Skip to main content
SpringerLink
Log in

Anxiety and Bereavement

  • Chapter
  • First Online:
Clinical Handbook of Anxiety Disorders

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Anxiety is a common emotional response following the loss of a loved one. For some individuals, anxiety during bereavement may reach clinical levels of severity and impairment. In addition, studies suggest that anxiety symptoms and disorders may complicate the grieving process and contribute to prolonged periods of acute grief. This chapter will review the relevant research on the prevalence of anxiety symptoms and disorders among bereaved individuals as well as predictors and risk factors of anxiety in this population. In addition, the authors will suggest areas for future research that can lead to a better understanding of anxiety in the context of bereavement as well as improved recognition of and intervention for anxiety and associated impairment among the bereaved.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Shear MK, Skritskaya NA. Bereavement and anxiety. Curr Psychiatry Rep. 2012;14:169–75. https://doi.org/10.1007/s11920-012-0270-2.

    Article  PubMed  Google Scholar 

  2. Zisook S, Schneider D, Shuchter S. Anxiety and bereavement. Psychiatr Med. 1990;8:83–96.

    CAS  PubMed  Google Scholar 

  3. Kreicbergs U, Valdismarsdóttir U, Onelöv E, Henter J-I, Steineck G. Anxiety and depression in parents 4–9 years after the loss of a child owing to a malignancy: a population-based follow-up. Psychol Med. 2004;34:1431–41. https://doi.org/10.1017/S0033291704002740.

    Article  PubMed  Google Scholar 

  4. Zhang Z, Shi Z, Wang L, Liu M. Post-traumatic stress disorder, anxiety and depression among the elderly: a survey of the hard-hit areas a year after the Wenchuan earthquake. Stress Health. 2012;28:61–8. https://doi.org/10.1002/smi.1403.

    Article  PubMed  Google Scholar 

  5. Johnson L-M, Torres C, Sykes A, Gibson DV, Baker JN. The bereavement experience of adolescents and early young adults with cancer: peer and parental loss due to death is associated with increased risk of adverse psychological outcomes. PLoS One. 2017;12:e0181024. https://doi.org/10.1371/journal.pone.0181024.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Dooley B, Fitzgerald A, Giollabhui NM. The risk and protective factors associated with depression and anxiety in a national sample of Irish adolescents. Ir J Psychol Med. 2015;32:93–105. https://doi.org/10.1017/ipm.2014.83.

    Article  CAS  PubMed  Google Scholar 

  7. Garrido MM, Prigerson HG. The end-of-life experience: modifiable predictors of caregivers’ bereavement adjustment. Cancer. 2014;120:918–25. https://doi.org/10.1002/cncr.28495.

    Article  PubMed  Google Scholar 

  8. Brunoni AR, Nunes MA, Pinheiro AP, Lotufo PA, Benseñor IM. Bereavement and common mental disorders in middle-aged adults: results from the Brazilian longitudinal study of adult health (ELSA-Brasil). J Affect Disord. 2014;152–154:369–74. https://doi.org/10.1016/j.jad.2013.09.039.

    Article  PubMed  Google Scholar 

  9. Keyes KM, Pratt C, Galea S, McLaughlin KA, Koenen KC, Shear MK. The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. Am J Psychiatry. 2014;171:864–71. https://doi.org/10.1176/appi.ajp.2014.13081132.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Onrust SA, Cuijpers P. Mood and anxiety disorders in widowhood: a systematic review. Aging Ment Health. 2006;10:327–34. https://doi.org/10.1080/13607860600638529.

    Article  CAS  PubMed  Google Scholar 

  11. Jacobs S, Hansen F, Kasl S, Ostfeld A, Berkman L, Kim K. Anxiety disorders during acute bereavement: risk and risk factors. J Clin Psychiatry. 1990;51(7):269–74.

    CAS  PubMed  Google Scholar 

  12. Zisook S, Chentsova-Dutton Y, Shuchter SR. PTSD following bereavement. Ann Clin Psychiatry. 1998;10:157–63. https://doi.org/10.1023/A:1022342028750.

