Complicated grief and deficits in emotional expressive flexibility.

There is growing evidence that deficits in emotion regulation may be at the heart of maladaptive reactions after bereavement. Expressive flexibility, or the ability to flexibly enhance or suppress emotional expression, appears to be especially important for adjustment in the aftermath of highly aversive events (Bonanno, Papa, Lalande, Westphal, & Coifman, 2004). In this study, we compared expressive flexibility in a sample of bereaved adults who lost their spouse 1.5-3 years earlier and a comparable sample of married adults. Approximately half of the bereaved adults had Complicated Grief (CG) and half were asymptomatic. Using a within-subjects design, we asked all participants to either enhance or suppress their expressions of emotion or to behave normally while viewing evocative pictures at a computer screen. Observer ratings of expressiveness made blind to condition showed no group differences in overall emotion. However, bereaved adults suffering from CG exhibited deficits in expressive flexibility. Specifically, the CG group was less able to enhance and less able to suppress emotional expression relative to asymptomatic bereaved and married adults.