Skip to main content
SpringerLink
Log in
Book cover

Clinical Handbook of Bereavement and Grief Reactions pp 103–137Cite as

Grief Reactions in the Elderly

  • Chapter
  • First Online:

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

Abstract

Learning Objectives

  1. 1.

    To recognize the nature of bereavement in old age as it differs from bereavement in other stages of life, including unique social and cultural constructs.

  2. 2.

    To understand the relationship between grief in older adults and comorbid medical and neurologic conditions, especially psychiatric and health-related quality of life.

  3. 3.

    To differentiate diagnostic criteria for bereavement-related diagnoses, address the current controversy around the “over-medicalization” of grief, and review the current evidence-based practices for clinical assessment, including the Inventory for Complicated Grief (ICG) [1].

  4. 4.

    To discuss the current evidence-informed treatment of bereavement-related depression and complicated grief, highlighting treatment response prediction as an area of interest and in need of further research.

  5. 5.

    To summarize recent research findings in neuroimaging and neurobiology that contribute to our understanding of grief reactions in older adults.

  6. 6.

    To address the importance of continued research into risk factors, prevention strategies for adverse grief reactions, and strategies for the facilitation of healthy adaptation to loss.

  7. 7.

    To briefly present what is known about other unique grief circumstances that require further bereavement research, including grief in older LGBTQ adults, suicide bereavement, and grief in the setting of palliative care and hospice medicine, and grief reactions following catastrophic natural disasters.

This is a preview of subscription content, 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   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
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

Learn about institutional subscriptions

References

  1. Prigerson HG, Maciejewski PK, Reynolds CF, Bierhals AJ, Newsom JT, Fasiczka A, et al. Inventory of complicated grief: a scale to measure maladaptive symptoms of loss. Psychiatry Res. 1995;59(1–2):65–79.

    Article  CAS  PubMed  Google Scholar 

  2. Winters S. How caregivers can help someone stuck in intense grief, Interview with Dr. Katherine Shear. Caring.com. 2016 [cited 2016 Nov 10]. https://www.caring.com/interviews/center-for-complicated-grief-interview

  3. Holmes T, Rahe R. The social readjustment rating scale an inventory of common stressors. J Psychosom Res. 1967;11:213–8.

    Article  CAS  PubMed  Google Scholar 

  4. Lichtenthal WG, Cruess DG, Prigerson HG. A case for establishing complicated grief as a distinct mental disorder in DSM-V. Clin Psychol Rev. 2004;24(6):637–62.

    Article  PubMed  Google Scholar 

  5. Newson RS, Boelen PA, Hek K, Hofman A, Tiemeier H. The prevalence and characteristics of complicated grief in older adults. J Affect Disord. 2011;132(1–2):231–8. https://doi.org/10.1016/j.jad.2011.02.021.

    Article  PubMed  Google Scholar 

  6. 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. http://linkinghub.elsevier.com/retrieve/pii/S1064748112605661

    Article  PubMed  Google Scholar 

  7. Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. The Lancet. 2007 Dec 14;370(9603):1960–73.

    Google Scholar 

  8. Okereke OI, Lyness JM, Lotrich FE, Reynolds CF III. Depression in late-life: a focus on prevention. Focus (Am Psychiatr Publ). 2013;11(1):22–31.

    Google Scholar 

  9. Bowlby J. Attachment and Loss: Attachment. V. Basic Books; 1969.

    Google Scholar 

  10. Shear MK, Ghesquiere AR, Glickman K. Bereavement and complicated grief. Curr Psychiatry Rep. 2013;15(11):1–13.

    Article  Google Scholar 

  11. Williams BR, Sawyer Baker P, Allman RM, Roseman JM. Bereavement among African American and white older adults. J Aging Health. 2007;19:313–33. http://www.ncbi.nlm.nih.gov/pubmed/17413138

    Article  PubMed  Google Scholar 

  12. Williams BR, Patricia Sawyer B, Allman RM. Nonspousal family loss among community-dwelling older adults. Omega J Death Dying. 2005;51(2):125–42. 18p. http://search.ebscohost.com/login.aspx?direct=true&db=jlh&AN=106401035&site=ehost-live

    Article  Google Scholar 

  13. Chentsova Dutton Y, Zisook S. Adaptation to bereavement. Death Stud. 2005;29(10):877–903.

    Article  PubMed  Google Scholar 

  14. Prigerson HO, Jacobs SC. Traumatic grief as a distinct disorder: a rationale, consensus criteria, and a preliminary empirical test. In: Stroebe MS, Hansson RO, Stroebe W, Schut H, editors. Handbook of bereavement research: consequences, coping, and care. Washington, DC: American Psychological Association; 2001. p. 613–45.

    Chapter  Google Scholar 

  15. Raphael B, Minkov C, Dobson M. Psychotherapeutic and pharmacological intervention for bereaved persons. In: Stroebe MS, Hansson RO, Stroebe W, Schut H, editors. Handbook of bereavement research—consequences, coping, and care. Washington, DC: American Psychological Association Press; 2001. p. 587–612.