    Article  CAS  PubMed  Google Scholar 

  13. Kristensen P, Weisæth L, Hussain A, Heir T. Prevalence of psychiatric disorders and functional impairment after loss of a family member: a longitudinal study after the 2004 Tsunami. Depress Anxiety. 2015;32:49–56.

    Article  Google Scholar 

  14. Prigerson HG, Bierhals AJ, Kasl SV, Reynolds CF III. Complicated grief as a disorder distinct from bereavement-related depression and anxiety: a replication study. Am J Psychiatry. 1996;153:1484. https://doi.org/10.1176/ajp.153.11.1484.

    Article  CAS  PubMed  Google Scholar 

  15. Golden A-MJ, Dalgleish T. Is prolonged grief distinct from bereavement-related posttraumatic stress? Psychiatry Res. 2010;178:336–41. https://doi.org/10.1016/j.psychres.2009.08.021.

    Article  PubMed  Google Scholar 

  16. Boelen PA, van den Bout J, de Keijser J. Traumatic grief as a disorder distinct from bereavement-related depression and anxiety: a replication study with bereaved mental health care patients. Am J Psychiatry. 2003;160:1339–41.

    Article  Google Scholar 

  17. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington: American Psychiatric Pub; 2013.

    Book  Google Scholar 

  18. Kaltman S, Bonanno GA. Trauma and bereavement: examining the impact of sudden and violent deaths. J Anxiety Disord. 2003;17:131–47. https://doi.org/10.1016/S0887-6185(02)00184-6.

    Article  PubMed  Google Scholar 

  19. Amick-Mcmullan A, Kilpatrick DG, Resnick HS. Homicide as a risk factor for PTSD among surviving family members. Behav Modif. 1991;15:545–59. https://doi.org/10.1177/01454455910154005.

    Article  CAS  PubMed  Google Scholar 

  20. Dyregrov K, Nordanger D, Dyregrov A. Predictors of psychosocial distress after suicide, SIDS and accidents. Death Stud. 2003; 27. https://doi.org/10.1080/07481180302892.

    Article  Google Scholar 

  21. Hays JC, Kasl S, Jacobs S. Past personal history of dysphoria, social support, and psychological distress following conjugal bereavement. J Am Geriatr Soc. 1994;42:712–8. https://doi.org/10.1111/j.1532-5415.1994.tb06529.x.

    Article  CAS  PubMed  Google Scholar 

  22. Onrust S, Cuijpers P, Smit F, Bohlmeijer E. Predictors of psychological adjustment after bereavement. Int Psychogeriatr. 2007;19:921–34. https://doi.org/10.1017/S1041610206004248.

    Article  PubMed  Google Scholar 

  23. Chen J, Bierhals A, Prigerson HG, Kasl S, Mazure C, Jacobs S. Gender differences in the effects of bereavement-related psychological distress in health outcomes. Psychol Med. 1999;29:367–80.

    Article  CAS  Google Scholar 

  24. Boelen PA, van den Bout J, van den Hout MA. The role of cognitive variables in psychological functioning after the death of a first degree relative. Behav Res Ther. 2003;41:1123–36. https://doi.org/10.1016/S0005-7967(02)00259-0.

    Article  PubMed  Google Scholar 

  25. He L, Yu W, Hu P, Xu W, Yan Y, Wang J. Predictive value of negative cognitive variables on emotional problems after bereavement. Chin J Clin Psych. 2014;22:605–9.

    Google Scholar 

  26. Mitchell AM, Sakraida TJ, Kim Y, Bullian L, Chiappetta L. Depression, anxiety and quality of life in suicide survivors: a comparison of close and distant relationships. Arch Psychiatr Nurs. 2009;23:2–10. https://doi.org/10.1016/j.apnu.2008.02.007.

    Article  PubMed  Google Scholar 

  27. Erlangsen A, Runeson B, Bolton JM, Wilcox HC, Forman JL, Krogh J, et al. Association between spousal suicide and mental, physical, and social health outcomes: a longitudinal and nationwide register-based study. JAMA Psychiat. 2017;74:456–64. https://doi.org/10.1001/jamapsychiatry.2017.0226.

