Objective Circumstances of the Death and Complicated Grief: Examining Indirect Associations Through Meaning Made of Loss
It has been proposed that losses by violent means and loss of primary attachment figures may increase the likelihood of developing a chronic and severe grief response (often referred to as complicated grief). Specifically, these losses may be more likely to violate cherished beliefs about the safety, security, and predictability of the world, and as a result, make it more difficult to find some benign (or even positive) meaning in the event. This study aims to test this hypothesis using path analysis. Participants include 741 bereaved young adults who lost someone within the past two years. Participants were recruited from introductory undergraduate psychology courses and completed surveys online for class credit. Direct and indirect effects showed that meaning made of the loss, as measured by the Integration of Stressful Life Experiences Scale (ISLES), mediated the relationship between objective risk factors (i.e., cause of death, relationship to the deceased) and Complicated Grief (CG) symptoms. Meaning made of the loss fully mediated the association for cause of death and partially mediated the association for relationship to the deceased. The Comprehensibility subfactor of the ISLES acted as a better mediator for cause of death than the Footing in the World subfactor. These findings show that, for the most part, meaning made out of loss statistically accounts for the association between objective risk factors and CG. These results have important clinical implications. Specifically, assessment tools and interventions have been developed that are based on a model of grief that views meaning making as a crucial determinant of adjustment to loss. These findings provide empirical evidence for such a model, and by extension, they indirectly support clinical applications based on a meaning-oriented theoretical model.