    Chapter  Google Scholar 

  16. Fujisawa D, Miyashita M, Nakajima S, Ito M, Kato M, Kim Y. Prevalence and determinants of complicated grief in general population. J Affect Disord. 2010;127(1–3):352–8. https://doi.org/10.1016/j.jad.2010.06.008.

    Article  PubMed  Google Scholar 

  17. Kersting A, Brähler E, Glaesmer H, Wagner B. Prevalence of complicated grief in a representative population-based sample. J Affect Disord 2011;131(1–3):339–343. doi:10.1016/j.jad.2010.11.032

    Google Scholar 

  18. Forstmeier S, Maercker A. Comparison of two diagnostic systems for complicated grief. J Affect Disord. 2007;99(1–3):203–11.

    Article  PubMed  Google Scholar 

  19. Middleton W, Burnett P, Raphael B, Martinek N. The bereavement response: a cluster analysis. Br J Psychiatry. 1996;169(2):167–71.

    Article  CAS  PubMed  Google Scholar 

  20. Lotterman JH, Bonanno GA, Galatzer-Levy I. The heterogeneity of long-term grief reactions. J Affect Disord. 2014;167:12–9. https://doi.org/10.1016/j.jad.2014.05.048.

    Article  PubMed  Google Scholar 

  21. Kersting A, Kroker K, Horstmann J, Ohrmann P, Baune BT, Arolt V, et al. Complicated grief in patients with unipolar depression. J Affect Disord. 2009;118(1–3):201–4.

    Article  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. Piper WE, Ogrodniczuk JS, Azim HF, Weideman R. Prevalence of loss and complicated grief among psychiatric outpatients. Psychiatr Serv. 2001;52(8):1069–74. http://www.ncbi.nlm.nih.gov/pubmed/11474053

    Article  CAS  PubMed  Google Scholar 

  24. Utz RL, Carr D, Nesse R, Wortman CB. The effect of widowhood on older adults’ social participation: an evaluation of activity, disengagement, and continuity theories. Gerontologist. 2002;42(4):522–33.

    Article  PubMed  Google Scholar 

  25. Ghesquiere A. “I was just trying to stick it out until i realized that i couldn’t”: a phenomenological investigation of support seeking among older adults with complicated grief*. Angela. 2008;44(3):735–45.

    Google Scholar 

  26. Hansson RO, Remondet JH. Old age and widowhood: issues of personal control and independence. J Soc Issues. 1988;44(3):159–74. http://onlinelibrary.wiley.com/doi/10.1111/j.1540-4560.1988.tb02083.x/full

  27. Wortman CB, Silver RC. Reconsidering assumptions about coping with loss: an overview of current research. In: Montada L, Filipp SH, Lerner MJ, editors. Life crises and experiences of loss in adulthood; 1992. p. 341–65. http://ezproxy.deakin.edu.au/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=1992-97717-018&site=ehost-live&scope=site.

    Google Scholar 

  28. Kamerman J, Doka KJ. Disenfranchised grief: recognizing hidden sorrow. Contemp Sociol. 1991;20(1):136.

    Article  Google Scholar 

  29. Johnson JG, First MB, Block S, Vanderwerker LC, Zivin K, Zhang B, et al. Stigmatization and receptivity to mental health services among recently bereaved adults. Death Stud. 2009;33(8):691–711. https://www.ncbi.nlm.nih.gov/pubmed/19697482

  30. Kalish RA. Social distance and the dying. Community Ment Health J. 1966;2(2):152–5.

    Article  CAS  PubMed  Google Scholar 

  31. Rubin SS. The death of a child is forever: the life course impact of child loss. In: Handbook of bereavement: theory, research, and intervention; 1993. p. 285–99. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=psyc3&AN=1993-97671-018.

    Chapter  Google Scholar 

  32. Carstensen LL, Gross JJ, Fung HH. The social context of emotional experience. In: Schaie KW, Lawton MP, editors. Annual review of gerontology and geriatric: vol 17, focus on emotion and adult development; 1997. p. 325–52. http://books.google.com/books?hl=fr&lr=&id=ZdYE4XSmAzEC&pgis=1.

    Google Scholar 

  33. Carstensen LL, Lang FR. Close emotional relationships in late life: further support for proactive aging in the social domain. Psychol Aging. 1994;9(2):315–24. http://doi.apa.org/getdoi.cfm?doi=10.1037/0882-7974.9.2.315

    Article  PubMed  Google Scholar 

  34. Moss M, Moss S, Hansson R. Bereavement and old age. In: Handbook of bereavement research—consequences, coping, and care. Washington, DC: American Psychological Association Press; 2001. p. 587–612.

    Google Scholar 

  35. Denckla CA, Mancini AD, Bornstein RF, Bonanno GA. Adaptive and maladaptive dependency in bereavement: distinguishing prolonged and resolved grief trajectories. Pers Individ Dif. 2011;51(8):1012–7.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kjos D, Nieponski MK. Review of relationships in old age. Fam J. 1997;5(4):356. http://login.ezproxy.library.ualberta.ca/login?url=http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=psyc3&AN=2004-20714-017%5Cnhttp://resolver.library.ualberta.ca/resolver?sid=OVID:psycdb&id=pmid:&id=doi:10.1177%2F1066480797054017&issn

    Article  Google Scholar 

  37. Aldwin C, Sutton K, Chiara G, Avron S. Age differences in stress, coping, and appraisal: findings from the normative aging study. J Gerontol Psychol Sci. 1996;5(4):79–188.

