Procedia - Social and Behavioral Sciences 127 ( 2014 ) 524 – 528

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1877-0428 © 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).Selection and peer-review under responsibility of Romanian Society of Applied Experimental Psychology.doi: 10.1016/j.sbspro.2014.03.303

ScienceDirect

PSIWORLD 2013

The relationship between irrational cognitions, autobiographical memory, coping strategies and complicated grief

Diana Nagya*, tefan Szamosközib

aDepartment of Clinical Psychology and Psychotherapy, No.37 Republicii Street, 400015, Cluj-Napoca, Romania bDepartment of Applied Psychology, No.37 Republicii Street, 400015, Cluj-Napoca, Romania

Abstract

Fifty-seven undergraduate college students who had lost a family member, a close friend or a life partner/spouse in the last 1 to 5 years completed online the Inventory of Complicated Grief-Revised (Prigerson et al., 1995), the Attitude and Belief Scale (Romanian version – Macavei, 2002), the Grief Cognitions Questionnaire (Boelen & Lensvelt-Mulders, 2005) and the Autobiographical Memory Test (Williams & Broadbent, 1986). Results show significant correlations between irrational cognitions, autobiographical memory, coping strategies and complicated grief. Also, autobiographical memory specificity emerged as a significant predictor of complicated grief symptoms. Implications of these findings are discussed.

© 2014 The Authors. Published by Elsevier Ltd. Selection and peer-review under responsibility of PSI WORLD 2013 and their Guest Editors: Dr Mihaela Chraif, Dr Cristian Vasile and Dr Mihai Anitei

Keywords: irrational cognitions; autobiographical memory; coping strategies; complicated grief.

1. Introduction

Most of the people confronted with the loss of a loved one recover without developing complications (Bonanno, 2004). However, it is estimated that between 10 and 20% of people confronted with the death of a close relative, friend or life partner/spouse experience complicated grief symptoms (Byrne & Raphael, 1994; Prigerson & Jacobs, 2001; Middleton, Burnett, Raphael, & Martinek, 1996). Recent studies show that complicated grief constitutes a

* Corresponding author. E-mail address: diana.nagy@ubbcluj.ro

© 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).Selection and peer-review under responsibility of Romanian Society of Applied Experimental Psychology.

525 Diana Nagy and Ştefan Szamosközi / Procedia - Social and Behavioral Sciences 127 ( 2014 ) 524 – 528

high risk factor for a significant number of adverse health outcomes, the most important being cancer, heart disease, high blood pressure and suicidal ideation (Pringerson et al., 1997). In relation to the latter, recent findings show that complicated grief poses an independent psychiatric risk for suicidal ideation. Also, strong associations were found between complicated grief symptoms and decreases in mental health and sense of well-being, respectively increases in a wide range of problematic symptoms. Therefore, left untreated, complicated grief increases the risk for developing severe impairments in social and occupational functioning (Chen et al., 1999; Prigerson et al., 1997; Silverman et al., 2000).

A number of distinct theoretical perspectives on grief exist, all of which have given rise to the development of assumptions, expectations and prescriptions as to the origins, constituents, process and appropriate treatment of complicated grief. One of the leading theories, which have guided recent research in the field is the cognitive-behavioral conceptualization of complicated grief (Boelen, van den Hout, & van den Bout, 2006). According to this model, three processes are crucial for the onset and maintenance of complicated grief symptoms: (a) impaired autobiographical memory, due to the poor integration of the loss into the database of autobiographical knowledge, (b) negative global beliefs and misinterpretations of grief reactions, and (c) anxious and depressive avoidance strategies.

In the present study, we aimed: (1) to investigate the relationship between the three components of the model, and (2) to establish the relationship between each of the three components and complicated grief and co-morbid symptoms, in terms of their predictive value. Based on the results of prior research showing associations between complicated grief and negative global beliefs, misinterpretations of grief reactions (Boelen, van den Hout, & van den Bout, 2003a, 2003b; Boelen, Kip, Voorsluijs, & van den Bout, 2004; Boelen & Lensvelt-Mulders, 2005), and avoidance coping, we did hypothesize the existence of a positive and significant correlation between complicated grief symptoms and irrational cognitions, respectively coping strategies. Also, we expected a negative and significant correlation between complicated grief symptoms and autobiographical memory specificity.

2. Method

2.1. Participants

A total number of sixty-eight undergraduate Psychology students were recruited via an Internet add concerning the research project. Data was collected electronically via online administration of the instruments. Fifty-seven participants returned complete data sets and were included in the final sample of the study. In order to be included in the study, the participants had to have experienced the death of a close relative (first- to fourth-degree relatives), a friend or a life partner/spouse in the last 1 to 5 years.

