The Reactions of Adolescents, Parents and Clinicians to Participating in Qualitative Research Interviews Regarding Adolescents Bereaved by Suicide and Other Traumatic Death

There are concerns that involving adolescents bereaved by suicide and other traumatic death in research may cause distress and harm. However, no study has investigated such bereaved adolescents’ research experiences. In addition, no study has looked at the experiences of parents and clinicians as participants in adolescent suicide and traumatic death bereavement research. This study aimed to explore the short-term impact of research participation experienced by adolescents, parents, and clinicians. A total of 61 participants (adolescents, n = 17; parents, n = 12; clinicians, n = 32) filled out a short survey within two weeks of having taken part in a qualitative interview study. Data were analyzed descriptively. Most participants had experienced no distress while participating and no negative effects of participating; rather, participation was experienced as helpful for them and they would highly recommend participating in a study like this to others. A few adolescents and parents reported some distress, related to anxiety about participation and the unpleasantness of grief memories. The study clearly indicates that bereaved adolescents, parents and clinicians can safely participate in research interviews regarding their experiences of grief and help after suicide, generally valuing the opportunity to share their experience. To prevent and mitigate potential distress, training of research staff and implementation of appropriate participant distress protocols are imperative. Future studies could include longitudinal follow-up of participants to assess any longer-term consequences.

When an Infant Grandchild Dies: Family Matters

<p>When a child dies the main focus of both clinical practitioners and researchers is on the parents and, to a lesser extent, the siblings. In contrast grandparents have been called the "forgotten grievers". Are grandparents "forgotten"? If so - by whom? My interest in this study, as a nurse working with bereaved families, was to explore how grandparents, parents and health/bereavement professionals constructed grandparent bereavement when an infant grandchild died unexpectedly. The 26 participants, living in New Zealand and the United Kingdom, included 16 grandparents and 6 parents from 11 families, in addition to 3 health/bereavement professionals. As a theoretical framework I used constructivist inquiry informed by writings on nursing, storying and postmodernism. Through an exploration of the methodological and ethical issues that arose and were addressed during the study, this work adds to knowledge of how constructivist inquiry can be used in nursing and bereavement research. In addition, the context of this research as a partnership with multiple family members contributes to the ongoing debate about whether participation in bereavement research may be harmful or therapeutic. Our conversations in this research formed a series of interviews and letters, which led to the development of a joint construction and each individual's story. A grandchild's death was constructed as a challenge which grandparents faced, responded to and then managed the changes that arose from the challenge. When facing this challenge, grandparents felt "pain" and had a strong sense of "being unprepared", despite extensive life experience. The context of their bereavement was seen as underpinned by their relationship as "parents of the adult parents" of the grandchild who died. This meant that grandparents placed their own pain second to their wish to support and "be with" the parents. Parents and health/bereavement professionals appreciated the support that grandparents offered at a time when they, too, were bereaved. It was outside the family where many grandparents found friends, colleagues or their community forgot, or chose not to acknowledge, their bereavement. From this work the stories of individuals offer previously unspoken voices, to appreciate the multiple meanings and ways in which grandparents are bereaved. In particular, recognising that some grandparents help to create a space within the family which maintains a continuing relationship with the grandchild who died. Combining the stories with the joint construction offers us as clinicians, researchers and members of communities, a perspective to consider in acknowledging grandparent bereavement as an ongoing part of people's lives.</p>

When an Infant Grandchild Dies: Family Matters

<p>When a child dies the main focus of both clinical practitioners and researchers is on the parents and, to a lesser extent, the siblings. In contrast grandparents have been called the "forgotten grievers". Are grandparents "forgotten"? If so - by whom? My interest in this study, as a nurse working with bereaved families, was to explore how grandparents, parents and health/bereavement professionals constructed grandparent bereavement when an infant grandchild died unexpectedly. The 26 participants, living in New Zealand and the United Kingdom, included 16 grandparents and 6 parents from 11 families, in addition to 3 health/bereavement professionals. As a theoretical framework I used constructivist inquiry informed by writings on nursing, storying and postmodernism. Through an exploration of the methodological and ethical issues that arose and were addressed during the study, this work adds to knowledge of how constructivist inquiry can be used in nursing and bereavement research. In addition, the context of this research as a partnership with multiple family members contributes to the ongoing debate about whether participation in bereavement research may be harmful or therapeutic. Our conversations in this research formed a series of interviews and letters, which led to the development of a joint construction and each individual's story. A grandchild's death was constructed as a challenge which grandparents faced, responded to and then managed the changes that arose from the challenge. When facing this challenge, grandparents felt "pain" and had a strong sense of "being unprepared", despite extensive life experience. The context of their bereavement was seen as underpinned by their relationship as "parents of the adult parents" of the grandchild who died. This meant that grandparents placed their own pain second to their wish to support and "be with" the parents. Parents and health/bereavement professionals appreciated the support that grandparents offered at a time when they, too, were bereaved. It was outside the family where many grandparents found friends, colleagues or their community forgot, or chose not to acknowledge, their bereavement. From this work the stories of individuals offer previously unspoken voices, to appreciate the multiple meanings and ways in which grandparents are bereaved. In particular, recognising that some grandparents help to create a space within the family which maintains a continuing relationship with the grandchild who died. Combining the stories with the joint construction offers us as clinicians, researchers and members of communities, a perspective to consider in acknowledging grandparent bereavement as an ongoing part of people's lives.</p>

Varieties of felt presence: Three surveys of presence phenomena in the general population and their relations to voice-hearing.