    Google Scholar 

  38. Cantor MH. Family and community: changing roles in an aging society. Gerontologist. 1991;31(3):337–46. https://www.ncbi.nlm.nih.gov/pubmed/1879709

  39. Grassi L. Bereavement in families with relatives dying of cancer. Curr Opin Support Palliat Care. 2007;1:43–9.

    Article  PubMed  Google Scholar 

  40. Kessler RC, Zhao S, Katz SJ, Kouzis AC, Frank RG, Edlund M, et al. Past-year use of outpatient services for psychiatric problems in the national comorbidity survey. Am J Psychiatry. 1999;156(1):115–23.

    Article  CAS  PubMed  Google Scholar 

  41. Bartels SJ. Improving the United States’ system of care for older adults with mental illness: findings and recommendations for the President’s new freedom commission on mental health. Am J Geriatr Psychiatry. 2003;11(5):486–97. http://www.sciencedirect.com/science/article/pii/S1064748112613116

    Article  PubMed  Google Scholar 

  42. Prigerson HG, Jacobs SC. Caring for bereaved patients. JAMA. 2001;286(11):1369. http://jamanetwork.com/journals/jama/fullarticle/194194

  43. Olsberg D, Winters M. Ageing in place: intergenerational and intrafamilial housing transfers and shifts in later life. AHURI Final Report No. 88. p.135; 2005.

    Google Scholar 

  44. DiGiacomo M, Lewis J, Phillips J, Nolan M, Davidson PM. The business of death: a qualitative study of financial concerns of widowed older women. BMC Womens Health. 2015;15:36.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Dietz J. Defining markets, defining moments: America’s 7 generational cohorts, their shared experiences, and why businesses should care. J Consum Mark. 2003;20(2):172–3. http://www.emeraldinsight.com/journals.htm?issn=0736-3761&volume=20&issue=2&articleid=1493869&show=html

    Article  Google Scholar 

  46. Olsberg D. Major changes for super, but women are still ms...ing out. Aust Account Rev. 2006;16(3):47–51.

    Article  Google Scholar 

  47. Halleröd B. Gender inequality from beyond the grave: intra-household distribution and wellbeing after spousal loss. Ageing Soc. 2012;33(5):783–803. http://www.scopus.com/inward/record.url?eid=2-s2.0-84878489123&partnerID=tZOtx3y1

    Article  Google Scholar 

  48. Burkhauser R V, Butler JS, Holden KC. How the death of a spouse affects economic well-being after retirement: a hazard model approach. Soc Sci Q 1991;72(3):504–519.

    Google Scholar 

  49. Burkhauser RV, Giles P, Lillard DR, Schwarze J. Until death do us part: an analysis of the economic well-being of widows in four countries. J Gerontol B Psychol Sci Soc Sci. 2005;60(5):S238–46. http://www.ncbi.nlm.nih.gov/pubmed/16131624

    Article  PubMed  Google Scholar 

  50. Byles JE, Feldman S, Mishra G. For richer, for poorer, in sickness and in health: older widowed women’s health, relationships and financial security. Women Health. 1999;29(1):15–30.

    Article  CAS  PubMed  Google Scholar 

  51. Feldman S, Byles JE, Beaumont R. Is anybody listening?’ The experiences of widowhood for older Australian women. J Women Aging. 2000;12(3–4):155–76.

    Article  CAS  PubMed  Google Scholar 

  52. Stroebe M, Stroebe W, Schut H. Gender differences in adjustment to bereavement: an empirical and theoretical review. Rev Gen Psychol. 2001;5(1):62–83.

    Article  Google Scholar 

  53. Federal Interagency Forum on Aging-Related Statistics. Older Americans. Key indicators of well-being. Washington, DC: Federal Interagency Forum on Aging-Related Statistics; 2012. p. 2012.

    Google Scholar 

  54. Stahl ST, Beach SR, Musa D, Schulz R. Living alone and depression: the modifying role of the perceived neighborhood environment. Aging Ment Heal. 2016;7863(October):1–7. http://www.ncbi.nlm.nih.gov/pubmed/27267633

    Google Scholar 

  55. United States Census Bureau. U.S. Census Bureau Projections show a slower growing, older, more diverse nation a half century from now. Press Release. 2012. http://www.census.gov/newsroom/releases/archives/population/cb12-243.html

  56. Gates GJ, Cook AM. United States Census 2010. http2010censusgov2010census. 2010.

    Google Scholar 

  57. Glass TA, de Leon CM, Marottoli RA, Berkman LF, Kannel W, Belanger A, et al. Population based study of social and productive activities as predictors of survival among elderly Americans. BMJ. 1999;319(7208):478–83. http://www.ncbi.nlm.nih.gov/pubmed/10454399%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC28199

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Eshbaugh EM. Perceptions of living alone among older adult women. J Community Health Nurs. 2008;25(3):125–37. http://openurl.ebscohost.com/linksvc/linking.aspx?&issn=0737-0016&date=2008&issue=3&jtitle=Journal of Community Health Nursing&volume=25&spage=125&doi=10.1080%2F07370010802221685&atitle=Perceptions of Living Alone Among Older Adult W

    Article  PubMed  Google Scholar 

  59. McInnis GJ, White JH. A phenomenological exploration of loneliness in the older adult. Arch Psychiatr Nurs. 2001;15(3):128–38.

