PDF
ePub
Citation
Print
Abstract
Background
While complicated grief can lead to adverse health outcomes, social support has been shown to be an important protective factor of its negative effects. The present study investigated the relationship between social support including satisfaction with support, received support, and negative interactions and complicated grief in the transitional context from caregiving to bereavement.
Methods
Bereaved caregivers (n=221) who participated in a multi-site study of dementia caregiving were assessed for complicated grief. Social support measured before and after death were used to examine the longitudinal associations among social support and complicated grief.
Results
We found that caregivers reporting greater increase in satisfaction with social support were likely to experience lower levels of complicated grief, while the amount of received social support did not significantly impact complicated grief. Negative social interaction was significantly associated with the level of complicated grief after the death of the care recipient.
References
1. Schulz R, Boerner K, Shear K, Zhang S, Gitlin LN. Predictors of complicated grief among dementia caregivers: a prospective study of bereavement. Am J Geriatr Psychiatry. 2006; 14(8):650–8.
2. Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, Goodkin K, et al. Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med. 2009; 6(8):): e1000121.
3. Simon NM, Pollack MH, Fischmann D, Perlman CA, Muriel AC, Moore CW, et al. Complicated grief and its correlates in patients with bipolar disorder. J Clin Psychiatry. 2005; 66(9):1105–10.
4. Prigerson HG, Bierhals AJ, Kasl SV, Reynolds CF 3rd, Shear MK, Day N, et al. Traumatic grief as a risk factor for mental and physical morbidity. Am J Psychiatry. 1997; 154(5):616–23.
5. Germain A, Caroff K, Buysse DJ, Shear MK. Sleep quality in complicated grief. J Trauma Stress. 2005; 18(4):343–6.
6. Maytal G, Zalta AK, Thompson E, Chow CW, Perlman C, Ostacher MJ, et al. Complicated grief and impaired sleep in patients with bipolar disorder. Bipolar Disord. 2007; 9(8):913–7.
7. Burke LA, Neimeyer RA, McDevitt-Murphy ME. African American homicide bereavement: aspects of social support that predict complicated grief, PTSD, and depression. Omega (Westport). 2010; 61(1):1–24.
8. Macias C, Jones D, Harvey J, Barreira P, Harding C, Rodican C. Bereavement in the context of serious mental illness. Psychiatr Serv. 2004; 55(4):421–6.
9. Ogrodniczuk JS, Joyce AS, Piper WE. Changes in perceived social support after group therapy for complicated grief. J Nerv Ment Dis. 2003; 191(8):524–30.
10. Vanderwerker LC, Prigerson HG. Social support and technological connectedness as protective factors in bereavement. J Loss Trauma. 2004; 9(1):45–57.
11. Hogan DP, Eggebeen DJ. Sources of emergency help and routine assistance in old age. Soc Forces. 1995; 73(3):917–36.
12. Gallagher SK, Gerstel N. Kinkeeping and friend keeping among older women: the effect of marriage. Gerontologist. 1993; 33(5):675–81.
13. Wilsey SA, Shear K. Descriptions of social support in treatment narratives of complicated grievers. Death Stud. 2007; 31(9):801–19.
14. White DL, Walker AJ, Richards LN. Intergenerational family support following infant death. Int J Aging Hum Dev. 2008; 67(3):187–208.
15. Bedard M, Raney D, Molloy DW, Lever J, Pedlar D, Dubois S. The experience of primary and secondary caregivers caring for the same adult with Alzheimer's disease. J Ment Health Aging. 2001; 7(2):287–96.
16. Litwin H, Landau R. Social network type and social support among the old-old. J Aging Stud. 2000; 14(2):213–28.
17. Mitrani VB, Czaja SJ. Family-based therapy for dementia caregivers: clinical observations. Aging Ment Health. 2000; 4(3):200–9.
18. Krause N, Markides K. Measuring social support among older adults. In J Aging Hum Dev. 1990; 30(1):37–53.
19. Somhlaba NZ, Wait JW. Psychological adjustment to conjugal bereavement: do social networks aid coping following spousal death? Omega (Westport). 2008; 57(4):341–66.
20. Hebert RS, Dang Q, Schulz R. Preparedness for the death of a loved one and mental health in bereaved caregivers of patents with dementia: findings from the REACH study. J Palliat Med. 2006; 9(3):683–93.
Table 1.
Demographic characteristics, social support, and caregiving characteristics
Table 2.
Correlations for complicated grief and social support constructsa
| Correlation coefficient | Pa | |
|---|---|---|
| Satisfaction with social support | ||
| Before death | ‐0.10 | 0.071 |
| After death | ‐0.26 | <0.001 |
| Change | ‐0.16 | 0.031 |
| Received social support | ||
| Before death | 0.02 | 0.142 |
| After death | 0.12 | 0.065 |
| Change | 0.10 | 0.072 |
| Negative social interaction | ||
| Before death | 0.12 | 0.065 |
| After death | 0.21 | 0.003 |
| Change | 0.06 | 0.105 |
Table 3.
Regression results on relationships between satisfaction with social support and complicated griefa
| B | SE | Pa | |
|---|---|---|---|
| Change in satisfaction with social support | –0.783 | 0.391 | 0.041 |
| Caregiver's age | –0.052 | 0.071 | 0.471 |
| Care-recipient's age | –0.264 | 0.112 | 0.033 |
| Female | –3.591 | 2.361 | 0.132 |
| Race (ref group: White) | |||
| Black | 1.791 | 2.193 | 0.412 |
| Hispanic | 0.262 | 2.794 | 0.934 |
| Caregiver education (ref group: <high school) | |||
| High school graduate | –2.564 | 2.264 | 0.261 |
| College graduate | –4.734 | 2.271 | 0.042 |
| Time since loss | 0.023 | 0.013 | 0.123 |
| REACH intervention assignment | –1.872 | 1.774 | 0.292 |
| Antidepressant use | 5.611 | 2.092 | 0.011 |
| Years of caregiving for care-recipient | –0.017 | 0.201 | 0.934 |
| Hours per day spent caregiving | –0.041 | 0.131 | 0.774 |
XML Download