    Article  Google Scholar 

  28. Cerel J, Fristad MA, Weller EB, Weller RA. Suicide-bereaved children and adolescents: a controlled longitudinal examination. J Am Acad Child Adolesc Psychiatry. 1999;38:672–9. https://doi.org/10.1097/00004583-199906000-00013.

    Article  CAS  PubMed  Google Scholar 

  29. Valdimarsdóttir U, Helgason ÁR, Fürst C-J, Adolfsson J, Steineck G. Awareness of husband’s impending death from cancer and long-term anxiety in widowhood: a nationwide follow-up. Palliat Med. 2004;18:432–43. https://doi.org/10.1191/0269216304pm891oa.

    Article  PubMed  Google Scholar 

  30. Carr D, House JS, Wortman C, Nesse R, Kessler RC. Psychological adjustment to sudden and anticipated spousal loss among older widowed persons. J Gerontol B Psychol Sci Soc Sci. 2001;56:S237–48. https://doi.org/10.1093/geronb/56.4.S237.

    Article  CAS  PubMed  Google Scholar 

  31. Kersting A, Brähler E, Glaesmer H, Wagner B. Prevalence of complicated grief in a representative population-based sample. J Affect Disord. 2011;131:339–43. https://doi.org/10.1016/j.jad.2010.11.032.

    Article  PubMed  Google Scholar 

  32. Bergman EJ, Haley WE, Small BJ. The role of grief, anxiety, and depressive symptoms in the use of bereavement services. Death Stud. 2010;34:441–58. https://doi.org/10.1080/07481181003697746.

    Article  PubMed  Google Scholar 

  33. Janssen HJ, Cuisinier MC, de Graauw KP, Hoogduin KA. A prospective study of risk factors predicting grief intensity following pregnancy loss. Arch Gen Psychiatry. 1997;54:56–61. https://doi.org/10.1001/archpsyc.1997.01830130062013.

    Article  CAS  PubMed  Google Scholar 

  34. Eisma MC, Boelen PA, Schut HA, Stroebe MS. Does worry affect adjustment to bereavement? A longitudinal investigation. Anxiety Stress Coping. 2017;30:243–52. https://doi.org/10.1080/10615806.2016.1229464.

    Article  PubMed  Google Scholar 

  35. Jacobson NC, Lord KA, Newman MG. Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression. J Affect Disord. 2017;211:83–91. https://doi.org/10.1016/j.jad.2017.01.011.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Marques L, Bui E, LeBlanc N, Porter E, Robinaugh D, Dryman MT, et al. Complicated grief symptoms in anxiety disorders: prevalence and associated impairment. Depress Anxiety. 2013;30:1211–6. https://doi.org/10.1002/da.22093.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Bui E, LeBlanc NJ, Morris LK, Marques L, Shear MK, Simon NM. Panic-agoraphobic spectrum symptoms in complicated grief. Psychiatry Res. 2013;209:118–20. https://doi.org/10.1016/j.psychres.2013.03.033.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Bui E, Horenstein A, Shah R, Skritskaya NA, Mauro C, Wang Y, et al. Grief-related panic symptoms in complicated grief. J Affect Disord. 2015;170:213–6. https://doi.org/10.1016/j.jad.2014.08.028.

    Article  PubMed  Google Scholar 

  39. Sung SC, Dryman MT, Marks E, Shear MK, Ghesquiere A, Fava M, et al. Complicated grief among individuals with major depression: prevalence, comorbidity, and associated features. J Affect Disord. 2011;134:453–8. https://doi.org/10.1016/j.jad.2011.05.017.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Naragon-Gainey K. Meta-analysis of the relations of anxiety sensitivity to the depressive and anxiety disorders. Psychol Bull. 2010;136:128. https://doi.org/10.1037/a0018055.