    Article  CAS  PubMed  Google Scholar 

  60. Choi SK, Meyer I. LGBT aging: a review of research findings, needs, and policy implications. Los Angeles: The Williams Institute.: UCLA School of Law; 2016.

    Google Scholar 

  61. Addis S, Davies M, Greene G, MacBride-Stewart S, Shepherd M. The health, social care and housing needs of lesbian, gay, bisexual and transgender older people: a review of the literature. Heal Soc Care Community. 2009;17(6):647–58.

    Article  Google Scholar 

  62. Bonanno GA, Kaltman S. The varieties of grief experience. Clin Psychol Rev. 2001;21(5):705–34.

    Article  CAS  PubMed  Google Scholar 

  63. Shah SM, Carey IM, Harris T, Dewilde S, Victor CR, Cook DG. Do good health and material circumstances protect older people from the increased risk of death after bereavement? Am J Epidemiol. 2012;176(8):689–98.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Stahl ST, Arnold AM, Chen J-Y, Anderson S, Schulz R. Mortality after bereavement: the role of cardiovascular disease and depression. Psychosom Med. 2016;78(6):697–703. https://www.ncbi.nlm.nih.gov/pubmed/26894326

  65. Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. Lancet. 2007;370:1960–73.

    Article  PubMed  Google Scholar 

  66. Mostofsky E, Maclure M, Sherwood JB, Tofler GH, Muller JE, Mittleman MA. Risk of acute myocardial infarction after the death of a significant person in one’s life/clinical perspective. Circulation. 2012;125(3):491–6. http://circ.ahajournals.org/content/125/3/491.abstract

    Article  PubMed  PubMed Central  Google Scholar 

  67. Anderson KL, Dimond MF. The experience of bereavement in older adults. J Adv Nurs. 1995;22(2):308–15.

    Article  CAS  PubMed  Google Scholar 

  68. Stroebe M, Stroebe W, Abakoumkin G. The broken heart: suicidal ideation in bereavement. Am J Psychiatry. 2005;162(11):2178–80.

    Article  PubMed  Google Scholar 

  69. Shah SM, Carey IM, Harris T, DeWilde S, Victor CR, Cook DG. The effect of unexpected bereavement on mortality in older couples. Am J Public Health. 2013;103(6):1140–5.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Parkes CM. Bereavement in adult life. BMJ. 1998;316(7134):856–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Szanto K, Prigerson H, Houck P, Ehrenpreis L, Reynolds CF. Suicidal ideation in elderly bereaved: the role of complicated grief. Suicide Life Threat Behav. 1997;27(2):194–207. http://www.ncbi.nlm.nih.gov/pubmed/9260302

    CAS  PubMed  Google Scholar 

  72. Latham AE, Prigerson HG. Suicidality and bereavement: complicated grief as psychiatric disorder presenting greatest risk for suicidality. Suicide Life Threat Behav. 2003;34:350–62.

    Article  Google Scholar 

  73. Szanto K, Shear MK, Houck PR, Reynolds CF, Frank E, Caroff K, et al. Indirect self-destructive behavior and overt suicidality in patients with complicated grief. J Clin Psychiatry. 2006;67(2):233–9.

    Article  PubMed  Google Scholar 

  74. Prigerson HG, Bierhals AJ, Kasl SV, Reynolds CF, 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.

    Article  CAS  PubMed  Google Scholar 

  75. Bartels SJ, Coakley E, Oxman TE, Constantino G, Oslin D, Chen H, et al. Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use. Am J Geriatr Psychiatry. 2002;10(4):417–27. http://linkinghub.elsevier.com/retrieve/pii/S1064748112613803

    Article  PubMed  Google Scholar 

  76. Sandler I, Tein J-Y, Cham H, Wolchik S, Ayers T. Long-term effects of the family bereavement program on spousally bereaved parents: grief, mental health problems, alcohol problems, and coping efficacy. Dev Psychopathol. 2016;28(3):801–18.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Friedman MJ. Seeking the best bereavement-related diagnostic criteria. Am J Psychiatry. 2016;173(9):864–5. http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.16050580