The mean age for the final sample (n = 57; 51 women and 6 men) was 23.68 years (SD = 3.21, range = 20 to 30 years). The mean time since death was 3.08 years (SD = 1.75). In terms of cause of death, 61.4 % (n = 35) lost a loved one due to natural causes, and 15.8% (n =9) of the respondents due to violent causes (e.g. accident, homicide and suicide). In terms of kinship to the deceased person, 22.8% (n = 13) lost a first-degree relative (parent, child), 59.6% (n = 34) lost a second-degree relative (grandparent, grandson, brother/sister), 5.3% (n = 3) lost a third-degree relative (great-grandparent, great-grandson, uncle/aunt), 7% (n = 4) lost a forth-degree relative (great-great-grandparent, great-great-grandson, cousin) and 5.3% (n = 3) lost someone unrelated (close friend, life partner or spouse).

2.2. Procedure

All of the participants provided demographic information and completed standardized measures of irrational cognitions, negative global beliefs and misinterpretations of grief reactions, coping strategies and complicated grief. Also, they completed an experimental task regarding autobiographical memory specificity. In addition to these measures, we collected information regarding the circumstances of their loss.

526 Diana Nagy and Ştefan Szamosközi / Procedia - Social and Behavioral Sciences 127 ( 2014 ) 524 – 528

2.3. Measures

Inventory of Complicated Grief-Revised (ICG-Revised; Boelen, van den Hout, & van den Bout, 2006). Is a 37-questions instrument measuring the level of complicated grief in individuals who have experienced a traumatic event, such as the death of a loved one, 6 months ago or longer. The ICG-Revised had strong psychometric properties (good internal consistency, test-retest reliability and concurrent validity with other tests).

Attitude and Belief Scale II (ABS II; Romanian version – Macavei, 2002). This 72-item scale measures the irrational/rational beliefs. In a sample of normal subjects (N = 350), internal consistency coefficients (Alpha Cronbach) ranged from .60 to .87, which are adequate for reporting reliable results.

Grief Cognitions Questionnaire (GCQ; Boelen & Lensvelt-Mulders, 2005). This 38-item scale measures nine categories of potentially problematic bereavement-related cognitions. The instrument has good internal consistency and adequate temporal stability.

Autobiographical Memory Test/Task (AMT; Williams & Broadbent, 1986). This experimental task was designed in order to measure autobiographical memory specificity, in response to determined cue-words. In the present study, the task included 10 cue-words, 5 negative and 5 positive.

Brief-Cope (B-Cope; Krägeloh, 2011). This 28-item scale measures the participants’ coping strategies, with reported good psychometric properties.

2.4. Design

For the present study, we employed a correlational design. Primary data for all the variables of interest was collected via the Internet (the instruments were administered online).

3. RESULTS

We provide below the descriptive statistics for all the variables of interest:

Table 1. Descriptive statistics

Variable Mean SD

Irrationality level (ABS II) 82.21 38.60

Autobiographical memory (AMT) 2.75 1.42

Complicated grief (ICG-R) 56.14 18.19

Using SPSS, first we computed a correlation analysis between all the variables of interest for the study. Results show significant correlations between the investigated variables (see Table 2).

Also, we computed a multiple regression analysis, with irrational cognitions, grief cognitions, autobiographical memory specificity and coping strategies as potential predictors. The overall regression model showed a significant prediction value (F (4,29) = 3,255; p < .05, R2 = .402), but only autobiographical memory specificity significantly predicted complicated grief symptoms (Beta = -.310, p < .05).

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Table 2. Pearson correlations between the interest variables

ICG-R ABS II GCQ B-Cope AMT ICG-R 1 .368** .414** .323 -.361* ABS II 1 .313* -.097 -.043 GCQ 1 -.078 .020 B-Cope 1 -.192 AMT 1**p<.01; *p<.05

4. DISCUSSION

As expected, we obtained positive significant correlations between complicated grief and: irrationality level, grief cognitions and coping strategies. Also, our results show a negative significant correlation between complicated grief and autobiographical memory specificity, as predicted. Autobiographical memory specificity emerged as a significant predictor of complicated grief symptoms, finding that supports the relationship between autobiographical memory and complicated grief highlighted in previous research (Golden, Dalgleish & Mackintosh, 2007).

The main limits of this study resides in its correlational nature and small sample size. We could not extract possible causal mechanisms related to complicated grief symptoms, but the association between these variables could be an area of further study.

Experimental studies should consider the manipulation of the core processes postulated by the cognitive behavioral model of complicated grief (Boelen, van den Hout, & van den Bout, 2006), and to establish the effects of this manipulation on complicated grief symptoms severity. Last but not least, investigating the impact of kinship, type of death (natural vs. violent), time since loss on the relationship between the core processes and complicated grief could open new avenues for future research.

Acknowledgements

This work was possible with the financial support of the Sectoral Operational Programme for Human Resources Development 2007-2013, cofinanced by the European Social Fund, under the project number POSDRU/107/1.5/S/76841 with the title „Modern Doctoral Studies: Internationalization and Interdisciplinarity”.

Also, I would like to thank my scientific advisor, Professor tefan Szamosközi, Ph.D., for his patient guidance, encouragement and valuable advice he has provided.

I want to thank all the members of the Department of Clinical Psychology and Psychotherapy who helped me in my supervisor’s absence, and in particular, I would like to thank Professor Daniel David, Ph.D., for his suggestions and comments that helped me improve the value of my work.

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