Experiences of felt presence (FP) are well documented in neurology, neuropsychology, and bereavement research, but systematic research in psychiatry is limited. Reports of FP are a feature of body disruption in psychosis, hypnagogic and hypnopompic experiences, solo pursuits, and spiritual encounters, yet systematic research comparing these phenomena is rare. Here we present a mixed-methods analysis from three online surveys as part of a comparative analysis of FP across three diverse contexts: a population sample which included people with experience of psychosis and voice-hearing (study 1, N = 75), people with spiritual &amp; spiritualist beliefs (study 2, N = 47), and practitioners of endurance/solo pursuits (study 3, N = 84). Participants were asked to provide descriptions of their FP experiences and completed questionnaires on FP frequency, hallucinatory experiences, dissociation, paranoia, social inner speech, and sleep. Hierarchical linear regression analysis indicated that FP frequency was predicted by a general tendency to experience hallucinations in all three studies, although paranoia and gender (female &gt; male) were also significant predictors in sample 1. Qualitative analysis highlighted shared and diverging phenomenology of FP experiences across the three studies, including a role for immersive states in FP. These data combine to provide the first picture of the potential shared mechanisms underlying different accounts of FP, supporting a unitary model of the experience. Data and code for the study are available via OSF.

Widowed Young: The Role of Stressors and Protective Factors for Resilience in Coping with Spousal Loss

While distressing, late life spousal loss is considered a normative life event and most demonstrate resilient recovery from grief. However, for 5–7% of the population spousal loss comes early, before the age of 50, and little is known about the factors that influence adjustment in this population. We used the DPM integrative framework to examine correlates and predictors of mental wellbeing and grief intensity in an international sample of 603 young widows and widowers. Contrary to existing bereavement research, loss-orientated stressors (e.g., expectedness and cause of death) did not predict bereavement outcomes. Employment and financial wellbeing were the only statistically significant restoration-orientated stressors associated with coping, mental wellbeing and grief intensity. We found no significant associations between parental status and coping or bereavement outcomes. Loss-orientated coping, followed by inter and intrapersonal protective factors for resilience and financial wellbeing were the greatest predictors of grief intensity. Loss-orientated coping was highest in early bereavement, the greatest predictor of grief intensity and associated with being unemployed, financial insecurity and decreased protective factors for resilience. Restoration-orientated coping was highest in later bereavement, was a weak predictor of grief intensity and associated with being employed, increased financial wellbeing and protective factors for resilience. Overall, we found the young-widowed population is at heightened risk of poor adjustment. Almost two-thirds reported decreased functioning, probable depression with high rates of psychological distress. Nearly half met diagnostic criteria for prolonged grief disorder. We discuss implications for research and clinical practice.

The grieving killjoy: Bereavement, alienation and cultural critique

In recent years, a range of scholars have put forth critical analyses of the consequences of the ideals of happiness, future-orientedness, and productivity which dominate contemporary Western cultures. The experience of grief—with its sadness, preoccupation with the past, and lack of initiative—is inherently at odds with such ideals. This conflict between grief and cultural ideals of happiness is reflected in the recent efforts within bereavement research to delineate pathological mourning from uncomplicated, normative mourning. While the latter is characterized by a gradual decline in emotional pain, sadness, lack of initiative, etc., complicated mourning is marked by a failure to meet normative standards for recovery. In this article, I will draw on loss experiences among bereaved parents in contemporary Danish society in order to shed light on how profound losses may catalyze estrangement from and opposition toward what has been termed the happiness imperative of contemporary Western societies. More specifically, I borrow the figure of the feminist killjoy, paraphrased as the grieving killjoy, as a lens through which bereavement experiences may be theorized and understood as a starting point for experientially driven cultural critique.

Grief and Bereavement in Parents After the Death of a Child in Low- and Middle-Income Countries

While great strides have been made in improving childhood mortality, millions of children die each year with significant health-related suffering. More than 98% of these children live in low- and middle-income countries (LMICs). Efforts have been made to increase access to pediatric palliative care (PPC) services to address this suffering in LMICs through policy measures, educational initiatives, and access to essential medicines. However, a core component of high-quality PPC that has been relatively neglected in LMICs is grief and bereavement support for parents after the death of their child. This paper reviews the current literature on parental grief and bereavement in LMICs. This includes describing bereavement research in high-income countries (HICs), including its definition, adverse effect upon parents, and supportive interventions, followed by a review of the literature on health-related grief and bereavement in LMICs, specifically around: perinatal death, infant mortality, infectious disease, interventions used, and perceived need. More research is needed in grief and bereavement of parents in LMICs to provide them with the support they deserve within their specific cultural, social, and religious context. Additionally, these efforts in LMICs will help advance the field of parental grief and bereavement research as a whole.