    Article  PubMed  Google Scholar 

  78. Parkes CM. Recent bereavement as a cause of mental illness. Br J Psychiatry. 1964;110:198–204.

    Article  CAS  PubMed  Google Scholar 

  79. Parkes CM. Effects of bereavement on physical and mental health-a study of the medical records of widows. Br Med J. 1964;2(August):274–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Thompson LW, Breckenridge JN, Gallagher D, Peterson J. Effects of bereavement on self-perceptions of physical health in elderly widows and widowers. J Gerontol. 1984;39(3):309–14. http://www.ncbi.nlm.nih.gov/pubmed/6715808

    Article  CAS  PubMed  Google Scholar 

  81. Bradbeer M, Helme RD, Yong H-H, Kendig HL, Gibson SJ. Widowhood and other demographic associations of pain in independent older people. Clin J Pain. 2003;19(4):247–54. http://www.ncbi.nlm.nih.gov/pubmed/12840619

    Article  PubMed  Google Scholar 

  82. Aartsen MJ, Smits CHM, van Tilburg T, Knipscheer KCPM, Deeg DJH. Activity in older adults: cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults. J Gerontol B Psychol Sci Soc Sci. 2002;57(2):P153–62. http://psychsocgerontology.oxfordjournals.org/content/57/2/P153.abstract

    Article  PubMed  Google Scholar 

  83. Rosenbloom CA, Whittington FJ. The effects of bereavement on eating behaviors and nutrient intakes in elderly widowed persons. J Gerontol. 1993;48(4):S223–9. http://www.ncbi.nlm.nih.gov/pubmed/8315246

    Article  CAS  PubMed  Google Scholar 

  84. Carr D, Utz R. Late-life widowhood in the United States: new directions in research and theory. Ageing Int. 2002;27(1):65–88. http://rci.rutgers.edu/~carrds/publications/carr_utz_2002.pdf

    Article  Google Scholar 

  85. Genevro JL, Marshall T, Miller T. Report on bereavement and grief research. Death Stud. 2004;28:491–575. https://doi.org/10.1080/07481180490461188.

    Article  PubMed  Google Scholar 

  86. Lannen PK, Wolfe J, Prigerson HG, Onelov E, Kreicbergs UC. Unresolved grief in a national sample of bereaved parents: impaired mental and physical health 4 to 9 years later. J Clin Oncol. 2008;26(36):5870–6.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Shear MK. Complicated grief. N Engl J Med. 2015;372(2):153–60. http://www.nejm.org/doi/abs/10.1056/NEJMcp1315618

    Article  CAS  PubMed  Google Scholar 

  88. Prigerson HG, Frank E, Kasl SV, Reynolds CF, Anderson B, Zubenko GS, et al. Complicated grief and bereavement-related depression as distinct disorders: preliminary empirical validation in elderly bereaved spouses. Am J Psychiatry. 1995;152(1):22–30.

    Article  CAS  PubMed  Google Scholar 

  89. Buckley T, Morel-Kopp M-C, Ward C, Bartrop R, McKinley S, Mihailidou AS, et al. Inflammatory and thrombotic changes in early bereavement: a prospective evaluation. Eur J Prev Cardiol. 2012;19(5):1145–52. http://www.ncbi.nlm.nih.gov/pubmed/21900365

    Article  PubMed  Google Scholar 

  90. Khanfer R, Lord JM, Phillips AC. Neutrophil function and cortisol: DHEAS ratio in bereaved older adults. Brain Behav Immun. 2011;25(6):1182–6.

    Article  CAS  PubMed  Google Scholar 

  91. 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 

  92. 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.

    Article  PubMed  Google Scholar 

  93. Simon NM, Shear KM, Thompson EH, Zalta AK, Perlman C, Reynolds CF, et al. The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Compr Psychiatry. 2007;48(5):395–9.

    Article  PubMed  Google Scholar 

  94. Hall CA, Reynolds CF 3rd, Butters M, Zisook S, Simon N, Corey-Bloom J, et al. Cognitive functioning in complicated grief. J Psychiatr Res. 2014;58:20–5.

    Article  PubMed  Google Scholar 

  95. Mancini AD, Bonanno GA. The persistence of attachment: complicated grief, threat, and reaction times to the deceased’s name. J Affect Disord. 2012;139(3):256–63.

    Article  PubMed  PubMed Central  Google Scholar 

  96. MacCallum F, Bryant RA. Attentional bias in complicated grief. J Affect Disord. 2010;125(1–3):316–22. https://doi.org/10.1016/j.jad.2010.01.070.

    Article  PubMed  Google Scholar 

  97. Alves L, Simões MR, Martins C, Freitas S, Santana I. Premorbid IQ Influence on screening tests’ scores in healthy patients and patients with cognitive impairment.J Geriatr Psychiatry Neurol. 2013;26(2):117–126. http://www.ncbi.nlm.nih.gov/pubmed/23584853.

  98. Golden A-MJ, Dalgleish T. Facets of pejorative self-processing in complicated grief. J Consult Clin Psychol. 2012;80(3):512–24. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22329823

    Article  PubMed  Google Scholar 

  99. Maccallum F, Bryant RA. Impaired autobiographical memory in complicated grief. Behav Res Ther. Elsevier Ltd; 2010;48(4):328–334. https://doi.org/10.1016/j.brat.2009.12.006

  100. O’Connor MF, Arizmendi BJ. Neuropsychological correlates of complicated grief in older spousally bereaved adults. J Gerontol B Psychol Sci Soc Sci. 2014;69(1):12–8.