    Article  PubMed  Google Scholar 

  41. Robinaugh DJ, McNally RJ, LeBlanc NJ, Pentel KZ, Schwarz NR, Shah RM, et al. Anxiety sensitivity in bereaved adults with and without complicated grief. J Nerv Ment Dis. 2014;202:620. https://doi.org/10.1097/NMD.0000000000000171.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Baker AW, Goetter EM, Bui E, Shah R, Charney ME, Mauro C, et al. The influence of anxiety sensitivity on a wish to die in complicated grief. J Nerv Ment Dis. 2016;204:314.

    Article  Google Scholar 

  43. Barlow DH, Sauer-Zavala S, Carl JR, Bullis JR, Ellard KK. The nature, diagnosis, and treatment of neuroticism: back to the future. Clin Psychol Sci. 2014;2:344–65.

    Article  Google Scholar 

  44. Goetter E, Bui E, Horenstein A, Baker AW, Hoeppner S, Charney M, et al. Five-factor model in bereaved adults with and without complicated grief. Death Stud. 2019;43:2014–209.

    Article  Google Scholar 

  45. Bowlby J. Attachment and loss: volume 3. New York: Basic Books; 1980.

    Google Scholar 

  46. Field NP, Sundin EC. Attachment style in adjustment to conjugal bereavement. J Soc Pers Relat. 2001;18:347–61. https://doi.org/10.1177/0265407501183003.

    Article  Google Scholar 

  47. Meier AM, Carr DR, Currier JM, Neimeyer RA. Attachment anxiety and avoidance in coping with bereavement: two studies. J Soc Clin Psychol. 2013;32:315–34. https://doi.org/10.1521/jscp.2013.32.3.315.

    Article  Google Scholar 

  48. Maccallum F, Bryant RA. Prolonged grief and attachment security: a latent class analysis. Psychiatry Res. 2018;268:297–302. https://doi.org/10.1016/j.psychres.2018.07.038.

    Article  PubMed  Google Scholar 

  49. Boelen PA, van den Bout J. Anxious and depressive avoidance and symptoms of prolonged grief, depression, and post-traumatic stress disorder. Psychol Belg. 2010; https://doi.org/10.5334/pb-50-1-2-49.

    Article  Google Scholar 

  50. Bowlby J. Attachment and loss: volume 2. New York: Basic Books; 1973.

    Google Scholar 

  51. Pini S, Gesi C, Abelli M, Muti M, Lari L, Cardini A, et al. The relationship between adult separation anxiety disorder and complicated grief in a cohort of 454 outpatients with mood and anxiety disorders. J Affect Disord. 2012;143:64–8. https://doi.org/10.1016/j.jad.2012.05.026.

    Article  PubMed  Google Scholar 

  52. Gesi C, Carmassi C, Shear KM, Schwartz T, Ghesquiere A, Khaler J, et al. Adult separation anxiety disorder in complicated grief: an exploratory study on frequency and correlates. Compr Psychiatry. 2017;72:6–12. https://doi.org/10.1016/j.comppsych.2016.09.002.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Temple University, Philadelphia, PA, USA

    Arielle Horenstein

  2. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Meredith E. Charney

  3. Department of Psychiatry, Harvard University, Boston, MA, USA

    Meredith E. Charney

Authors
  1. Arielle Horenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meredith E. Charney
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arielle Horenstein .

Editor information

Editors and Affiliations

  1. Department of Psychiatry Massachusetts General Hospital, Boston, MA, USA

    Eric Bui

  2. Department of Psychiatry Massachusetts General Hospital, Boston, MA, USA

    Meredith E. Charney

  3. Department of Psychiatry Massachusetts General Hospital, Boston, MA, USA

    Amanda W. Baker

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Horenstein, A., Charney, M.E. (2020). Anxiety and Bereavement. In: Bui, E., Charney, M., Baker, A. (eds) Clinical Handbook of Anxiety Disorders. Current Clinical Psychiatry. Humana, Cham. https://doi.org/10.1007/978-3-030-30687-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-30687-8_10

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-30686-1

  • Online ISBN: 978-3-030-30687-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation