Complicated Grief in Survivors of Suicide
Abstract
Summary: Complicated grief is a newly defined and distinctive psychiatric disorder that occurs in response to a significant loss through death. New findings suggest that survivors who were close to the deceased are at heightened risk for complicated grief. Little is known about whether close kinship (spouses, parents, children, siblings, vs. in-laws, aunts/uncles, nieces/nephews, friends, or coworkers) to a suicide victim also represents a heightened risk for complicated grief. Assessing for complicated grief is important, especially with survivors of suicide, because of the potential for associated health risks. This report contains preliminary data from an exploratory, descriptive pilot study examining complicated grief in adult survivors of suicide. Sixty bereaved subjects, within one month after the suicide of a family member or significant other, were assessed for complicated grief symptoms. Statistically significant differences, as measured with the Inventory of Complicated Grief, were noted between closely related and distantly related survivors of the suicide victim. These preliminary results indicate that health care professional's assessments and interventions for complicated grief should take into consideration the bereaved's familial and/or social relationship to the deceased. The closely related survivors of suicide had higher levels of complicated grief and could be at risk of developing physical and/or mental health problems, including suicidal ideation, in the future.
References
Bereavement and depression.. Journal of Clinical Psychiatry, (1990). 51, S34–S38
The enigma of suicide.. New York: Simon & Schuster, (1991).
Diagnostic criteria for complicated grief disorder.. American Journal of Psychiatry, (1997). 154, 904–910
Pathological grief: Diagnosis and explanation.. Psychosomatic Medicine, (1993). 55, 260–273
Diagnostic criteria for traumatic grief.. Death Studies, (2000). 24, 185–199
Psychotherapy of traumatic grief: A review of evidence for psychotherapeutic treatments.. Death Studies, (2000). 24, 479–495
Traumatic grief: Diagnosis, treatment, and prevention.. Philadelphia: Taylor & Francis Group, (1999).
Pathologic grief: Maladaptation to loss.. Washington, DC: American Psychiatric Press, (1993).
Anxiety disorders during acute bereavement: Risk and risk factors.. Journal of Clinical Psychiatry, (1990). 51, 269–274
The measurement of grief: Bereaved and nonbereaved.. Hospice Journal, (1986). 2, 21–36
Is suicide bereavement different? A reassessment of the literature.. Suicide and Life-Threatening Behavior, (2001). 31, 91–102
Influence of complicated grief on suicidal ideation among bereaved older adults.. American Journal of Geriatric Psychiatry, (submitted).
Grief reactions among suicide survivors: An exploratory comparison of relationships.. Death Studies, (1988). 12, 21–39
Online 1999.. Available: www.nimh.nih.gov/publicat/harmaway.cfm
Online 2003.. Available: www.nimh.nih.gov/research/suicidefaq.cfm
Recovery from bereavement.. New York: Basic Books, (1983).
Rates and risks of complicated grief among psychiatric clinic patients in Karachi, Pakistan.. Death Studies, (2002). 26, 1–12
Preliminary explorations of the harmful interactive effects of widowhood and marital harmony on health, health service use, and health care costs.. The Gerontologist, (2000). 40, 349–357
Influence of traumatic grief on suicidal ideation among young adults.. American Journal of Psychiatry, (1999). 156, 1994–1995
Consensus criteria for traumatic grief: A preliminary empirical test.. British Journal of Psychiatry, (1999). 174, 67–73
Traumatic grief as a risk factor for mental and physical morbidity.. American Journal of Psychiatry, (1997). 154, 616–623
Clinical case conference: Traumatic grief: A case of loss-induced distress.. American Journal of Psychiatry, (1997). 154, 1003–1008
Anxiety among widowed elders: Is it distinct from depression and grief?. Anxiety, (1996). 2, 1–12
Traumatic grief and bereavement-related depression as distinct disorders: Preliminary empirical validation in elderly bereaved spouses.. American Journal of Psychiatry, (1995). 152, 22–30
The inventory of complicated grief: A scale to measure certain maladaptive symptoms of loss.. Psychiatry Research, (1995). 59, 65–79
Survivor-victim status: Attachment and sudden death bereavement.. Suicide and Life-Threatening Behavior, (1991). 21, 385–401
Post traumatic stress symptoms in the first years of conjugal bereavement.. Anxiety Research, (1991). 4, 225–234
Quality of life impairments associated with diagnostic criteria for traumatic grief.. Psychological Medicine, (2000). 30, 857–862
Suicidology. Online 1999.. Available: www.suicidology.org/index.html
Suicidal ideation in elderly bereaved: The role of complicated grief.. Suicide and Life-Threatening Behavior, (1997). 27, 194– 207
Healthy People 2010. With understanding and improving health objectives for improving health (2 vols, 2nd ed).. Washington, DC: US Department of Health and Human Services, Public Health Service, (2000).
The Surgeon General's call to action to prevent suicide.. Washington, DC: (1999).
Survivors of a family member's suicide: Implications for practice.. Nurse Practitioner, (1991). 16(7), 31–35
Agonizing questioning: Experiences of survivors of suicide victims.. Nursing Research, (1990). 39, 224–229
Uncomplicated bereavement.. Journal of Clinical Psychiatry, (1993). 54, 365–372
Depression through the first year after the death of a spouse.. American Journal of Psychiatry, (1991). 148, 1346–1352
Anxiety and bereavement.. Psychiatric Medicine, (1990). 8, 83–96
Adjustment to widowhood.. In S. Zisook (Ed.), Biopsychosocial aspects of bereavement. Washington DC: American Psychiatric Press, (1987).