    Article  PubMed  Google Scholar 

  101. Gupta S, Bonanno GA. Complicated grief and deficits in emotional expressive flexibility. J Abnorm Psychol. 2011;120(3):635–43.

    Article  PubMed  Google Scholar 

  102. Burton CL, Yan OH, Pat-Horenczyk R, Chan ISF, Ho S, Bonanno GA. Coping flexibility and complicated grief: a comparison of American and Chinese samples. Depress Anxiety. 2012;29(1):16–22.

    Article  PubMed  Google Scholar 

  103. Boelen PA. Personal goals and prolonged grief disorder symptoms. Clin Psychol Psychother. 2011;18(6):439–44.

    Article  PubMed  Google Scholar 

  104. Germain A, Shear KM, Walsh C, Buysse D, Monk T, Reynolds CF III, et al. Dream content in complicated grief: a window into loss-related cognitive schemas running head: dreams in complicated grief. Death Stud. 2013;37(3):269–84.

    Article  PubMed  PubMed Central  Google Scholar 

  105. Maccallum F, Bryant RA. Self-defining memories in complicated grief. Behav Res Ther. 2008;46(12):1311–5. https://doi.org/10.1016/j.brat.2008.09.003.

    Article  PubMed  Google Scholar 

  106. O’Connor MF, Wellisch DK, Stanton AL, Eisenberger NI, Irwin MR, Lieberman MD. Craving love? Enduring grief activates brain’s reward center. NeuroImage. 2008;42(2):969–72.

    Article  PubMed  PubMed Central  Google Scholar 

  107. Arizmendi B, Kaszniak AW, O’Connor MF. Disrupted prefrontal activity during emotion processing in complicated grief: an fMRI investigation. Neuroimage 2016;124:968–976. http://dx. doi.org/10.1016/j.neuroimage.2015.09.054

    Google Scholar 

  108. Shear MK, Reynolds CF 3rd, Simon NM, Zisook S, Wang Y, Mauro C, Duan N, Lebowitz B, Skritskaya N. Optimizing Treatment of Complicated Grief: A Randomized Clinical Trial. JAMA Psychiatry. 2016;73(7):685–94. https://doi.org/10.1001/jamapsychiatry.2016.0892.

    Article  PubMed  Google Scholar 

  109. Solomon CG, Shear MK. Complicated grief. N Engl J Med. 2015;372(2):153–60. http://www.nejm.org/doi/pdf/10.1056/NEJMcp1315618

    Article  CAS  Google Scholar 

  110. McCabe PJ, Christopher PP. Symptom and functional traits of brief major depressive episodes and discrimination of bereavement. Depress Anxiety. 2016;33(2):112–9.

    Article  PubMed  Google Scholar 

  111. Guerin S, Dodd P, Tyrell J, McEvoy J, Buckley S, Hillery J. An initial assessment of the psychometric properties of the complicated grief questionnaire for people with intellectual disabilities (CGQ-ID). Res Dev Disabil. 2009;30(6):1258–67.

    Article  PubMed  Google Scholar 

  112. Ito M, Nakajima S, Fujisawa D, Miyashita M, Kim Y, Shear MK, et al. Brief measure for screening complicated grief: Reliability and discriminant validity. PLoS One. 2012;7(2):e31209.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  113. Bui E, Mauro C, Robinaugh D, Skritskaya NA, Wang Y, Gribbin C, et al. Structured clinical interview for complicated grief: reliability, validity, and exploratory factor analysis. Depress Anxiety. 2015;116(8):1477–90.

    Google Scholar 

  114. Doering BK, Eisma MC. Treatment for complicated grief. Curr Opin Psychiatry. 2016;29(5):286–91. http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00001504-201609000-00004

    Article  PubMed  Google Scholar 

  115. Cozza SJ, Fisher JE, Mauro C, Zhou J, Ortiz CD, Skritskaya N, et al. Performance of DSM-5 persistent complex bereavement disorder criteria in a community sample of bereaved military family members. Am J Psychiatry. 2016;(8):appiajp201615111442. http://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.15111442

  116. Shear MK, Reynolds CF, Simon NM, Zisook S, Wang Y, Mauro C, et al. Optimizing treatment of complicated grief: a randomized clinical trial. JAMA Psychiatry. 2016;73(7):685–94. http://www.ncbi.nlm.nih.gov/pubmed/27276373

    Article  PubMed  Google Scholar 

  117. Bui E, Nadal-Vicens M, Simon NM. Pharmacological approaches to the treatment of complicated grief: rationale and a brief review of the literature. Dialogues Clin Neurosci. 2012;14(1958–5969 (Electronic):149–57.

