Complicated Grief

Have you lost a loved one or someone close to you? Have you been grieving seemingly endlessly? 

While complicated grief (CG) after the death of a loved one has often been perceived as avoidance-driven, current research implicates approach behavior (Buqo et al., 2022, p. 985). Researchers have taken a deep look at how coping styles may forecast CG; however, emotional closeness was not examined. An important study by Buqo et al. (2022) took a deeper look at the differential relationship of approach- and avoidance-based coping on CG and symptoms of depression.

Complicated grief (CG) is a maladaptive response to a passing characterized by excessive yearning or longing for the loved one, emotional pain, struggle accepting the loss, and a temporary inability to react or a feeling of shock (Buqo et al., 2022, p. 986). While most who experience loss may adjust and continue to live a functional life, those with CG experience numerous functional impairments and see a considerable decrease in their engagement in life. Regardless of sharing some of the same symptoms, CG is different from bereavement-related depression centred on symptom presentation. Attachment theory provides information about the traditional views of CG, suggesting that after the passing of an attachment figure, a person avoids reminders of the departed individual, resulting in a restricted life and the development of CG. Even though this attachment theory of CG, founded on an avoidance-driven model, has increased in some prominence, other researchers advise that avoidance on its own cannot explain CG. For instance, people facing CG were more likely to retrieve loss reminders toward them instead of pushing them away in a computer-built experimental paradigm. Maccallum and Bryant (2019, as cited in Buqo et al., 2022) illustrated that persons who met the criteria for CG were likely to retrieve closer names to that of those who passed, while those without CG did not display this tendency.

Several coping styles may impact the outcomes in CG (Buqo et al., 2022, pp. 986–987). A small number of studies deliver evidence that supports the attachment theory of CG; however, selected coping measures in studies of CG speak of coping styles in a broader manner and are not precise to coping with reminders of the loss, which is the driving force under attachment theory. In addition to attachment theory, the identity continuity theory of CG involves additional factors that might help forecast CG responses after a loss. Given knowledge of this theory, disturbance to important aspects of a person’s sense of self might contribute to maladjustment after a loss. Research shows that such a disturbance is especially likely to result in higher levels of CG when the lost role is highly central to the individual’s sense of self, as with the loss of emotionally close persons (Buqo et al., 2022).

The Inventory of Complicated Grief is a 19-part self-report questionnaire that assesses symptoms of CG. The items are scored on a 5-point scale (ranging from 0 ¼ (never) to 4 ¼ (always)) (Buqo et al., 2022, p. 989). The Center for Epidemiologic Studies Short Depression Scale is a 10-item condensed self-report questionnaire to assess depression symptoms. Items are scored on a 4-point scale (ranging from 0 ¼ (rarely or none of the time) to 3 ¼ (100% of the time)). The results of this study display evidence that CG symptomology might not be fully described by avoidance-driven coping behavior after experiencing loss (pp. 992–993). In reality, approach-focused coping (e.g., approaching reminders of the loss by thinking about them more often and then dwelling on the emotional response) was connected with greater levels of CG, and avoidance-based coping was not connected with CG.

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Buqo, T., Ward-Ciesielski, E. F., & Krychiw, J. K. (2022). Do coping strategies differentially mediate the relationship between emotional closeness and complicated grief and depression? Omega, 84(4), 985–997.