Bereavement is a highly personal process, study finds

January 03, 1994|By Frank D. Roylance | Frank D. Roylance,Staff Writer

Family members who accept the popular notion that Mom or Pop should "cry it out" after the death of their spouse and then "get over it" after a respectable period of mourning may have it all wrong, University of Maryland Baltimore County researchers believe.

An 18-month survey of 159 Baltimore-area men and women who lost a spouse to cancer also found that people who join bereavement support groups may not recover any faster than those who don't.

"Bereavement has been with us forever, so there has grown up a great deal of folklore and tradition about what grief entails, and how long it should take to recover from it," said the study's author, Dr. Leon Levy, a clinical psychologist, professor and chairman of UMBC's psychology department.

But scientific inquiry suggests that "we cannot generalize about how long it should take to recover from the loss of a spouse, or expect that it [recovery] should take a certain form," he said.

"One of our most interesting findings is that there is such variability to how people adapt" to the loss of a spouse, Dr. Levy said. And "adapt" may be the best word for it.

"People don't ever recover from the loss," he said, "but they adapt to it."

"We had trouble finding some people for interviews because they had decided to take long trips," said Dr. Levy. "Some remarried, and in some cases they expressed concern about how others would think of them for remarrying."

"That's something that needs to be discouraged," he said. Rather than a sign of disloyalty, remarrying "might be a testament to the quality of the experience [marriage] that they might want to go through it again."

"At least two people . . . had cosmetic surgery."

Parts of the study have been published in OMEGA, the Journal of Death and Dying; The Hospice Journal and The American Journal of Community Psychology.

Sponsored by a $413,000 grant from the National Institute of Mental Health, Dr. Levy, 68, and his associates conducted extensive tests and interviews with 114 women and 45 men who lost their spouses to cancer. Recruited from area cancer centers and hospices, they ranged in age from their mid-40s to early 80s, with the average just over 60.

Each was questioned within a month or two of the loss, then again six months, 13 months and 18 months later. The sessions, which ended in September 1991, included a battery of interviews, questionnaires and standardized tests measuring levels of depression, stress, anger and anxiety.

"Overall, there certainly was improvement over the 18-month period, in terms of their levels of anxiety, depression, anger and . . . stress," Dr. Levy said.

More than 65 percent of the widows and widowers scored above the threshold for serious depression in the first months after their loss. At the end of 18 months, that proportion had dropped to 33 percent.

"That's a fairly high percentage," Dr. Levy said. "It doesn't mean they weren't functioning, but it does mean they are functioning in spite of being quite depressed."

For example, 19 percent of the group showed high levels of depression at the start of the study that declined only slightly by the end. Another 11 percent started out with relatively low levels of depression that climbed to a high level after 18 months.

Twenty-four percent of the group showed low levels of depression throughout.

Measurements of stress showed similar variation. Twenty percent of the group showed signs of high stress throughout the 18 months, while 32 percent never experienced serious distress.

Coping skills

"The best single predictor of how distressed a person will be at 18 months [after the death] is clearly how distressed they were at the beginning," he said.

Some people may just be better equipped, perhaps by previous losses or personality, to handle such losses, Dr. Levy said.

Losing a spouse "may be one of the most stressful of life's experiences," he said, "but . . . the coping skills you've used in the past are the ones you'll use here."

The second-best indicator of how people will fare is their "social support -- the extent to which they feel they have someone they can turn to for understanding, advice, help, emotional and material support," Dr. Levy said.

One of the NIMH's primary goals in sponsoring the study was to establish whether participation in bereavement "support" groups and hospice care had any real benefits for the surviving spouse.

The study found that the 29 percent of the study's subjects who joined bereavement groups recovered at the same rate as the 71 percent who didn't. That might suggest the groups don't do any good.

But maybe not.

The joiners also showed signs of more serious distress than the nonjoiners, and while they improved, they remained more distressed at the end of the 18-month study.

"These groups may have served as a kind of safe haven during a period of intense distress, so that they could begin recovering," Dr. Levy said. It's possible they might have fared worse without the groups' support, he said.

Data needed

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