    PubMed  PubMed Central  Google Scholar 

  118. Simon NM, Shear MK, Fagiolini A, Frank E, Zalta A, Thompson EH, et al. Impact of concurrent naturalistic pharmacotherapy on psychotherapy of complicated grief. Psychiatry Res. 2008;159(1–2):31–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Zygmont M, Prigerson HG, Houck PR, Miller MD, Shear MK, Jacobs S, et al. A post hoc comparison of paroxetine and nortriptyline for symptoms of traumatic grief. J Clin Psychiatry. 1998;59(5):241–5.

    Article  CAS  PubMed  Google Scholar 

  120. Hensley PL, Slonimski CK, Uhlenhuth EH, Clayton PJ. Escitalopram: an open-label study of bereavement-related depression and grief. J Affect Disord 2009;113(1–2):142–9.

    Google Scholar 

  121. Shear MK, Wang Y, Skritskaya N, Duan N, Mauro C, Ghesquiere A. Treatment of complicated grief in elderly persons: a randomized clinical trial. JAMA Psychiatry. 2014;71(11):1287–95. http://www.ncbi.nlm.nih.gov/pubmed/25250737

    Article  PubMed  CAS  Google Scholar 

  122. Shear K, Frank E, Houck PR, Reynolds CF 3rd. Treatment of complicated grief. JAMA. 2005;293(21):2601–8. https://www.ncbi.nlm.nih.gov/pubmed/15928281

  123. Acierno R, Rheingold A, Amstadter A, Kurent J, Amella E, Resnick H, et al. Behavioral activation and therapeutic exposure for bereavement in older adults. Am J Hosp Palliat Med. 2012;29(1):13–25. http://ajh.sagepub.com/cgi/doi/10.1177/1049909111411471

    Article  Google Scholar 

  124. Wittouck C, Van Autreve S, Portzky G, van Heeringen K. A CBT-based psychoeducational intervention for suicide survivors: a cluster randomized controlled study. Crisis. 2014;35(3):193–201.

    Article  PubMed  Google Scholar 

  125. Stroebe M, Schut H. Family matters in bereavement: toward an integrative intra-interpersonal coping model. Perspect Psychol Sci. 2015;10(6):873–9. http://pps.sagepub.com/content/10/6/873.abstract

    Article  PubMed  Google Scholar 

  126. Boelen PA, van den Hout MA, van den Bout J. A cognitive-behavioral conceptualization of complicated grief. Clinical Psychology: Science and Practice; 2006. p. 109–28.

    Google Scholar 

  127. Bryant RA, Kenny L, Joscelyne A, Rawson N, Maccallum F, Cahill C, et al. Treating prolonged grief disorder. JAMA Psychiatry. 2014;71(12):1332. http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/jamapsychiatry.2014.1600

    Article  PubMed  Google Scholar 

  128. Litz BT, Schorr Y, Delaney E, Au T, Papa A, Fox AB, et al. A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder. Behav Res Ther. 2014;61:23–34.

    Article  PubMed  PubMed Central  Google Scholar 

  129. Klinitzke G, Dolemeyer R, Steinig J, Wagner B, Kersting A. Internet-based therapy after pregnancy loss - the impact of social support on bereavement. Verhaltenstherapie. 2013;23(3):181–8.

    Article  Google Scholar 

  130. Rosner R, Bartl H, Pfoh G, Kotoučová M, Hagl M. Efficacy of an integrative CBT for prolonged grief disorder: a long-term follow-up. J Affect Disord. 2015;183:106–12.

    Article  PubMed  Google Scholar 

  131. Rosner R, Pfoh G, Kotoučová M, Hagl M. Efficacy of an outpatient treatment for prolonged grief disorder: a randomized controlled clinical trial. J Affect Disord. 2014;167:56–63.

    Article  PubMed  Google Scholar 

  132. Eisma MC, Boelen PA, van den Bout J, Stroebe W, Schut HAW, Lancee J, et al. Internet-based exposure and behavioral activation for complicated grief and rumination: a randomized controlled trial. Behav Ther. 2015;46(6):729–48. https://doi.org/10.1016/j.beth.2015.05.007.

    Article  PubMed  Google Scholar 

  133. Wagner B, Knaevelsrud C, Maercker A. Internet-based cognitive-behavioral therapy for complicated grief: a randomized controlled trial. Death Stud. 2006;30(5):429–53.

    Article  PubMed  Google Scholar 

  134. Wittouck C, Van Autreve S, De Jaegere E, Portzky G, van Heeringen K. The prevention and treatment of complicated grief: a meta-analysis. Clin Psychol Rev. 2011;31(1):69–78. https://doi.org/10.1016/j.cpr.2010.09.005

  135. de Groot M, Neeleman J, van der Meer K, Burger H. The effectiveness of family-based cognitive-behavior grief therapy to prevent complicated grief in relatives of suicide victims: the mediating role of suicide ideation. Suicide Life Threat Behav. 2010;40(November):425–37.

    Article  PubMed  Google Scholar 

  136. Bruinsma SM, Tiemeier HW, Heemst JV, van der Heide A, Rietjens J. Risk factors for complicated grief in older adults. J Palliat Med. 2015;18(5):438–46. http://online.liebertpub.com/doi/10.1089/jpm.2014.0366

    Article  PubMed  Google Scholar 

  137. Stahl ST, Schulz R. Changes in routine health behaviors following late-life bereavement: a systematic review. Journal of Behavioral Medicine. 2014:736–55.

