Complicated grief (CG): emotional and cognitive factors

Golden, Ann-Marie Jelena (2008). Complicated grief (CG): emotional and cognitive factors. PhD thesis The Open University.



Complicated Grief (CG) is a new diagnostic concept referring to a profile of symptoms indicative of a pathological bereavement reaction. CG overlaps in terms of symptomatology with other disorders such as Major Depressive Disorder (MOD) and Posttraumatic Stress Disorder (PTSD). In both PTSD and MDD various cognitive and emotion processes have been shown to be important in onset, maintenance, recovery and treatment. For this reason it is important to understand the role of such factors in CG where there is little published research examining these issues. This thesis therefore seeks to document the profile of cognitive-affective processing reported in the disorder by comparing individuals with and without a CG diagnosis, recruited from Croatia. The research uses a range of self-report, behavioural, cognitive and emotion processing tasks from the existing literature.

Chapter I reviews the general literature and Chapter 2 describes the translation and validation of the questionnaire measures. Chapter 3 describes the samples of CG and non CG participants used in thesis studies. Six empirical studies are then reported in Chapters 4 - 9. Chapter 4 examines cognitive processes of mental regulation including thought suppression, thought control, emotion regulation (appraisal, suppression and expressivity) and coping strategies. Chapter 5 presents diary data on sleep patterns and intrusive memories and thoughts, as well as questionnaire data on sleep and physical health impairments. Chapter 6 looks at fragmentation and disorganization in narrative accounts of the bereavement and of a negative non-bereavement related event. Chapter 7 focuses on processes in reasoning and thinking such as counterfactual thinking, judgement of risk, attributional style, posttraumatic cognitions, dissociation, self-evaluation and rumination style. Chapter 8 looks at autobiographical memory. Finally, Chapter 9 revisits a number of the key issues using different participant sampling. The data indicate that the cognitiveaffective profile of CG appears highly similar to that of PTSD and depression. The data and their implications, along with limitations of the research and future directions are presented in a General Discussion (Chapter 10).

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