) 411–421.

Carr D (2010). New perspectives on the dual process model (DPM): What have we learned? What questions remain? OMEGA: Journal of Death and Dying 61(4) 371–380.

Caserta MS, Lund DA (2007). Toward the development of an inventory of daily widowed life (IDWL): guided by the dual process model of coping with bereavement. Death Studies 31(6) 505–535.

Cheng C (2001). Assessing coping flexibility in real-life and laboratory settings: a multimethod approach. Journal of Personality and Social Psychology 80(5) 814–833.

Cohen S, Kamarck T, Mermelstein R (1983). A global measure of perceived stress. Journal of Health and Social Behavior 24(4) 385–396.

Folkman S, Moskowitz JT (2004). COPING: pitfalls and promise. Annual Review of Psychology 55(1) 745–774.

Gross JJ (1998). Antecedent- and response-focused emotion regulation: divergent consequences for experience, expression, and physiology. Journal of Personality and Social Psychology 74(1) 224–237.

Gross JJ (1999). Emotion regulation: past, present, future. Cognition & Emotion 13(5) 551–573.

Gross JJ (2002). Emotion regulation: affective, cognitive, and social consequences. Psychophysiology 39(3) 281–291.

Hobson CJ, Kamen J, Szostek J, Nethercut CM, Tiedmann JW, Wojnarowicz S (1998). Stressful life events: a revision and update of the social readjustment rating scale. International Journal of Stress Management 5(1) 1–23.

Kashdan TB, Rottenberg J (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review 30(7) 865–878.

Katz S, Kravetz S, Grynbaum F (2005). Wives’ coping flexibility, time since husbands’ injury and the perceived burden of wives of men with traumatic brain injury. Brain Injury 19(1) 81–90.

Kessler RC, Sonnega A, Bromet E, et al (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry 52(12) 1048–1060.

Lazarus RS, Folkman S (1984). Stress, appraisal, and coping. New York, NY: Springer.

Machin L (2014). Working with loss and grief (2nd edn). London: Sage.

McIlwain CD (2005). When death goes pop: death, media & the remaking of community. New York: Peter Lang Publishing, Inc.

O'Connor M, Sussman TJ (2014). Developing the yearning in situations of loss scale: convergent and discriminant validity for bereavement, romantic breakup, and homesickness. Death Studies 38(7) 450–458.

Ott CH, Lueger RJ, Kelber ST, Prigerson HG (2007). Spousal bereavement in older adults: common, resilient, and chronic grief with defining characteristics. The Journal of Nervous and Mental Disease 195(4) 332–341.

Parkes CM, Benjamin B, Fitzgerald RG (1969). Broken heart: a statistical study of increased mortality among widowers. British Medical Journal 1(5646) 740–743.

Prigerson HO, Jacobs SC (2001). Traumatic grief as a distinct disorder: a rationale, consensus criteria, and a preliminary empirical test. In MS Stroebe, RO Hansson, W Stroebe & H Schut (eds) Handbook of bereavement research: consequences, coping, and care. Washington, DC, US: American Psychological Association 613–645.

Richardson VE (2006). A dual process model of grief counseling. Journal of Gerontological Social Work 48(3-4) 311–329

Richardson VE (ed) (2010). Dual process model of coping with bereavement. Special issue of OMEGA: Journal of Death and Dying 61(4).

Roussi P, Krikeli V, Hatzidimitriou C, Koutri I (2007). Patterns of coping, flexibility in coping and psychological distress in women diagnosed with breast cancer. Cognitive Therapy & Research 31(1) 97–109.

Russell DW (1996). UCLA loneliness scale (version 3): reliability, validity, and factor structure. Journal of Personality Assessment 66(1) 20–40.

Shear K, Frank E, Houck PR, Reynolds CF (2005). Treatment of complicated grief: a randomised controlled trial. Journal of the American Medical Association 293(21) 2601–2608.

Stroebe M (1992). Coping with bereavement: a review of the grief work hypothesis. OMEGA: Journal of Death and Dying 26(1) 19–42.

Stroebe M, Schut H (1999). The dual process model of coping with bereavement: rationale and description. Death Studies 23(3) 197–224.

Stroebe M, Schut H (2010). The dual process model of coping with bereavement: a decade on. OMEGA: Journal of Death and Dying 61(4) 273–289.

Stroebe M, Schut H, Stroebe W (2007). Health outcomes of bereavement. The Lancet, 370(9603) 1960–1973.

Wilcox S, Evenson KR, Aragaki A et al (2003). The effects of widowhood on physical and mental health, health behaviors, and health outcomes: the women's health initiative. Health Psychology 22(5) 513–522.

Downloads

Published

2015-01-02

Issue

Section

Article