    Google Scholar 

  138. Stahl S, Schulz R. The effect of widowhood on husbands’ and wives’ physical activity: the cardiovascular health study. J Behav Med. 2014;37(4):806–17. http://10.0.3.239/s10865–013–9532-7%5Cnhttp://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=pbh&AN=99371078&site=ehost-live&custid=s4121186

    Article  PubMed  Google Scholar 

  139. Manzoli L, Villari P, Pirone G, Boccia A. Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med. 2007;64(1):77–94.

    Article  PubMed  Google Scholar 

  140. O’Connor M, Nickerson A, Aderka IM, Bryant RA. The temporal relationship between change in symptoms of prolonged grief and posttraumatic stress following old age spousal bereavement. Depress Anxiety. 2015;32(5):335–40.

    Article  PubMed  Google Scholar 

  141. 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(7):1339–41.

    Article  PubMed  Google Scholar 

  142. Iii CFR. Assessment and treatment of major depression in older ADults: a view from the boundary of psychiatry and. Neurology. 2016:1–11.

    Google Scholar 

  143. 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(1–3):453–8.

    Article  PubMed  PubMed Central  Google Scholar 

  144. Hartz GW. Adult grief and its interface with mood disorder: proposal of a new diagnosis of complicated bereavement. Compr Psychiatry. 1986;27(1):60–4.

    Article  CAS  PubMed  Google Scholar 

  145. Horowitz MJ, Siegel B, Holen A, Bonanno GA, Milbrath C, Stinson CH. Diagnostic criteria for complicated grief disorder. Am J Psychiatry. 1997;154(7):904–10.

    Article  CAS  PubMed  Google Scholar 

  146. Prigerson HG, Shear MK, Jacobs SC, Reynolds CF, Maciejewski PK, Davidson JRT, et al. Consensus criteria for traumatic grief: A preliminary empirical test. Br J Psychiatry. 1999;174(JAN.):67–73.

    Article  CAS  PubMed  Google Scholar 

  147. 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)

    Google Scholar 

  148. Simon NM, Wall MM, Keshaviah A, Dryman MT, Leblanc NJ, Shear MK. Informing the symptom profile of complicated grief. Depress Anxiety. 2011;28(2):118–26.

    Article  PubMed  Google Scholar 

  149. Shear MK, Simon N, Wall M, Zisook S, Neimeyer R, Duan N, et al. Complicated grief and related bereavement issues for DSM-5. Depress Anxiety. 2011;28:103–17.

    Article  PubMed  PubMed Central  Google Scholar 

  150. Organization WH. International classification of diseases (ICD). World Health Organization. 2011;

    Google Scholar 

  151. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition (DSM-5) . Diagnostic Stat Man Ment Disord 4th Ed TR. 2013;280.

    Google Scholar 

  152. Ogden Patricia S, Simmonds GJ. Psychologists’ and counsellors’ perspectives on prolonged grief disorder and its inclusion in diagnostic manuals. Couns Psychother Res. 2014;14(3):212–20.

    Article  Google Scholar 

  153. APA. Diagnostic and statistical manual of mental disorders. 4th ed; 1994. p. 69–81.

    Google Scholar 

  154. Moayedoddin B, Markowitz JC. Abnormal grief: should we consider a more patient-centered approach? Am J Psychother. 2015;69(4):361–78.

    PubMed  Google Scholar 

  155. Papa A, Sewell MT, Garrison-Diehn C, Rummel C. A randomized open trial assessing the feasibility of behavioral activation for pathological grief responding. Behav Ther. 2013;44(4):639–50.

    Article  PubMed  Google Scholar 

  156. National Hospice and Palliative Care Organization. National Hospice and Palliative Care Organization: Facts and Figures—Hospice Care in America. 2012;

    Google Scholar 

  157. Ghesquiere AR, Aldridge MD, Johnson-Hürzeler R, Kaplan D, Bruce ML, Bradley E. Hospice services for complicated grief and depression: results from a national survey. J Am Geriatr Soc. 2015;63(10):2173–80.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Scientist Training Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Gregg A. Robbins-Welty B.S.

  2. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Sarah T. Stahl Ph.D. & Charles F. Reynolds III M.D.

Authors
  1. Gregg A. Robbins-Welty B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah T. Stahl Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Charles F. Reynolds III M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles F. Reynolds III M.D. .

Editor information

Editors and Affiliations

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

    Eric Bui

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Science+Business Media LLC

About this chapter

Cite this chapter

Robbins-Welty, G.A., Stahl, S.T., Reynolds, C.F. (2018). Grief Reactions in the Elderly. In: Bui, E. (eds) Clinical Handbook of Bereavement and Grief Reactions . Current Clinical Psychiatry. Humana Press, Cham. https://doi.org/10.1007/978-3-319-65241-2_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65241-2_6

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-65240-5

  • Online ISBN: 978-3-319-65241-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation