The Pennsylvania State University.
The Pennsylvania State University.
Behav Ther. 2022 May;53(3):428-439. doi: 10.1016/j.beth.2021.11.002. Epub 2021 Nov 19.
The dual-process model proposes that early and later bereavement involves different types of stressors and adaptation processes (Stroebe & Schut, 1999, 2010). It is thus possible that different factors facilitate adaptation during the early months versus subsequent years following widowhood. Elevated depressive symptoms, though prevalent after widowhood, may indicate problematic adaptation, as they are associated with poor long-term physical and mental health outcomes. We predicted that neutral death acceptance would be associated with less increase in depression during early widowhood (when confronted with loss-oriented stressors), whereas perceived control would predict depressive symptom decline during later widowhood (when adapting to controllable restoration-oriented stressors). Older adults (N = 265) reported on neutral death acceptance, perceived control, and depression before widowhood and on depression 0.5, 1.5, and 4.0 years after the death of their spouse. Bilinear spline growth modeling revealed that, on average, depressive symptoms increased from before to 0.5 years after spouse death and fell from 0.5 to 4.0 years after spouse death. Neutral death acceptance predicted a smaller increase in depression from before to 0.5 years after spouse death, as well as a smaller subsequent decrease in depression from 0.5 to 4.0 years after spouse death. Perceived control predicted a larger decrease in depression from 0.5 to 4.0 years after spouse death. Neutral death acceptance and perceived control had unique associations with resilience and recovery throughout early and later widowhood. These variables may be fruitful targets in interventions for depression throughout the full course of widowhood.
双过程模型提出,早期和晚期丧亲涉及不同类型的应激源和适应过程(Stroebe & Schut,1999,2010)。因此,在丧偶后的早期几个月和随后的几年中,不同的因素可能有助于适应。尽管丧偶后抑郁症状普遍存在,但它们可能表明适应不良,因为它们与较差的长期身心健康结果有关。我们预测,中立的死亡接受度与丧偶早期(当面临以损失为导向的应激源时)抑郁程度的增加较少相关,而感知控制则与丧偶后期(当适应可控制的恢复为导向的应激源时)抑郁症状的下降相关。老年参与者(N=265)在丧偶前报告了中立的死亡接受度、感知控制和抑郁程度,以及丧偶后 0.5、1.5 和 4.0 年的抑郁程度。双线性样条增长模型显示,平均而言,抑郁症状从丧偶前到丧偶后 0.5 年增加,然后从丧偶后 0.5 年到 4.0 年下降。中立的死亡接受度预测了从丧偶前到丧偶后 0.5 年抑郁程度的较小增加,以及从丧偶后 0.5 年到 4.0 年抑郁程度的较小后续下降。感知控制预测了从丧偶后 0.5 年到 4.0 年抑郁程度的较大下降。中立的死亡接受度和感知控制与整个早期和晚期丧偶过程中的韧性和恢复有独特的关联。这些变量可能是整个丧偶过程中抑郁干预的有成效的目标。